Bloqueio do plexo braquial guiado por neuroestimulação elétrica em jabuti piranga (Chelonoidis carbonarius) submetido à intervenção cirúrgica em membro torácico: Relato de caso / Brachial plexus block guided by electrical neurostimulation in a tortoise (Chelonoidis carbonarius) undergoing surgical intervention in the forelimb: Case report

A anestesia local tem sido recomendada para intervenções cirúrgicas quando se procura evitar a anestesia geral do animal com o intuito de minimizar os riscos, que podem ocorrer durante o aprofundamento do plano anestésico, além de promover uma rápida recuperação. O presente trabalho descreve o caso de um jabuti piranga (C. carbonarius) submetido à contenção química associada a bloqueio anestésico em plexo braquial para realização da excisão cirúrgica de um abcesso em membro tórácico direito, sendo apresentadas considerações sobre a aplicabilidade desta técnica em quelônios com destaque para os cuidados a serem tomados pelo anestesista durante a intervenção.(AU)

Local anesthesia has been recommended for surgical interventions when trying to avoid the need of general anesthesia of the animal and to minimize any risks that may occur during the deepening of the anesthetic plane, in addition to promoting a quick recovery. The present work describes the case of a tortoise (C. carbonarius) submitted to chemical restraint associated whit anesthesic blockage in the brachial plexus during surgical intervention to remove an abscess in the right thoracic limb, presenting considerations about the applicability of this technique in chelonians, with emphasis on the care to be taken by the anesthesiologist during the intervention.(AU)

Anatomorphometry of the brachial plexus under high-definition system: an experimental study in rats

Purpose: To study the anatomorphometry of the plexus brachialis (PB) of rats under a high-definition video system. Methods: Ten male Wistar rats discarded from other research that did not interfere in the morphology of the animal, respecting the principle of reduction, were used. All animals were submitted to the same protocol. Initially, the cervical region was shaved. The animals were placed in a dorsal position. A single elbow-to-elbow incision was performed and dissection started at the deltopectoral sulcus. The procedures were performed under a video system. To measure the structures, the Image J software was used. Results: All the PB evaluated originated from the C5-T1 spinal nerves. C5 and C6 converged to form the truncus superior, the root of C7 originated the truncus medius, and the confluence of C8 and T1 originated the truncus inferior. It was found the union of C7, C8, and T1 to form truncus inferomedialis instead of separate medial and inferior truncus. C8 (1.31 mm) was the thickest root, the truncus inferior (1.80 mm) and the nerve radialis (1.02 mm), were the thickest. Conclusions: The anatomy of the PB is comparable to humans, admitting variations. The videomagnification system is useful to perform microsurgical dissection.

Fratura de úmero em uma curicaca (Theristicus caudatus) - manejo anestésico e cirúrgico / Humerus fracture in a buff-necked ibis (Theristicus caudatus) - anesthesia and surgical procedures

Background: The medical science of birds, with the exception of aviculture, has a very short history compared to other subdisciplines of veterinary medicine. With this in mind, the current work aims to report the case of a buff-necked ibis with an open fracture of the left humerus, presenting the surgical treatment and anesthetic protocol used, in order to contribute to the avian medical literature. Case: An adult buff-necked ibis (Theristicus caudatus) was referred to the University Veterinary Hospital with an open fracture of the left humeral shaft, 7 days after rescue. During the physical examination, a skin lesion was identified in the fracture area, with signs of low vascularization, devitalization, necrotic tissues, and purulent secretions being noted. On radiographic examination, the fracture was classified as comminuted, with exposure of the left humeral shaft. After evaluating the limb, it was decided to amputate the wing, and 24 h later, the patient was referred to the operating room after fasting for 4 h. As pre-anesthetic medication, ketamine (20 mg/kg) and midazolam (1 mg/kg) were administered, both intramuscularly. Orotracheal intubation was performed, after which the tracheal tube was connected to a Baraka-type gas-free system and the supply of isoflurane was started through a universal vaporizer, diluted in 100% oxygen. For transoperative analgesia, brachial plexus block was performed using 2% lidocaine (2 mg/kg). During the surgical procedure, an incision was made in the skin and subcutaneous tissue in the middle third of the left humerus, and detachment of the greater deltoid muscle was performed with a periosteal elevator, followed by excision of the tensor propatagialis. In the ventrodorsal region, circular ligation of the brachial vein, ulnar vein and artery, and median-ulnar nerve was carried out, and disarticulation of the scapulacoracoid-humeral region. Subsequently, abolition of dead space and a myorrhaphy were performed, followed by demorrhaphy. In the immediate post-operative period, morphine (5 mg/kg), meloxicam (0.1 mg/kg), and enrofloxacin (10 mg/kg) were administered intramuscularly. The patient was discharged from the hospital 6 h after the end of the surgical procedure. Discussion: Interest in the conservation of wild birds is one of the causes of the increased demand for anesthetic and surgical procedures in these species. However, it is a challenge for professionals in the field. The use of analgesics is recommended for reasons of well-being, but also because of the possibility of reducing the concentration of inhalational anesthetics in surgical procedures. Ketamine associated with midazolam promotes sufficient sedation and muscle relaxation in the patient, enabling safe preoperative management, in addition to reducing the amount of inhaled anesthetics used during the transoperative period. Isofluorane promotes safe general anesthesia for birds and has an advantage over injectable drugs, as it provides better dynamic control of anesthetic depth in these species. The brachial plexus block performed is a simple procedure that promotes quality anesthesia and analgesia in the perioperative period. The choice for amputation was due to the absence of musculature for closure, severe skin, muscle, and bone devitalization, and the infectious process in the region, factors that would prevent osteosynthesis. Although amputation through the bone is preferable, the disarticulation technique was used due to the absence of a healthy proximal humeral fragment. The patient's death can be explained by the poor nutritional status the bird was in, as it presented an open fracture with severe contamination, a concomitant injury that occurred during the possible trauma, and the excessive time between the day of the trauma and the day of medical attendance. However, the surgical and anesthetic procedures were adequate and satisfactory for the patient. The importance of identifying and treating diseases secondary to contaminated fractures in these species is emphasized.

Anestesia regional intravenosa (bloqueio de Bier) em urubu-de-cabeça-preta (Coragyps atratus) submetido à amputação de dígito / Regional intravenous anaesthesia (Bier's block) in black-headed vulture (Coragyps atratus) submitted to digit amputation

Background: The Coragyps atratus flies long distances in search of food and has a marked behaviour of food competition. Since they are frequently found in areas of recent human occupation, they are subject to trauma, which may require surgical interventions. Locoregional blocks are used as part of a balanced-anaesthesia protocol and are currently being evaluated in birds, with brachial plexus block being the main technique described in the literature. However, to our knowledge, this is the first description of intravenous regional anaesthesia (Bier's block) in a vulture. Thus, we aim to report the use of Bier's block with 1% lidocaine, in a black-headed vulture submitted to digit amputation. Case: A black-headed vulture (Coragyps atratus), weighing 2 kg, was rescued and referred to the Veterinary Hospital due to its inability to fly. Physical examination revealed a swollen digit in the right pelvic limb. Radiographic examination confirmed the intermediate phalanx fracture of the 4th digit of the right pelvic limb with signs suggestive of advanced osteomyelitis. The animal was referred to surgery for amputation of the affected digit. Before surgery, water and food were withdrawn for 12 h. Pre-anaesthetic medication consisted of 1 mg/kg midazolam and 0.5 mg/kg morphine intramuscularly (IM). Anaesthetic induction was performed through face mask with isoflurane, followed by orotracheal intubation with a 3 mm-endotracheal tube. Anaesthesia was maintained with isoflurane through a non-rebreathing circuit in 100% oxygen. Using a multiparametric monitor, heart rate (HR), respiratory rate (RR), end-tidal CO2 (EtCO2 ), oxyhemoglobin saturation (SpO2 ), electrocardiography (ECG), systolic blood pressure (SBP) and core temperature (CT) were evaluated. Antisepsis of the right pelvic limb was performed and an elastic band was applied around the distal region of the affected tibia to serve as a tourniquet. A scalp vein set was used to access the lateral saphenous vein in the region distal to the tourniquet, and 5 mg/ kg lidocaine 1% was injected intravenously. The patient remained stable during the procedure, with no need for analgesic rescue. The tourniquet was gradually released 40 min past its application, being completely removed after 45 min of surgery. The anaesthetic supply was interrupted, with extubation after 4 min; the patient had satisfactory anaesthetic recovery. Discussion: The present report describes the success in using the technique of intravenous regional anaesthesia with 1% lidocaine for digit amputation performed on a specimen of black-headed vulture. The pre-anaesthetic medication provided analgesia, satisfactory sedation for venoclysis, and anaesthetic induction without complications. Anaesthetic induction and maintenance in birds are preferably performed with inhaled anaesthetics, thus the choice of mask induction. Despite the reduction in RR soon after induction, the patient remained on spontaneous ventilation. Bier's block using 5 mg/kg lidocaine showed to be an easy and safe technique in vultures, but doses up to 6 mg/kg lidocaine are not associated with adverse effects in birds. The intravenous regional anaesthesia technique described in this manuscript promoted adequate analgesia for the digit amputation procedure in black-headed vultures and allowed hemodynamic stability without significant anaesthetic complications. Thus, the present report points to the potential use of this locoregional block in other birds.

Bloqueio do plexo-braquial e peridural lombossacra em um quati (Nasua nasua) / Brachial 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 themto exchange between domestic and wild areas, increasing the occurrence of traumas. Procedures performed in this speciesdemand anesthetic protocols that take comorbidities into account and cause minimal cardiorespiratory depression as wellas rapid recovery. It is in such context that locoregional anesthesia has become an essential tool. Thus, we aim to reportthe use of two techniques of locoreginal block: brachial plexus block and lumbosacral epidural block, in a Nasua nasuasubmitted 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 UniversidadeFederal 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 wereconfirmed in the distal radius and in the distal portion of the tail. The patient was referred for surgery. After 8 h of waterand 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-rebreathingcircuit (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 coretemperature (CT) using a multiparametric monitor. After the stabilization period, the animal was positioned in lateral...

Bloqueio do plexo-braquial e peridural lombossacra em um quati (Nasua nasua) / Brachial 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 themto exchange between domestic and wild areas, increasing the occurrence of traumas. Procedures performed in this speciesdemand anesthetic protocols that take comorbidities into account and cause minimal cardiorespiratory depression as wellas rapid recovery. It is in such context that locoregional anesthesia has become an essential tool. Thus, we aim to reportthe use of two techniques of locoreginal block: brachial plexus block and lumbosacral epidural block, in a Nasua nasuasubmitted 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 UniversidadeFederal 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 wereconfirmed in the distal radius and in the distal portion of the tail. The patient was referred for surgery. After 8 h of waterand 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-rebreathingcircuit (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 coretemperature (CT) using a multiparametric monitor. After the stabilization period, the animal was positioned in lateral...(AU)

Crises epilépticas reativas por hiperlipidemia em cão Maltês / Reactive seizures due to hyperlipidemia in a maltese dog

Background: Primary hyperlipidemia is a condition that affects some specific breeds. It has been previously describedin Miniature Shnauzer, Beagles, Shetland Shepdog and West Highland White Terrier. There are no reports of primaryhyperlipidemia in Maltese dogs. It is a hereditary disorder of lipoprotein metabolism. The etiology is unknown and maybe related to a genetic problem in lipoprotein lipase or to the absence of apaprotein CII. Clinical signs include spontaneousarterosclerosis, retinal lipemia, cutaneous xanthomas, abdominal pain, lethargy, vomiting and / or diarrhea. Neurologicalmanifestations such as seizures and behavioral changes may also occur. The aim of this report is to describe a case ofreactive seizures due to hyperlipidemia in a dog.Case: A 5-year-old male Maltese dog was admitted with a history of seizures. Hypertension and abdominal distensionwith large amounts of intestinal gases were found in general physical examination. Neurological examination revealedimpaired nasal septum sensory perception, which was slightly bilaterally reduced, and pain on cervical palpation and inthe brachial plexus region. Based on history and clinical examination, it was possible to locate the lesion in the thalamocortical region and to suspect idiopathic epilepsy, reactive seizures, and symptomatic epilepsy due to meningoencephalitisof unknown origin. The diagnosis of primary hyperlipidemia was made by exclusion with the aid of laboratory tests andultrasound. After the establishment of a fat restriction diet, bezafibrate, phenobarbital, and omega-3 supplementation, theanimal improved significantly with the reduction of epileptic seizures.Discussion: The initial clinical suspicion was hyperadrenocorticism as the primary cause of hyperlipidemia. This suspicion was based on the presence of polyphagia, polydipsia, polyuria and abdominal distension, together with laboratory...

Crises epilépticas reativas por hiperlipidemia em cão Maltês / Reactive seizures due to hyperlipidemia in a maltese dog

Background: Primary hyperlipidemia is a condition that affects some specific breeds. It has been previously describedin Miniature Shnauzer, Beagles, Shetland Shepdog and West Highland White Terrier. There are no reports of primaryhyperlipidemia in Maltese dogs. It is a hereditary disorder of lipoprotein metabolism. The etiology is unknown and maybe related to a genetic problem in lipoprotein lipase or to the absence of apaprotein CII. Clinical signs include spontaneousarterosclerosis, retinal lipemia, cutaneous xanthomas, abdominal pain, lethargy, vomiting and / or diarrhea. Neurologicalmanifestations such as seizures and behavioral changes may also occur. The aim of this report is to describe a case ofreactive seizures due to hyperlipidemia in a dog.Case: A 5-year-old male Maltese dog was admitted with a history of seizures. Hypertension and abdominal distensionwith large amounts of intestinal gases were found in general physical examination. Neurological examination revealedimpaired nasal septum sensory perception, which was slightly bilaterally reduced, and pain on cervical palpation and inthe brachial plexus region. Based on history and clinical examination, it was possible to locate the lesion in the thalamocortical region and to suspect idiopathic epilepsy, reactive seizures, and symptomatic epilepsy due to meningoencephalitisof unknown origin. The diagnosis of primary hyperlipidemia was made by exclusion with the aid of laboratory tests andultrasound. After the establishment of a fat restriction diet, bezafibrate, phenobarbital, and omega-3 supplementation, theanimal improved significantly with the reduction of epileptic seizures.Discussion: The initial clinical suspicion was hyperadrenocorticism as the primary cause of hyperlipidemia. This suspicion was based on the presence of polyphagia, polydipsia, polyuria and abdominal distension, together with laboratory...(AU)

Description of brachial plexus of sloth (Bradypus variegatus) / Descrição do plexo braquial do bicho-preguiça (Bradypus variegatus)

The species Bradypus variegatus is known as the common sloth, an endemic mammal from neotropical regions, which has been suffering from devastating anthropogenic activities. Our study aimed to describe the brachial plexus of B. variegates, regarding the origin and distribution of nerves, through the sampling of 10 adult females. Analyses were carried out at the Anatomy Section, "Departamento de Morfologia e Fisiologia Animal", "Universidade Federal Rural de Pernambuco", under license no. 034/2015 of the Ethics Committee on the Use of Animals. The results determined that the brachial plexus of the common sloth starts from the fifth cervical spine segment until the second thoracic segment. This area contains the long and suprascapular thoracic nerves, which originate immediately from the medullary segment 5 and 6, respectively, and from the pectoral, subscapular, axillary, radial, musculocutaneous, medial, forearm and ulnar medial cutaneous nerves, arising from a trunk comprised of cervical spine nerves (C) 7, C8, C9, and thoracic (T) 1 and T2. Regarding other wild and domestic animals, different suggestions were observed about the origin of the plexus in B. variegatus, however, the constituent nerves and their innervation areas did not demonstrate any discrepancies.(AU)

A espécie Bradypus variegatus é conhecida como preguiça-comum. Trata-se de um mamífero endêmico de regiões neotropicais que vem sofrendo com a ação antrópica devastadora. Esses Bradipodídeos possuem três dedos nos membros torácicos e pélvicos, são arborícolas consagrados e descem ao solo apenas para excretar e trocar de árvore. O estudo teve como objetivo descrever o plexo braquial de B. variegatus em relação à origem e distribuição dos nervos. Para tal, utilizou-se 10 fêmeas adultas. As análises foram realizadas no Pavilhão de Anatomia do Departamento de Morfologia e Fisiologia Animal da Universidade Federal Rural de Pernambuco, sob a licença nº 034/2015 do Comitê de Ética no Uso de Animais. Os cadáveres foram obtidos após morte natural, fixados em formaldeído a 20%, conservados em solução salina a 30% em tanques e dissecados para a visualização dos nervos destinados a inervar os membros e músculos torácicos. Uma vez feito, constatou-se que o plexo braquial da preguiça-comum se origina do quinto segmento espinal cervical, se estendendo até o segundo segmento torácico. Sendo formado pelos nervos torácico longo e supraescapular, de origem imediatamente do segmento medular 5 e 6, respectivamente, e pelos nervos peitorais, subescapulares, axilar, radial, musculocutâneo, mediano, cutâneo medial do antebraço e ulnar, decorrentes de um tronco formado a partir de nervos espinais cervicais (C) 7, C8, C9, e torácicos (T) 1 e T2. Em comparação a outros animais silvestres e domésticos foram observadas diferentes disposições em relação à origem do plexo de B. variegatus, todavia, os nervos constituintes e suas áreas de inervação não apresentaram discrepâncias.(AU)

Description of brachial plexus of sloth (Bradypus variegatus) / Descrição do plexo braquial do bicho-preguiça (Bradypus variegatus)

The species Bradypus variegatus is known as the common sloth, an endemic mammal from neotropical regions, which has been suffering from devastating anthropogenic activities. Our study aimed to describe the brachial plexus of B. variegates, regarding the origin and distribution of nerves, through the sampling of 10 adult females. Analyses were carried out at the Anatomy Section, "Departamento de Morfologia e Fisiologia Animal", "Universidade Federal Rural de Pernambuco", under license no. 034/2015 of the Ethics Committee on the Use of Animals. The results determined that the brachial plexus of the common sloth starts from the fifth cervical spine segment until the second thoracic segment. This area contains the long and suprascapular thoracic nerves, which originate immediately from the medullary segment 5 and 6, respectively, and from the pectoral, subscapular, axillary, radial, musculocutaneous, medial, forearm and ulnar medial cutaneous nerves, arising from a trunk comprised of cervical spine nerves (C) 7, C8, C9, and thoracic (T) 1 and T2. Regarding other wild and domestic animals, different suggestions were observed about the origin of the plexus in B. variegatus, however, the constituent nerves and their innervation areas did not demonstrate any discrepancies.(AU)

A espécie Bradypus variegatus é conhecida como preguiça-comum. Trata-se de um mamífero endêmico de regiões neotropicais que vem sofrendo com a ação antrópica devastadora. Esses Bradipodídeos possuem três dedos nos membros torácicos e pélvicos, são arborícolas consagrados e descem ao solo apenas para excretar e trocar de árvore. O estudo teve como objetivo descrever o plexo braquial de B. variegatus em relação à origem e distribuição dos nervos. Para tal, utilizou-se 10 fêmeas adultas. As análises foram realizadas no Pavilhão de Anatomia do Departamento de Morfologia e Fisiologia Animal da Universidade Federal Rural de Pernambuco, sob a licença nº 034/2015 do Comitê de Ética no Uso de Animais. Os cadáveres foram obtidos após morte natural, fixados em formaldeído a 20%, conservados em solução salina a 30% em tanques e dissecados para a visualização dos nervos destinados a inervar os membros e músculos torácicos. Uma vez feito, constatou-se que o plexo braquial da preguiça-comum se origina do quinto segmento espinal cervical, se estendendo até o segundo segmento torácico. Sendo formado pelos nervos torácico longo e supraescapular, de origem imediatamente do segmento medular 5 e 6, respectivamente, e pelos nervos peitorais, subescapulares, axilar, radial, musculocutâneo, mediano, cutâneo medial do antebraço e ulnar, decorrentes de um tronco formado a partir de nervos espinais cervicais (C) 7, C8, C9, e torácicos (T) 1 e T2. Em comparação a outros animais silvestres e domésticos foram observadas diferentes disposições em relação à origem do plexo de B. variegatus, todavia, os nervos constituintes e suas áreas de inervação não apresentaram discrepâncias.(AU)

Criteria for assessing peripheral nerve injury: behavioral and functional assessment in non-operated Wistar rats

Purpose To evaluate the normality pattern in functional tests of peripheral nerves. Methods Sixty female and sixty male Wistar rats were submitted to vibrissae movement and nictitating reflex for facial nerve; grooming test and grasping test for brachial plexus; and walking tracking test and horizontal ladder test for lumbar plexus. The tests were performed separately, with an interval of seven days between each. Results All animals showed the best score in vibrissae movement, nictitating reflex, grooming test, and horizontal ladder test. The best score was acquired for the first time in more than 90% of animals. The mean of strength on the grasping test was 133.46±12.08g for the right and 121.74±8.73g for the left anterior paw. There was a difference between the right and left sides. There was no difference between the groups according to sex. There is no statistical difference comparing all functional indexes between sex, independent of the side analyzed. The peroneal functional index showed higher levels than the sciatic and tibial functional index on both sides and sex. Conclusions The behavioral and functional assessment of peripheral nerve regeneration are low-cost, easy to perform, and reliable tests. However, they need to be performed by experienced researchers to avoid misinterpretation.(AU)

Tumor maligno da bainha de nervo periférico em rim esquerdo de canino da raça whippet / Malignant tumor of the peripheral nerve sheath in a left whippet canine kidney

Background: Malignant tumors of the peripheral nerve sheath (MTPNS`s) are considered rare tumors that can affect soft tissues. In dogs, the occurrence is more common in the nerves of the brachial plexus, but they can affect the lumbosacral plexus and cranial nerves. Rarely, they can affect spinal nerves and nerve roots and the urinary tract, especially in kidneys. The present report aims to describe a clinical case of a 10-year-old sterilized female whippet, who had a history of persistent hematuria for months, with subsequent diagnosis of MTPNS as the cause of hematuria. Case: The patient came for evaluation with a history of persistent hematuria. Evaluation of abnormal elements and sedimentation, showed the description of numerous red blood cells and the presence of proteinuria. The abdominal ultrasound revealed a left kidney with enlarged dimensions, irregular contour, loss of corticomedullary definition. The urinary vesicle showed an increase in cellularity. On physical examination, the patient had vital parameters within the normal range. A Snap 4DX® Plus exam was requested, which showed a reaction for Dirofilaria immitis. With this result, it was initially suspected that renal vasculitis. After starting the treatment, the patient started to present normal colored urine. However, after the end of this period, the patient returned to hematuria. After six months of treatment and without justification for the permanence of hematuria, urethrocystoscopy was indicated, which revealed a urinary vesicle with a hemorrhagic focus. A urinary bladder wall biopsy was performed, which showed no changes. Four months after the urethrocystoscopic exam, the patient had her first azotemic crisis. This time that the left renal neoformation observed on ultrasound examination. With the discovery of the origin of the problem, a therapeutic approach could be instituted, consisting of the left...

Tumor maligno da bainha de nervo periférico em rim esquerdo de canino da raça whippet / Malignant tumor of the peripheral nerve sheath in a left whippet canine kidney

Background: Malignant tumors of the peripheral nerve sheath (MTPNS`s) are considered rare tumors that can affect soft tissues. In dogs, the occurrence is more common in the nerves of the brachial plexus, but they can affect the lumbosacral plexus and cranial nerves. Rarely, they can affect spinal nerves and nerve roots and the urinary tract, especially in kidneys. The present report aims to describe a clinical case of a 10-year-old sterilized female whippet, who had a history of persistent hematuria for months, with subsequent diagnosis of MTPNS as the cause of hematuria. Case: The patient came for evaluation with a history of persistent hematuria. Evaluation of abnormal elements and sedimentation, showed the description of numerous red blood cells and the presence of proteinuria. The abdominal ultrasound revealed a left kidney with enlarged dimensions, irregular contour, loss of corticomedullary definition. The urinary vesicle showed an increase in cellularity. On physical examination, the patient had vital parameters within the normal range. A Snap 4DX® Plus exam was requested, which showed a reaction for Dirofilaria immitis. With this result, it was initially suspected that renal vasculitis. After starting the treatment, the patient started to present normal colored urine. However, after the end of this period, the patient returned to hematuria. After six months of treatment and without justification for the permanence of hematuria, urethrocystoscopy was indicated, which revealed a urinary vesicle with a hemorrhagic focus. A urinary bladder wall biopsy was performed, which showed no changes. Four months after the urethrocystoscopic exam, the patient had her first azotemic crisis. This time that the left renal neoformation observed on ultrasound examination. With the discovery of the origin of the problem, a therapeutic approach could be instituted, consisting of the left...(AU)

Bloqueio do plexo braquial em jumento - relato de caso / Brachial plexus block in donkey - case report

A anestesia locorregional reduz o requerimento de agentes inalatórios e diminui as respostas autonômicas a estímulos cirúrgicos nocivos. Objetiva-se descrever um bloqueio anestésico do plexo braquial guiado por neuroestimulador em jumento, submetido à amputação do membro anterior direito. Foi realizada medicação pré-anestésica com detomidina 0,01mg.kg-1, indução com diazepam 0,05mg.kg-1 e cetamina 2mg.kg-1, todos pela via intravenosa (IV), e a manutenção da anestesia com isoflurano. O plexo braquial foi bloqueado por acesso subescapular, sendo usado neuroestimulador. Utilizou-se 1mg.kg-1 de bupivacaína 0,5% sem vasoconstritor, associada a 1mg.kg-1 de lidocaína 2% sem vasoconstrictor. Os valores de FC e ƒ durante o procedimento cirúrgico variaram de 62 a 78bpm e de 24 a 32rpm, respectivamente. Foram coletadas quatro amostras de sangue para dosagem de cortisol. Este, antes da aplicação da medicação pré-anestésica, foi de 6,4µg/dL e, 30 minutos após a MPA, foi de 2,8µg/dL. A recuperação anestésica foi rápida e sem complicações. O bloqueio do plexo braquial guiado por neuroestimulador mostrou-se eficaz em jumentos, fornecendo analgesia e anestesia satisfatória.(AU)

Locoregional anesthesia reduces the requirement for inhaled agents and reduces the autonomic responses to noxious surgical stimuli. The aim of this study was to describe an anesthetic block of the brachial plexus guided by a neurostimulator in a donkey submitted to right limb amputation. Preanesthetic medication was performed with detomidine 0.01mg.kg-1 induction with diazepam 0.05mg.kg-1 and ketamine 2mg.kg-1 all intravenously, and maintenance of anesthesia with isoflurane. The brachial plexus was blocked by subscapular access, using a neurostimulator. For this purpose, 1mg.kg -1 of bupivacaine 0.5%, without vasoconstrictor, and 1mg.kg- 1 of lidocaine 2%, without vasoconstrictor were used. The values of HR and ƒ during the surgical procedure ranged from 62 to 78bpm, and 24 to 32bpm, respectively. Four blood samples were collected for cortisol dosing. This, prior to the application of the pre-anesthetic medication was 6.4µg/dL and 30 minutes was 2.8µg/dL. Anesthesia recovery was rapid and uncomplicated. Neurostimulator-guided brachial plexus blockade proved to be effective in donkeys, providing satisfactory analgesia and anesthesia.(AU)

Bloqueio do plexo braquial em jumento - relato de caso / Brachial plexus block in donkey - case report

A anestesia locorregional reduz o requerimento de agentes inalatórios e diminui as respostas autonômicas a estímulos cirúrgicos nocivos. Objetiva-se descrever um bloqueio anestésico do plexo braquial guiado por neuroestimulador em jumento, submetido à amputação do membro anterior direito. Foi realizada medicação pré-anestésica com detomidina 0,01mg.kg-1, indução com diazepam 0,05mg.kg-1 e cetamina 2mg.kg-1, todos pela via intravenosa (IV), e a manutenção da anestesia com isoflurano. O plexo braquial foi bloqueado por acesso subescapular, sendo usado neuroestimulador. Utilizou-se 1mg.kg-1 de bupivacaína 0,5% sem vasoconstritor, associada a 1mg.kg-1 de lidocaína 2% sem vasoconstrictor. Os valores de FC e ƒ durante o procedimento cirúrgico variaram de 62 a 78bpm e de 24 a 32rpm, respectivamente. Foram coletadas quatro amostras de sangue para dosagem de cortisol. Este, antes da aplicação da medicação pré-anestésica, foi de 6,4µg/dL e, 30 minutos após a MPA, foi de 2,8µg/dL. A recuperação anestésica foi rápida e sem complicações. O bloqueio do plexo braquial guiado por neuroestimulador mostrou-se eficaz em jumentos, fornecendo analgesia e anestesia satisfatória.(AU)

Locoregional anesthesia reduces the requirement for inhaled agents and reduces the autonomic responses to noxious surgical stimuli. The aim of this study was to describe an anesthetic block of the brachial plexus guided by a neurostimulator in a donkey submitted to right limb amputation. Preanesthetic medication was performed with detomidine 0.01mg.kg-1 induction with diazepam 0.05mg.kg-1 and ketamine 2mg.kg-1 all intravenously, and maintenance of anesthesia with isoflurane. The brachial plexus was blocked by subscapular access, using a neurostimulator. For this purpose, 1mg.kg -1 of bupivacaine 0.5%, without vasoconstrictor, and 1mg.kg- 1 of lidocaine 2%, without vasoconstrictor were used. The values of HR and ƒ during the surgical procedure ranged from 62 to 78bpm, and 24 to 32bpm, respectively. Four blood samples were collected for cortisol dosing. This, prior to the application of the pre-anesthetic medication was 6.4µg/dL and 30 minutes was 2.8µg/dL. Anesthesia recovery was rapid and uncomplicated. Neurostimulator-guided brachial plexus blockade proved to be effective in donkeys, providing satisfactory analgesia and anesthesia.(AU)

Bloqueio de plexo braquial guiado por neuroestimulador para amputação em bezerro / Nerve stimulator-guided brachial plexus block performed in the amputation of a calf’s forelimb

Background: Locoregional anesthesia techniques enable the performance of procedures in the distal portion of the limbs,through the parenteral administration of local anesthetic nerve block. There are devices that can increase the effectivenessof these blocks by accurately locating the nerves. These devices include peripheral nerve stimulators, which enable anesthetic to be injected near the plexus, thus reducing the volume of anesthetic required and allowing for the specific blockadeof a nerve branch by desensitizing exclusively the area of interest. This paper describes the use of nerve stimulator in thebrachial plexus block (BPB) of a calf subjected to amputation of the left foreleg.Case: A newborn calf weighing 30 kg, with a history of injury to the left foreleg, was treated at the Veterinary Hospital ofthe Federal Rural University of the Semi-Arid Region. Clinical and X-ray examinations revealed a fracture in the medialportion of the metacarpus and radiographic alterations indicative of osteomyelitis, so amputation of the affected limb wasrecommended. Prior the beginning, during and after the surgical procedure, the animal was submitted to the evaluation ofits physiological parameters (heart and respiratory rate, capillary refill time, diastolic, systolic and mean blood pressure andrectal temperature). Because it is a newborn animal, it was decided not to pre-operatively fast. After applying preanestheticmedication (xylazine 0.01 mg/kg IV), anesthesia was induced with ketamine (2 mg/kg IV) and midazolam (0.3 mg/kg IV)and maintained with isoflurane. For the brachial plexus block, 0.4 mL/kg (1.5 mg/kg) of 0.375% bupivacaine was usedand aided by a peripheral nerve stimulator to generate 10 mA current, 1 HZ frequency and 100 μs pulse duration, coupledto a nerve stimulation needle, it was possible to observe flexion movements...

Bloqueio de plexo braquial guiado por neuroestimulador para amputação em bezerro / Nerve stimulator-guided brachial plexus block performed in the amputation of a calfs forelimb

Background: Locoregional anesthesia techniques enable the performance of procedures in the distal portion of the limbs,through the parenteral administration of local anesthetic nerve block. There are devices that can increase the effectivenessof these blocks by accurately locating the nerves. These devices include peripheral nerve stimulators, which enable anesthetic to be injected near the plexus, thus reducing the volume of anesthetic required and allowing for the specific blockadeof a nerve branch by desensitizing exclusively the area of interest. This paper describes the use of nerve stimulator in thebrachial plexus block (BPB) of a calf subjected to amputation of the left foreleg.Case: A newborn calf weighing 30 kg, with a history of injury to the left foreleg, was treated at the Veterinary Hospital ofthe Federal Rural University of the Semi-Arid Region. Clinical and X-ray examinations revealed a fracture in the medialportion of the metacarpus and radiographic alterations indicative of osteomyelitis, so amputation of the affected limb wasrecommended. Prior the beginning, during and after the surgical procedure, the animal was submitted to the evaluation ofits physiological parameters (heart and respiratory rate, capillary refill time, diastolic, systolic and mean blood pressure andrectal temperature). Because it is a newborn animal, it was decided not to pre-operatively fast. After applying preanestheticmedication (xylazine 0.01 mg/kg IV), anesthesia was induced with ketamine (2 mg/kg IV) and midazolam (0.3 mg/kg IV)and maintained with isoflurane. For the brachial plexus block, 0.4 mL/kg (1.5 mg/kg) of 0.375% bupivacaine was usedand aided by a peripheral nerve stimulator to generate 10 mA current, 1 HZ frequency and 100 μs pulse duration, coupledto a nerve stimulation needle, it was possible to observe flexion movements...(AU)

Bloqueio do plexo braquial com uso de neuroestimulador em coruja-orelhuda (Asio clamator) submetida à amputação de asa / Brachial plexus block with use of a neurostimulator in a striped owl (Asio clamator) undergoing wing amputation

Background: The use of distinct drugs and techniques for establishing balanced anesthesia protocols has shown promisingresults in birds. The techniques of locoregional block can be incorporated to these protocols, thereby providing intra- andpost-operative analgesia and reducing the requirement for general anesthesia. Additionally, the use of neurostimulatorsincreases the chances of success and reduces the risk of toxicity; however, there are limited reports in the literature of itsapplicability in wild birds. Therefore, the aim of this study was to describe the brachial plexus block technique guidedusing a neurolocalizer in a striped owl (Asio clamator) submitted for right wing amputation.Case: A striped owl weighing 400 g with a history of exposed fracture of the right wing was supplied by the clinical sectorat the Veterinarian Hospital of the Federal University of Bahia. Following hydration and stabilization of vital signs, theanimal was referred to the surgical center for amputation of the limb. Dexmedetomidine (10 µg.kg−1 IM) was administeredas premedication, and after 20 min, anesthetic induction was performed using sevoflurane (FiO2 = 100%) via a mask followed by maintenance using the same drug. The animal was positioned in a left lateral decubitus position with access to thebrachial plexus determined by palpation and identification of the border of the following muscles: pectoral, cranial branchof the brachial biceps, and dorsal branch of the ventral serratus. The brachial plexus nerves are situated in the subcutaneous site craniodorsal to the axillary depression. For the block, a neurolocalizer was used, fixing the positive electrode toapproximately 5 cm from the needle insertion site (21G × 2’”) in the axillary depression, which remained connected to theneurostimulator by the second electrode. At first, the needle was attached to the peripheral nerve stimulator using a pulsefrequency of 1 Hz with an...

Bloqueio do plexo braquial com uso de neuroestimulador em coruja-orelhuda (Asio clamator) submetida à amputação de asa / Brachial plexus block with use of a neurostimulator in a striped owl (Asio clamator) undergoing wing amputation

Background: The use of distinct drugs and techniques for establishing balanced anesthesia protocols has shown promisingresults in birds. The techniques of locoregional block can be incorporated to these protocols, thereby providing intra- andpost-operative analgesia and reducing the requirement for general anesthesia. Additionally, the use of neurostimulatorsincreases the chances of success and reduces the risk of toxicity; however, there are limited reports in the literature of itsapplicability in wild birds. Therefore, the aim of this study was to describe the brachial plexus block technique guidedusing a neurolocalizer in a striped owl (Asio clamator) submitted for right wing amputation.Case: A striped owl weighing 400 g with a history of exposed fracture of the right wing was supplied by the clinical sectorat the Veterinarian Hospital of the Federal University of Bahia. Following hydration and stabilization of vital signs, theanimal was referred to the surgical center for amputation of the limb. Dexmedetomidine (10 µg.kg−1 IM) was administeredas premedication, and after 20 min, anesthetic induction was performed using sevoflurane (FiO2 = 100%) via a mask followed by maintenance using the same drug. The animal was positioned in a left lateral decubitus position with access to thebrachial plexus determined by palpation and identification of the border of the following muscles: pectoral, cranial branchof the brachial biceps, and dorsal branch of the ventral serratus. The brachial plexus nerves are situated in the subcutaneous site craniodorsal to the axillary depression. For the block, a neurolocalizer was used, fixing the positive electrode toapproximately 5 cm from the needle insertion site (21G × 2”) in the axillary depression, which remained connected to theneurostimulator by the second electrode. At first, the needle was attached to the peripheral nerve stimulator using a pulsefrequency of 1 Hz with an... (AU)

Paravertebral cervical block for osteosynthesis of humeral fracture in foal / Bloqueio paravertebral cervical para realização de ostessíntese de fratura de úmero em potro

A modified cervical paravertebral block of the brachial plexus was performed with the aid of a nerve stimulator for osteosynthesis with four intramedullary pins in a 5-month-old colt weighing 180 kg diagnosed with a closed, complete, and oblique humerus fracture. Xylazine 2% (0.5 mg kg-1 IV) was administered as the pre-anesthetic medication. Anesthesia was induced with ketamine 10% (2 mg kg-1 IV) and midazolam 0.5% (5 mg kg-1 IV) and maintained with isoflurane. The animal was on mechanical ventilation. The nerve block was induced with administration of ropivacaine 0.75% in the ventral branches of C6 (intervertebral space C5–C6) and C7 (intervertebral space C6–C7) and in the branches of C8 and T1 at their convergence at the cranial margin of the first rib. During the 130-min duration of the surgery, no analgesic rescue was required. In conclusion, this blockade can be performed safely and promotes numbness of the humeral and olecranon regions.

Realizou-se o bloqueio paravertebral cervical modicado do plexo braquial, com auxílio de estimulador de nervos, para execução de osteossíntese com quatro pinos intramedulares, em potro de 5 meses, com 180 kg, diagnosticado com fratura fechada, completa e oblíqua de úmero. O animal foi submetido a anestesia com medicação pré-anestésica, xilazina 2% (0,5 mg kg-1 IV) e indução anestésica com cetamina 10% (2 mg kg-1 IV) associada ao midazolam 0,5% (0,5 mg kg-1 IV). A manutenção anestésica foi feita com isoflurano, sendo sempre mantido em ventilação mecânica. O bloqueio foi feito com ropivacaína 0,75% nos ramos ventrais de C6 (espaço intervertebral C5 – C6), C7 (espaço intervertebral C6 – C7) e nos ramos de C8 e T1 em sua convergência na margem cranial da primeira costela. Durante os 130 minutos de duração da cirurgia, não foi necessário qualquer resgate analgésico. Conclui-se que esse bloqueio foi realizado de forma segura e promoveu insensibilidade da região de úmero e olecrano.