Cranioplasty Using Autologous Fasciae Latae Graft for Nasal Bone Fracture Repair in a Dog

Background: In facial reconstruction, several kinds of grafts can be used, like bone grafting, cutaneous grafting, biological membranes, fasciae latae, biomaterials, and others. The advantage of using fasciae latae in the tissue reparation is the need of little blood supply, making it a viable option in the restoration of biological functions. The objective of this study was to describe the case of a female poodle, 12-year-old, and with subcutaneous emphysema due to fracture of the nasal bone, submitted to cranioplasty using fasciae latae.Case: It was attended a 12-year-old female poodle due to a traumatic brain injury. At physical examination, the animal had presented facial swelling and respiratory distress with inspiratory effort. Additionally, were verified subcutaneous emphysema and a depression in the nasal plane region with crepitus on palpation. Radiographic examinations revealed nasal bone and maxilla fractures. The animal was submitted to cranioplasty for nasal bone fracture repair. To access the nasal bone and frontal sinus was performed an incision in the dorsal midline from the level of medial orbital rim to the nasal plane. The subcutaneous tissue was divulsioned to allow the exposure of the nasal bone fracture, whose small fragments prevented the internal fixation. The bone defect was then repaired using free autologous fasciae latae of 2 cm wide x 3 cm long, sutured to the periosteum. Subcutaneous emphysema gradually decreased until its resolution at three days postoperatively. The surgical wound had complete healing at 10 days after surgery without concomitant complications.Discussion: The choice of the reconstructive technique is based on the operative planning and the surgeon’s experience. In the present case we opted for the autologous fasciae latae graft since its ready availability and lesser predisposition to immunogenic sensibilization and rejection. In addition, we opted for the autologous fasciae latae graft because it is an occlusive material that would prevent the air flow through it during the inspiration and expiration, and consequently the aggravation of the subcutaneous emphysema. In fact, the resolution of the subcutaneous emphysema occurred three days after grafting. Furthermore, the resolution of the subcutaneous emphysema was determined by the lower retraction of the autologous fasciae latae graft due to the scar fibrous tissue deposition. The choice of the reconstructive technique is also based on the viability of the recipient bed, which should provide adequate blood supply for the reception of the free graft. In the present case, however, the bone defect did not provide adequate blood supply and structural support. Due to this, the autologous fasciae latae graft was crucial to the verified results, since it requires less blood supply and structural support to remain the graft viable. We concluded that the autologous fasciae latae graft may be a viable option for the anatomical and functional reconstruction of traumatic lesions localized in the skull, particularly the nasal bone, due to the satisfactory follow-up in the present case without the occurrence of complications. A larger sample size, however, it is necessary to evaluate the real effectiveness of the autologous fasciae latae graft in reconstructive skull surgery on small animals

Omentalização prostática em cães

A próstata é a única glândula sexual nos cães e, embora seja encontrada em todos os mamíferos, sua importância clínica é maior no homem e nesta espécie animal devido à quantidade de afecções que os acometem. Diversas técnicas cirúrgicas têm sido utilizadas para o tratamento de cistos e abscessos prostáticos em cães, e há alguns anos foi relatado o primeiro uso da técnica de omentalização prostática para o tratamento de cistos e abscessos, com sucesso efetivo, e até o momento, não há informações de seu emprego no Brasil. Sendo assim, este trabalho teve como objetivo avaliar a recuperação e o período pós-operatório de animais submetidos a esta técnica, durante o período de 2002 a 2004. Foram estudados 17 machos, sendo 11 com cistos prostáticos, 4 com abscesso e 2 com cisto paraprostático. Quinze se recuperaram sem complicações, enquanto um apresentou incontinência urinária por dois dias após a cirurgia. Um animal veio a óbito em decorrência de septicemia preexistente. A baixa incidência de complicações e o curto período de hospitalização fazem da omentalização a cirurgia de escolha para o tratamento de abscessos e cistos prostáticos em cães.The prostate is the only acessory sex gland in the male dog and, although the prostate is found in all mammals, it has a great importance in men and dogs due to the frequency of disorders. Several techniques have been employed for the treatment of prostatic cysts and abscesses and, a few years ago, it was successfully described the use of prostatic omentalisation for this purpose; until now, there are no data about this surgery in Brazil. So, the aim of this study was to evaluate the animal recovery, as well as the post operative period of dogs that underwent prostatic omentalisation, from 2002 to 2004. It was evaluated 11 dogs with prostatic cysts, 4 dogs with prostatic abscesses and 2 with paraprostatic cysts. Fifteen dogs had an uneventful recovery while one dog had a minor incontinence for two days. One dog died due to a previous long term sepsis. The low incidence of post operative complications and brief hospitalization period make omentalisation the surgery of choice for the treatment of prostatic cysts and abscess

Acute Trigeminal Nerve Neuritis in German Shepherd

Background: Trigeminal nerve is composed by ophthalmic, maxillary and mandibular portion, presenting sensory and motor functions. Its most common conditions include vascular, neoplastic, infectious and inflammatory causes. Neuritis is an inflammation caused by a primary nerve injury that can progress to demyelination and even degeneration of nerve fibers. The present report aims to describe an unusual case of a female dog, German Shepherd breed, with acute manifestation of trigeminal nerve neuritis whose etiology may be associated with erlichiosis, since infection with Ehrlichia spp. through serological test was verified.Case: A 3-year-old female German Shepherd , weighing 26.8 kg and not neutered, was attended at Veterinary Hospital Dr. Halim Atique - UNIRP, São José do Rio Preto, SP, Brazil presenting apathy, sialorrhea and polydipsia for seven days. The tutor reported an episode of foamy and yellowish vomit three days ago and ixodidiosis last week. Physical examination revealed flaccid open-mouthed posture, with mild bilateral masseter and moderate temporal muscle atrophy. Water was offered to the animal and it was observed that it could not properly seize, confirming a false polydipsia. The neurological examination revealed a slight decrease in head sensitivity, difficulty in chewing and seizure of food. It was not observed alterations in the other pairs of cranial nerves or other neurological parameters (postural reactions and spinal reflexes), and the diagnose of bilateral dysfunction of the trigeminal nerve was based on the affected neuroanatomic region. On neurological examination, other lesions of the nervous system were ruled out, suggesting an isolated manifestation of the trigeminal nerve. CBC revealed anemia, intense thrombocytopenia and leukocytosis by neutrophilia. Radiographic examination ruled out the possibility of trauma due to the absence of mandible fracture and also temporomandibular joint alterations. Masseter and temporal muscle biopsy were performed, and myositis or other masticatory muscle alterations were discarded among the diagnostic possibilities. Serological tests showed non-reactive results for toxoplasmosis and neosporosis, but reagent for Erlichia spp.Discussion: Idiopathic trigeminal neuritis (ITN) has an unknown etiology, but is not related to signs of systemic disease, and is usually not associated with deficits in other cranial nerves. The main clinical sign related to this condition is acute jaw paralysis, with inability to close the mouth, and in some cases is observed sensitivity deficits in face, as observed in the dog of this report during the neurological examination. In the patient of the present report, no justifiable causes were found for the presented symptoms, except the presence of erlichiosis. The treatment was based on the use of prednisone, doxycycline, antioxidants and vitamin complex. Response to treatment was satisfactory after seven days, and complete remission of clinical signs occurred nine days after its onset. Although cranial nerve neuritis is an uncommon clinical manifestation of erlichiosis, the patient in this study presented a good response to the treatment instituted, suggesting that erlichiosis is an important differential diagnosis for neuritis

Estudo comparativo entre a administração de toxina botulínica “A” e a orquiectomia no tratamento da hiperplasia prostática benigna do cão

A hiperplasia prostática benigna (HPB) tem início no animal com um a dois anos de idade, sendo que 80% dos cães com cinco anos apresentam evidências histológicas de sua presença. A fisiopatologia da doença não está totalmente compreendida, no entanto, a diidrotestosterona é o principal hormônio envolvido. Recentemente, o efeito da toxina botulínica A (TB-A) foi investigado na próstata, mostrando que esta induz atrofia do parênquima e redução do volume. Como o cão é o único animal doméstico que apresenta esta alteração, este se apresenta como modelo experimental para novos estudos da HPB humana. Com base nisso, este estudo objetivou fornecer informações acerca dos efeitos da TB-A sobre a próstata, libido e qualidade do sêmen, comparando os dados com animais orquiectomizados. Para tanto, 18 cães adultos, com evidências ultra-sonográficas de HPB foram submetidos à castração ou administração de 250 ou 500 U de TB-A, e avaliados durante 16 semanas. A orquiectomia mostrou-se um excelente tratamento para a HPB, promovendo redução de 80% do volume prostático. Aplicação da TB-A não ocasionou alterações significativas na libido, ereção ou qualidade e características seminais. Efeitos locais e sistêmicos também não foram observados. Administração de 250 U da TB-A promoveu redução máxima de 9,4% do volume prostático, entretanto, tal redução não foi significativa. Por outro lado, a administração de 500 U de TB-A reduziu significamente as variáveis comprimento, altura e volume da próstata. Desta forma, o presente ensaio contribui de forma singular e inovadora para o conhecimento dos efeitos desta nova modalidade de tratamento na HPB canina.Benign prostatic hyperplasia (BPH) starts the development in animals aging about 1 – 2 years. 80% of 5 years-old dogs have histologic evidences of BPH. Despite the little knowledge concerning about this disease, dihydrotestosterone is the main involved hormone. Recently, the effect of botulinum toxin A (BT-A) on rat and human prostate was investigated, and prostatic parenchyma atrophy and decrease in glandular volume were observed. The dog is one of a few animals that can develop BPH spontaneously and is frequently used as an animal model for human prostatic hyperplasia. Based on that, this study aimed to provide information on BT-A effects on prostate, libido and semen quality, in comparison to orchiectomized dogs. For that, 18 adults dogs, with Ultrasonographic evidences of BPH were submitted to orchiectomy or administration of 250 or 500 U of BT-A, and evaluated along 16 weeks. Orchiectomy presented excellent results on BPH, reducing the prostate volume up to 80%. Administration of BT-A did not significantly interfered on libido, erection or semen characteristics. Local and systemic effects also were not observed. Administration of 250 U of BT-A has promoved a maximum decrease of 9,4% on prostatic volume. However, this reduction was not statistically significant. On the other hand, 500 U of BTA administration has shown to significantly reduce the length, height and volume of prostate. This way, the present study is an innovative and singular contribution for the knowledge of the effects of BT-A on canine prostate.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Intra-prostatic injection of botulinum toxin type A in treatment of dogs with spontaneous benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is a common, naturally developing, age-related condition in dogs. The pathogenesis of BPH is not completely known; however, DHT is a hormone involved in enlargement of the prostate. Recently, the effect of botulinum toxin A (BT-A) was investigated in the rat and human prostate and has shown to induce atrophy of the gland on the canine prostate. This study investigated the effect of BT-A in the canine prostate and on the semen. Eight sexually intact male dogs with BPH (detected radiographically and ultrasonographically), and with clinical signs of BPH (e.g. hematuria or tenesmus) were used. Each lobe of the prostate received an injection of 125 U of BT-A with one-needle pass under transabdominal ultrasound guidance. The clinical results were evaluated at baseline and after treatment. No local complications or systemic adverse effects were reported. At 4 weeks, the mean prostate volume (PV) was not significantly changed after BT-A (from 17.70 +/- 6.34 to 16.48 +/- 5.98 cm(3)). At 8 weeks the PV had further decreased to 16.04 +/- 5.80 cm(3), reaching its maximum effect, but that change was not significant. The results were maintained at 16 weeks. All dogs had normal libido, erection, and ejaculation during semen collection. No significant difference was observed in all seminal parameters. Results suggest that the administration of 250 U of BT-A do not contribute to PV reduction and do not adversely affect the semen quality of dogs with BPH. (C) 2012 Elsevier B.V. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

UTERINE PROLAPSE IN QUEEN AND UTERINE PROLAPSO UTERINO EM GATA E RETROFLEXÃO UTERINA EM CADELA

<span><p align="justify">Obstetrical emergencies are problem in veterinary clinics and hospital. So, the aim of this report is to describe the clinical-surgical aspect of one of them, the uterine prolapse. Complete protrusion and retroflexion of uterus had been diagnosed in a queen and female dog, respectively. After the stabilization of the animals and reduction of the prolapses followed by ovary-hysterectomy, one of the animals came to death due to septicemia and hypovolemic shock. Rapid assessment and intensive treatments are required to sustain the life of the animal.</p><p align="justify">KEY WORDS: Cat, dog, uterine prolapse, uterine retroflexion.</p></span> <span><p align="justify">Emergências obstétricas, como o prolapso uterino, constituem um problema em clínicas e hospitais veterinários. Neste relato descreve-se o aspecto clínico-cirúrgico do prolapso uterino. Diagnosticaram-se, em uma gata e em uma cadela, protrusão completa e retroflexão uterina, respectivamente. Após a estabilização dos animais e redução dos prolapsos seguidos de ovário-histerectomia, um dos animais veio a óbito, em decorrência de septicemia e choque hipovolêmico. Portanto, a rápida avaliação e tratamentos intensivos são requeridos para assegurar a vida do animal.</p><p align="justify"> </p><p align="justify">PALAVRAS-CHAVES: Cão, gato, prolapso uterino, retroflexão uterina</p></span&gt

Pre-emptive methadone or tramadol analgesia for mastectomy and ovariohysterectomy in bitches

Summary Background: mastectomy in bitches is a critical surgery and pain control can be challenging. Objective: to evaluate the efficacy of pre-emptive analgesia with methadone (MET) or tramadol (TRA) in postoperative pain management, cardiorespiratory effects, and anaesthetic/analgesic consumption in female dogs undergoing ovariohysterectomy (OVH) and mastectomy. Methods: a prospective randomized blind clinical trial was used to evaluate 48 bitches of various breeds, aged 10±3.7 years, weighing 16±12 kg, and with multiple mammary tumours. The animals were distributed in two groups: TRA group received 5 mg/kg tramadol and MET group 0.5 mg/kg methadone intramuscularly, 10 minutes prior to anaesthesia induction with propofol followed by maintenance with isoflurane. Heart (HR) and respiratory (RR) rates, mean arterial pressure (MAP), propofol induction dose (PID), oxyhemoglobin saturation (SpO2), end-tidal isoflurane concentration (EtISO), and carbon dioxide pressure (EtCO2) were measured during the intra-operative period. Post-operative pain was evaluated for 12 hours and rated according to the Melbourne pain scale. Rescue analgesia (0.5 mg/kg methadone, 2 mg/kg lidocaine, or 0.01 mg/kg/min ketamine IV) was given when necessary and post-operative analgesic consumption recorded. Statistical tests were used to compare treatments. Results: rescue analgesia requirements, pain score, PID and analgesic consumption were significantly lower (p<0.05) in MET group. The HR was higher in TRA group, while EtCO2 and MAP were higher in MET group (p<0.05). Conclusions: methadone was more effective than tramadol in pre-emptive analgesia but not completely adequate on controlling pain in bitches subjected to unilateral mastectomy and OVH. MET led to lower cardiovascular depression and lower propofol dose required for anesthesia induction. However, methadone increased EtCO2 and thus special care with patient ventilation is advised.Resumo Introdução: a mastectomia em cadelas é um procedimento severamente álgido e o controle da dor é um desafio. Objetivo: avaliar a eficácia da analgesia preventiva com metadona ou tramadol sob dor pós-operatória, parâmetros cardiorrespiratórios e consumo anestésico em cadelas submetidas à ovariohisterectomia e mastectomia. Métodos: ensaio clínico prospectivo cego randomizado em 48 cadelas, de diferentes raças, idade 10 ± 3,7 anos, peso 16 ± 12 kg com tumores mamários múltiplos. Os animais foram distribuídos em dois grupos: grupo TRA, tramadol 5 mg/kg e grupo MET, metadona 0,5 mg/kg por via intramuscular, administrados 10 minutos antes da indução anestésica com propofol e manutenção com isofluorano. As variáveis mensuradas foram: frequência cardíaca (FC), respiratória (fR), pressão arterial média (PAM), dose de indução propofol (PID), saturação da oxihemoglobina (SpO2), concentração de isofluorano (EtISO) e pressão de dióxido de carbono (EtCO2) ao final da expiração. A dor pós-operatória foi avaliada durante 12 horas (Escala Melbourne). A necessidade de resgate (metadona 0.5 mg/kg, lidocaína 2 mg/kg, ou cetamina 0.01 mg/kg/min IV) analgésico e o consumo pós-operatório de analgésicos foram registrados. Testes estatísticos foram utilizados para comparar os tratamentos. Resultados: a necessidade de resgate analgésico, escore de dor, PID e o consumo de analgésicos foram menores (p<0,05) no grupo MET. A FC maior no grupo TRA, enquanto EtCO2 e PAM maiores no grupo MET (p<0,05). Conclusões: a administração preventiva de metadona foi mais eficaz, mas não totalmente adequada para o controle da dor pós-operatória do que o tramadol, promovendo redução na depressão cardiovascular e o requerimento de propofol para indução da anestesia. No entanto, a metadona aumentou a EtCO2, recomendando cuidado especial com a ventilação dos pacientes.Resumen Fundamento: la mastectomia en perras es un procedimiento severamente álgido y el control del dolor es un desafío. Objetivo: evaluar la eficacia del tratamiento analgésico preventivo con metadona (MET) o tramadol (TRA) sobre el dolor postoperatorio, parámetros cardiorrespiratorios y consumo de anestésicos en perras sometidas a ovariohisterectomía (OVH) y mastectomía. Métodos: ensayo clínico prospectivo aleatorizado ciego en 48 perras de diversas razas, edad 10±3,7, peso corporal 16±12 kg y con múltiples tumores mamarios. Los animales fueron distribuidos en dos grupos: el grupo TRA recibió 5 mg/kg de tramadol y el grupo MET 0,5 mg/kg de metadona por vía intramuscular 10 minutos antes de inducir anestesia con propofol seguido de mantenimiento con isofluorano. Las variables evaluadas fueron: frecuencia cardíaca (HR), respiratoria (RR), presión arterial media (MAP), dosis de inducción con propofol (PID), saturación de oxihemoglobina (SpO2), concentración de isofluorano (EtISO) y presión de dióxido de carbono (EtCO2) medidos durante el proceso intra-operativo. El dolor postoperatorio fue evaluado de acuerdo con la escala Melbourne durante 12 horas. Analgesia de rescate (metadona 0.5 mg/kg, lidocaína 2 mg/kg, o ketamina 0.01 mg/kg/min IV) se suministró cuando se consideró necesario, y se registró el consumo de analgésico posterior a la cirugia. Se aplicaron pruebas estadísticas para comparar los tratamientos. Resultados: los requerimientos de rescate analgésico, intensidad del dolor, PID y consumo analgésico fueron significativamente menores (p<0,05) en el grupo MET. La HR fue mayor en el grupo TRA, mientras que EtCO2 y MAP fueron mayores en el grupo MET (p<0,05). Conclusiones: la administración preventiva de MET es más eficaz que el tramadol, pero no completamente adecuada para el control del dolor posoperatorio en perras sometidas a mastectomia unilateral y OVH. MET promueve menor depresión cardiovascular y requerimiento de propofol para inducción anestésica. Sin embargo, dado que MET incrementa la EtCO2, se recomienda cuidado especial con la ventilación de estos pacientes

Semen parameters and seminal plasma protein and biochemical profiles of dogs with benign prostatic hyperplasia after botulinum toxin type A intraprostatic injection

This study aimed to determine the effects of different concentrations of botulinum toxin type A (BT-A) on semen parameters, and seminal plasma biochemical and protein profiles of dogs with benign prostatic hyperplasia (BPH). Eighteen sexually intact male dogs with BPH were randomly divided in three groups, and received an intraprostatic injection of saline solution (control group - CG), 250UI (GI) or 500UI (GII) of BT-A under transabdominal ultrasound guidance. Semen was collected at baseline, 2, 4 and 8 weeks after treatment. Semen parameters were determined and seminal plasma pH, total protein (TP), total chlorides (TC), calcium (Ca), potassium (K), and sodium (Na) concentrations were assessed. One-dimensional sodium dodecyl sulfatepolyacrilamide gel eletrophoresis (SDS- PAGE) was performed to determine seminal plasma protein profile. Sperm parameters and seminal plasma pH, TP, TC, Ca and K mean values did not change significantly at any time point and among treated groups (P>0.05). The SDS-PAGE analysis of the pooled fractions identified 31 protein bands with molecular weights ranging from 3.9 to 106.2kDA in all treatment groups during the entire evaluation period. Regardless the used dose, intraprostatic BT-A injection do not alter semen parameters and seminal plasma biochemical and protein profiles of dogs with BPH.O objetivo do presente estudo foi determinar a ação de diferentes concentrações de toxina botulínica tipo A (TB-A) sobre os parâmetros seminais, perfis bioquímicos e proteicos do plasma seminal de cães com hiperplasia prostática benigna (HPB). Dezoito cães hígidos, não orquiectomizados com HPB foram divididos em três grupos, os quais foram submetidos à injeção intra-prostática de solução salina (grupo controle - GC), 250UI (GI) ou 500UI (GII) de TB-A. Amostras seminais foram coletadas previamente aos tratamentos e após 2, 4 e 8 semanas. Os parâmetros seminais assim como os valores de pH e concentrações de proteínas totais (TP), cloretos totais (CT), cálcio (Ca), potássio (K), sódio (Na) do plasma seminal foram mensurados após as coletas. O perfil proteico do fluido prostático foi estabelecido por meio de eletroforese SDS-PAGE. Não foram constatadas diferenças significativas quanto aos parâmetros espermáticos e perfil bioquímico do plasma seminal intragrupos e intergrupos (P>0,05). À SDS-PAGE foram identificadas 31 bandas proteicas com pesos moleculares de 3,9 a 106,2kDA, em todos os tratamentos e durante todo o período de avaliação. Dessa forma, concluiu-se que, independentemente da dose utilizada, a injeção intra-prostática de TB-A não altera os parâmetros seminais, assim como os perfis bioquímico e proteico do plasma seminal de cães com HPB.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Omentalização prostática em cães

A próstata é a única glândula sexual nos cães e, embora seja encontrada em todos os mamíferos, sua importância clínica é maior no homem e nesta espécie animal devido à quantidade de afecções que os acometem. Diversas técnicas cirúrgicas têm sido utilizadas para o tratamento de cistos e abscessos prostáticos em cães, e há alguns anos foi relatado o primeiro uso da técnica de omentalização prostática para o tratamento de cistos e abscessos, com sucesso efetivo, e até o momento, não há informações de seu emprego no Brasil. Sendo assim, este trabalho teve como objetivo avaliar a recuperação e o período pós-operatório de animais submetidos a esta técnica, durante o período de 2002 a 2004. Foram estudados 17 machos, sendo 11 com cistos prostáticos, 4 com abscesso e 2 com cisto paraprostático. Quinze se recuperaram sem complicações, enquanto um apresentou incontinência urinária por dois dias após a cirurgia. Um animal veio a óbito em decorrência de septicemia preexistente. A baixa incidência de complicações e o curto período de hospitalização fazem da omentalização a cirurgia de escolha para o tratamento de abscessos e cistos prostáticos em cães