Brachycephalic Syndrome in Dogs - Endoscopic Findings in the Airways

Background: Brachycephalic dogs have several abnormalities in the airways, which generate clinical manifestations that impair the quality of life of these animals. Primary alterations promote airflow obstruction and increase intraluminal negative pressure, causing secondary alterations due to a cycle of inflammation with consequent obstruction. With the onset of inflammation and other alterations in the airways, clinical manifestations can be observed, such as snoring, reverse sneezing, coughing, dyspnea, cyanosis, syncope, and vomiting. Endoscopic examination of the airways allows visualization and diagnosis of morphological changes in these animals. This study aimed to evaluate the endoscopic findings of the airways and determine the quantitative and qualitative assessment of the severity of clinical manifestations in 14 dogs with brachycephalic syndrome (BS). Materials, Methods & Results:  Historical and anamnesis data and clinical, respiratory, and digestive manifestations were collected from the owners’ reports. The clinical manifestations were classified as mild, moderate, or severe. All animals were subjected to endoscopy of the airways, and image findings were grouped according to the anatomical site where they were observed, then the abnormalities were correlated with the severity of the clinical manifestations. When comparing the frequency of endoscopic abnormalities with the severity of clinical manifestations, it is interesting to observe that animals with severe disease more frequently presented the following alterations: prolongation and thickening of the soft palate, laryngeal changes, presence of hyperemia, lymphoid hyperplasia and polyps in the nasopharynx, hypoplasia and presence of tracheal secretion and thickening of the dorsal tracheal muscle; bronchial collapse, hypoplasia of the main bronchi and bronchial hyperemia and the presence of aberrant nasal turbinates. Comparison between the means of nonparametric variables was performed using the Mann-Whitney test, with a 5% significance level.  Discussion: A higher frequency of French Bulldog dogs included in the study was observed, probably due to their greater popularity, although any brachycephalic dog may be affected by BS. Considering that nostril stenosis is a congenital alteration, which is usually diagnosed early, and since the animals included in the study were dogs referred for the rhinoplasty procedure the higher frequency of young dogs in the study was not surprising. The results revealed a significant difference in the endoscopic findings with the severity of the clinical manifestations in different variables, such as prolongation and thickening of the soft palate, eversion of the laryngeal saccules, presence of laryngeal inflammation and collapse, presence of polyps or lymphoid hyperplasia in the nasopharynx, thickening of the dorsal muscle of the trachea, polyps in the trachea and hypoplasia in addition to bronchial hyperemia. The larynx was the most affected anatomical site, with alterations present in 92.8% of the evaluated dogs. Based on these findings, it can be concluded that airway obstruction caused by primary alterations can cause secondary alterations, with consequent clinical manifestations in brachycephalic dogs it is possible to suggest that dogs with this syndrome may present severe manifestations of the disease, regardless of age. Furthermore, it can be concluded that in this study, dogs with BS had frequent laryngeal alterations and that alterations in the main bronchi were present in all animals with severe manifestations of the disease. Keywords: airway obstruction, bronchial collapse, endoscopy, larynx

Bronquite crônica canina – revisão de literatura

A bronquite crônica é uma doença de alta ocorrência em cães. Sua etiologia é associada a causas alérgicas e/ou infecciosas, levando a irritação das vias aéreas, acúmulo de muco e sinais clínicos como a tosse produtiva. O diagnóstico baseia-se nos achados clínicos e radiográficos. Para descartar processo infeccioso, é indicado lavado brônquio-alveolar, com realização de citologia e cultura microbiológica. O protocolo terapêutico já estabelecido na clínica de pequenos animais, associado ao manejo complementar se tronam ferramentas imprescindíveis para resolução de casos mais complicados. O presente trabalho teve como objetivo estabelecer uma revisão bibliográfica sobre a bronquite crônica canina, baseando-se nos achados clínicos e estudo epidemiológico para o correto diagnóstico, tratamento e manejo

Broncopneumonia refratária por antibioticoterapia inadequada em cão

Afecções do aparelho respiratório inferior são rotineiras na clínica de pequenos animais e possuem diversas etiologias sendo necessária, portanto, precisão no momento da identificação dos agentes envolvidos, que acarretará em intervenções adequadas caso a caso.  O lavado broncoalveolar (LBA) constitui-se como importante meio diagnóstico que pode ser utilizado em animais com broncopneumonia que não respondem a terapia padrão. Apesar do LBA ser uma técnica simples, o mesmo não é rotineiramente utilizado na medicina veterinária. Desta forma, o presente trabalho vem destacar não somente a importância da realização do LBA na identificação dos microrganismos envolvidos e suas respectivas sensibilidades e resistências aos antibióticos, como também demonstrar a importância do diálogo com os tutores quanto a administração, conservação dos fármacos e até mesmo sobre a interrupção do tratamento sem recomendação veterinária

Brachycephalic Syndrome in Dogs - Endoscopic Findings in the Airways

Background: Brachycephalic dogs have several abnormalities in the airways, which generate clinical manifestations that impair the quality of life of these animals. Primary alterations promote airflow obstruction and increase intraluminal negative pressure, causing secondary alterations due to a cycle of inflammation with consequent obstruction. With the onset of inflammation and other alterations in the airways, clinical manifestations can be observed, such as snoring, reverse sneezing, coughing, dyspnea, cyanosis, syncope, and vomiting. Endoscopic examination of the airways allows visualization and diagnosis of morphological changes in these animals. This study aimed to evaluate the endoscopic findings of the airways and determine the quantitative and qualitative assessment of the severity of clinical manifestations in 14 dogs with brachycephalic syndrome (BS). Materials, Methods & Results:  Historical and anamnesis data and clinical, respiratory, and digestive manifestations were collected from the owners’ reports. The clinical manifestations were classified as mild, moderate, or severe. All animals were subjected to endoscopy of the airways, and image findings were grouped according to the anatomical site where they were observed, then the abnormalities were correlated with the severity of the clinical manifestations. When comparing the frequency of endoscopic abnormalities with the severity of clinical manifestations, it is interesting to observe that animals with severe disease more frequently presented the following alterations: prolongation and thickening of the soft palate, laryngeal changes, presence of hyperemia, lymphoid hyperplasia and polyps in the nasopharynx, hypoplasia and presence of tracheal secretion and thickening of the dorsal tracheal muscle; bronchial collapse, hypoplasia of the main bronchi and bronchial hyperemia and the presence of aberrant nasal turbinates. Comparison between the means of nonparametric variables was performed using the Mann-Whitney test, with a 5% significance level.  Discussion: A higher frequency of French Bulldog dogs included in the study was observed, probably due to their greater popularity, although any brachycephalic dog may be affected by BS. Considering that nostril stenosis is a congenital alteration, which is usually diagnosed early, and since the animals included in the study were dogs referred for the rhinoplasty procedure the higher frequency of young dogs in the study was not surprising. The results revealed a significant difference in the endoscopic findings with the severity of the clinical manifestations in different variables, such as prolongation and thickening of the soft palate, eversion of the laryngeal saccules, presence of laryngeal inflammation and collapse, presence of polyps or lymphoid hyperplasia in the nasopharynx, thickening of the dorsal muscle of the trachea, polyps in the trachea and hypoplasia in addition to bronchial hyperemia. The larynx was the most affected anatomical site, with alterations present in 92.8% of the evaluated dogs. Based on these findings, it can be concluded that airway obstruction caused by primary alterations can cause secondary alterations, with consequent clinical manifestations in brachycephalic dogs it is possible to suggest that dogs with this syndrome may present severe manifestations of the disease, regardless of age. Furthermore, it can be concluded that in this study, dogs with BS had frequent laryngeal alterations and that alterations in the main bronchi were present in all animals with severe manifestations of the disease. Keywords: airway obstruction, bronchial collapse, endoscopy, larynx

Estudo da variabilidade da frequência cardíaca, por meio de eletrocardiografia contínua, em cães obesos, antes e após dieta terapêutica para emagrecimento.

O sistema nervoso autônomo (SNA) exerce papel de regulação do sistema cardiovascular por meio da modulação simpática e parassimpática, que atuam de maneira associadas na regulação da homeostase (Pumprla et al. 2002). Este balanço exercido pelo SNA é determinado por inúmeros fatores incluindo a respiração, estresse, temperatura, pressão sanguínea e atividade física (Vanderlei et al. 2009). A regulação nervosa cardíaca sofre influência da obesidade, mas ainda não foi esclarecida qual a resposta autonômica presente neste distúrbio (Pascon 2009). Sabe-se que o aumento de 10% da gordura corpórea é capaz de levar à diminuição da ação parassimpática e aumento da frequência cardíaca (Van Vliet et al. 1995). A Variabilidade da Frequência Cardíaca (VFC) permite avaliar a modulação autonômica sobre o coração, por meio dos intervalos de despolarizações ventriculares, ao eletrocardiograma (ECG), e fornece informações sobre a relação e contribuição do SNA na influência neural do controle da frequência cardíaca (Kleiger et al. 2005). O presente estudo tem por objetivo avaliar a VFC, por meio de exame eletrocardiográfico, em cães obesos, com Escore de Condição Corporal (ECC) 8/9 e 9/9, comparando com a VFC dos mesmos animais, após terapia com ração terapêutica no período de 6 meses

Conservative treatment of ventricular tumors secondary to mammary neoplasia in dog

Cardiac neoplasms are uncommon, but secondary or metastatic neoplasms are relatively frequent, with an incidence 60 times higher than the primary ones. A particularly high frequency of metastatic cardiac involvement has been observed in lung squamous cell carcinomas, urinary tract tumors, and melanomas. However, the incidence is low because of breast tumors in dogs. Cardiac tumors may be symptomatic or, more commonly, an incidental finding observed during the investigation of unrelated problems. The clinical presentation is associated with that of a disseminated neoplasm, and cardiac metastases are generally asymptomatic but should be considered in patients with a history of neoplasia who present with impaired conduction, breathlessness, cardiomegaly, or arrhythmias. The present report aimed to describe a clinical case of cardiac metastasis of breast neoplasia in a dog in which we focusedon conservative clinical treatment and the importance of investigating the incidental clinical findings

Evaluation of the right ventricular function in dogs with brachycephalic syndrome before and after rhinoplasty

Brachycephalic dogs are usually affected by primary and secondary anatomical changes in the airways that contribute to the brachycephalic syndrome. Chronically, these changes contribute to an increase in pulmonary arterial pressure and right cardiac overload (cor pulmonale). The right cardiac function in 17 dogs with brachycephalic syndrome was assessed using echocardiography before, and at 30 and 60 days after rhinoplasty. The maximum pulmonary systolic flow velocity, the pressure gradient between the AP and RV (GrFP), the right ventricular systolic function (tricuspid ring systolic excursion (TAPSE), the variation of the right ventricular area (FAC), the velocity of the systolic displacement of the right ventricular myocardium (S’) by tissue Doppler) and right ventricular diastolic function (transtricuspid flow and the relationship between the E and A waves, evaluation of the E’ and A’ waves using tissue Doppler of the free wall of the right ventricle) were evaluated. The right ventricular fractional area, velocity, and pressure gradient of pulmonary arterial flow showed the best sensitivity in these analyses. The present study reinforces the concept that obstructions in the anterior airways contribute to pulmonary hypoxia. However, the correction of these obstructions proved to be beneficial in the reduction of right heart overload

Study of the heart rate variability in dogs with brachycephalic syndrome submitted to rhinoplasty surgery

The aim of the present study was to evaluate the HRV in the brachycephalic races, before and after surgical correction of the stenosis of the nostrils, by means of prolonged electrocardiography, observing the excess of the parasympathetic stimulation regarding the occurrence of bradyarrhythmias and their clinical consequences, and possibility of improvement of the autonomic balancing after the treatment, increasing the quality and life expectancy of these patients. Sixteen dogs with nostril stenosis were included, where the analysis and progression of the HRC findings at different moments before the surgical procedure (day 0) and after the procedure were performed in two moments, 30 and 60 days. The technique of alavestibulplasty was performed and HRV analysis was recorded by means of prolonged electrocardiography. For this examination, the indexes were analyzed in the time domain. Regarding the clinical findings, there was an improvement in the evaluation of the heart and respiratory rate, as well as a reduction in parasympathetic activity, as shown in the bradyarrhythmias. Regarding the HRV indexes in the time domain, rMSSD and SDNN associated with mean heart rate findings, have brought strong indications that the reduction of parasympathetic stimulation is related to the reduction of HRV in these animals. The rMSSD is the HRV index in the domain of the time that early changed can be used as indicator of the increase of the parasympathetic activity caused by the Brachycephalic Syndrom