Tissue Necrosis in Equine Associated with use of Phenylbutazone

Background: Wounds that occur with tissue necrosis and that result from the application of medications through the most diverse accesses are described as drug skin medical embolism or Nicholas syndrome in human medicine, with wide description. In veterinary medicine, this subject has not yet been described extensively and specifically in veterinary medicine, especially regarding to wounds that occurred after the application of non-intravenous medications in horses, even though these lesions are recurrent in the clinical routine.  This report aims to describe a case of skin necrosis in a horse, due to phenylbutazone infection. Case: A 7 year-old Mangalarga Marchador horse, weighing 400 kg, was admitted to the Veterinary Hospital for Large Animals of the Universiade Federal Rural do Rio de Janeiro (UFRRJ), with a history of phenylbutazone injection to the left side of the neck. The animal had an extensive wound on the neck and face on the left side and was characterized by the presence of cold and devitalized skin, with a hardened and parched appearance and that easily detached.  During the anamnesis, a single administration of 10 mL of a non-steroidal anti-inflammatory drug based on phenylbutazone was reported intramuscularly for about 10 days to control the pain resulting from the claudication present for 14 days. The medication was administered in the region of the lateral border of the neck, on the left side. After drug administration, the animal presented an increase in volume at the application site. After 24 h, the lesion spread from the inoculation region, extending to the head and chest of the animal. During debridement, it was found that the lesion did not reach the underlying muscle tissue. In addition to the wound, the animal had upper eyelid palsy, lower lip, and auricular ptosis. Treatment with surgical debridement of devitalized tissue, topical application of ozonated sunflower oil, ketanserin, and a free skin graft was instituted. During hospitalization, the animal had a corneal ulcer in the left eye with an unfavorable prognosis due to paralysis of the upper eyelid, with enucleation of the affected eyeball. The animal was under veterinary care for 180 days and was discharged when his wound was already in an advanced stage of healing. Discussion: The history of the application of phenylbutazone intramuscularly and the location and characteristics of the lesion presented by the patient in the present report suggest that this animal presented aseptic tissue necrosis resulting from the administration of non-steroidal anti-inflammatory drugs, phenylbutazone. Although aseptic tissue necrosis, better known as Nicolau's syndrome or drug embolism cutis, is widely characterized and described in this species, there are studies in the literature that reproduce the syndrome in pigs and rabbits. Phenylbutazone was able to cause arterial damage, mainly in the tunica intima of the artery in which the medication was administered, with perivascular inflammatory infiltrate and subsequent skin necrosis at the site of administration. In addition to the skin lesion, the animal started to show signs compatible with the left facial nerve lesion, evidenced by the immobility of the upper eyelid and labial and ear ptosis. This resulted in corneal ulceration and subsequent enucleation. The animal also developed chewing difficulty in the first months of hospitalization. This dysfunction may be due to a lesion of the mandibular nerve, responsible for innervating the masticatory muscles and the oral mucosa. However, the animal showed improvement in this aspect, no longer showing this condition after 90 days of hospitalization.  The treatment used was successful in healing the wound. Keywords: wound, tissue necrosis, iatrogenic injury, Nicolau Syndrome, treatment, horse. Título: Necrose tissular em equino associada ao uso de fenilbutazona. Descritores: ferida, necrose tecidual, iatrogenia medicamentosa, síndrome de Nicolau, tratamento, cavalo

TUBERCULOSE BOVINA EM PROPRIEDADE RURAL NO MUNICÍPIO DE SEROPÉDICA, RIO DE JANEIRO, BRASIL: RELATO DE CASO

A tuberculose é uma das principais doenças infecciosas de importância econômica em bovídeos, podendo acometer outras espécies de animais e inclusive o homem, causando perdas econômicas ao setor de produção, além de ocasionar agravos à saúde pública. É uma zoonose de notificação obrigatória que no Brasil possui um programa de controle e erradicação instituído pelo Ministério da Agricultura, Pecuária e Abastecimento (MAPA), o Programa Nacional de  Controle e Erradicação da Brucelose e Tuberculose (PNCEBT) dos bovídeos, que tem por objetivo principal a redução da prevalência e da incidência da brucelose e tuberculose nessas espécies. O Núcleo de Defesa Agropecuária (NDA) do Rio de Janeiro da Secretaria de Estado de Agricultura, Pecuária, Pesca e Abastecimento (SEAPPA) do Rio de Janeiro é responsável pelas ações de vigilância veterinária oficial no município de Seropédica. O presente trabalho tem por objetivo relatar a ocorrência de um foco de tuberculose no município de Seropédica e as ações executadas pelo serviço de vigilância oficial da SEAPPA. No ano de 2020, os técnicos do NDA Rio de Janeiro receberam o informe de notificação com laudo laboratorial positivo para tuberculose, pela técnica de histoquímica em seções de pulmão e encéfalo, de uma fêmea bovina da raça Girolando, com aproximadamente seis anos, necropsiada numa propriedade rural localizada no município de Seropédica. Após a notificação, o serviço oficial realizou a vistoria da propriedade e solicitou ao produtor que realizasse a tuberculinização nos demais animais conforme prevê o regulamento do PNCEBT. Houve a notificação imediata às Secretarias Municipais de Saúde e Agricultura domunicípio de Seropédica para as providências junto ao produtor e demais envolvidos, haja vista que as medidas com relação aos animais na propriedade já haviam sido executadas pelo serviço oficial de modo a debelar o foco. Com a apresentação do atestado de exames negativos ao teste de tuberculinização comparativo simples dos demais bovinos do plantel, foi encerrado o foco napropriedade. Conclui-se que a tuberculose bovina está presente no estado do Rio de Janeiro, e que necessita da conscientização tanto por parte dos médicos veterinários quanto dos produtores para maior adesão do PNCEBT, controlando assim a enfermidade nos rebanhos. Há a necessidade da realização de um estudo epidemiológico para conhecimento da prevalência da tuberculose no estado por se tratar de uma questão de saúde pública, uma vez que os testes de tuberculinização são obrigatórios apenas para fins de trânsito para as finalidades reprodução e participação em eventos agropecuários, existindo vários criatórios que não realizam exames e assim, outros focos podem existir devido à prática da troca de animais principalmente entre os pequenos produtores

Equine Colic Syndrome Induced by the Ingestion of Sugarcane

Background: Equine colic syndrome comprises numerous conditions associated with abdominal pain in horses. Impaction, a common cause of this manifestation, is strongly related to these animals’ diet. Highly fibrous diets such as sugarcane can predispose horses to colic. The clinical condition can be worsened by fermentative processes, which lead to dysbiosis, circulatory disorders and even endotoxemia. The aim of this study was to report 4 cases of colic syndrome among 8 horses that underwent an experiment to adapt them to a sugarcane-based diet, and to correlate the animals’ clinical conditions to the forage they ingested. Cases: Eight male castrated Mangalarga Marchador horses, between 5.5 and 7 years old, were subjected to an experiment to test the feasibility of sugarcane as forage. Four of these horses were taken to the Large Animal Veterinary Hospital (HVGA) of the Federal Rural University of Rio de Janeiro for treatment of abdominal signs of discomfort a few days after the exclusive consumption of sugarcane, in a proportion of 1.75% of live weight in dry matter. The animals’ symptoms ranged from behavioral signs indicative of pain to changes in vital parameters and structure of the feces, as well as changes revealed by transrectal palpation. Three of the 4 cases presented impaction in the small colon, and 1 of the horses also presented impaction in the right dorsal colon and rostral displacement of the pelvic flexure, with accumulation of contents in the right ventral colon and sternal flexure. Two of the cases were treated medically, while the other 2 required surgical intervention. The clinical condition of all the patients evolved favorably and they were discharged between 2 and 18 days. Discussion: Colic originating in the digestive system is a syndrome strongly associated with management, especially with respect to confinement, nutrition, and parasite control. During the experiment, 4 of the 8 horses fed with sugarcane presented with colic syndrome. The low quality of sugarcane fiber is due to the high degree of lignification of the plant cell wall, which favors accumulation of ingesta. The poor digestibility and sweet taste of this roughage favor increased consumption. Furthermore, its high sucrose content, associated with an increased rate of passage in the small intestine, alters the intestinal microbiome, and hence, the fermentation byproducts and pH of the ingesta. High intestinal content, allied to longer retention times in the colon and activation of the renin-angiotensin-aldosterone system, promote greater dryness of the ingesta, predisposing the occurrence of impactions in the most distal portion of the large intestine. Intestinal distension and mesenteric traction caused by the accumulation of contents and gases trigger pain, which can worsen due to displacement of the large colon. Small colon impaction, which is easily identified by transrectal palpation, evolves gradually and its treatment, both clinical and surgical, tends to have a favorable prognosis. The need for alternative food sources for horses is a growing demand; however, sugarcane as an exclusive roughage has been shown to be unsafe for horses. The low quality of the fiber and the high sucrose content of this forage can alter the digestive physiology of horses through changes in the passage rate, microbiome and motility of digesta, predisposing them to intestinal dysfunction, ingesta compaction and displacement of the large colon. Keywords: horse, acute abdomen, nutrition, diet, forage, digestibility, gastrointestinal disease. Título: Síndrome cólica em equinos induzida por ingestão de cana de açúcar. Descritores: cavalo, abdômen agudo, nutrição, dieta, foragem, digestibilidade, doença gastrointestinal

Tissue Necrosis in Equine Associated with use of Phenylbutazone

Background: Wounds that occur with tissue necrosis and that result from the application of medications through the most diverse accesses are described as drug skin medical embolism or Nicholas syndrome in human medicine, with wide description. In veterinary medicine, this subject has not yet been described extensively and specifically in veterinary medicine, especially regarding to wounds that occurred after the application of non-intravenous medications in horses, even though these lesions are recurrent in the clinical routine.  This report aims to describe a case of skin necrosis in a horse, due to phenylbutazone infection. Case: A 7 year-old Mangalarga Marchador horse, weighing 400 kg, was admitted to the Veterinary Hospital for Large Animals of the Universiade Federal Rural do Rio de Janeiro (UFRRJ), with a history of phenylbutazone injection to the left side of the neck. The animal had an extensive wound on the neck and face on the left side and was characterized by the presence of cold and devitalized skin, with a hardened and parched appearance and that easily detached.  During the anamnesis, a single administration of 10 mL of a non-steroidal anti-inflammatory drug based on phenylbutazone was reported intramuscularly for about 10 days to control the pain resulting from the claudication present for 14 days. The medication was administered in the region of the lateral border of the neck, on the left side. After drug administration, the animal presented an increase in volume at the application site. After 24 h, the lesion spread from the inoculation region, extending to the head and chest of the animal. During debridement, it was found that the lesion did not reach the underlying muscle tissue. In addition to the wound, the animal had upper eyelid palsy, lower lip, and auricular ptosis. Treatment with surgical debridement of devitalized tissue, topical application of ozonated sunflower oil, ketanserin, and a free skin graft was instituted. During hospitalization, the animal had a corneal ulcer in the left eye with an unfavorable prognosis due to paralysis of the upper eyelid, with enucleation of the affected eyeball. The animal was under veterinary care for 180 days and was discharged when his wound was already in an advanced stage of healing. Discussion: The history of the application of phenylbutazone intramuscularly and the location and characteristics of the lesion presented by the patient in the present report suggest that this animal presented aseptic tissue necrosis resulting from the administration of non-steroidal anti-inflammatory drugs, phenylbutazone. Although aseptic tissue necrosis, better known as Nicolau's syndrome or drug embolism cutis, is widely characterized and described in this species, there are studies in the literature that reproduce the syndrome in pigs and rabbits. Phenylbutazone was able to cause arterial damage, mainly in the tunica intima of the artery in which the medication was administered, with perivascular inflammatory infiltrate and subsequent skin necrosis at the site of administration. In addition to the skin lesion, the animal started to show signs compatible with the left facial nerve lesion, evidenced by the immobility of the upper eyelid and labial and ear ptosis. This resulted in corneal ulceration and subsequent enucleation. The animal also developed chewing difficulty in the first months of hospitalization. This dysfunction may be due to a lesion of the mandibular nerve, responsible for innervating the masticatory muscles and the oral mucosa. However, the animal showed improvement in this aspect, no longer showing this condition after 90 days of hospitalization.  The treatment used was successful in healing the wound. Keywords: wound, tissue necrosis, iatrogenic injury, Nicolau Syndrome, treatment, horse. Título: Necrose tissular em equino associada ao uso de fenilbutazona. Descritores: ferida, necrose tecidual, iatrogenia medicamentosa, síndrome de Nicolau, tratamento, cavalo

Equine Colic Syndrome Induced by the Ingestion of Sugarcane

Background: Equine colic syndrome comprises numerous conditions associated with abdominal pain in horses. Impaction, a common cause of this manifestation, is strongly related to these animals’ diet. Highly fibrous diets such as sugarcane can predispose horses to colic. The clinical condition can be worsened by fermentative processes, which lead to dysbiosis, circulatory disorders and even endotoxemia. The aim of this study was to report 4 cases of colic syndrome among 8 horses that underwent an experiment to adapt them to a sugarcane-based diet, and to correlate the animals’ clinical conditions to the forage they ingested. Cases: Eight male castrated Mangalarga Marchador horses, between 5.5 and 7 years old, were subjected to an experiment to test the feasibility of sugarcane as forage. Four of these horses were taken to the Large Animal Veterinary Hospital (HVGA) of the Federal Rural University of Rio de Janeiro for treatment of abdominal signs of discomfort a few days after the exclusive consumption of sugarcane, in a proportion of 1.75% of live weight in dry matter. The animals’ symptoms ranged from behavioral signs indicative of pain to changes in vital parameters and structure of the feces, as well as changes revealed by transrectal palpation. Three of the 4 cases presented impaction in the small colon, and 1 of the horses also presented impaction in the right dorsal colon and rostral displacement of the pelvic flexure, with accumulation of contents in the right ventral colon and sternal flexure. Two of the cases were treated medically, while the other 2 required surgical intervention. The clinical condition of all the patients evolved favorably and they were discharged between 2 and 18 days. Discussion: Colic originating in the digestive system is a syndrome strongly associated with management, especially with respect to confinement, nutrition, and parasite control. During the experiment, 4 of the 8 horses fed with sugarcane presented with colic syndrome. The low quality of sugarcane fiber is due to the high degree of lignification of the plant cell wall, which favors accumulation of ingesta. The poor digestibility and sweet taste of this roughage favor increased consumption. Furthermore, its high sucrose content, associated with an increased rate of passage in the small intestine, alters the intestinal microbiome, and hence, the fermentation byproducts and pH of the ingesta. High intestinal content, allied to longer retention times in the colon and activation of the renin-angiotensin-aldosterone system, promote greater dryness of the ingesta, predisposing the occurrence of impactions in the most distal portion of the large intestine. Intestinal distension and mesenteric traction caused by the accumulation of contents and gases trigger pain, which can worsen due to displacement of the large colon. Small colon impaction, which is easily identified by transrectal palpation, evolves gradually and its treatment, both clinical and surgical, tends to have a favorable prognosis. The need for alternative food sources for horses is a growing demand; however, sugarcane as an exclusive roughage has been shown to be unsafe for horses. The low quality of the fiber and the high sucrose content of this forage can alter the digestive physiology of horses through changes in the passage rate, microbiome and motility of digesta, predisposing them to intestinal dysfunction, ingesta compaction and displacement of the large colon. Keywords: horse, acute abdomen, nutrition, diet, forage, digestibility, gastrointestinal disease. Título: Síndrome cólica em equinos induzida por ingestão de cana de açúcar. Descritores: cavalo, abdômen agudo, nutrição, dieta, foragem, digestibilidade, doença gastrointestinal