Intestinal Intussusception Associated with Cloacal Protusion in Trachemys scripta elegans

Background: Gastrointestinal dysfunction in reptiles is a common condition seen in animal medicine, and is often caused by inappropriate husbandry. The purpose of this report is to describe the case of a surgical procedure for enterectomy of the small intestines, performed as treatment for an intussusception with cloacal protrusion that occurred in a red-eared slider (Trachemys scripta elegans) kept as a pet.Case: A 20-year-old red-eared slider (Trachemys scripta elegans) was taken into medical care after the owner’s observation of a cloacal protrusion that had started 72 h previously. During physical examination the protrusion was noted as an intestinal segment of approximately 5 cm, which was not reducible. Complementary examinations, including radiography and hematological profiling, were performed and revealed no significant findings; therefore, it was decided that an exploratory celiotomy would be conducted. The patient was referred to the surgical unit for the procedure and underwent surgical anesthesia. After appropriate antisepsis of the surgical area, a plastron osteotomy was performed using a previously sterilized oscillatory saw at a 45º angulation. The celomatic membrane was subsequently incised to enable both cavity and intestinal inspection allowing observation of the intussusception in the small intestine of the animal with the intussuscept segment protruding through the cloaca. The intussusception was undone, and an enterectomy was performed to remove the unviable intestine, using intestinal resection and subsequent anastomosis with simple interrupted sutures using 4-0 nylon, followed by intestinal reposition in the cavity. The celomatic membrane was closed using continuous suture with 4-0 nylon. The plastron fragment was then repositioned with the aid of eight cerclage fixations using 2-0 stainless steel wire. It was subsequently covered in self-polymerizing resin acrylic in order to promote impermeability and to protect the surgical wound. During the recovery period, supportive treatment and analgesia and antibiotic therapy were performed. The patient’s first defecation was observed five days after the procedure, and gastrointestinal tract functions returned to normal after four weeks. In six weeks, the patient was discharged.Discussion: In this case, exploratory celiotomy was performed due to the extension of the necrotic areas of the protruded mucosa. Plastron osteotomy is generally indicated because of the possibility of wide organ exposure. During the long healing period of reptiles, a surgical wound can be a gateway for pathogens that lead to postoperative surgical complications. As such, the use of acrylic resin in the present case was to create a protective barrier that would offer more resistance and impermeability. End-to-end enterectomy, in this instance, proved to be an efficient treatment for the small intestines cloacal protrusion, just as it was for the intussusception that preceded it. The probable cause of this case of intussusception was not well defined, and reptiles kept as pets have several diseases that can affect the gastrointestinal tract. The environment temperature also strongly influences gastrointestinal tract functions, which can lead to motility decline and imbalance of the intestinal flora, followed by the production of gases and toxins by microorganisms responsible for dysfunctions. Inadequate temperature management was the suspected main cause of intussusception in this case, as the patient was kept without access to sunlight or a heating source. In conclusion, the enterectomy with subsequent anastomosis that we performed was successful in the treatment of cloacal protruded intussusception of the small intestines in this red-eared slider (Trachemys scripta elegans)

Bloqueio de plexo braquial em canino: relato de caso / Canine brachial plexus block: case report

Fraturas de origem traumática são comuns na medicina veterinária, onde o tratamento instituído para a redução da fratura normalmente são procedimentos cirúrgicos, e são classificadas dentro da anestesia como procedimentos de grau de dor severa a torturante. Para analgesia real se utilizam bloqueios regionais, um deles é o bloqueio do plexo braquial e? uma técnica que leva a dessensibilizac?a?o de membro torácico, por embebic?a?o de anestésico local perineural, possibilitando a realização de diversos procedimentos cirúrgicos distais a? articulação esca?pulo-umeral ou umerorradioulnar. O objetivo deste trabalho foi relatar o bloqueio do plexo braquial em um canino, através da técnica de bloqueio regional que leva a dessensibilização. Foi atendido um canino com fratura exposta no membro torácico esquerdo, região de rádio e ulna distal. O animal passou por um osteossíntese do rádio esquerdo e o bloqueio local com bupivacaína realizado com o auxílio do estimulador de membros periféricos com neurolocalizador. No decorrer do procedimento, o paciente manteve-se estável e o emprego de bloqueio de plexo braquial se mostrou uma alternativa efetiva para analgesia para procedimento realizado

Cystic Endometrial Hyperplasia in a Domestic Rabbit (Oryctolagus cuniculus domesticus)

Background: Cystic endometrial hyperplasia is a hormone-dependent disease induced by systemic increase in progesterone that can occur in several domestic species, such as the rabbit. This disease may be associated with sex steroid hormones, especially progesterone, and may be asymptomatic, and it is diagnosed using complementary imaging tests such as total abdominal ultrasound. However, surgical excisional biopsy with histopathological tissue analysis is the gold standard. This study reports a case of asymptomatic cystic endometrial hyperplasia in a female Miniature Lion Lop rabbit (Oryctolagus cuniculus domesticus) treated with therapeutic ovariohysterectomy.Case: A domestic, adult, female Miniature Lion Lop rabbit (Oryctolagus cuniculus domesticus), aged approximately 5 years and weighing 3.2 kg, was referred to specialized care to undergo ovariohysterectomy, an elective procedure. The tutor only reported the occurrence of a single episode of vulvar secretion more than 2 years ago, treated with antibiotics, with remission of clinical signs. In the intraoperative period after celiotomy, the uterine horn and uterine body showed a significant increase in volume, with abnormal color changes and tissue consistency; however, both changes were clinically asymptomatic. Subsequently, biopsy was performed during the ovariohysterectomy procedure. The excised uterus and ovaries were placed in 10% formalin and histopathologically analyzed. The macroscopic histopathological examination of the sectioned tissue revealed a slight amount of brownish fluid inside the uterine horns, in addition to multiple cystic areas in the uterine mucosa. Microscopic examination revealed marked hyperplasia of well-differentiated endometrial epithelial cells, occasionally forming cystic structures of different sizes. Moderate congestion, mild multifocal hemorrhage, and mild multifocal inflammatory infiltrate in the lamina comprising lymphocytes and plasma cells were also observed. Therefore, a diagnosis of cystic endometrial hyperplasia with mild lymphoplasmacytic endometritis was made. Observation of the patient was recommended without therapeutic indication.Discussion: Although the pathogenesis of cystic endometrial hyperplasia remains unknown, it is suggested that it is associated with the presence of sex steroids. Hence, this is a common disease in female rabbits, as they have non-seasonal polyestrous cycles and induced ovulation. Cystic endometrial hyperplasia may be asymptomatic or subclinical, without any significant clinical signs. Conversely, when associated with an infection such as pyometritis, the clinical signs include intermittent hematuria, anemia, lethargy, anorexia, and tenderness in the uterus on palpation. Although diagnosis can be made using total abdominal ultrasound and radiography, it can only be confirmed by the histopathological evaluation of the biopsied uterine tissue. Histopathological features of this disease include endometrial thickening with irregular glandular cystic elevations and hyperplasia of the pseudostratified cylindrical ciliated cells of the uterine glands. Furthermore, lymphoplasmacytic infiltrate is found in the uterine tissue, demonstrating an inflammatory reaction or bacterial infection concomitant with endometrial hyperplasia. In this case, the treatment of choice was therapeutic ovariohysterectomy, which is considered curative in this disease. Thus, ovariohysterectomy can resolve cystic endometrial hyperplasia in a domestic female Miniature Lion Lop rabbit.Keywords: surgery, ovariohysterectomy, rabbits, wildlife.Título: Hiperplasia endometrial cística em coelho-doméstico (Oryctolagus cuniculus domesticus)Descritores: cirurgia, ovariosalpingohisterectomia, coelhos, animais selvagens

Intestinal intussusception associated with cloacal protusion in Trachemys scripta elegans

Background: Gastrointestinal dysfunction in reptiles is a common condition seen in animal medicine, and is often caused by inappropriate husbandry. The purpose of this report is to describe the case of a surgical procedure for enterectomy of the small intestines, performed as treatment for an intussusception with cloacal protrusion that occurred in a red-eared slider (Trachemys scripta elegans) kept as a pet. Case: A 20-year-old red-eared slider (Trachemys scripta elegans) was taken into medical care after the owner’s observation of a cloacal protrusion that had started 72 h previously. During physical examination the protrusion was noted as an intestinal segment of approximately 5 cm, which was not reducible. Complementary examinations, including radiography and hematological profiling, were performed and revealed no significant findings; therefore, it was decided that an exploratory celiotomy would be conducted. The patient was referred to the surgical unit for the procedure and underwent surgical anesthesia. After appropriate antisepsis of the surgical area, a plastron osteotomy was performed using a previously sterilized oscillatory saw at a 45º angulation. The celomatic membrane was subsequently incised to enable both cavity and intestinal inspection allowing observation of the intussusception in the small intestine of the animal with the intussuscept segment protruding through the cloaca. The intussusception was undone, and an enterectomy was performed to remove the unviable intestine, using intestinal resection and subsequent anastomosis with simple interrupted sutures using 4-0 nylon, followed by intestinal reposition in the cavity. The celomatic membrane was closed using continuous suture with 4-0 nylon. The plastron fragment was then repositioned with the aid of eight cerclage fixations using 2-0 stainless steel wire. It was subsequently covered in self-polymerizing resin acrylic in order to promote impermeability and to protect the surgical wound. During the recovery period, supportive treatment and analgesia and antibiotic therapy were performed. The patient’s first defecation was observed five days after the procedure, and gastrointestinal tract functions returned to normal after four weeks. In six weeks, the patient was discharged. Discussion: In this case, exploratory celiotomy was performed due to the extension of the necrotic areas of the protruded mucosa. Plastron osteotomy is generally indicated because of the possibility of wide organ exposure. During the long healing period of reptiles, a surgical wound can be a gateway for pathogens that lead to postoperative surgical complications. As such, the use of acrylic resin in the present case was to create a protective barrier that would offer more resistance and impermeability. End-to-end enterectomy, in this instance, proved to be an efficient treatment for the small intestines cloacal protrusion, just as it was for the intussusception that preceded it. The probable cause of this case of intussusception was not well defined, and reptiles kept as pets have several diseases that can affect the gastrointestinal tract. The environment temperature also strongly influences gastrointestinal tract functions, which can lead to motility decline and imbalance of the intestinal flora, followed by the production of gases and toxins by microorganisms responsible for dysfunctions. Inadequate temperature management was the suspected main cause of intussusception in this case, as the patient was kept without access to sunlight or a heating source. In conclusion, the enterectomy with subsequent anastomosis that we performed was successful in the treatment of cloacal protruded intussusception of the small intestines in this red-eared slider (Trachemys scripta elegans)

Padrões fisiológicos hematológicos para Bugios-ruivos (Alouatta guariba clamitans): revisão de literatura: Physiological hematological patterns for howler monkeys (Alouatta guariba clamitans): literature review

As avaliações hematológicas são de suma importância na medicina veterinária, e, em animais ex situ, exames periódicos são necessários para monitorar a sanidade e bem-estar do plantel. Porém, para muitas espécies de animais silvestres, ainda é um desafio encontrar valores de referência padronizados para todos os componentes sanguíneos. Partindo deste princípio, o objetivo desta revisão é relatar os padrões fisiológicos hematológicos e bioquímicos para Bugios-ruivos (Alouatta guariba clamitans) hígidos descritos na literatura nacional e internacional. Os dados obtidos em diferentes estudos foram planilhados e discutidos na presente revisão. Considerando o grande número de animais pertencentes ao gênero Alouatta sp., conclui-se necessários novos estudos com aprofundamento da padronização de valores fisiológicos hematológicos, bioquímicos e hemostáticos, para obtenção de valores de referência de  de animais hígidos da espécie Alouatta guariba clamitans, facilitando assim a distinção para o diagnóstico de patologias. Porém, ainda há poucos estudos conduzidos sobre a hematologia de primatas não-humanos de uma forma geral, levando em consideração as variáveis como idade, dieta, gênero, condições ambientais e estado reprodutivo, evitando assim a inferência de dados obtidos para outras espécies de primata-não-humanos do novo mundo

Uso de Musa spp. no tratamento antiparasitário em animais: Revisão de literatura: Use of Musa spp. as an antiparasitic treatment in animals: Literature review

A fitoterapia caracteriza-se na utilização de substratos naturais, em diferentes preparações, para melhora de estados patológicos, seja na atenuação ou na cura dos mesmos, bem como na sua profilaxia. A fitoterapia é uma alternativa ao uso de anti-helmínticos, embora financeiramente acessível para o caso de algumas plantas, normalmente está associada ao conhecimento empírico, portanto carece de maiores estudos científicos para determinar a eficácia das diversas espécies de plantas com potencial antiparasitário.  Dentre elas está a bananeira (Musa spp.) que vem sendo citada como um fitoterápico com atividade anti-helmíntica principalmente por possuir em sua composição taninos que exercem ação direta sobre helmintos, interferindo no ciclo natural destes parasitas. Partindo desse princípio, o objetivo da presente revisão é descrever os estudos científicos que utilizaram Musa spp. como alternativa para o tratamento antiparasitário em Medicina Veterinária. Os estudos descritos na presente revisão apresentam resultados, bem como metodologias distintas entre si, embora as análises coproparasitológicas tenham sido semelhantes entre todos os estudos revisados. Todavia as formas e os intervalos de administração, quantidade/dose e frequência diferenciam-se entre estudos, e poucos realizaram testes de toxicidade da Musa spp. Portanto a utilização da Musa spp. como antiparasitário ainda carece de estudos na medicina veterinária, bem como estudos sobre a sua toxicidade, dosagem e frequência de administração.&nbsp

Anestesia total intravenosa (TIVA) e uso de bloqueio raquidiano para colocefalectomia em um canino – relato de caso / Total intravenous anesthesia (TIVA) and use of rachidian block for colocephalectomy in a canine – case report

A colocefalectomia é uma cirurgia ortopédica que baseia-se na remoção da cabeça e colo femorais, com a finalidade de eliminar o atrito entre a articulação coxofemoral e o fêmur. Esse procedimento é considerado com grau moderado de dor, sendo assim, pode-se utilizar anestésicos locais, tendo em vista que desempenham com grande êxito o bloqueio de nervos regionais. O presente relato tem como objetivo abordar a utilização da anestesia total intravenosa (TIVA) e da anestesia local raquidiana em um canino para procedimento de colocefalectomia. Foi atendido um canino, fêmea, sete meses de idade, com histórico de claudicação do membro pélvico esquerdo e atrofia muscular devido à epífisiólise. Após exames físico, complementares e pré-operatórios, o animal foi submetido ao procedimento de colocefalectomia. O protocolo anestésico escolhido para a cirurgia foi na medicação pré-anestésica a associação de metadona e midazolam IM, e após manutenção com anestesia total intravenosa (TIVA) na taxa de 3ml/h, contendo remifentanil (5mcg/kg/h), lidocaína (1mg/kg/h) com cetamina (0,6mg/kg/h) e ainda foi realizado bloqueio local raquidiano com o agente bupivacaína.  Ao longo do procedimento, o paciente se manteve com os parâmetros estáveis. Ao final, o bloqueio raquidiano mostrou-se mais vantajoso quando comparado ao bloqueio peridural e o uso da TIVA se mostrou benéfico, eficaz e seguro para manutenção deste paciente em questã[email protected]

Contenção química de Peixe-Boi-da-Amazônia (Thichechus inunguis – Natterer, 1883): Revisão de Literatura / Chemical containment of Amazonian Manatee (Trichechus inunguis – Natterer, 1883): Literature review

O peixe-boi-da-Amazônia é uma espécie altamente derivada em termos evolutivos, apresentando muitas adaptações fisiológicas ao modo de vida aquático, como a realização da apneia voluntária, o que pode levar a intercorrências anestésicas durante o procedimento de contenção química. Para contenção química desta espécie são descritos poucos relatos de sedação e anestesia geral, sendo indicada a contenção física para procedimentos simples. O objetivo desta revisão é descrever os procedimentos relatados na literatura de contenção química e física realizada na espécie peixe-boi-da-Amazônia (Trichechus inunguis), para manejo em cativeiro. As drogas e doses citadas na literatura para espécie é a associação de cloridrato de tiletamina e cloridrato de zolazepam na dosagem de 2,85mg/Kg, por via intramuscular, acompanhado de oxigenioterapia por canulação nasotraqueal. Considerando a incipiência da clínica e cirurgia sobre peixe-boi-da-Amazônia, é extremamente relevante as recomendações anestésicas até o momento descritas na literatura, decorrem de experiências clínicas, com baixo número de indivíduos avaliados, sendo uma área nova em anestesiologia a ser estudada. 

Ilium and femur osteosynthesis in crab-eating fox (Cerdocyon thous)

Background: Fractures and dislocations are common orthopedic conditions arising from traumas from anthropic interaction on wild species, such as those caused by road trampling. Among the treatments, osteosynthesis is considered the method of choice in the treatment of fractures, such as ilium body fractures and femoral fractures. Based on this context, with regard to the incidence of auto accidents and few studies describing osteosynthesis techniques for crab-eating fox, the present study aimed to report the osteosynthesis performed on the body of the ileum and femur of a wild specimen of Cerdocyon thous. Case: A female, adult, crab-eating fox (Cerdocyon thous), coming from wild life was referred to hospital care with a history of run over. After specific examinations, it was diagnosed a complete transverse femoral shaft fracture, an oblique ilium body fracture, a pubic and ischial fracture, and pelvic canal narrowing. The treatment instituted was osteosynthesis of the femoral and ilium body fractures through the use of a 2.7 mm locking plate and screws. In the postoperative period, radiographic examination was performed, where bone callus formation was observed in the 5th week and bone remodeling and consolidation in the 11th week. After 140 days of rehabilitation, the animal was able to be released in the wild, with effective return of function of the pelvic limbs. The release was performed by environmental agencies in a national natural reserve, using radio necklace monitoring Discussion: Osteosynthesis techniques and preoperative and postoperative management proved to be effective for the return of adequate function of the pelvic limbs in Cerdocyon thous. For wild animals, the use of internal orthopedic implants (plate and screws, for example) become the most suitable for osteosynthesis. They decrease the risks of complications resulting from the management, since they require minimal postoperative manipulation. Thus, they maintain the wild behavior of the animal even in captivity. Among the complications observed in the clinical case, we can mention the use of long plate in the osteosynthesis of the ilium body and the narrowing of the pelvic canal as the most relevant. In relation to the pelvic canal narrowing and the reproductive cycle of the species, the crab-eating fox presents monogamous behavior, gestation of 3 to 6 pups per litter and breastfeeding for approximately 3 months. Because litters are relatively large (number of individuals per calving), the pups are relatively small - approximately 120 g at birth -, so it is expected that no complications occur during the gestational period. The treatment of fractures with the use of locking plates was efficient, obtaining bone consolidation at 10 weeks postoperatively, thus corroborating the scientific descriptions for bone consolidation in canids. Finally, the destination for release and monitoring by radiotelemetry was a joint decision between the environmental agencies of the State and the Union. The release decision was based on the maintenance of the wild behavior without evidence of meekness of the specimen, the absence of sanitary restrictions, as well as the population biology and the genetic flow since the release of the animal was carried out near the rescue site. It is concluded that the surgical treatment instituted by the femoral and ilium osteosynthesis was effective for the Cerdocyon thous specimen, cu

Anesthetic Management of an Orange-Spined-Hairy-Dwarf-Porcupine (Sphiggurus villosus) Undergoing Myelography

 Background: The orange-spined hairy dwarf porcupine (Sphiggurus villosus) is a mammal that belongs to the rodentia order. Accidents involving this porcupine and dogs have become usual in some cities of Brazil. Dog bites may eventually result in spinal injuries. When there is clinical evidence of spinal cord injury, a myelography under general anesthesia may be required to allow identification of the exact location of the injury. To the authors’ knowledge, there is only one case report about anesthesia in Sphiggurus villosus where dissociative anesthesia was employed. This paper describes one case report of inhalation anesthesia with isoflurane in a Sphiggurus villosus undergoing myelography.Case: A 1.6 kg orange-spined hairy dwarf porcupine, with a history of dog bite was referred to the Veterinary Hospital of the University. On clinical examination, the patient was in good physical condition, alert, with an approximately 1-cm injury near the 10th and 11th thoracic vertebrae. Nociception in pelvic limbs was present whereas proprioception was absent. Radiographic examinations were suggestive of vertebral dislocation and fracture between the 10th and 11th thoracic verte­brae. A myelography was then requested by the responsible veterinarian. The porcupine received intramuscular midazolam (0.5 mg/kg) in combination with meperidine (10 mg/kg) as premedication. Anesthesia was induced and maintained with isoflurane in 100% oxygen via a face mask connected to a non-rebreathing circuit. Monitored variables at 5-min intervals included: pulse rate (PR) and systolic arterial blood pressure (SAP) measured by a Doppler ultrasound with its probe positioned at the palmar metacarpal artery; pulse oximetry (SpO2) measured by a sensor positioned at the tarsus; rectal temperature; and respiratory rate (RR). During the myelography, the range of values for the above mentioned variables were: PR, 189-206 beats/min; SAP, 90-130 mmHg; SpO2, 94-96%; RR, 32-40 breaths/min; and rectal temperature decreased by 0.5oC. Anesthetic recovery was uneventful. Postoperative pain relief was achieved with intramuscular tramadol (5 mg/kg).Discussion: To the authors’ knowledge, this is the first case report of inhalation anesthesia in a Sphiggurus villosus speci­men. In a previous case report, other authors described anesthesia for myelography in a porcupine with IM tiletamine/ zolazepam (5 mg/kg). In the case reported here, dissociative anesthetics, such as tiletamine, were avoided because these agents may increase intracranial pressure, cerebral blood flow and cerebrospinal fluid pressure, which are undesirable in patients with spinal trauma. Although physiologic variables were considered to be stable during anesthesia with isoflurane in this report, these findings have to be interpreted carefully. First, normal range of values for physiologic variables has not been reported for porcupines. Second, accuracy of the measurement techniques used (e.g. noninvasive measurement of SAP) has not been validated. Under the conditions reported in this case report, premedication with meperidine and mid­azolam was effective to induce good muscle relaxation and allowed anesthetic induction with isoflurane via a face mask. This anesthetic protocol provided adequate conditions for performing the myelography in a porcupine and physiologic variables remained stable throughout the procedure.Keywords: rodents, anesthesia, spinal trauma