scholarly journals Congenital Extrahepatic Portosystemic Deviation in a Mixed-Breed Dog

2019 ◽  
Vol 47 ◽  
Author(s):  
Ellen Bethânia De Oliveira Cavalcanti ◽  
Gustavo Cancian Baioto ◽  
Clairton Marcolongo-Pereira ◽  
Mayara Coutinho Carlos de Souza ◽  
Alice Corrêa Rassele ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Signs ◽  
Hepatic Metabolism ◽  
Abdominal Ultrasound ◽  
Systemic Circulation ◽  
Medical Support ◽  
Pure Breed ◽  
Neurological Signs ◽  
Mixed Breed ◽  
Cava Vein

Background: Portosystemic deviation (PSD) is a congenital or acquired vascular anomaly that allows an abnormal blood flow from the portal vein directly to the systemic circulation. This liver by-pass avoids hepatic metabolism of several toxins. Congenital PSDs are usually solitary and extra-hepatic, with a high incidence in pure-breed dogs. Acquired PSDs are usually multiple and occur as a consequence of portal hypertension. Surgery is the definitive treatment. Clinicians and surgeons may present difficulties in the propaedeutic of animals with PSD. This paper aims at reporting a successful surgical treatment of a solitary extra-hepatic congenital PSD in a mixed-breed dog.Case: A 7-month-old mixed-breed dog, female, spayed, weighing 8 kg, was presented with a history of sudden syncope after feeding. Complementary exams revealed normocytic hypochromic anaemia, hypoalbuminemia and increased alanine aminotransferase and alkaline phosphatase. Abdominal ultrasound revealed an anomalous vessel inserted in the caudal cava vein, compatible with a congenital extra-hepatic PSD. Computed tomography revealed the anomalous vessel, with 1,1 cm of diameter, originated from the cranial mesenteric vein and it inserted in the cranial margin of the caudal cava vein. A medical support was started with hydration, metronidazole, lactulose, probiotic and Hepatic diet.  After 15 days the dog was submitted to surgery and a 5 mm ameroid constrictor ring was placed to gradually close the anomalous vessel. The dog recovered well and an abdominal ultrasound was repeated after 30 days, showing the ameroid constrictor ring ring in the left cranial abdominal region, occluding the PSD close to its insertion in the caudal cava vein. The patient was followed up for more than three years, gained weight and presented a healthy normal life.Discussion: Although PSD is more often diagnosed in pure-breed dogs, this paper reports a case in a mixed-breed dog. However clinical signs and the age of onset were compatible with this pathology. Dogs with PSD may present neurological, gastrointestinal and urinary disorders, related to failure of the detoxification process and toxin by-pass to the systemic circulation. Young dogs are usually presented overdue underdevelopment, reduced body height or weight loss as described in this report. Hepatic encephalopathy is a result of the production of ammonia and several other toxins, which escapes hepatic metabolism, and once they remain liposoluble, they are able to cross-pass the blood-brain barrier and produce the neurological signs, which might be more pronounced after feeding, as in the reported case, although this dog presented only mild neurological signs. The haematological and biochemical findings in the dog of this report were also compatible with PSD. Hypoglycemia, hypocholesterolemia, increased of bile acids and serum ammonia may also be present but they were not demonstrated in this case. Abdominal ultrasound was able to identify the anomalous extra-hepatic vessel which was precisely described by computed tomography, which allower surgical planning. Medical support is recommended for the patient´s clinical estabilization, as performed in this case. Surgery is the treatment of choice for congenital solitary PSD, as in the reported case, and placement of the ameroid constrictor is the most employed technique, as performed. Patient´s improvement starts in the day after surgery and it is completed within a couple months. The patient of this report did not present any complications in the postoperative period and for more than three years, showing total remission of the clinical signs and good life´s quality.

scholarly journals Focal Peripheral Neuropathy Associated with Lymphoma in Dogs

2021 ◽  
Vol 49 ◽  
Author(s):  
Paloma Helena Sanches Da Silva ◽  
Gleidice Eunice Lavalle ◽  
Bernardo De Caro Martins ◽  
Bruna Voltolin De Sena ◽  
Ana Luísa Fajardo Ferreira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Peripheral Neuropathy ◽  
Trigeminal Nerve ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Cranial Nerves ◽  
Clinical Signs ◽  
Canine Lymphoma ◽  
Neurological Signs ◽  
Chemotherapy Protocol

Background: Peripheral neuropathies result in sensory, motor or autonomic dysfunctions due to impairment of peripheral spinal or cranial nerves. Neoplasms such as lymphoma are cited as one of the many aetiological causes and it may affect the nerve directly, by compression, or indirectly, or paraneoplastic, by remote action of the neoplasm located in an extra-neural site. This study aimed to report two cases of cranial nerve neuropathy (trigeminal and facial) associated with canine lymphoma, contributing to a better understanding of its paraneoplastic effects on the nervous system, as well as the diagnosis and treatment of these conditions.Cases: Two cases of canine lymphoma associated with possible signs of paraneoplastic peripheral neuropathy were attended at the Veterinary Hospital from the Universidade Federal de Minas Gerais (HV UFMG). Case 1. A spayed mixed breed bitch, with lethargy and unilateral exophthalmos. Brain computed tomography revealed a retrobulbar mass and cytology was diagnostic for extranodal lymphoma. Subsequent to computed tomography, the dog was presented with hypotrophy of the facial musculature and difficulty in grasping food, consistent with trigeminal nerve palsy, which resolved after institution of the 19-week chemotherapy protocol from the University of Wisconsin. Nevertheless, disease reccurred and a rescue protocol was initiated. Case 2. A female Dalmatian, spayed, was diagnosed with multicentric lymphoma, after cytology of the left mandibular lymph node. Chemotherapy was initiated with the same protocol of the previous case. However, the disease progressed and it was observed facial asymmetry with ptosis of the left eyelid, pina and lips, in addition to difficulty in grasping food, suggesting facial and trigeminal cranial nerve palsy. Clinical signs resolved after institution of a rescue chemotherapy protocol. However, in both cases, disease progression and poor clinical condition resulted in decision of euthanasia and necropsy was not authorized.Discussion: Canine lymphoma is often associated with paraneoplastic syndromes, with neuropathy being one of its possible clinical manifestations. In spite of that its pathogenesis remains unclear, with little information in the veterinary literature. Diagnosis is challenging and must be initially based on recognition of neurological clinical signs and lesion localization, as in the reported cases with lesions located on the fifth and seventh cranial nerves. In the patient from the first case, the absence of clinical signs and laboratory abnormalities suggestive of endocrinopathies, associated with neurological signs restricted to the trigeminal nerve, bilaterally, before starting chemotherapy and without the identification of brain lesions in computed tomography, suggested paraneoplastic involvement as the cause of neuropathy. In the second case described, the absence of clinical signs and laboratory abnormalitiess suggestive of endocrinopathies or nutritional deficiencies, associated with neurological signs restricted to the facial and trigeminal cranial nerves, suggested direct or indirect tumour involvement. Both cases showed improvement of neurological clinical signs after chemotherapy which favored the therapeutic diagnosis. Nevertheless, failure to authorize necropsy of patients made it impossible to confirm that peripheral neuropathy is secondary to the remote effect of lymphoma.

scholarly journals Clinical improvement of encapsulating peritoneal sclerosis after challenging course and 6 months of total parenteral nutrition in child with nephronophthisis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Saeed Mohammed AlZabali ◽  
Abdulkarim AlAnazi ◽  
Khawla A. Rahim ◽  
Hassan Y. Faqeehi
Keyword(s):  
Peritoneal Dialysis ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Bowel Perforation ◽  
Clinical Signs ◽  
Oral Intake ◽  
Pediatric Intensive Care ◽  
Abdominal Ultrasound ◽  
Peritoneal Dialysis Catheter ◽  
Refractory Peritonitis

Abstract Background Encapsulating peritoneal sclerosis is a rare but potentially lethal complication of long-term peritoneal dialysis that is associated with significant morbidity and mortality. The occurrence of encapsulating peritoneal sclerosis varies worldwide, but is increased in patients maintained on peritoneal dialysis for 5–8 years. The etiology of encapsulating peritoneal sclerosis remains unidentified, and a high index of clinical suspicion is required for diagnosis. Case presentation We report a 5-year-old Saudi female with end-stage renal disease secondary to nephronophthisis type 2. She underwent peritoneal dialysis for 30 months, with four episodes of peritonitis. She presented with clinical signs of peritonitis. Three days later, she developed septic shock, which required pediatric intensive care unit admission. The peritoneal dialysis catheter was removed because of refractory peritonitis. Her course was complicated by small bowel perforation, and severe adhesions were revealed on abdominal ultrasound and computed tomography, consistent with a diagnosis of EPS. This finding was later confirmed by diagnostic laparotomy performed twice and complicated by recurrent abdominal wall fistula. She received total parenteral nutrition for 6 months and several courses of antibiotics. The patient received supportive treatment including nutritional optimization and treatment for infection. No other treatments, such as immunosuppression, were administered to avoid risk of infection. Following a complicated hospital course, the patient restarted oral intake after 6 months of total parenteral nutrition dependency. Her abdominal fistula resolved completely, and she was maintained on hemodialysis for few years before she received a kidney transplant. Conclusion When treating patients using peritoneal dialysis, it is important to consider encapsulating peritoneal sclerosis with refractory peritonitis, which is not always easy to identify, particularly if the patient has been maintained on peritoneal dialysis for less than 3 years. Early identification of encapsulating peritoneal sclerosis and appropriate conservative treatment, including nutritional optimization and treatment of infections, are essential to achieve a better prognosis.

scholarly journals Nasal Delivery of Acute Medications for Migraine: The Upper Versus Lower Nasal Space

2021 ◽  
Vol 10 (11) ◽  
pp. 2468
Author(s):  
Vincent Martin ◽  
John Hoekman ◽  
Sheena K. Aurora ◽  
Stephen B. Shrewsbury
Keyword(s):  
Acute Treatment ◽  
Drug Efficacy ◽  
Hepatic Metabolism ◽  
Rapid Onset ◽  
Systemic Circulation ◽  
Nasal Delivery ◽  
Attractive Alternative ◽  
Gi Tract ◽  
Onset Of Action ◽  
First Pass

The acute treatment of migraine requires effective drugs that are well tolerated and provide rapid and consistent pain relief. Oral tablets are the most commonly used acute treatment for migraine; however, their effectiveness is limited by the rate of gastrointestinal (GI) tract absorption and first-pass hepatic metabolism, and they may not be ideal for patients experiencing GI motility issues. Nasal delivery is an attractive alternative route as it may circumvent GI tract absorption, avoid first-pass metabolism in the liver, and potentially reduce the frequency of GI adverse events. The large surface area and high vascularity within the nose may permit rapid absorption of therapeutics into the systemic circulation, allowing for rapid onset of action. However, the site of drug deposition (upper versus lower nasal cavity) may influence drug pharmacokinetics. Most approved nasal migraine therapies target the lower nasal space where the epithelium is less permeable, and they may be quickly cleared away due to increased ciliary function or dripping from the nose or swallowing, resulting in variable absorption and limited bioavailability. Together with its abundant vascularization, relative mucosal thickness stability, and low clearance rates, the upper nasal space harnesses the benefits of nasal delivery to potentially maximize drug efficacy.

Serum cobalamin concentrations and small intestinal ultrasound changes in 75 cats with clinical signs of gastrointestinal disease: a retrospective study

2016 ◽  
Vol 19 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Maria C Jugan ◽  
John R August
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Disease ◽  
Clinical Signs ◽  
Small Animal ◽  
Abdominal Ultrasound ◽  
Wall Layer ◽  
Normal Serum ◽  
Definitive Diagnosis ◽  
Albumin Concentration ◽  
Small Intestinal

Objectives The aim of the study was to evaluate ultrasonographic changes in the small intestine of cats with clinical signs of gastrointestinal disease and low or low–normal serum cobalamin concentrations. Methods Records for client-owned cats presenting to the small animal hospital with signs of gastrointestinal disease and in which serum cobalamin concentrations were measured from 2000–2013 were reviewed. Inclusion criteria were cobalamin concentrations <500 ng/l, abdominal ultrasound within 1 month of cobalamin testing and definitive diagnosis. Results Of 751 serum cobalamin measurements, hypocobalaminemia or low–normal cobalamin was identified in 270 cats, abdominal ultrasound was performed in 207 of those cats and a diagnosis was available for 75 of them. Small intestinal ultrasound changes were detected in 49/75 (65%) cats. Abnormalities included thickening, loss of wall layer definition, echogenicity alterations and discrete masses. Serum cobalamin concentrations <500 ng/l were observed with diagnoses of inflammatory disease, neoplasia, infectious disease and normal histopathology. Cobalamin concentration was significantly lower in cats with lymphoma or inflammatory bowel disease compared with other gastrointestinal neoplasia ( P = 0.031). No difference was found between cobalamin concentration and the presence of ultrasound abnormalities, specific ultrasound changes or albumin concentration. Conclusions and relevance One-third of symptomatic cats with hypocobalaminemia or low–normal cobalamin concentrations may have an ultrasonographically normal small intestine. For the majority of cats in this study, histopathologic abnormalities were observed in the small intestine, regardless of ultrasound changes. These findings suggest gastrointestinal disease should not be excluded based on low–normal cobalamin concentrations, even with a concurrent normal ultrasound examination. Additional studies are needed in cats with low–normal serum cobalamin concentrations, as a definitive diagnosis was not pursued consistently in those cats. However, data from this study suggest that careful monitoring, histopathologic evaluation and future cobalamin supplementation may be warranted.

Phlegmonous gastritis in 2 yearling horses

2022 ◽  
pp. 104063872110650
Author(s):  
Julie B. Engiles ◽  
Francisco A. Uzal ◽  
Mauricio A. Navarro ◽  
Virginia B. Reef ◽  
Susan J. Bender
Keyword(s):  
Clinical Signs ◽  
Poor Response ◽  
Abdominal Ultrasound ◽  
Mucosal Injury ◽  
Response To Treatment ◽  
Bacterial Populations ◽  
Proliferative Enteropathy ◽  
Mucosal Involvement ◽  
Phlegmonous Gastritis ◽  
History Of

Phlegmonous gastritis was diagnosed in 2 yearling fillies that were presented with a 1-wk history of fever, lethargy, and hypoproteinemia, associated with a previous diagnosis of equine proliferative enteropathy based on clinical signs and PCR assay detection of Lawsonia intracellularis in fecal samples. Abdominal ultrasound revealed enlargement of the stomach and expansion of its submucosal layer with hypoechoic fluid, as well as thickened hypomotile small intestinal segments. Given the poor prognosis and poor response to treatment, both horses were euthanized, one on the day of presentation and the other after 3 wk of intensive medical management including a combination of antimicrobials, analgesics, and intravenous colloids. At autopsy, acute mural gastritis characterized by severe submucosal edema with suppurative inflammation (i.e., phlegmonous gastritis) and necroulcerative enteritis compatible with the necrotizing form of equine proliferative enteropathy were identified in both horses. The gastric inflammation was associated with thrombosis and mixed bacterial populations, including Clostridium perfringens, that were confined to the submucosa without evidence of mucosal involvement; toxin genes compatible with C. perfringens type C were identified in one case. Human phlegmonous gastritis is an uncommon, often-fatal pyogenic infection that is often associated with mucosal injury, bacteremia, or immunocompromise. Our finding of this unusual gastric lesion in 2 horses with similar signalment, clinical disease, and spectrum of postmortem lesions suggests a similar etiopathogenesis that possibly involves local, regional, or distant hematogenous origin, and should be considered a potential complication of gastrointestinal mucosal compromise in horses.

scholarly journals Ischemic myelopathy caused by fibrocartilaginous embolism in a horse

2018 ◽  
Vol 48 (2) ◽  
Author(s):  
Welden Panziera ◽  
Ronaldo Michel Bianchi ◽  
Paula Reis Pereira ◽  
Mariana Martins Flores ◽  
Monique Togni ◽  
...  
Keyword(s):  
Cross Sections ◽  
Clinical Course ◽  
Clinical Signs ◽  
Histological Findings ◽  
Hind Limbs ◽  
Fibrocartilaginous Embolism ◽  
Mixed Breed ◽  
Liquefactive Necrosis ◽  
Gross Lesions ◽  
Multiple Blood

ABSTRACT: This report described clinical, epidemiological, and pathological aspects of ischemic myelopathy caused by fibrocartilaginous embolism (FCE) in a 10-year-old, mixed breed gelding. Clinically, the horse presented acute hind limbs paralysis, with a clinical course of approximately 24 hours. At necropsy, no gross lesions were observed. Cross-sections of the spinal cord revealed focally extensive areas of malacia from the T10 to L4 segments. Focally extensive areas of liquefactive necrosis involving the gray matter and adjacent white matter were observed on histologic sections. The lumen of multiple blood vessels in the periphery of the necrotic areas was occluded by fibrocartilaginous emboli that strongly stained with alcian blue. Clinical signs, gross necropsy, and histological findings observed in this case were identical to those described in the literature for ischemic myelopathy caused by FCE in the horse and other species.

scholarly journals Cerebral Cavernous Hemangioma in a Dog

2019 ◽  
Vol 47 ◽  
Author(s):  
Viviane Motta dos Santos Moretto ◽  
Luciana Maria Curtio Soares ◽  
Esthefanie Nunes ◽  
Uiara Hanna Araújo Barreto ◽  
Valéria Régia Franco Sousa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endothelial Cells ◽  
Cavernous Hemangioma ◽  
Clinical Signs ◽  
Ct Scanning ◽  
Ct Scans ◽  
Elastic Fibers ◽  
Post Contrast ◽  
The Right ◽  
The Brain

Background: Cerebral cavernous hemangioma is a rare neoplasm of vascular origin in the brain, characterized by abnormally dilated vascular channels surrounded by endothelium without muscle or elastic fibers. Presumptive diagnosis is performed by magnetic resonance or computed tomography (CT) scanning and can be confirmed by histopathology. The prognosis of intracranial cavernous hemangioma is poor, with progression of clinical signs culminating in spontaneous death or euthanasia. The purpose of this paper is to report a case of cerebral cavernous hemangioma in a dog, presenting the clinical findings, tomographic changes, and pathological findings.Case: This case involved a 2-year-old medium sized mixed breed female dog presenting with apathy, hyporexia, ataxia, bradycardia, dyspnea, and seizure episodes for three days. Hemogram and serum biochemistry of renal and hepatic function and urinalysis did not reveal any visible changes. CT scanning was also performed. The scans revealed a hyperdense nodule of 15.9 x 14 mm, with well defined borders, and a hypodense halo without post-contrast enhancement and mass effect in the right parietal lobe was observed in both transverse and coronal sections. Based on the image presented in the CT scans, the nodule was defined as a hemorrhagic brain lesion. The animal died after a seizure. The right telencephalon was subjected to necropsy, which revealed a reddish-black wel-defined nodule 1.7 cm in diameter extending from the height of the piriform lobe to the olfactory trine at the groove level and extending towards the lateral ventricle, with slight compression and deformation of the thalamus but no other macroscopic alterations in the other organs. The histopathology indicated that this nodular area in the encephalus contained moderate, well-delimited but unencapsulated cellularity, composed of large vascular spaces paved with endothelial cells filled with erythrocytes, some containing eosinophilic fibrillar material (fibrin) and others with organized thrombus containing occasional neutrophil aggregates. The endothelial cells had cytoplasm with indistinct borders, elongated nuclei, scanty crust-like chromatin, and cellular pleomorphism ranging from discrete to moderate, without mitotic figures.Discussion: The histological findings characterized the morphological changes in the brain as cavernous hemangioma, and the growth and compression of this neoplasm were considered the cause of the clinical signs of this dog. The main complaint was seizures, although ataxia and lethargy were also noted. These clinical signs are often related to changes in the anterior brain and brainstem. The literature does not list computed tomography as a complementary diagnostic method in cases of cerebral cavernous hemangioma in dogs, but CT scanning was useful in confirming cerebral hemorrhage. The main differential diagnosis for cerebral cavernous hemangioma would be a hamartoma, but what differentiates them histologically is the presence of normal interstices between the blood vessels, since no intervening neural tissue occurs in the case of cerebral hemangioma. Therefore, even in the absence of immunohistochemistry to more confidently confirm a cavernous hemangioma, the clinical signs, CT scans and especially the pathological findings were consistent with a case of cerebral cavernous hemangioma, a benign neoplasm with a poor prognosis due to the severe neurological changes it causes and its difficult treatment.

scholarly journals Incidence of Pet Intoxications in the Emergency Clinic, Faculty of Veterinary Medicine Cluj-Napoca

2021 ◽  
Vol 78 (1) ◽  
pp. 101
Author(s):  
Amalia Marina NEAGU ◽  
Ecaterina DIAC ◽  
Andrei Razvan CODEA ◽  
Andras NAGY ◽  
Adrian OROS ◽  
...  
Keyword(s):  
Veterinary Medicine ◽  
Ethylene Glycol ◽  
Epidemiological Study ◽  
Clinical Signs ◽  
Mixed Breed ◽  
Microsoft Office ◽  
Common Field

Veterinary toxicology is a common field in veterinary medicine, being a science closely related to other clinical and para clinical disciplines. The multitude of toxics and the ability of each organism to respond differently to them, non-specific clinical signs and an inadequate anamnesis can often put the clinician in difficulty when seeking to diagnose. The aim of the study was to highlight the incidence of pet poisoning cases, over a period of 10 years of time at the emergency clinic, faculty of Veterinary Medicine Cluj-Napoca. An epidemiological study was performed with the help of the emergency clinic archive, where the files of the intoxicated patients were selected. The data were centralized in the Microsoft Office Excel. The results obtained revealed the sum of 256 cases of pet poisoning in the last ten years (0.611% of the number of cases registered during this period), of which the predominantly affected species was the dog of mixed breed. Also, within the most common poisonings, the ones with ethylene glycol and anticoagulants rodenticides were observed. In the present study a correlation was established between breed, age, sex and the most frequent incidence of poisoning, common toxins and the connection between the periods of the year.

Assessing the utility of head computed tomography in the role 2 hospital setting on operation TRENTON

2020 ◽  
pp. bmjmilitary-2020-001416
Author(s):  
Edward Sellon ◽  
M Ballard
Keyword(s):  
Computed Tomography ◽  
United Nations ◽  
Head Injuries ◽  
South Sudan ◽  
Hospital Setting ◽  
Medical Facility ◽  
Medical Support ◽  
Imaging Capability ◽  
Ct Brain ◽  
Head Computed Tomography

Operation TRENTON was the British government’s humanitarian contribution to the United Nations Mission in South Sudan. This included the Bentiu-based role 2 medical facility, deployed to provide medical support to approximately 2000 UN peacekeepers and UN staff in the region of the country’s largest Protection of Civilian camps. A portable CT brain scanner was installed due to concern over the risk of head injuries and the extended clinical timelines. We provide a short reflection on the utility of this imaging capability in the deployed role 2 environment.

Sign in / Sign up

Export Citation Format

Share Document