Peritoneopericardial Diaphragmatic Hernia in a Persian Cat

Background: Peritoneopericardial diaphragmatic hernia is a congenital defect characterized by an anomalous communication between the abdominal cavity and pericardial sac, which can lead to displacement of the abdominal viscera into the thoracic cavity. The occurrence in felines is higher among long-haired breeds, mainly the Persian breed, possibly based onan autosomal recessive inheritance. The diagnosis of PPDH is performed by means of chest radiography with or without contrast, in association with other imaging tests such as ultrasonography and echocardiography. Our objective in this study was to report the occurrence and macroscopic changes in a case of peritoneopericardial diaphragmatic hernia in a Persian feline. Case: A 9-year-old male Persian cat weighing 3.4 kg was referred to the HPET-Private Veterinary Clinic, Salvador, Bahia, with an history of weight loss and chronic intermittent vomiting during the preceding 6 months, with lateral decubitus and breathing difficulties. Ultrasonography revealed findings suggestive of an infiltrative process in the stomach and duodenum, enlarged gastric lymph nodes, and some nodular images indicating slight displacement of the liver. Chest radiography revealed a cardiac silhouette with markedly enlarged dimensions associated with a dorsal deviation of the terminal trachea, and echocardiography revealed a small amount of pericardial effusion. The patient showed initial clinical improvement after blood transfusion; however, after 2 days, he exhibited significant clinical worsening and was therefore euthanized with the owner's consent. Post mortem evaluation revealed partial herniation of the liver and gallbladder into the chest cavity through a diaphragmatic hernia ring. The heart was partially surrounded by the left medial lobe of the liver, which was displaced into the pericardial sac. Herniated hepatic lobes had an irregular capsular surface with evident lobulation and tension lipidosis. In the abdominal cavity, the remainder of the liver (right lateral and medial lobes) was observed to be slightly enlarged, with an irregular surface, diffusely reddish with intense evidence of the lobular pattern and white and firm multifocal areas (fibrosis). In the duodenum, close to the pylorus, there was a nodule measuring 2.8 x 2.5 x 1.0 cm, with a whitish and ulcerated surface. When cut, it was soft and exhibited a homogeneous, whitish compact surface.Histopathological examinationshowed marked proliferation of fibrous connective tissue, which for the most part separated the lobes by septa and surrounded the portal space (fibrosis), a marked diffuse chronic inflammatory infiltrate composed of lymphocytes and plasma cells. In addition, marked bile duct hyperplasia and multifocal areas of fatty degeneration (steatosis).Discussion: The diagnosis was based on the association of clinical and pathological findings. Considering the age and clinical signs presented by the patient in this report, as well as the presence of few radiographic signs that were indicative of PPDH, the first differential diagnosis thought was pericardial neoplasia. Peritoneopericardial diaphragmatic hernia in felines is always of congenital origin and may occur asymptomatically depending on the number and involvement of herniated viscera. In this case, the patient's diagnosis of peritoneopericardial hernia was a necropsy finding; the fact that in agreement with previous reports of high rates of incidental diagnoses reinforces the importance of performing necropsy for confirmation or diagnosis of unexpected pathologies. In the present case, peritoneopericardial diaphragmatic hernia in isolation may not have led to severe anemia that culminated in the patient's death. The anatomopathological findings were compatible with biliary cirrhosis and multifocal liver fibrosis, accompanied by the presence of anemia and consequent hypovolemia. Keywords: congenital diaphragmatic hernia, congenital abnormalities, cats. Título: Hérnia Diafragmática Peritoneopericárdica em um Felino da Raça PersaDescritores: hérnia diafragmática congênita, anomalias congênitas, felinos.

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Peritoneopericardial diaphragmatic hernia in the dog and cat

Journal of the Hellenic Veterinary Medical Society ◽

10.12681/jhvms.15638 ◽

2018 ◽

Vol 67 (3) ◽

pp. 189

Author(s):

X. NIKIPHOROU ◽

R. CHIOTI ◽

M. N. PATSIKAS ◽

L. G. PAPAZOGLOU

Keyword(s):

Diagnostic Imaging ◽

Diaphragmatic Hernia ◽

Surgical Repair ◽

Abdominal Cavity ◽

Clinical Signs ◽

Plain Radiography ◽

Exercise Intolerance ◽

Abdominal Organs ◽

Septum Transversum ◽

Peritoneopericardial Diaphragmatic Hernia

Peritoneopericardial diaphragmatic hernia (PPDH) is a congenital communication between the pericardial sac and the abdominal cavity allowing displacement of abdominal organs to the pericardial sac. Peritoneopericardial diaphragmatic hernia is thought to occur due to a failure of the development of septum transversum. Vomiting, exercise intolerance and respiratory distress are the most common clinical signs. Diagnosis of PPDH is based on plain radiography. Physical examination and diagnostic imaging may detect the presence of other congenital anomalies. Surgical repair of the PPDH is the treatment of choice for animals with clinical signs. Prognosis following surgical repair of PPDH is favorable. Animals with no clinical signs related to PPDH may not undergo surgical repair.

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Turlock-Like Bunyavirus Associated with Encephalomyelitis and Myocarditis in an Ostrich Chick

Journal of Veterinary Diagnostic Investigation ◽

10.1177/104063870201400501 ◽

2002 ◽

Vol 14 (5) ◽

pp. 363-370 ◽

Cited By ~ 3

Author(s):

H. L. Shivaprasad ◽

P. R. Woolcock ◽

M. D. McFarland ◽

M. Curtis ◽

N. Karabatsos

Keyword(s):

Plasma Cells ◽

Abdominal Cavity ◽

Clinical Signs ◽

Neutralizing Antibody ◽

Prototype Strain ◽

Pericardial Fluid ◽

Tissue Homogenate ◽

Negative Stain ◽

Size And Morphology ◽

The Brain

In the fall of 1995, a 20-day-old female ostrich chick, 1 of a group of 20, was presented live with clinical signs of 2 days duration characterized by unsteady gait, circling to the left, and walking backward. Another bird with similar clinical signs had died and another had recovered. The bird was euthanized and examined at necropsy. Twenty-five milliliters of serous fluid was in the abdominal cavity and there was increased pericardial fluid. Histopathology of the brain revealed mild to moderate nonsuppurative encephalitis characterized by mild multifocal malacia, perivascular cuffing by lymphocytes, and gliosis. The heart had multifocal infiltrations of lymphocytes mixed with macrophages and a few plasma cells throughout the myocardium. Cytopathic effects were observed in primary chicken embryo liver cells following inoculation with a tissue homogenate prepared from the brain of the affected ostrich. Virus particles the size and morphology of the family Bunyaviridae were observed in cell culture lysate by negative-stain electron microscopy. Viral characterization demonstrated that the virus isolate is a previously unknown serotypic variant (subtype) of Turlock virus. Twelve of 65 sera collected over a 3-year period from ostriches aged from 1 month to 4 years were positive for neutralizing antibody to both the Turlock prototype strain and the new subtype of Turlock virus described in this report.

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Cytopathological diagnosis of visceral histiocytic sarcoma in five dogs

Polish Journal of Veterinary Sciences ◽

10.2478/v10181-012-0114-3 ◽

2012 ◽

Vol 15 (4) ◽

pp. 751-758 ◽

Cited By ~ 1

Author(s):

R. Sapierzyński ◽

D. Jagielski ◽

I. Dolka ◽

M. Fabisiak

Keyword(s):

Imaging Techniques ◽

Systemic Disease ◽

Abdominal Cavity ◽

Clinical Signs ◽

Final Diagnosis ◽

Histiocytic Sarcoma ◽

Quick Method ◽

Visceral Mass ◽

Veterinary Clinic ◽

Fine Needle

Abstract Histiocytic sarcoma is a malignant neoplastic proliferation of atypical histiocytes with tendency to spread, characterized by fast progression to disseminated form - disseminated histiocytic sarcoma. Cytopathology is a low, invasive, cheap, and quick method of diagnosis commonly used in veterinary oncology. The aim of the presented study was description of cases of visceral histiocytic sarcomas in dogs diagnosed by cytopathology and immunocytochemistry. The study was conducted on 5 dogs which were brought to the veterinary clinic because of unspecific clinical signs and tumoral masses recognized in the thoracic or abdominal cavity. Samples of cells were collected during ultrasonography- assisted fine-needle aspiration biopsy (FNAB), smears were stained with Giemsa method and immunocytochemistry (CD3, CD79α, cytokeratin, vimentin, desmin) was also performed in all patients. Four of five dogs were Bernese mountain dogs, nonspecific clinical signs of systemic disease were present in all cases. Visceral mass or masses were detected by ultrasonography or radiography. Final diagnosis of histiocytic sarcoma was obtained on the basis of routine cytopathological examination and confirmed by immunocytochemistry. On the basis the results obtained it can be stated that in cases of typical clinical and cytopathologic pictures, examination of cellular samples collected during ultrasonography-assisted fine-needle biopsy supported by some immunocytopathological characteristics seems to be sufficient method of diagnosis of histiocytic sarcoma in dogs. Visceral histiocytic sarcoma should be included into differential diagnosis in every Bernese mountain dog with nonspecific clinical signs, ambiguous results of hematologic examination and when tumoral mass or masses within a body cavity were detected in imaging techniques.

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Congenital peritoneopericardial diaphragmatic hernia in an geriatric Persian cat

Medicina Veterinária (UFRPE) ◽

10.26605/medvet-v14n2-2542 ◽

2020 ◽

Vol 14 (2) ◽

pp. 117-122

Author(s):

Anderson Barros Archanjo ◽

Marcel Arcanjo Silva Azevedo ◽

Dyeime Ribeiro Souza ◽

Leonardo Oliveira Trivilin ◽

Paulo Sérgio Cruz Andrade Júnior ◽

...

Keyword(s):

Clinical Examination ◽

Diaphragmatic Hernia ◽

Mammary Carcinoma ◽

Abdominal Cavity ◽

Rare Condition ◽

Histopathological Analysis ◽

Espírito Santo ◽

First Report ◽

Espirito Santo ◽

Peritoneopericardial Diaphragmatic Hernia

Peritoneopericardial diaphragmatic hernia (PPDH) is a rare condition that is caused by defective diaphragm and pericardium development. It occurs in dogs and cats and is most prevalent in Weimaraner and Persian breeds. This study presents the first report of a congenital peritoneopericardial diaphragmatic hernia in a geriatric cat in Espírito Santo in Brazil. A 12-year old male Persian cat was referred to the veterinary hospital. Clinical examination revealed hyporexia, cachexia, alopecia, dyspnea, and an adherent and irregularly shaped nodule in the left caudal breast. Cytopathological examination of the abdominal nodulation revealed a mammary carcinoma. Thoracic radiography revealed PPDH. The animal was euthanized. On necropsy, the abdominal cavity revealed a part of the liver inside the diaphragm, and the thoracic view revealed the heart and liver inside the pericardial sac. Histopathological analysis confirmed mammary carcinoma and revealed dermatophytic pseudomycetoma. This is the first report of PPDH, which was incidentally detected, in a geriatric Persian cat that had survived for several years without diagnosis in Espírito Santo, Brazil. From the observations made, we conclude that comprehensive clinical examination, involving imaging, is important in detecting congenital abnormalities such as PPDH.

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Acute fasciolosis in cattle in southern Brazil

Pesquisa Veterinária Brasileira ◽

10.1590/s0100-736x2013000600003 ◽

2013 ◽

Vol 33 (6) ◽

pp. 705-709 ◽

Cited By ~ 6

Author(s):

Maria de Lourdes Adrien ◽

Ana Lucia Schild ◽

Clairton Marcolongo-Pereira ◽

Letícia Fiss ◽

Jerônimo L. Ruas ◽

...

Keyword(s):

Fasciola Hepatica ◽

Abdominal Cavity ◽

Clinical Signs ◽

Early Spring ◽

Eosinophil Infiltration ◽

Coagulation Necrosis ◽

Economic Losses ◽

Southern Brazil ◽

Bile Duct Proliferation ◽

Mild Anemia

This study describes the epidemiological and pathological aspects of an outbreak of acute fasciolosis in cattle in southern Brazil. Fifteen out of 70 three-year-old pregnant cows lost weight in the 30-40 days prior to calving. Clinical signs included diarrhea, weakness, mild anemia and jaundice. Dark yellow fluid in the abdominal cavity was observed at necropsy. Fibrin and clotted blood were adhered to the pericardium and lung, primarily in the diaphragmatic lobes. The liver was enlarged, and the capsular surface was irregular with clear areas and petechiae. At the cut surface, the liver was irregular, firm and edematous, and several hemorrhagic channels could be observed. Areas of fibrosis through the parenchyma and whitish thrombi occluding the great vessels were also observed. The livers of 10 cows that not died were condemned at slaughter for lesions of fasciolosis similar to those observed at necropsy. Microscopically, the liver showed areas of coagulation necrosis, extensive hemorrhages in the streaks or foci and disruption of the parenchyma with neutrophil and eosinophil infiltration. Fibrosis and bile duct proliferation were also observed. Immature Fasciola hepatica flukes were observed in the parenchyma surrounded by degenerated hepatocytes, neutrophils, eosinophils, and hemorrhages. The outbreak occurred on a farm located in an area endemic for fasciolosis, although the acute form of the disease is not common in cattle in this region. It is likely that the cows were infected by F. hepatica metacercariae released in the late fall or early spring in the rice stubble where the herd was grazing prior to calving. Although mortality due to fasciolosis in cattle is infrequent, outbreaks can occur and treatments that are effective in both the immature and adult forms of the parasite should be administered to prevent economic losses.

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Potential Role of Hepatozoon canis in a Fatal Systemic Disease in a Puppy

Pathogens ◽

10.3390/pathogens10091193 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1193

Author(s):

Andrea De Bonis ◽

Mariasole Colombo ◽

Rossella Terragni ◽

Barbara Bacci ◽

Simone Morelli ◽

...

Keyword(s):

Potential Role ◽

Complete Blood Count ◽

Systemic Disease ◽

Clinical Signs ◽

Whole Body ◽

Hepatozoon Canis ◽

Veterinary Clinic ◽

Imidocarb Dipropionate ◽

Thoracolumbar Region

Canine hepatozoonosis caused by Hepatozoon canis is an emerging disease in Europe. Clinical pictures vary from subclinical to life-threatening and non-specific clinical signs are predominantly reported. A 2-month-old female puppy originating from Southern Italy was adopted and moved to Northern Italy. Then, the dog was brought to a local veterinary practice for gastrointestinal signs, migrating lameness and pruritic dermatitis, and then tested positive for Hepatozoon spp. gamonts at the blood smear. After treatment with imidocarb dipropionate and doxycycline, the dog showed an initial clinical improvement. However, gastrointestinal signs recurred, and diffuse superficial pyoderma appeared on the thoracolumbar region, along with fever, lethargy, and weight loss. Eight months from the first onset of clinical signs, the dog was referred to a veterinary clinic and subjected to complete blood count, urine and fecal analysis, along with abdominal ultrasonography, whole-body CT and gastroduodenal endoscopy. Skin biopsies and blood samples were subjected to a PCR-coupled sequencing protocol, which scored both positive for H. canis. Alterations were consistent with a pre-existing cholangiohepatitis and multiple acquired extrahepatic shunts secondary to portal hypertension. The dog was euthanatized due to a clinical worsening two months later. The potential role of H. canis in the systemic disease observed, clinic-pathological findings and epizootiological implications are discussed.

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Патоморфологічна характеристика парвовірусного ентериту в собак

Scientific Messenger of LNU of Veterinary Medicine and Biotechnology ◽

10.15421/nvlvet8210 ◽

2017 ◽

Vol 19 (82) ◽

pp. 45-49

Author(s):

N. Radsikhovskii ◽

S. Zaika

Keyword(s):

Veterinary Medicine ◽

Clinical Signs ◽

Mesenteric Lymph Nodes ◽

Veterinary Clinic ◽

Pathological Conditions ◽

Rapid Tests ◽

Viral Enteritis ◽

Hemorrhagic Enteritis ◽

City State ◽

The City

Viral enteritis occupy a leading place in the infectious pathology of dogs and lead to severe disorders of such systems as the gastrointestinal, cardiovascular and respiratory.The comprehensive diagnosis of this pathology in dogs is not developed enough. The high variability of clinical signs for parvovirus enteritis, the complexity of the appeal with a large number of qualitative indicators, complicate the diagnosis of this disease for a practical veterinarian. The methods of pathomorphological diagnosis are simple, cheap and accessible to any veterinarian doctor. It is precisely from them that the causes of death of the animal begin to be established, with many diseases and pathological conditions, these methods remain decisive when making a diagnosis.The aim of the work was to study and analyze the pathomorphological features in parvovirus enteritis of dogs.Materials and methods of research. The work was carried out at the Faculty of Veterinary Medicine of the Zhytomyr National Agroecological University, as well as in the veterinary clinics of the city of Zhytomyr: the private veterinary clinics «Bagira» and «Doctor-Zoo», the educational and scientific-production clinic of veterinary medicine of the Faculty of Veterinary Medicine of the (ZNAEU) in the city state Zhitomir Hospital of Veterinary Medicine and Aybolit Private Veterinary Clinic in the period from 2014 to 2017 in breeding and breeding dogs.Diagnostic studies to confirm parvovirus enteritis were performed using the VetExpert and ELISA and PCR rapid tests on the basis of the private veterinary laboratory of Bald Ltd. (Kyiv).The pathoanatomical section of dogs of all ages who died from parvovirus enteritis was performed by partial evisceration in a generally accepted sequence.The article presents the results of the study of pathoanatomical changes in dogs for parvovirus enteritis, which depended on the form of manifestation of the disease – intestinal, cardiac or mixed. The most pronounced pathological and anatomical changes were found in the gastrointestinal tract (intestinal form), mainly in the small intestine.In the dead animals, a complex of pathoanatomical signs that can be considered characteristic of parvovirus enteritis are found: hemorrhagic enteritis, serous-hemorrhagic inflammation of the mesenteric lymph nodes, signs of hepatitis, acute altered myocarditis, and in the lungs – hemorrhages and foci of atelectasis and enlargement of the spleen.

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Bullous Pemphigoid in a Dog

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.106575 ◽

2021 ◽

Vol 49 ◽

Author(s):

Suélen Dalegrave ◽

Denner Francisco Tomadon Fiorin ◽

Eduarda Gabriela Mansour ◽

Monica Regina De Matos ◽

Renato Herdina Erdmann ◽

...

Keyword(s):

Bullous Pemphigoid ◽

Plasma Cells ◽

Histopathological Examination ◽

Clinical Signs ◽

Clinical Manifestations ◽

Punch Biopsy ◽

Mucous Membrane Pemphigoid ◽

Histopathological Analysis ◽

Biopsy Material ◽

Clinicopathological Findings

Background: In dogs, bullous pemphigoid (BP) is a subepithelial autoimmune disease, a rare dermatopathy in the clinical routine. BP is characterized by formation of vesicles and subepidermal blisters that result from dissolution of the dermal-epithelial junction. Clinical signs of BP usually include severe dermatological alterations with a variable prognosis. The aim of this work is to report a case of BP in a dog to contribute information for diagnosis, and to present clinical and pathological aspects that emerge during development of BP.Case: An adult male mongrel dog exhibited hyperemic, exudative, crusty lesions on the lip commissure and periocular areas. Results from laboratory tests were normal. Results from parasitological and mycological tests on skin scrapings were negative. Imprint cytology of the crusts revealed presence of gram-positive cocci bacteria. In the histopathological analysis of punch biopsy material, the epidermis was detached from the dermis, leading to formation of vesicles. There were inflammatory infiltrates containing neutrophils, eosinophils, and high amounts of fibrin, and areas of multifocal orthokeratotic hyperkeratosis. Multifocal infiltrates containing lymphocytes, histiocytes, and plasma cells were observed on the superficial portions of the dermis, which indicated a diagnosis of BP. After the definitive clinical diagnosis, the animal was treated with enrofloxacin (Baytril Flavour®; 5 mg/kg once a day for 10 days), and prednisolone (Prediderm®; 2 mg/kg once a day until further instructions). On the follow-up visit, 15 days later, the clinical picture had improved, and the lesions had decreased. Continuity of the treatment was prescribed, along with a gradual decrease in the corticoid dose. The dose of prednisolone was initially reduced to 1 mg/kg once a day, and later to 0.5 mg/kg until improvement of the clinical status of the patient. Remission of the lesions was observed 13 weeks later.Discussion: The diagnosis of BP was established after identification of the clinical cutaneous lesions and observation of microscopic findings on punch biopsy material obtained from the ocular and lip regions. BP does not exhibit breed or sex predisposition, and affects adult dogs. The clinical signs of BP are characteristic of autoimmune diseases that affect the dermoepidermal junction, and consist of erythematous, ulcerated, crusty, and painful lesions on the nose, dorsal area of the muzzle, and periorbital region. However, these lesions must be differentiated, by histological analysis, from several other conditions with a similar clinical presentation. Diseases that must be considered in the differential diagnosis comprise other variants of the pemphigus complex, lupus erythematosus, drug eruption, erythema multiforme, toxic epidermal necrolysis, epitheliotropic lymphoma, inherited bullous epidermolysis, mucous membrane pemphigoid, and lymphoreticular neoplasia. The clinicopathological findings indicated that the lesions were compatible with BP. The occurrence of necrotic and erythematous lesions is due to production of antibodies accompanied by a strong response of neutrophils, which results in loss of cell adhesion and epidermal necrosis. The presence of detachment of the epidermis from the dermis, inflammation in the superficial portion of the dermis, and infiltrates containing lymphocytes, histiocytes and plasma cells observed at the histopathological examination indicated the occurrence of BP. The skin histopathological examination warranted establishment of a diagnosis and therapeutic success. The lack of recurrence of clinical manifestations 43 weeks after the end of the glucocorticoid treatment demonstrated that the therapeutic approach and the cooperation of the owner are essential for success of the treatment.

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MIGRATION OF THE INTRAUTERINE DEVICE TO THE ABDOMINAL CAVITY

I P Pavlov Russian Medical Biological Herald ◽

10.23888/pavlovj20172247-262 ◽

2017 ◽

Vol 25 (2) ◽

pp. 247-262

Author(s):

D. A. Rahmonov ◽

F. Sh. Rashidov ◽

E. L. Kalmykov ◽

M. M. Marizoeva ◽

O. B. Bobdjonova ◽

...

Keyword(s):

Surgical Treatment ◽

Intrauterine Device ◽

Abdominal Cavity ◽

Clinical Signs ◽

Uterine Cavity ◽

Pain Syndrome ◽

Pregnant Patient ◽

Pelvic Cavity ◽

And Migration ◽

Laparoscopic Removal

The aim: demonstration of our experience of surgical treatment of patients with migrated intrauterine device (IUD) into the abdominal cavity. The results of surgical treatment of migrated IUDs in the pelvic cavity are summarized in 17 women. The average age of the patients was 33,23,4 years. The timing of implantation of the IUDs varied from 10 days to 24 months. In all cases, the intra operational finding was T-shaped a copper device. The reason behind the women's consultation was an increase in pain syndrome in the lesser pelvis (n=15), dysuric phenomenon (n=1) and the onset of pregnancy (n=1). Perforation of the uterus and migration of the spiral occurred from 10 days to 2 years after its implantation. All patients were operated laparoscopicaly. The average duration of operations was 45,510,5 minutes. In the postoperative period there were no complications from the pelvic organs and postoperative wounds. The period of hospitalization of patients was 3,50,7 days. In all cases there was a regression of clinical signs and recovery. In one pregnant patient (gestation period 5-6 weeks) the pregnancy proceeded without particular pathological abnormalities and resulted in the birth of a full-term child. Laparoscopic removal of the IUD migrating from the uterine cavity to the abdominal cavity is the method of choice in the treatment of this group of patients, avoiding development of intra- and postoperative complications and a shorter length of stay in the hospital. The effectiveness of the procedure reaches 100%. The most common cause of complication of the IUD is the perforation of the uterus during its implantation.

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Successful Treatment and Management of Canine Ehrlichiosis-Leishmaniosis-Heartworm Comorbidity

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.113295 ◽

2021 ◽

Vol 49 ◽

Author(s):

Adam Leal-Lima ◽

Tiago Cunha Ferreira ◽

Társsila Mara Vieira Ferreira ◽

Pedro Covas Coelho ◽

Diana Célia Sousa Nunes-Pinheiro

Keyword(s):

Successful Treatment ◽

Leishmania Infantum ◽

Dirofilaria Immitis ◽

Clinical Signs ◽

Vitamin Supplement ◽

Total Blood ◽

Veterinary Clinic ◽

Canine Ehrlichiosis ◽

One Year ◽

Visceral Leishmaniosis

Background: Canine vector borne diseases (CVBD) are common in tropical countries where the climate favors arthropods abundance. Comorbidity with one or more CVBD are reported as clinical complication and worsen prognostic. Canine visceral leishmaniosis (CanL) is an endemic zoonotic disease in Brazil caused by Leishmania infantum, with several restrictions to canine treatment and suggestion of reservoirs euthanasia for disease control. Heart worm (HW) is a helminthic disease caused by Dirofilaria immitis infection in dogs. It is a chronic heart disease, which can lead to death by congestive heart failure. Canine ehrlichiosis (CE) is caused by Ehrlichia canis bacterial infection with a zoonotic potential and fatal to dogs in acute and chronic presentations. Exposed the above, this study aims to describe a successful treatment and management of a dog with CanL, CE, and HW comorbidity. Case: A 3-year-old male uncastrated black Labrador dog, weighing 35 kg, was admitted to the veterinary clinic due to immunochromatographic CanL positive test performed by municipal zoonosis control center active surveillance in August 2014. Clinical exam showed a mild shedding, intermittent eye white/yellow discharge and popliteal lymph nodes enlargement. After positive for CanL, veterinary requested more laboratorial exams. IFAT and ELISA were positive for CanL, blood smear showed presence of microfilaria, and bone marrow cytology showed Ehrlichia spp. morulae and microfilaria. Initial treatment prescribed was oral doxycycline, omeprazole, ranitidine, and domperidone for 30 days, and allopurinol and ivermectin until further recommendation. Additionally, repellent collar, repellent spray and vitamin supplement was indicated. After first month, marbofloxacin for 30 days and three doses of immune stimulant protocol were administrated. After three months of treatment, dog still positive for heartworm, ehrlichiosis, and CanL. Doxycycline protocol was repeated. Dog became consistently negative for all pathogens one year later with persistent thrombocytopenia but without clinical signs, ergo allopurinol and ivermectin were discontinued. After four years of follow up, the animal had an acute pancreatitis and died, with unremarkable total blood count and negative for all pathogens. Discussion: CVBD coinfections are commonly reported as worsen prognostic in endemic regions. The pathogens reported here share a host immunomodulation competence. L. infantum and Ehrlichia spp.downregulates Th1 response, whereas D. immitis increase as Th2 profile. The therapeutic protocol was iniciated by staging CanL. Since the patient had clinical signs, allopurinol was prescribed as a well-established drug for CanL. Marbofloxacin was added due to its high safety drug in clinical improvement of infected dogs with and without renal disease and in vitro effectiveness against L. infantum. Domperidone was used to promote Th1 cytokine profile as INF-γ, IL-2, IL-12, and TNF-α. We used an immunostimulant protocol to favor polarization to the Th1 profile comprised by 30 days of domperidone protocol followed by a vaccine and an immunomodulator. Doxycycline was used successfully for Ehrlichia spp. and HE clearance after two treatment courses and one year of ivermectin every 15 days. The animal presented intermittent coughing episodes on the first treatment course, but no medical intervention was needed besides exercise restriction. Our report shows the successful management of one dog with CanL, CE and HE comorbidity. This success was possible due to early detection and good therapeutic choice.Keywords: canine visceral leishmaniosis, coinfection, Dirofilaria immitis, Erhlichia canis, Leishmania infantum, treatment.

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