Skin Burn by Termal Mattress - A Therapeutic Approach

Background: Burns are caused by a direct or indirect action of heat on an organism, compromising the functional integrity of the skin. Hypothermia is a common intercurrence in animals during the transoperative period; thermal mattresses are used to maintain the animal’s body temperature, but inappropriate use can cause the patient’s skin to burn. In humans, burns are quite common; however, in veterinary medicine, they are infrequent. The aim of this study was to describe a case of accidental burn in a canine caused by a thermal mattress, emphasizing wound treatment and analgesia used.Case: A 12-year-old male canine without defined breed weighing 15 kg underwent an emergency exploratory laparotomy due to rupture of a spleen mass and presented with intercurrence hypothermia during the anesthesia procedure, which was controlled using a thermal mattress. Ten days after the surgical procedure, he developed a skin lesion with erythema, suffusion, and necrosis, evolving skin displacement along the entire back with a lot of pain which was possibly caused by the use of a thermal mattress in the transoperative procedure. The intuited analgesic treatment involved the use of numerous and different drugs, including Methadone (0.3 mg/kg, QID, SC), Dipyrone (25 mg/kg, TID, IV), and Ketamine (0.5 mg/kg, TID, SC) (during hospitalization), as well as Tramadol (4 mg/kg, TID, PO) and Dipyrone (25 mg/kg, TID, PO) after medical release as support therapy. For the wound treatment, calcium alginate was initially used daily and subsequently changed for daily application of dermisana oil. The patient followed up weekly for approximately two months for wound monitoring as well as adjustments to the drug therapy. The would almost completely healed, but the patient showed a significant worsening in the general clinical condition correlated with the neoplasm that he had, and the owner and clinical staff of the veterinary hospital opted for euthanasia.Discussion: Hypothermia should be avoided as much as possible during anesthesia, as the body’s temperature is very important in homeostasis, in addition to being able to change the pharmacokinetics and pharmacodynamics of some drugs. The use of a thermal mattress to avoid hypothermia during the intraoperative period is a common and useful tool in veterinary routine, but should be used with caution and constant monitoring of the animal under general anesthesia to avoid skin burns which are not immediately noted. When diagnosed, the treatment should aim for wound healing and provide analgesia. Different pharmacological approaches can be used for this purpose, including topical therapies with different products that provide wound healing and regard to analgesia can be used for association of non-steroidal anti-inflammatory drugs such as meloxicam, opioids like morphine and tramadol, and N-Methyl-D-aspartate (NMDA) blockers like ketamine for analgesia. Burn treatment is difficult but can have a favorable prognosis. In the present report, the conservative wound management using sodium alginate and dermisana oil almost completely cured the wound, and the canine responded positively to the analgesic protocol instituted with the association of different drugs. It is still important to highlight the attendance and commitment of the owner in the proposed treatment, as euthanasia, in this case, was due to the comorbidity presented by the patient

Anestesia em pacientes de risco: um abordagem anestésica aos pacientes cardiopatas, nefropatas, hepatopatas, pediátricos e senis

A anestesiologia veterinária por muitas vezes é diretamente relacionada, pelos tutores de cães e gatos, a um procedimento de extremo risco. Tratando-se de um paciente com alguma disfunção, como no caso dos cardiopatas, nefropatas, hepatopatas, entre outros, o medo e tensão, exercidos por parte dos tutores, e próprio médico veterinário aumenta. Este trabalho visa, por meio de pesquisa, com dados científicos, analisar a melhor abordagem anestésica para cada tipo de paciente, mostrando um panorama geral e indicativo sobre os fármacos e sua funcionalidade para cada sistema

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

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. 

Anestesia em Jacaré-americano (Alligator mississipiensis) para Amputação de Membro

Background: The knowledge of secure anesthetic protocols for reptiles is very important, especially because they are aggressive species and they have peculiar physiology, unpredictable reactions to the same drug in different environmental conditions and different physiological responses can be observed. The anesthetic protocol aims immobilization, analgesia and muscle relaxation for adequate, safe and easily reversible anesthesia. Few reports have been described on anesthesia in animals and, before that, the objective of this study is to report the anesthetic protocol that was used and vital parameters monitoring in an Alligator mississipiensis that was submitted to surgery for limb amputation.Case: A female American alligator was attended, with about 8-year-old, 2 m long and 268,964 pounds, with fight history with other animal six months ago, resulting in a wound in the right toracic limb. When the lesion occurred, it was the breeding season of the species, so we chose not to perform the treatment at that time. An X-ray of the member was performed, which showed, among other changes, osteomyelitis and septic arthritis. Thus, the limb amputation was indicated. Ketamine association (10 mg/kg) and medetomidine (0.1 mg/kg) were used as anestesic premedication, both administered intramuscularly. For anesthetic induction, propofol (4 mg/kg) intravenously was used. The animal was intubated using an endotracheal tube number 11 without inflating the cuffing, and for the maintenance it was employed isoflurane. The heart rate was measured using Doppler and the respiratory rate by visual and balloon observation in the oxygen circular system. The other parameters were measured using a multiparameter monitor sensor connected to the tongue. The local anesthetic block was made close to the incision line, the medium third humerus with 2 mg/kg of 2% lidocaine without vasoconstrictor, diluted in 0.9% NaCl until the volume of 10 mL is completed to assist in analgesia. The parameters recorded during the procedure, which lasted 80 min, remained within the normal pattern of species (three breaths per minute, 30 heart beats per min and 80.6°F temperature). After surgery meloxicam (0.2 mg/kg) and atipamezole reverser (0.5 mg/kg) were administered, both intramuscularly. The animal took about seven hours to fully return from anesthesia.Discussion: Different anesthetics protocols may be employed to crocodilians using both local anesthetic techniques and general, in order to promote analgesia, muscle relaxation and adequate anesthesia. Still, it is very important to monitor the patient during the procedure, in order to be a different physiology kind of species. Cardiac auscultation is quite difficult in these animals, so it is recommended to use non-invasive electronic equipment as the Doppler, the multiparameter monitor, the pulse oximeter and esophageal stethoscope for assistance in monitoring heart and respiratory rate, providing important trans-operative information. The realization of amputations in crocodilians is common, however there are few reports in the literature about their anesthesia, this way, this article has a significant contribution to a better anesthetic protocol clarification to be used in these animals. Therefore, it is concluded that the anesthetic protocol based on premedication with ketamine and medetomindina, propofol induction and maintenance with isoflurane, besides local anesthesia with lidocaine was effective and safe for thoracic limb amputation surgery in an American alligator

Urolitíase em porquinho-da-índia (Cavia Porcellus): relato de caso / Urolithiasis in guinea pig (Cavia Porcellus): case

A urolitíase refere-se à presença de sedimento a base de cristais no trato urinário, muito comum em porquinhos-da-índia (Cavia porcellus), principalmente quando estes animais tem uma alimentação desbalanceada com dieta rica em cálcio. A etiologia não está bem elucidada, porém existem fatores de predisposição para patologia, como a ingestão inadequada de água, retenção de urina, higiene inadequada da gaiola e obesidade. Os sinais clínicos variam de acordo com o local onde se encontram e o tamanho do cálculo, mas comumente os animais apresentam anorexia hematúria, estrangúria, polaquiúria, postura encolhida e debruçada, além de vocalização ao urinar. O diagnóstico dessa patologia deve-se basear nos sinais clínicos, exame físico, urinálise, além de exames de imagem como ultrassonografia e radiografia. O tratamento de escolha para urolitíase em cobaios é cirúrgico, sendo esse a cistotomia ou a uretrostomia. A mudança de manejo também é muito importante para se evitar recidivas. O presente trabalho tem como objetivo relatar o caso completo de um porquinho-da-índia apresentando urolitíase em vesícula urinária. Foi atendido um porquinho-da-índia de dois anos com alimentação rica em cálcio, apresentando hematúria há três dias e dor na palpação abdominal. Foi realizado o exame ultrassonográfico, onde se observou a presença de um urólito, que pelo pequeno tamanho poderia ser expelido sozinho, sendo indicado apenas acompanhamento ultrassonográfico. Porém o roedor retornou com o mesmo quadro de hematúria e dor na palpação abdominal, porém no exame ultrassonográfico mostrou um urólito de maior tamanho, sendo indicado a retirada por cistotomia. Após dois meses o animal retornou com o mesmo quadro de recidiva e com o urólito maior, sendo realizado novamente o procedimento de cistotomia para retirada do cálculo. O cobaio recuperou-se da cirurgia e foi indicado mudança de manejo e alimentação para o mesmo, afim de evitar novas recidivas. Sendo assim, esta patologia comum em cobaios, quando diagnosticada corretamente e fazendo o tratamento correto tem um prognostico positivo como do caso em questão

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]

Infusão contínua de tramadol em canino submetido a colocefalectomia / Continuous infusion of tramadol in canine submitted to colocefalectomy

Em procedimentos ortopédicos, a dor gerada é mais intensa do que outros procedimentos em tecido mole, sendo indicada a utilização de terapia analgésica agressiva, prevenindo o desenvolvimento de dor crônica, já que hoje em dia existe uma preocupação maior em relação a dor na saúde animal. Objetivou-se relatar o uso de infusão contínua de tramadol no controle da dor em cirurgia de colocefalectomia em um cão. O animal não apresentava alterações nos parâmetros clínicos e hematológicos, sendo classificado como ASA II quanto ao risco anestésico. Foi administrado acepromazina como medicação pré-anestésica. A indução anestésica foi realizada com a associação de propofol e diazepam intravenoso, seguido da intubação orotraqueal e manutenção anestésica com isofluorano ao efeito. Na sequência, administrou-se bolus do opioide tramadol (2 mg/kg, IV), iniciando-se a infusão contínua na taxa de 3 mg/kg/h, IV. Os parâmetros fisiológicos do paciente mantiveram-se estáveis durante o procedimento, e a recuperação se mostrou suave e confortável. O tramadol está dentro dos principais analgésicos utilizados na rotina veterinária, porém não de comum uso pela via intravenosa em infusão contínua. Assim, a infusão contínua de tramadol foi considerada efetiva no controle da dor para cirurgia de colocefalectomia no trans e pós anestésico imediato.

Acidente botrópico em um canino: abordagem terapêutica – relato de caso / Botropic accident in a canine: therapeutic approach – case report

Acidentes com a serpente do gênero Bothrops são muito comuns em animais de companhia, devido a agressividade destas serpentes e a curiosidade dos pequenos animais, principalmente caninos. Estes animais peçonhentos possuem uma toxina que produz um efeito anticoagulante, vasculotóxico e nefrotóxico causando sinais clínicos graves em animais de companhia. Este trabalho tem como objetivo relatar um acidente botrópico em um canino fêmea sem raça definida, de dez anos de idade, pesando 19kg, apresentando sangramento na cavidade oral e dispneia. Logo no atendimento emergencial foi coletado exames de sangue e, ao eritrograma, evidenciou-se considerável trombocitopenia. Inicialmente foi realizado terapia de suporte com oxigenioterapia e fluidoterapia. Foi administrado soro antiofídico polivalente, sendo este essencial para melhora do quadro do paciente. Além disso, foi administrado analgésicos devido alto grau de algia do paciente. A antibioticoterapia realizada também foi indispensável no tratamento devido áreas necrosadas causadas pela picada, além de infecções secundárias. A administração de corticosteroides e pré infusão de soro antiofídico reduz reações imediatas, como dispneia, tosses, náuseas, pruridos e urticaria. Pode se concluir que a conduta clínica e terapêutica utilizada, baseada nos sinais clínicos apresentados e resultados de exames de sangue mostrou-se eficiente. O soro antiofídico polivalente foi capaz de neutralizar o veneno inoculado e a associação terapêutica utilizada foi fundamental para a melhora significativa do animal.

Pub. 22 Diabetes insípido em um cão Diabetes Insipidus in a Dog

ABSTRACT Background: Diabetes insipidus (DI) is a rare endocrine disorder in dogs altering the mechanism of retention and excretion of water, with concomitant polyuria and polydipsia (PU/PD), and low urine specifi c gravity. The water deprivation test followed by response to application of desmopressin is the diagnostic test for the disease. However, the literature is still scarce about laboratorial and clinical aspects of DI in small animals. Thus, the aim of this study is to report a case of DI in a canine, emphasizing its diagnosis through the water deprivation test. Case: A male mongrel dog, 5 years-old, not neutered, 13kg of body weight, was presented with intense PU/PD (500mL/kg/ day of water consumption). Physical examination showed normal routine clinical parameters. Additional tests were asked (abdominal ultrasound, blood count, serum biochemical (creatinine, alanine aminotransferase (ALT), total cholesterol, alkaline phosphatase (ALP) and glucose) and dexamethasone suppression test), but they showed no signifi cant changes. Thus, it was suspected that the animal had an uncommon endocrinopathy, DI. For its confi rmation, it was made the water deprivation test with application of desmopressin acetate. The patient remained without access to water and without fl uidtherapy with urethral sounding and bladder emptying. The measurement of urinary gravity and volume were made every hour for 12 h. After 8 h from the start of the test, it was made the application of desmopressin acetate (three drops in the conjunctival sac), because the animal began to exhibit tremors and muscle weakness (urine specifi c gravity: 1005). In this period, their body weight decreased 11.6%. After application of desmopressin, urine specifi c gravity increased gradually every hour, ending with urine specifi c gravity measurements of 1023, confi rming the diagnosis of central DI. Discussion: The diagnosis of DI can be a challenge to the veterinary practitioner since it is a rare disease in small animals, and often is not included in the differential diagnoses. Furthermore, additional tests such as common hematological, biochemical and electrolyte profi les usually have normal results, or secondary infl uences of dehydration. The water deprivation test confi rms the inability of the animal to concentrate urine in DI. However, this test is potentially dangerous because of the serious consequences of dehydration, requiring constant monitoring. In DI of central origin (DIC), the urinary concentration usually starts 1 to 3 h after administration of desmopressin acetate, and tends to be within the normal reference value, as can be observed in this case. Because there were not neurological signs, the fi nal diagnosis of the animal was acquired DIC. DIC is acquired by the destruction of cells of supraoptic and paraventricular nuclei of the hypothalamus, or even, loss of the ducts that carry the anti-diuretic hormone (ADH) by the pituitary for secretion and storage. Desmopressin acetate (dDAVP), a synthetic analogue of vasopressin, was used for the initial treatment (three drops in the conjunctival sac, once a day) which controlled the PU/PD of the animal. After four months of treatment initiation, the animal has moved to a drop of the drug, twice a day. The dog of the present case has reported good prognosis, since small animals with acquired DIC become relatively asymptomatic in response to appropriate therapy