Pseudopterygium in a Rabbit - Treatment with Tracolinus

Background: Pseudopterygium, also known as aberrant conjunctival growth, is poorly described in the literature, although it is known that this abnormality is uncommon and affects dwarf rabbits and their crossbreeds. The etiology of this disease is unknown, but there are hypotheses that the conjunctival growth cause may have its origins in immunological factors, inflammation, traumatic conditions, or cartilage dysplasias. Thus, this study reports the treatment efficacy applied in a rabbit, through the continuous use of tracolimus eye drops, after surgical procedure of conjunctival fold resection, as a way of controlling the pseudopterygium in rabbits.Case: This case report discusses the positive results from the surgical and therapeutic conduct of a clinical case attended by the Ophthalmology and Microsurgical Veterinary Service at the Hospital Veterinário Universitário (HVU) of the UFSM. The patient was a male rabbit, sterilized cunicle, approximately 2-year-old, crossed with a dwarf rabbit. The owner's main complaint was the change in the aspect of the left eye, with progressive worsening in the previous four weeks. In the ophthalmological examination, the animal did not present impaired vision or discomfort, however, a vascularized pink membrane was noted, which consisted of a fold of the bulbar conjunctiva, that grew centripetally and covered 90% of the cornea in 360 degrees. The diagnosis was confirmed through visual inspection and the patient's history. The eye alteration had a characteristic aspect, described as proliferation of the bulbar conjunctiva over the cornea, in a centripetal manner and without signs of inflammation. In addition, other ophthalmological alterations were ruled out during the patient's physical and specific examination. The patient was referred for anesthetic evaluation and, in addition, pre-surgical blood tests were performed, which were normal, according to the expected ranges for the species. Subsequently, the animal was submitted to surgical treatment, which consisted of dividing the exuberant conjunctiva, followed by three radial incisions in equal portions. Next, the conjunctival fold was completely incised to the edge of the limbus, without the need of sutures. Anterior lamellar keratectomy was performed on the portion where the membrane was attached to the cornea. For home care, tobramycin-based eye drops (QID, for 7 days) and 0.02% aqueous tacrolimus eye drops (BID - continuous use) were prescribed. The animal was reevaluated 7, 14, 30, 60, 120 and 180 days after surgical correction, and no recurrence of pseudopterygium was observed during the follow-up period. The prognosis of patients with pseudopterygium is reserved, as it is known that the disease may recur after surgical treatment. Therefore, the continuous use of the chosen immunomodulating eye drops was recommended as well as periodic follow-up of the patient.Discussion: In the current study, it was not possible to increase knowledge regarding about the pseudopterygium etiology. Although the condition is not serious, it can cause partial impairment of vision and chronic discomfort. However, the vision field described in the rabbit in this current case remained unchanged, in accordance with other cases described in the literature. Furthermore, no signs of patient discomfort were detected. Some surgical techniques described in the literature for correction of pseudopterygium, shows membrane’s growth recurrence. The use of immunomodulatory drugs is suggested for relapses controlling. In this study, the tracolimus eye drops efficacy was tested, and presented good results in the patient's evaluations for a long period after surgery. The use of immunomodulators is an option for adjuvant topical treatment for controlling pseudopterygium growth, which, associated with corrective surgical treatment, has shown positive results.Keywords: conjunctiva, aberrant, immunomodulator, treatment, bunny.Título: Pseudopterígio em coelho - tratamento com tracolimusDescritores: conjuntiva, aberrante, imunomodulador, tratamento, coelho.

Short-term Heart Rate Variability Analysis in Healthy Dogs of Different Ages

Background: The modulation of heart rate by autonomic nervous system may be evaluated by the heart rate variability (HRV), which illustrates the fluctuations between RR intervals. To evaluate this analysis, the intervals between 2 QRS complexes are measured. In general, high HRV values are expected in healthy individuals; otherwise, low values are indicative of organism dysfunction. Studies conducted in healthy humans show that HRV suffers reduction with ageing and that there is autonomic immaturity in neonates. The aim of this study was to describe the characteristic pattern of cardiac autonomic behavior in healthy dogs in different age groups through short-term HRV analysis.Materials, Methods & Results: A total of 87 healthy dogs were studied. HRV was analyzed in time and frequency domain, using Holter and heart rate monitor. It was observed that puppies (below one year old) presented a lower parasympathetic predominance and, consequently, lower HRV values on time domain (SDNN, PNN50% e RMSSD) compared to the other 2 groups and on frequency domain (LF, HF and LF/HF) compared to the adult animals group (between 1 and 7-year-old), which presented higher HRV values when compared to the other groups. Elderly dogs (over 8-year-old) exhibited a natural tendency to decrease cardiac parasympathetic HRV indexes.Discussion: The use of the HRV method as a prognostic index and as an arrhythmogenic marker for various canine heart diseases presents interesting perspectives. However, before it may be employed for these purposes, a better understanding should be established regarding the physiological behavior of autonomic cardiac modulation in different age groups to serve as a basis for future analyses. This study observed that puppies presented higher values for HR and, therefore, shorter RR intervals than the other groups (adult and elderly dogs), what was observed on Holter and heart rate monitor methods (HRM). There were significant differences between puppies and the other 2 groups (adults and elderly) for all time-domain variables using both methods (Holter and HRM methods). SDNN was significantly lower in puppies compared to adults and elderly dogs. In addition, both RMSSD and PNN50%, which were more reliable over shorter periods of time, also presented means and medians that were significantly lower in puppies. Regarding frequency-domain HRV parameters observed on Holter method, these indexes were decreased on the elderly group compared to adult dogs, which is a possible effect of aging. Also, puppies revealed lower frequency-domain HRV parameters on both methods when compared to adult dogs. The influence of age on HRV is possibly related to the stage of development of an individual, starting at conception up to the maturity in relation to the mechanisms that cause variations in HR. There are studies in humans that suggest a gradual increase in parasympathetic activity during childhood, followed by a steady decrease as aging occur. The present study observed the same pattern in dogs. The balance between sympathetic and parasympathetic systems is influenced by age in dogs, which alters HRV values in the short-term. The HRV method´s analysis is relatively simple and non-invasive for assessing cardiac autonomic function; also, it is widely used in human medicine as a risk measure for sudden cardiac death. The 24-hour HRV analysis is highly challenging, as it is time-consuming, expensive, delays diagnosis, and has a large number of artifacts; in this way, standards for its short-term analysis were developed. Keywords: cardiology, autonomic nervous system, heart rate monitor, Holter.

Listeriosis Outbreak in Sheep Raised in Feedlots in the Southern Region of Rio Grande do Sul State, Brazil

Background: A listeriosis outbreak in a sheep fattening feedlot in the Southern Region of Rio Grande do Sul State, Brazil is described. This disease is caused by Listeria monocytogenes and represents a risk to public health since it affects not only ruminants but also humans. This agent is widely spread in the environment, such as in the soil and water. It is also found in decaying vegetable matter and the feces and fluids of domestic animals. The aim of this study was to describe a listeriosis outbreak in sheep raised in feedlots, its epidemiology, and to establish the importance of this disease in this type of sheep management system, evaluate the possible sources of infection, and suggest ways to control it.Cases: Sheep were kept in a 2-sector shed, one with east solar orientation and the other with west solar orientation, the latter with free access to domestic birds. Sheep were fed silage and concentrate. Seven sheep were affected, 5 died and 2 recovered. Clinically, the sheep displayed loss of balance, excessive drooling, and tremors; one exhibited circling, head deviation, apathy, nystagmus, lateral recumbency, paddling, and labored breathing. At necropsy, macroscopic lesions were not found, and histologically several micro-abscesses and perivascular cuffs with lymphocytes, macrophages, and neutrophils were present in the brain stem. Listeria monocytogenes suspected colonies were observed in the microbiological culture, and the bacteria was identified by biochemical analysis. The immunohistochemistry test in brain stem sections was positive for the antibody BD DifcoTM Listeria O Antiserum Poly Serotypes 1 and 4.Discussion: A listeriosis outbreak in a feedlot sheep was confirmed through epidemiological findings, histological lesions, bacterial culture, and immunohistochemistry analysis. This infection is frequent in sheep fed silage of poor quality or other food with improper storage and lack of hygiene. In the present outbreak, the bacteria were isolated from silage. However, it is likely that domestic birds, which were raised in the same place and had free access to the west sector of the feedlot, were the initial source of infection, because the sheep from the opposite sector (east) did not get ill. The disease caused by environmental contamination or through contact with fluids and feces of ducks, chickens, cattle, and pigs has already been described in outbreaks that occurred in the central region of Rio Grande do Sul. Sheep aggregation in feedlot systems is also a favorable factor for the development of the bacteria and the occurrence of outbreaks because the accumulation of feces and urine cause humidity on the stalls. This allows outbreaks to occur in other seasons of the year, such as in the outbreak reported herein. The exchange of silage that served as food for sheep was another control measure, and new cases were not reported 8 months after these procedures were taken. In the outbreak studied, 2 sheep that exhibited clinical signs were treated with oxytetracycline and recovered. Some authors report that treatment for listeriosis is inefficient because neurological lesions are irreversible. Nonetheless, other studies have reported the recovery of some animals when they were treated with oxytetracycline or a combination of oxytetracycline and dexamethasone or ampicillin and gentamicin like in the outbreak described in this paper.Keywords: Listeria monocytogenes, central nervous system, silage, feedlot, ovine.

Necrotic Wound Caused by Jararaca (Bothrops jararaca) in a Dog - Hyperbaric Oxygen Therapy (HBTO)

Background: Snakebites are the main responsible for envenoming in dogs and the bothropic venom remains the most common in Brazil, which can induce a necrotic skin wound. Hyperbaric oxygen therapy (HBOT) use 100% oxygen under high pressure and used to treat different wounds in human patients. To the authors’ knowledge, no reports regarding to use the HBOT in skin wound caused by snakebite (Bothrops jararaca) are present in the literature. The present clinical case aimed to describe the use of HBOT for the treatment of an extensive necrotic wound caused by jararaca snakebite in a dog.Case: A neutered 8-year-old mixed-breed dog, weighing 12 kg, was admitted with a 7-day history of extensive necrotic wound was identified in the face and neck causing by a snakebite, and no sign of pain. The procedure of HBOT (single sessions of 1.5 ATM, 45 min, repeated every 48 h, up to 12 sessions) was decided, and the complete blood cells, alanine aminotransferase, creatinine, creatine kinase, prothrombin time, activated partial thromboplastin time, wound clinical evaluation were measured at the following time-points: 2nd, 5th, 10th, and 12th sessions. At the 5th session was identified leukopenia, neutropenia and lymphopenia. Wound re-epithelialization was initiated after the 5th session, and the complete epithelialization was identified at the 12th session of HBOT. During the HBOT no side effects were identified. Three months after the HBOT finished, the animal returned to the clinic and the clinical status evolved positively, and the wound was completed healed.Discussion: This report described the treatment of an extensive necrotic skin wound caused by snakebite (Bothrops jararaca) in an 8-year-old, neutered, mixed-breed dog using the HBOT. The wound healing was achieved after 12 sessions, similar to the literature, which reported a ranging from 1 to 12 sessions. The HBOT protocol used in this case was similar as reported for human patients with chronic wounds due to the lack of HBOT protocols for animals. No reports regarding the use of HBOT for treat necrotic wound caused by snakebite was described in the literature, and to the authors’ knowledge, this is the first report in Brazil describing the use of HBOT in dogs. On the other hand, dogs with surgically induced skin wounds and treated with daily session of HBOT using the treatment protocol of 1.7 ATM (30 min) and 2.0 ATM (40 min) up to 7th day of treatment did not show significant results on healing [9]. This fact was associated with the HBOT achievement in the proliferative and remodeling phases of the healing process. The high intensity of HBOT was between the 5th and 10th session since the wound showed a higher area decrease rate and consequently increase of wound contraction. This period was corresponding to the 10th and 20th day of the healing process, which can be identified angiogenic activity, re-epithelialization, and collagen maturation. The decrease in PVC has been associated with the anticoagulant and/or hemorrhagic activity caused by the venom, and leukopenia, neutropenia and lymphopenia was related with possible bone marrow exhaustion. Single sessions of HBOT (1.5 ATM, 45 min, and repeat each 48 h, up to 12 session) induces healing of necrotic wound caused by snakebite (Bothrops jararaca) in an 8-year-old, neutered, mixed-breed dog without any side effects.Keywords: dog, healing, hyperbaric chamber, skin wound, snake.

West Nile Fever Virus Infection in Horses in São Paulo State, Brazil

Background: The West Nile virus (WNV) antibodies were reported in Brazil in the serum samples taken from horses and birds in the Midwest region and Paraíba state in 2008 and 2013, respectively. In 2014, the first human case was confirmed in a rural worker in the state of Piauí and, in 2018, the virus was isolated from the central nervous system of a horse with nervous symptoms in the state of Espírito Santo. The virus is a member of the Flaviviridae family of the genus Flavivirus (neurotropic), infecting several mammalian species, with humans and horses being the most susceptible. Approximately 35% of horses develop clinical signs, thus they are considered the best sentinels for this disease. The aim of this case report is to describe the first confirmed cases of West Nile Fever (WNF) in two horses in the state of São Paulo.Cases: Two horses with neurological symptoms were treated at the Veterinary Hospital of Cruzeiro do Sul University (São Paulo, SP), in 2019. Both horses came from neighboring regions that have a large Atlantic Forest preservation area and are also routes for migratory birds, known to be competent hosts for transmitting the West Nile Fever virus, such as the swallow, the falcon and the hawk. The first one had symptoms, such as weakness and sporadic seizures; however, after recovering, it was hospitalized a few days later due to kidney failure and laminitis. The second one showed incoordination, pelvic limb weakness, and was walking in circles, evolving to seizures. Both animals were euthanized, and their central nervous system samples and total blood samples were tested for rabies, herpes virus, and WNV; the first 2 tests showed negative results. Ribonucleic acids (RNA) were extracted from erythrocytes using the polymerase chain reaction (PCR) technique in-house. The WNV-specific reverse transcription-polymerase chain reaction amplification products were obtained using the nested PCR-multiplex PCR combination.Discussion: Since the 1940s, several WNF outbreaks have been reported around the world (Africa, Europe, Asia and Middle East). In the 2000s, the USA had the most amount of WNF cases reported; cases started being reported in Central and South America in the following years. The virus was identified for the first time in Brazil in 2014. Since then, our country is a route for migratory birds, with many states still having forests, several arboviruses are found such as WNF, which could become a public health problem. Both horses in the present study showed neurological signs and the horse that recovered had renal failure. Such signs are inconclusive, however, similar to those that occur in humans infected by the virus in its neurotropic form. The emergence of new diseases is an important aspect of public health. The literature is vast regarding the description of the pathogenesis, clinical signs, diagnosis, viral persistence and sequelae of WNF in humans, however, it is scarce regarding the viral persistence and sequelae of the disease in horses. Future studies are needed to understand the post-infection period in horses, as they are the most sensitive animals along with humans to this virus. Here, we report the first confirmed cases of WNF in the city of São Paulo to bring awareness about considering this disease while diagnosing horses with nervous system disorders.Keywords: encephalitis, horses, flavivirus, mosquito.Título: Infecção pelo vírus da Febre do Nilo Ocidental em equinos no Estado de São PauloDescritores: encefalite, equinos, flavivírus, mosquito.

Nasal Transmissible Venereal Tumor (TVT) in Dogs

Background: Transmissible venereal tumors (TVT) are naturally occurring neoplasms that can be transmitted through copulation or cell transplantation. It is a disease that affects canines, has no preference for sex or breed, and generally noticed in the external genital apparatus. Extragenital occurrence may eventually be seen; however, nasal involvement has been described in only a few reports of studies conducted in Brazil. Therefore, the objective of this study is to report 3 cases of nasal TVT in dogs who were treated in 2 municipalities in the mountainous region of Santa Catarina, Brazil.Cases: This case report includes 3 male mixed-breed canines of age 3-13. Only 1 of the animals was castrated. As per the medical history, some points, such as an enlarged nasal region, sneezing, nasal discharge, and hoarseness, reported by the dogs’ respective owners were similar among all the dogs. Likewise, nosebleed was observed on physical examination in all the cases. The result of cytological examination was inconclusive only in 1 case. Rhinoscopy, incisional biopsy, and histopathological examination were then performed for achieving a definitive diagnosis. In the 2 cases wherein cytology gave conclusive results, the cytological smears showed changes suggestive of TVT, such as cells with eccentric nuclei and little cytoplasm, which had vacuoles inside them. In 2 cases, radiographic examinations of the skull were also performed. The images showed changes in bone radiopacity, conformation of trabeculae with areas of bone lysis and cell proliferation, and irregularity in the contour of the nasal bone. After TVT diagnosis was confirmed, chemotherapy was initiated using vincristine at a dose of 0.75 mg/m2 for 2 cases and 0.025 mg/kg for the remaining case. The number of chemotherapy sessions and duration of treatment until the resolution of lesions and clinical signs varied as per the differences in the patients’ blood counts performed prior to each session.Discussion: TVT occurs between 1 and 7 years of life. It occurs more frequently in sexually active animals and has no preference for breed. Of the 3 cases reported herein, only one of the patients was elderly. All the patients were male mixed-breed dogs, and only 1 of them was castrated. The implantation of neoplastic cells through natural mounts, licks, scratches, or bites of affected areas are the most widely accepted reasons for the transmission of this neoplasm. With regard to the nasal presentation described in the present report, it is hypothesized that the smelling or licking of the neoplastic areas by the animal may favor cell implantation, leading to the subsequent development of a tumor. Nasal TVT should be considered as a differential diagnosis for dogs with chronic symptoms of the upper respiratory tract, such as increased local volume, nasal discharge, nosebleed, and sneezing. These signs are consistent with those described in this report. Radiographic evaluation was performed in 2 cases and both showed changes in bone radiopacity and trabeculae conformation, in addition to areas of bone lysis and cell proliferation, which are common in neoplastic processes. A presumptive diagnosis can be achieved from the medical history, clinical signs, and physical examination. Cytological and histopathological examination are the confirmatory methods; however, it is used less frequently and especially when cytological evaluation does not provide a definitive diagnosis. Antineoplastic chemotherapy with vincristine is the first-choice treatment protocol, which also proved to be effective for the patients in this report. Although TVT commonly affects the external genitalia of dogs, in the cases reported herein, it was located exclusively in the nasal region. Keywords: TVT, dog, nasal, vincristine.Título: Tumor venéreo transmissível (TVT) nasal em cãesDescritores: TVT, cão, nasal, vincristine.

Nasal Transmissible Venereal Tumor (TVT) with Bone Metastasis in a Dog

Background: Transmissible venereal tumor (TVT) is a highly contagious round cell neoplasm that affects dogs, and it is usually transmitted through coitus. The tumor is mainly located in the genital area; however, the neoplasm can also be extragenital, affecting the nose, mouth, and eyes, as well as the skin and superficial lymph nodes. Cytological examination is the most commonly used method for definitive diagnosis due to its low cost and fast execution. Chemotherapy, radiotherapy, surgical resection, and other procedures such as cryosurgery are the possible treatment options. The objective of this report was to describe a case of extragenital TVT with nasal primary site and metastasis in the bone tissue in a dog treated at a private veterinary hospital in the city of Belém, Pará, Brazil.Case: A 6-year-old male domiciliary Labrador Retriever dog, weighing 24.2 kg, received oncologic treatment in a private veterinary hospital in the city of Belém, Pará, Brazil. The animal had a history of neoplastic disease, and he had undergone TVT resection associated with chemotherapy treatment more than 3 years ago. The clinical examination revealed a volume increase in the periorbital region, left lateral ocular displacement, left nostril excessive epistaxis, recurrent sneezing, cough, and pain signs, and tumor metastasis was suspected. Complementary exams of oncological cytology, computed tomography (CT), hemogram, and serum biochemistry were requested for diagnosis and staging of the condition, and supportive therapy was prescribed. The cytological report showed a dense population of neoplastic round cells with characteristics of TVT. CT indicated the presence of a heterogeneous hypodense mass with irregular contours and partially defined limits, with slight uptake of the intravenously injected contrast medium that obliterated the nasal cavity, maxillary recess, nasopharyngeal meatus, frontal sinus, and sphenoid sinus on the left side. The hematological analysis revealed mild anemia, neutrophilia, and lymphopenia, while the biochemical analysis only showed hypocalcemia. The prescribed therapy was amoxicillin + potassium clavulanate, omega-3, firocoxib, tranexamic acid, and finally chemotherapy with lomustine. Since the patient did not return for follow-up, the outcome could not be determined.Discussion: The patient described in this report was a domiciliary dog who did not live with other pets, but had access to the community environment and contact with other animals. The animal’s history, clinical signs, and cytological and imaging findings were consistent with those of TVT. In extragenital presentations of TVT, the inguinal and sublumbar lymph nodes, lungs, and abdominal organs are most commonly affected. Furthermore, bone involvement is rare, as this has not been commonly described in the literature as compared to the other sites of metastases. An abrasive brush was used for the cytological sample collection, because it provides slides with richer cells as compared to the imprint samples. CT is an important tool for the diagnosis of neoformations in the skeleton, and this method demonstrated high efficiency in identifying the bone involvement and the degree of the invasion and lesion in this case. The therapeutic agents used in this case were different from the usual, since the patient was given lomustine (40 mg/capsule, orally) in the metronomic chemotherapy. This drug has been previously used as an alternative in a canine TVT case resistant to vincristine.Keywords: neoplasm, extragenital, computed tomography, TVT.Título: Tumor Venéreo Transmissível (TVT) nasal com metástase óssea em um cãoDescritores: neoplasia, extragenital, tomografia computadorizada, TVT.

Nephrectomy in a Dog infected with Dioctophyma renale - Mato Grosso do Sul, Brazil

Background: Dioctophymosis is caused by Dioctophyma renale, a parasite known as the giant kidney worm, that can parasitize the kidneys of domestic and wild animals. There are also reports of its occurrence in humans, thus revealing its zoonotic potential. In most cases, parasitized animals are asymptomatic. This parasite can cause atrophy or destroy the renal parenchyma, although ectopic locations may occur. The diagnosis is made through ultrasonography, based on the presence of eggs in the urine, visualization of the parasite, or during necropsy. Therefore, the aim of this work was to report the case of a young dog infected with D. renale and subjected to nephrectomy in the state of Mato Grosso do Sul, Brazil.Case: A 6-month-old bitch with a clinical suspicion of hydronephrosis in the right kidney was referred to the Veterinary Hospital of Anhanguera-Uniderp University in the city of Campo Grande, MS. A physical examination of the patient revealed an alteration in the urinary system. An abdominal ultrasound, urinalysis, complete blood count (CBC) tests and biochemical profile were ordered. The erythrogram indicated erythrocytosis resulting from dehydration and loss of body fluids, while enzyme levels (creatinine, urea, alanine aminotransferase [ALT] and albumin) were within normal limits. The abdominal ultrasound showed the presence of a cylindrical and rounded structure characteristic of a nematode and in the right kidney, and loss of renal parenchyma typical of D. renale infection. A urinalysis then revealed the presence of helminth eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affected right kidney, which showed destruction of the renal parenchyma. One adult female and one adult male parasite were removed from inside the kidney, measuring approximately 50 cm and 35 cm in length. The patient was successfully treated, kept in hospital for observation, and returned two weeks later for reassessment of her renal function and removal of stitches. Discussion: Dioctophymosis is often diagnosed based on ultrasound and urine tests. These tests proved sufficient to diagnose parasitism by D. renale. However, the infection is usually discovered during necropsy. D. renale is popularly known as the giant kidney worm, as it can reach up to 100 cm in length. In the present case, the female parasite was 50 cm long and the male was 35 cm. The patient presented parasitism very young, at just 6 months of age. The parasitic infection of the animal was attributed to the ingestion of water or food contaminated with an intermediate host, the aquatic annelid Lumbriculus variegatus. It is suggested that the ingestion of food or water contaminated with the infective stage of the parasite may have occurred at 2 months of age or younger, since the prepatent period is approximately 6 months. The parasite was found only in the patient’s right kidney. Hydronephrosis was reported in the patient and was caused by obstruction of the internal urethral ostium by the adult nematode. In this case, the recommended surgical treatment was nephrectomy, to which the patient was subjected, leading to successful recovery. This case occurred in the state of Mato Grosso do Sul, where there are no records of parasitism by D. renale in domestic dogs, unlike other states in Brazil. We therefore emphasize the importance of new studies on D. renale, given the lack of clear records describing the parasite’s epidemiological data, biological cycle and diagnosis, which may hinder the prevention and control of this zoonotic disease.Keywords: canine dioctophymosis, helminth, nematoid, giant kidney worm, hydronephrosis.Descritores: dioctofimose canina, helminto, nematoide, verme gigante renal, hidronefrose.

Braquial Plexus Block and Lumbosacral Epidural in a South American Coati (Nasua nasua)

Background: The South American coatis (Nasua nasua) are capable of adapting to different habitats, which allowed them to exchange between domestic and wild areas, increasing the occurrence of traumas. Procedures performed in this species demand anesthetic protocols that take comorbidities into account and cause minimal cardiorespiratory depression as well as rapid recovery. It is in such context that locoregional anesthesia has become an essential tool. Thus, we aim to report the use of two techniques of locoreginal block: brachial plexus block and lumbosacral epidural block, in a Nasua nasua submitted to osteosynthesis of the radius and caudectomy due to trauma.Case: A adult male coati weighing 2.3 kg was referred to the Veterinary Medical Teaching Hospital of the Universidade Federal do Paraná (UFPR) - Setor Palotina with a history of trauma. Physical examination showed crackling in the radius and ulnar region, and also abnormal angulation in the distal portion of the tail. After taking x-rays, fractures were confirmed in the distal radius and in the distal portion of the tail. The patient was referred for surgery. After 8 h of water and food withdrawal, the animal was premedicated with a combination of ketamine (10 mg/kg), midazolam (0.3 mg/kg) and methadone (0.2 mg/kg), intramuscularly (IM). Induction of anesthesia was performed with propofol titrated to effect (total dose 4 mg/kg) and anesthesia was maintained with isoflurane in spontaneous ventilation using a non-rebreathing circuit (Baraka). It was evaluated heart rate (HR), respiratory rate (RF), end-tidal CO2 (EtCO2), expired isoflurane fraction (FE´Iso), oxyhemoglobin saturation (SpO2), electrocardiography (ECG), systolic blood pressure (SBP) and core temperature (CT) using a multiparametric monitor. After the stabilization period, the animal was positioned in lateral recumbence. A subscapular brachial plexus block was performed with bupivacaine (0.2 mL/kg) using a peripheral nerve stimulator to ensure the correct perineural deposition of the local anesthetic. During anesthesia, rescue analgesia was administered when there was a 20% increase in HR, RR or SBP compared to baseline values. Thus, in this case, two rescues with fentanyl (2 µg/kg) were necessary. The animal remained stable and, at the end of the first procedure, he was placed in ventral recumbence, with the hindlimbs pulled cranially in order to locate the lumbosacral space. Epidural injection was performed with lidocaine (0.18 mL/kg). Rescue analgesia was not necessary during the caudectomy procedure. The procedure had a total duration of 3 h and extubation occurred 3 min after inhalation anesthesia withdrawal. At the end of the surgery, the animal was medicated with meloxicam (0.1 mg/kg) and methadone (0.2 mg/kg). Two h after the end of the surgery, the animal was able to feed again.Discussion: The literature is scarce regarding anesthetic techniques in the Nasua nasua species, especially in the context of locoregional anesthesia. In this report, the protocol used as pre-anesthetic medication was considered satisfactory. Brachial plexus block is a safe technique for desensitizing the forelimb for surgical procedures distal to the scapulohumeral joint. Despite some morphological differences in the spinal anatomy of coatis, there was no difficulty in identifying the epidural space or inserting the needle. The absence of complications, and the hemodynamic stability during the anesthesia period, combined with the satisfactory recovery of the patient points to the success of the techniques used in the present report.

Mandibulectomy in feline with bacterial fibrosing osteomyelitis

Background: Fibrosing osteomyelitis is a chronic inflammatory process caused by infectious agents that lead to the destruction and replacement of bone tissue by fibroblasts. The diagnosis is based especially on histopathological and bacterial culture. In cases where extensive and irreversible injuries are observed, surgical treatment may be indicated. The objective of this work is to report the clinical, radiographic, histopathological, and microbiological aspects of a cat presenting fibrosing osteomyelitis.Case: A 10-year-old male feline, no defined breed, weighing 3.9 kg was referred to one Private Veterinary Clinic of Fortaleza, CE, Brazil with a history of left mandibular enlargement, presenting dysphagia, sialorrhea, an increase in firm consistency along of the left mandibular body, temporomandibular arthralgia and decreased joint motion range. On cranium radiograph, signs of proliferative osteopathy of irregular contours were observed in the branch and body of the left mandible and extending to the rostral region of the right mandible, suggesting a neoplastic process. After anesthesia, for better assessment of the oral cavity, a sample was collected by incisional biopsy, however, the histopathological result was nonspecific. In view of the inconclusive condition, it was decided to perform left hemimandibulectomy combined with right partial mandibulectomy. Tissue samples were obtained and sent for microbiological and histopathological analyses. The last test revealed an inflammatory reaction consisting of neutrophils and plasma cells, associated with a large amount of fibrous connective tissue, multifocal bacterial aggregates, necrosis and bone resorption. Based on the findings, the diagnosis of chronic bacterial osteomyelitis was concluded. The microbiological culture demonstrated the growth of the bacterium Pseudomonas aeruginosa, with sensitivity to cefovecin, which was administered to the treatment in doses of 8 mg/kg/SC, every 15 days, for 60 days. After 10 days of the surgery, the patient was able to start the process of swallowing and seizing pasty food.Discussion: Although radiography is a diagnostic method of choice to assess the extent of bone involvement, it hardly allows the distinction between neoplastic processes and osteomyelitis. Thus, in addition to the cranium radiographic examination, that revealed signs of proliferative osteopathy with irregular contours in branch and body topography of the left mandible were required biopsy and bacterial culture. After mandibulectomy, difficulty in retracting the tongue and anorexia were observed in the first days. Despite that, from the 12th day on, there was an improvement in food seizure, with the return to voluntary feeding. Mandibulectomy is indicated in cases where extensive and irreversible lesions are observed, although excision of the caudal mandible to the third or fourth premolar tooth is not recommended, because it compromises the sublingual musculature, with fall of the tongue and loss of function apprehension. In the present case, the caudal portion of the right mandibular branch was maintained, which facilitated the return of spontaneous feeding. The tissue removed was necessary to perform a microbiological culture with antibiogram, essential to determine the possible etiologic agent and choosing antimicrobial drugs. For the treatment of P. aeruginosa infection, cefovecin was prescribed due to the dosage and route of administration that collaborate with the mandibular surgery, once that the oral treatment is more difficult. Post-surgical complications related to mandibular resection, such as anorexia and difficulty in grasping food, are common. However, in the present case, the patient had an adequate reestablish after 15 days. Therefore, hemimandibulectomy is effective in treating fibrosing osteomyelitis, with maintenance of the patient's ingestive function.