Compared study on the effects of mechanical controled ventilation (MCV) with or without the use of positive-end-expiratory-pressure (PEEP) on inter-pleural pressure variation in horse anesthesia

One of the main death causes in equines during anesthesia and recovery periods is hipoxemia due to intrapulmonary "shunts". In human beings, hipoxy is treated with the use of Positive-End- Expiratory Pressure (PEEP), that in this species hinders airway closure, increases functional residual capacity and improves arterial oxygenation. We studied the effects of PEEP on inter-pleural pressure and on the cardio-vascular system, comparing Spontaneous Ventilation (SV), with Controlled Mechanical Ventilation (CMV) by itself and with PEEP of 10 cm H2O. We used 12 adult horses, females and males. These animals were submitted to general anesthesia with SV, CMV and CMV with PEEP of 10 cm H2O. The anesthetic procedure was equal for all horses. The hemodynamic, ventilatory and oxygenation parameters were evaluated. The statistical analysis of the results showed that when comparing SV, CMV and CMV with PEEP, there was no significant decrease in arterial blood pressure, nor significant alterations in cardiac and respiratory rate, pH, HCO3, BE and SatHb. When comparing SV, and CMV, an increase in PaO2 was noticed, parallel to a constant increase in PaCO2. No significant alterations in "shunt", alveolar-arterial relation and oxygen contend, were noticed. However during CMV and CMV with PEEP lower "shunt" values were noticed. Inter-pleural pressure showed significant alterations, decreasing during CMV and with CMV with PEEP, in comparison to VE. We concluded that CMV and CMV with PEEP of 10 cm H2O do not harm the cardio-respiratory system.Uma das principais causas de mortalidade em anestesia eqüina é a grave hipoxemia, conseqüência da formação de "shunt" intrapulmonar. Em seres humanos, a hipóxia é tratada com uso de pressão positiva no final da expiração (PEEP), que, nesta espécie, previne o fechamento de vias aéreas, aumenta a capacidade residual funcional e melhora a oxigenação arterial. Estudamos os efeitos de PEEP sobre a variação do deltaPpl e sua repercussão no sistema cardiovascular, comparando ventilação espontânea (VE), à ventilação mecânica controlada (VMC) sem PEEP e com PEEP de 10 cm H2O. Foram utilizados 12 animais adultos de ambos os sexos que foram submetidos a anestesia geral em ventilação espontânea, VMC sem e com PEEP. A técnica anestésica foi padronizada para todos os indivíduos. Os parâmetros hemodinâmicos, ventilatórios e de oxigenação foram mensurados no decorrer do experimento. A análise estatística dos resultados demostra que: não houve queda significativa da PAM entre os diferentes tipos de ventilação, nem alteração significativa das freqüências respiratória e cardíaca, pH, HCO3, BE e SatHb entre os três tipos de ventilação. Notou-se aumento da PaO2 entre VE e VMC paralelo a um aumento constante da PaCO2. Não foram verificadas reduções significativas do gradiente alvéolo-arterial, "shunt" e conteúdo de oxigênio. Durante a VCM e VCM com PEEP, observaram-se os valores mais baixos de "shunt". Houve alterações significativas do deltaPpl, que diminuiu durante a VMC e VMC com PEEP. Concluímos que a VMC e VMC com PEEP de 10 cm H2O não são deletérios ao sistema cardiopulmonar

Acompanhamento radiográfico e ultrassonográfico de calcificação distrófica no ligamento sesamoideo oblíquo em cavalo de salto. Seguimento durante 20 meses

Mineralization of the anatomical structures involved in the limb movement of horses has been reported to induce lameness and interfere with athletic performance. A 4-year-old jumping horse in sport activity was reported at Veterinary Hospital of University of São Paulo, with mild lameness and a mineralized oblique distal sesamoidean ligament (ODSL) of the left forelimb, revealed by a purchase radiographic and ultrasound examination. Mineralization is more common in tendons than ligaments. This report calls for attention to these structures when performing image exams, even in mild lameness. Long-term favorable follow-up by ultrasonographic and radiographic examination showed that the severe ligament injury in this case did not decrease the athletic activity until the present day. A mineralização de estruturas anatômicas envolvidas na movimentação dos membros predispõe à claudicação e interfere no desempenho atlético. Foi admitido no Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da USP-SP um equino macho, da raça Brasileiro de Hipismo, com quatro anos de idade e histórico de claudicação leve e ligamento sesamoideo oblíquo distal mineralizado do membro torácico esquerdo, diagnosticado por exame de compra. A mineralização apresenta alta incidência em tendões, sendo em menor proporção nos ligamentos. Esse relato visa atentar à essas estruturas ao se realizar exames rotineiros de imagem, apesar de claudicação leve. O acompanhamento a longo prazo por ultrassonografia e radiografia mostrou que lesões graves de ligamentos, como no presente caso, não diminuíram a atividade atlética até o momento

Comparative study of equine mesenchymal stem cells from healthy and injured synovial tissues: an in vitro assessment

Abstract\ud \ud Background\ud Bone marrow and adipose tissues are known sources of mesenchymal stem cells (MSCs) in horses; however, synovial tissues might be a promising alternative. The aim of this study was to evaluate phenotypic characteristics and differentiation potential of equine MSCs from synovial fluid (SF) and synovial membrane (SM) of healthy joints (SF-H and SM-H), joints with osteoarthritis (SF-OA and SM-OA) and joints with osteochondritis dissecans (SF-OCD and SM-OCD) to determine the most suitable synovial source for an allogeneic therapy cell bank.\ud \ud \ud Methods\ud Expression of the markers CD90, CD105, CD44, and CD34 in SF-H, SM-H, SF-OA, SM-OA, SF-OCD and SM-OCD was verified by flow cytometry, and expression of cytokeratin, vimentin, PGP 9.5, PCNA, lysozyme, nanog, and Oct4 was verified by immunocytochemistry. MSCs were cultured and evaluated for their chondrogenic, osteogenic and adipogenic differentiation potential. Final quantification of extracellular matrix and mineralized matrix was determined using AxioVision software. A tumorigenicity test was conducted in Balb-Cnu/nu mice to verify the safety of the MSCs from these sources.\ud \ud \ud Results\ud Cultured cells from SF and SM exhibited fibroblastoid morphology and the ability to adhere to plastic. The time elapsed between primary culture and the third passage was approximately 73 days for SF-H, 89 days for SF-OCD, 60 days for SF-OA, 68 days for SM-H, 57 days for SM-OCD and 54 days for SM-OA. The doubling time for SF-OCD was higher than that for other cells at the first passage (P < 0.05). MSCs from synovial tissues showed positive expression of the markers CD90, CD44, lysozyme, PGP 9.5, PCNA and vimentin and were able to differentiate into chondrogenic (21 days) and osteogenic (21 days) lineages, and, although poorly, into adipogenic lineages (14 days). The areas staining positive for extracellular matrix in the SF-H and SM-H groups were larger than those in the SF-OA and SM-OA groups (P < 0.05). The positive mineralized matrix area in the SF-H group was larger than those in all the other groups (P < 0.05). The studied cells exhibited no tumorigenic effects.\ud \ud \ud Conclusions\ud SF and SM are viable sources of equine MSCs. All sources studied provide suitable MSCs for an allogeneic therapy cell bank; nevertheless, MSCs from healthy joints may be preferable for cell banking purposes because they exhibit better chondrogenic differentiation capacity.This research was supported by Fundação Coordenação de Aperfeiçoamento\ud de Pessoal de Nível Superior (CAPES), Brasília, SP, Brazil, and by Fundação de\ud Amparo à Pesquisa do Estado de São Paulo (FAPESP), São Paulo, SP, Brazil.\ud These sponsors did not have any influence on the study design, on the\ud collection, analysis and interpretation of data, or on the writing of the\ud manuscript and decision to submit for publication

Comparação entre duas técnicas de biópsia renal guiadas por laparoscopia em eqüinos

A biópsia renal é técnica de diagnóstico útil para identificação do tipo e severidade e acompanhamento da evolução da doença renal. A alta incidência de lesões renais em eqüinos, geralmente em conseqüência de distúrbios digestivos ou respiratórios, freqüentemente associados a endotoxemia, nos motivou a estudar a técnica de biópsia renal guiada por laparoscopia, comparando o uso de agulha com pinça de biópsia. Foram utilizados 10 eqüinos hígidos, distribuídos aleatoriamente em dois grupos. Em cinco animais foi realizada biópsia renal com agulha descartável do tipo tru-cut e nos outros cinco com pinça de biópsia de 5mm, sendo que o procedimento foi guiado em ambos os grupos com auxílio da laparoscopia. Os animais permaneceram em estação durante a biópsia, que foi realizada mediante sedação e analgesia e bloqueio anestésico local em 2 pontos no flanco esquerdo, sendo um para introdução do trocarte e laparoscópio e outro para introdução da agulha ou pinça. As técnicas foram comparadas quanto à segurança, intensidade do sangramentro, tempo de execução e significância da amostra colhida. Em todos os procedimentos, foi possível a inspeção da cavidade peritoneal e escolha do local de colheita do material, com ausência de acidentes ou complicações o que nos permitiu validar ambas as técnicas. A análise histológica dos fragmentos demonstrou maior porcentagem de biópsias consideradas adequadas no grupo em que foi utilizada pinça laparoscópica o que nos leva a indicar preferencialmente seu uso.Renal biopsy is a useful diagnostic technique for the identification to the type of lesion, severity of the disease and its evolution. The high incidence of renal lesions in horses, which usually are a consequence of digestive and respiratory diseases and are frequently associated with endotoxemia, prompted us to study the laparoscopic technique for renal biopsy compair the use of needle and forceps. For the purpose of this study ten helthy horses were randomly chosen and divided into two grups of five animals each: in one group laparoscopic guided renal biops was performed using tru-cut needles and in the other group using 5mm laparoscopic forceps. Procedures were carried out with the animals in standing position. Animals were given a sedative analgesic combination and local anesthetic was infiltrated in two specific points on the left flank. One point was used to introduce the trocar and laparoscopic, the other was used to introduce the forceps or the needle. The techniques were compared as regards safety, intensity of bleeding, time for execution and significance of the sample obtained. In all of the procedures, were possible to inspect the abdominal cavity, and chose the place to collect samples, without acidents or complications. The histological analysis of the sample showed a higher percentage of adequate biopsies in the group where laparoscopic forceps were used that permit us to viable both of them with preference for the forcps use

Estudo anátomo-cirúrgico do cólon transverso do eqüino por acesso paralombar esquerdo

O cólon transverso é um estreitamento do canal alimentar, sujeito a sofrer processos obstrutivos. A ampliação do conhecimento sobre essa estrutura e adjacentes é de grande importância cirúrgica. Neste estudo foram utilizados 10 cadáveres de eqüinos de diferentes raças, idades e sexos, divididos em dois grupos de cinco. No primeiro grupo foi realizada uma incisão no 16º espaço intercostal esquerdo e posterior ressecção da 16ª costela. No segundo grupo a incisão foi feita sobre a 17ª costela com a remoção da mesma. Todas as estruturas identificadas foram registradas em fichas individuais, assim como a extensão exteriorizada do cólon transverso. Em todas os animais o cólon transverso foi totalmente visualizado e parcialmente exteriorizado, sendo que houve melhor manipulação e exteriorização no segundo grupo, além da maior facilidade no emprego da técnica, com a incisão sobre a costela a ser ressecada. Dessa forma, concluímos que o cólon transverso pode ser acessado pela fossa paralombar esquerda, sendo que a remoção da 17ª costela proporciona o melhor acesso para essa estrutura.The transverse colon is a constriction of the bowel lumen, which can be submitted to obstructive process. The knowledge enlargement about this structure and the adjacent ones has a great surgical importance. For such study, ten anatomic pieces, from equines corpses of different breed, age and sex, were used and divided in two groups. In the first group an incision was made in the left 16 intercostal space and farther resection of the 16 rib. In the second group an incision was made over the 17 rib, before its ressection. All the identified structures were registered into individual files, such as the extension of the exteriorized portion. In all of the studied pieces, the transverse colon was entirely visualized and partially exteriorized. However, we had better handling and exteriorization in the second group, as well as we noticed its technique was of easier execution. In accordance with the results, through this work is possible to conclude that the transverse colon can be approached by the left flank, and that the removal of the 17 rib provides a better access to the transverse colon

Relationship between the use of therapeutic shoeing, period of treatment and rehabilitation of horses with chronic laminitis

Foram revisados os dados de 138 equinos com laminite, atendidos no período de dez anos. Destes, 48 casos de laminite crônica foram selecionados com o objetivo de relacionar a recuperação clínica dos cavalos com a utilização de dois métodos diferentes de distribuição de apoio sobre os cascos: palmilha de isopor e palmilha de isopor associada ao ferrageamento. Os cavalos foram divididos de acordo com a recuperação clínica, método de distribuição de apoio escolhido e grau de rotação da terceira falange. Também foi estabelecido o tempo médio de tratamento. Considerando os graus de rotação 3 a 5, 6 a 8, 9 a 11 e acima de 11, e comparados os dois métodos de distribuição de apoio sobre os cascos, não foi observada diferença estatística na porcentagem de animais com recuperação clínica. Contudo, dos animais que utilizaram palmilha de isopor, 43,5 ± 14% recuperaram-se clinicamente, e nos que utilizaram palmilha de isopor associada ao ferrageamento, obteve-se 69,5 ± 19% de recuperação clínica. Não houve correlação entre o aumento do grau de rotação da terceira falange e tempo de tratamento. Também a recuperação clínica dos animais não teve relação com tempo de tratamento. A literatura correlaciona vários fatores ao prognóstico, porém, neste trabalho demonstrou-se que a o retorno à função anteriormente exercida pelo cavalo não está relacionado ao tempo de tratamento, contudo, sofre influência da utilização do método de ferrageamento.Data from 138 horses with laminitis treated in the period of ten years were reviewed. Of these, 48 cases of chronic laminitis were selected in order to relate the clinical recovery of horses using two different methods of distribution of body weight on the hooves: foam pad and foam pad associated with shoeing. The horses were divided according to clinical recovery, the weight distribution method chosen and degree of rotation of the third phalange. Also the average time of treatment was established. Considering the degrees of rotation 3-5, 6-8, 9-11 and above 11, and comparing the two methods of distribution of body weight on the hooves, there was no statistical difference in the percentage of animals with clinical recovery. However, 43.5 ± 14% of horses that used foam pad and 69,5 ± 19% of them that used foam pad associated with shoeing recovered clinically. There was no correlation between the increase of the degree of rotation of the third phalanx and treatment time. Clinical recovery of animals was not related to treatment time. Several factors are correlated with prognosis in the literature, but this study demonstrated that the return of the function previously performed by the horse is not related to treatment time, however, is influenced by the use of shoeing

Clinical and Complementary Diagnosis of Sinus Neoplasia in Horses

Background: Sinus neoplasms are reported as low frequency in horses. Its clinical characteristics are often nonspecific, depend on complementary methods for diagnosis, and when diagnosed, generally they are already advanced, limiting therapeutic possibilities. The objective of this case series was to detail clinical aspects and complementary exams for sinus neoplasms for early diagnosis, comparing them with the literature.Cases: Four horses were treated at the College of Veterinary Medicine and Animal Science of the University of São Paulo, with different clinical signs and previous diagnoses, which when evaluated by respiratory endoscopy, radiography, oral cavity evaluation and histopathological exams, revealed the diagnosis of anaplastic carcinoma, poorly differentiated carcinoma, ossifying fibroma and lymphoma. Previous diagnosis, based mainly on clinical signs, were sinusitis secondary to apical infection, ethmoidal hematoma, sinus cyst and sinusitis secondary to periapical disease. The cases of anaplastic carcinoma (case 1) and lymphoma (case 4) presented with an advanced degree of the disease with involvement and destruction of paranasal structures and adjacent tissues, in addition to a poor general condition, which made surgical treatment impossible and led to euthanasia. In these cases, previous treatment was made to apical infection and periodontal disease with secondary sinusitis, but negative evolution led to suspicion of neoplasia, confirmed by histopathological exam of incisional biopsy of the mass in oral cavity. Benign ossifying fibroma (case 3) presented with progressive respiratory difficulty due to occlusion of the lumen of some nasal meatus and radiographic signs of invasion and deformation of the adjacent bones, it was submitted for surgical excision and there was no recurrence until hospital discharge. The poorly differentiated carcinoma (case 2) was a multilobulate neoformation in the ethmoidal region, similar to ethmoid hematoma in endoscopic and radiographic evaluation, it was submitted for excision and two sessions of electrochemotherapy with bleomycin, associated with administration of piroxicam, which obtained a good result until the period of 1 year after discharge.Discussion: It was found that many characteristics are common with these types of neoplasms, and the clinical signs, such as nasal secretions, airway obstruction, increased facial volume, severe alterations in oral cavity, although unspecific, suggest the differential diagnosis for neoplasms. It is important to differentiate from other diseases noting the evolution and growth of these tumors, like in cases 1 and 4, especially the growth to internal tissues, using complementary methods described here, like endoscopic and radiographic examination. Late identification or even manipulation of neoplasms, without proper diagnosis, leads to a few prognoses regarding life. When it is possible to perform surgical excision, complementary methods are important to guide the procedure, and definitive diagnosis is made through histopathologic exam and some need immunohistochemistry analysis. Cases 2 and 3 had surgical access, were submitted to excision and treatment with good results, both with close monitoring in first months and prolonged quality of life. These results highlight the importance of complementary methods for early diagnosis, correct intervention and monitoring of evolution.Keywords: sinus neoplasia, paranasal sinus, tumor, head, horses

A survey on equine neoplasias over a 15-year period in a veterinary hospital

Apesar de vários estudos fornecerem informações sobre a incidência de neoplasias em equinos, há grande variação na distribuição, em decorrência de diferenças regionais, como clima e população racial. Foram analisados 133 casos de neoplasias dentre os 6669 equídeos atendidos no Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, durante um período de 15 anos, representando 2% do total de atendimentos. A neoplasia mais frequente foi o carcinoma de células escamosas (45%), diferindo da maioria dos estudos realizados mundialmente. No sistema tegumentar, a neoplasia mais comum foi o melanoma (34,2%); nos sistemas ocular e urogenital, foi o carcinoma de células escamosas (76,9% e 40,9% respectivamente). Em 68% dos casos foi realizado tratamento cirúrgico, em 10%, tratamento clínico e em 22%, nenhum tipo de tratamento, por opção do proprietário ou indicação de eutanásia. Óbitos por causas relacionadas às neoplasias ocorreram em 14% dos casos. Os achados sugerem que o carcinoma de células escamosas ocorre mais frequentemente em nosso atendimento hospitalar. Este fato pode estar relacionado à exposição prolongada à luz ultravioleta, cuja quantidade de radiação em regiões tropicais vem aumentando consideravelmente nas últimas décadas.Although several prior studies have provided information regarding incidence of tumors in horses, there is a wide variation due to regional differences, such as climate and breed population. A number of 133 cases involving tumors was found among the 6669 equides submitted to the Veterinary Hospital (HOVET) of the School of Veterinary Medicine of the University of São Paulo, during a 15 years period, representing 2% of all records. The most commonly found neoplasm was the squamous cells carcinoma (45%), different from most of the studies worldwide. The most common neoplasia in the integument system was melanoma (34,2%) and in the ocular (76,9%) and urogenital systems (40,9%) was squamous cells carcinoma. Surgical intervention was recommended in 68% of the cases, while a clinical approach was chosen in 10% of them. Twenty two percent of the horses were not treated due to of the owner option or euthanasia indication. Death associated with tumors occurred on 14% of the animals during the hospitalization period or treatment. The squamous cell carcinoma occurs more often in our veterinary hospital and may be related to prolonged exposure to ultraviolet radiation, whose amount in the tropics has increased considerably in the last decades

Evaluation of Ventral Laparoscopic Abomasopexy Using Surgical Staples Associated with Suture Material in Dairy Cattle

Background: Displaced Abomasum is known for being on of the main illnesses that affect milking cows. Increase in diagnosis of this illness is due to advancement in diagnosis techniques. Increase in incidence of this illness can be explained by genetic selection of animals with high production, breed systems and changes to the diet with a higher level of protein. For laparoscopic treatment, several surgical changes were performed to optimize the procedure and thus achieve better results. The main purpose of this study was to evaluate applicability of the ventral laparoscopic abomasopexy technique, using surgical clamps attached to the suture thread, to milking cows.Materials, Methods & Results: Six adult cows were placed under anesthesia with isoflurane and placed in dorsal decubitus. Animals were kept with no water for 24 h and no food for 48 h. Four laparoscopic accesses were performed. The first one was created with the intention of inspecting the abdominal cavity and the remaining three for access of surgical instruments. Serous membrane of the abomasum was cauterized, combined with suture threads and placed at the greater abomasal curvature. The free part of suture threads was kept out of the abdominal cavity and after traction of the abomasum against the abdominal wall was tied to the skin. Ultrasound exam was performed for abdominal evaluation after abomasopexy. Anesthesia time and surgery time were recorded and analyzes through average and standard deviation (SD). The average anesthesia time recorded was 94 min (SD 14.63 min) and average surgery time was 51 min (SD 14.71 min). The fasting period was considered adequate, however all animals had to undergo intubation with orogastric tube to drain liquids and gas during the procedure. Four of the six animals had lineal adhesion. Three of the four animals that had adhesion did not keep the abomasum at the retroperitoneal area, however viscera movement was stopped in the abdominal cavity.Discussion: Abomasopexy through laparoscopy is a safe technique, especially when compared with other invasive methods of abomasopexy. However, to perform this type of surgery availability of adequate equipment and a well trained surgical team are required. This study was performed at a surgery room under full anesthesia. In a field situation, the veterinarian can have some difficulties but such adversities must not be considered and impediment for performance of surgery on the field as its performance is possible. Even though surgical clamps were small, they were considered adequate for what was suggested. The applied 0 degree laparoscopic optic presented restrictions for cavity inspection, therefore we believe that an optical lenses with 30 degree angle could facilitate this laparoscopy inspection. To induce greater and more lasting adherence we suggest cauterizing a greater area of the serous membrane of the abomasum. We also suggest not performing this procedure during lactation peak, when fasting and surgery can cause economic losses. Complications associated with this technique could not be avoided. The technique has shown favorable results, but its clinical applicability depends on application on animals subjected to the conditions of a milk production cycle

Não deixe seu cavalo engolindo ar

Aerofagia faz com que ocorra desgate irregular dos dentes, redução na ingestão de alimentos, perda de peso, deformidade na musculatura do pescoço, desconforto abdominal, entre outras conseqüência