Tumor neuroendócrino em coração de cão / Neuroendocrine tumor involving the heart of a dog

Background: Neuroendocrine tumors are epithelial tumors with predominant neuroendocrine differentiation. Ectopic thyroid carcinoma develops in the ectopic thyroid parenchyma, in the anterior mediastinum, being an important differential diagnosis of paraganglioma, although occurring less frequently than the same. The cells invade the mediastinal fat reaching the adventitia of the aorta. There is a possibility of metastatic formations in the lung, kidneys, and pancreas. A supporting treatment was provided. The present study proposes the exposition and description of a case of neuroendocrine tumor in the heart, considering the rarity of the involvement of this tumor in the canine species. Case: A 9-year-old American Bulldog male canine was treated at home in the city of Rio de Janeiro. On clinical examination, dyspnea, edema of the hind limbs and an increase in abdominal volume were observed. With the suspicion of congestive heart failure, mainly on the right, cardiac exams were requested. Because it was an aggressive animal, sedation was performed with a combination of tiletamine and zolazepam. During cardiac auscultation, the presence of S4 was noticed, characterizing a gallop rhythm. No alterations were observed on the electrocardiographic examination. The echocardiogram showed a tumor mass in the atrium and dilation of the venous return vessels. The tumor enveloped 80% of the atrium of a 9-year-old male American Bulldog. The abdominocentesis procedure was performed to drain abdominal free fluid. Furosemide, enalapril and digoxin were prescribed as a treatment. Three months after the start of treatment, the animal presented intense dyspnea that culminated in the death of the patient, who later had the body sent for necropsy and subsequent tissue collection for histopathological analysis. Based on the immunohistochemical markers chromogranin and synaptophysin, the work here presented describes a case of a neuroendocrine tumor suggestive of paraganglioma involving a dog's heart. Discussion: Brachycephalic dogs, such as Boxers, Bulldogs and Boston Terriers, are predisposed to the development of paragangliomas. The genetic predisposition is related to hyperplasia of the carotid bodies generated by chronic hypoxia, resulting from obstructive processes in the airways. As the reported dog is an American Bulldog, the possibility of the tumor in question was reinforced. Paragangliomas are more frequent in males from nine to thirteen years of age, commonly associated with other endocrine neoplasms. It is also an important marker present in paragangliomas. In contrast to the literature, the report points to a neuroendocrine tumor suggestive of paraganglioma, without eliminating the possibility of an ectopic thyroid tumor, because although TTF-1 appears in most thyroid tumors, not all of them are present, although it is very suggestive. Treatment in question, attributed to the control of right congestive heart failure, although with little effect, denotes that the obstructive process of the return pathway, even with the use of drugs that prevent congestion, did not delay the evolution of the disease. However, it is observed that the treatment resources for these tumors, whether by surgical or chemotherapy option, also have few answers. The lack of literature on ectopic thyroid tumors influences the diagnosis of paraganglioma. Thus, clinical and complementary findings, mainly along with immunohistochemistry, were essential in the diagnosis of neuroendocrine tumor. After 3 months of the start of the treatment, the animal died.

Hypertrophic phenotypic cardiomyopathy in an ocelot (Leopardus pardalis)

Background: Hypertrophic cardiomyopathy phenotype (HCM) is the most common cardiac disease in domestic cats but is rarely described in wild species. This phenotype is characterized by concentric hypertrophy of the left ventricle and may be of familial inheritance or secondary to other diseases such as hyperthyroidism, chronic kidney disease, systemic arterial hypertension, and hyperaldosteronism. HCM can cause diastolic and systolic dysfunction and may cause congestive heart failure in affected animals. The present work aims to describe the first report of cardiomyopathy of the hypertrophic phenotype in a specimen of Leopardus pardalis, kept under human care. Case: A 11-year-old female ocelot (Leopardus pardalis) kept under human care, during a preventive care visit, had hypertrophic cardiomyopathy phenotype detected by cardiological evaluation with echocardiogram and a murmur grade III/ VI could be detected on cardiac auscultation. This preventive care occurred under chemical restraint with ketamine [6 mg/kg, i.m] associates with midazolam [0.5 mg/kg, i.m] and other evaluations have been done like complete blood count (CBC), biochemistry (alanine aminotransferase, aspartate aminotransferase, total proteins, albumin, albumin:globulin ratio, creatinine, urea, sodium, potassium, calcium, phosphorus, and globulin) and tyroid hormones [free tyroxine (T4) and thyroid-stimulating hormone (TSH)]. Medical management based on clopidogrel, and atenolol was administered for 3 months until the patient showed manifestations of congestive heart failure (CHF) 80 days later the initial evaluation. In this moment the patient presented with dyspnea, so a cardiological and laboratory evaluation was requested. On pulmonary auscultation crackling was identified, suggesting pulmonary edema and, on echocardiographic examination, some parameters had worsened. The CBC and biochemistry were all within reference ranges. Then, the beta-blocker was discontinued and replaced by pimobendan combined with furosemide as treatment of CHF, and the condition stabilized. After one year, the patient was re-evaluated and showed a slight improvement in the condition but still remained stable. Also, feline proBNP levels was tested (SNAP Feline proBNP® IDEXX) in this moment and it was increased. Discussion: The findings on echocardiography associated with the subjective evaluation associated with progressive worsening and clinical manifestation of CHF, as well as the response to treatment, even though there are no reference values for the species, reinforce the diagnosis. There is no evidence to suggest diseases that may contribute to secondary left ventricular hypertrophy. It is believed that pimobendan plays a key role in maintaining hemodynamic balance, since this has already been observed in other mammalian species. The use of beta blockers is commonly employed in domestic cats with HCM, and they have been prescribed in an attempt to promote greater ventricular relaxation, decrease left ventricular outflow obstruction, thus improving ventricular filling for maintenance of cardiac output. In view of the atrial enlargement and possible risk of thrombus formation, clopidogrel was prescribed, extrapolating what is known from domestic cats. It is reasonable to conclude that in this case, the cardiomyopathy behaved similarly to what is observed in domestic cats, both in its clinical evolution and in the means of diagnosis, and in its response to the therapy instituted.

Polioencephalomalacia in sheep - clinical and magnetic resonance imaging findings

Background: Polioencephalomalacia (PEM) is a neurological disease in ruminants, which is characterized by malacia of brain gray matter. Thiamine deficiency and sulfur intoxication are the most common causes of PEM in sheep. Affected animals present signs of cerebrocortical syndrome, including amaurosis, ataxia, head pressing, mental depression, seizures, and opisthotonus. The neurological examination aims to determine the neurolocalization of the lesions and advanced imaging techniques are useful for confirming the affected area(s) in the central nervous system. The aim of this study is to describe clinical features and ante-mortem diagnosis using magnetic resonance imaging (MRI) in a sheep with PEM. Case: A 18-month-old male Dorper sheep from a flock started receiving concentrate 7 days before. According to the owner, no clinical signs of abnormality were observed on the previous morning. However, in the afternoon, the animal became selfisolated and did not follow the flock to the sheepfold. The following day, he was found in recumbency. Physical examination revealed lateral recumbency, rectal temperature 39.5ºC, 52 bpm, 120 bpm, congested mucous membranes, capillary refill time 1 s, ruminal (4/5 min) and intestinal hypomotility. The assessment of the central nervous system revealed a decreased level of consciousness, focal seizures, opisthotonus, and absence of menace response. The following differential diagnoses were listed: PEM, head trauma, focal symmetrical encephalomalacia, bacterial encephalitis, and rabies. Treatment was composed of dexamethasone [0.2 mg/kg - i.v., SID (1st-3rd day), 0.1 mg/kg, i.v., SID (4th-6th day), and 0.05 mg/kg, i.v., SID (7th-9th day)]; mannitol [1 g/kg - i.v. and diazepam 0.4 mg/kg, i.v. single dose at admission]; vitamin B1 [10 mg/kg - i.m., SID], furosemide [1 mg/kg - i.v., SID for 3 days] and sulfadoxine/trimethoprim [30 mg/kg - i.m., SID for 10 days]. After the initial treatment, the patient showed mild clinical improvement; however, the amaurosis was still present. Magnetic resonance imaging of the brain was performed on the 2nd day of hospitalization, showing a symmetrical hypersignal in the parietal and occipital cortices, in the axial and sagittal sequences weighted in T2 and FLAIR. Discussion: This study aimed to describe the clinical signs and MRI findings in a sheep with PEM. In this case, the sudden change to the feed composition probably led to ruminal dysbiosis, inhibition of thiamine-producing microorganisms and proliferation of bacteria that synthesize thiaminase. Thiamine therapy proved to be effective and capable of reverting the clinical signs. The decrease in the level of consciousness, cortical blindness, and opisthotonus are due to alterations in the parietal cortex, in the occipital cortex, and in the cerebellum, respectively, which were demonstrated by hypersignal areas in the MRI. Therefore, the neurolocalization of the lesion based on neurologic examination and the MRI findings were related. The physicochemical and cytological evaluations of the cerebrospinal fluid, and dosage of thiamine and the concentration of hydrogen sulphide in the rumen were not performed. However, the response to thiamine treatment associated with the neurologic examination and MRI findings helped in determining the diagnosis. Additionally, MRI can be used as a useful tool for the ante mortem diagnosis of PEM.

Digoxin for atrial fibrillation: good, but not too good: a case report / Digoxina para fibrilação atrial: boa, mas não muito: relato de caso

Digoxin is a cardiotonic glycoside that is traditionally used for the treatment of heart failure and atrial fibrillation in humans and animals. However, the use of digoxin is still a challenge in clinical practice due to its narrow therapeutic range and its potential interaction with several drugs, which could facilitate the development of toxicity. A 12-year-old Labrador retriever was referred with a clinical diagnosis of heart failure and atrial fibrillation, anorexia, vomiting, and diarrhea. He had been medicated with digoxin, furosemide, lisinopril, and amiodarone. The patient also showed clinical signs of hip osteoarthritis and received firocoxib for four days. He additionally received drugs for gastrointeritis. The electrocardiogram demonstrated atrial fibrillation and signs of digitalis toxicity. Laboratory examination showed a high concentration of plasma digoxin, and 5 days after withdrawal of the drugs, the symptoms disappeared, as did the digitalis effects seen in the previous electrocardiogram.(AU)

A digoxina é um glicosídeo cardiotônico tradicionalmente utilizado no tratamento de insuficiência cardíaca e fibri-lação atrial em humanos e animais. Porém, o uso da digoxina continua sendo um desafio na prática clínica devido a sua estreita faixa terapêutica, bem como a sua potencial interação com diversos fármacos, facilitando o desenvolvimento de toxicidade. Um Labrador Retriever de 12 anos de idade foi encaminhado com diagnóstico clinico de insuficiência cardíaca, apresentando fibrilação atrial, anorexia, vômitos e diarreia. Ele vinha sendo medicado com digoxina, furosemida, lisinopril e amiodarona. Ele havia sido concomitantemente medicado com firocoxibe por quatro dias para tratamento de osteoartrite coxo-femoral, além de medicamentos para gastroenterite. O eletrocardiograma demonstrou fibrilação atrial e sinais de toxicidade digitalica. O exame laboratorial revelou alta concentração de digoxina plasmática sendo que, cinco dias após a suspensão dos medica-mentos, o paciente já apresentava melhora clinica acentuada, enquanto os efeitos digitálicos observados no eletrocardiograma anterior desapareceram.(AU)

Avaliação de soluções eletrolíticas e vias da administração sobre o teor de umidade das fezes de equinos desidratados experimentalmente / Evaluation of electrolyte solutions and administration routes on the moisture content of feces of experimentally dehydrated horses

A ocorrência de processos fisiopatológicos que cursam com desidratação da ingesta no trato gastrointestinal dos equinos é comum na rotina clínica. Fatores como diminuição da motilidade intestinal e sobrecarga intraluminal de conteúdo desidratado podem levar a compactação em segmentos como estômago, ceco e cólons. Este estudo objetivou realizar a comparação entre soluções eletrolíticas enterais hipotônica (SeHIPO) e isotônica (SeISO) e a solução Ringer com lactato de sódio (RL IV) sobre o teor de umidade das fezes de equinos submetidos a um período de desidratação experimental (PD). Foram utilizados seis equinos adultos, todas fêmeas com idades entre 10 e 15 anos, média de 440 kg de peso corpóreo. O PD constou de 36 horas de jejum hídrico e alimentar associadas a duas administrações intravenosas de furosemida, sendo a primeira imediatamente no início (T-36) e a segunda 12 horas após o início do PD. Os tratamentos utilizados foram: SeHIPO e SeISO, ambas administradas por via nasogástrica em fluxo contínuo (HETfc), e RL IV administrada pela via intravenosa. Todos os tratamentos foram administrados a uma taxa de infusão contínua de 15mL kg-1 h-1 durante 8 horas consecutivas. O delineamento experimental utilizado foi o crossover6x3, onde cada animal foi submetido, em sistema de rodízio, aos três tratamentos em momentos distintos. As soluções eletrolíticas enterais demonstraram maior eficácia na recomposição do teor de umidade das fezes quando comparadas à terapia RL IV. A hidratação enteral com soluções isotônicas e hipotônicas administrada em fluxo contínuo são eficazes em restaurar o teor de umidade das fezes, podendo ofertar uma opção econômica, segura e eficiente na reidratação de pacientes e nas afecções que cursam como obstruções intraluminais simples.

The occurrence of pathophysiological processes that curse with digesta dryness in the gastrointestinal tract of horses is common in clinical routine, factors such as decreased intestinal motility and intraluminal overload of dry content can lead to compaction in segments such as cecum and colon. This study aimed to compare a hypotonic enteral solution (SeHIPO), an isotonic enteral solution (SeISO) and a Ringer with sodium lactate solution (RL IV) over the moisture content of equine feces submitted to an experimental dehydration protocol. Six adult horses were used, all females aged between 10 and 15 years, average body weight of 440 kg. The PD consisted of a 36 hours period of water and food fasting associated with two intravenous administrations of furosemide, the first immediately at the beginning (T-36) and the second 12 hours after the beginning of the PD. The treatments used were: SeHIPO (hypotonic enteral solution administered via nasogastric), SeISO (enteral isotonic solution administered via nasogastric) and RL IV (Ringer's solution with sodium lactate administered intravenously), all treatments were administered by continuous infusion at a rate of 15mL kg-1 h-1 for 8 consecutive hours. The experimental design used was the 6x3 crossover, where each animal is submitted, in a rotation system, to the three treatments at different times. Enteral fluid therapy with isotonic and hypotonic solutions administered in continuous flow are effective in restoring the moisture content of feces, and may offer an economical, safe, and efficient option for rehydrating patients and in conditions that progress as simple intraluminal obstructions.

Effect of intrabronchial platelet rich plasma on the exercise-induced pulmonary hemorrhage endoscopic score in thoroughbred racehorses using furosemide: a preliminary study / [Efeito da instilação intrabronquial de plasma rico em plaquetas no escore endoscópico da hemorragia pulmonar induzida por exercício em cavalos Puro-Sangue Inglês de corrida e usuários de furosemida: um estudo preliminar]

The high prevalence of exercise-induced pulmonary hemorrhage (EIPH) in athletic horses constitutes to be a challenge to the racing industry and a source of major concern to animal welfare. Both experimental and clinical evidence indicate that the use of autologous platelet-rich plasma (PRP) is a promising effector of repair in a variety of pulmonary conditions. The present study evaluated the effect of intrabronchial instillation of PRP on EIPH endoscopic scores from 37 Thoroughbred racehorses. Inclusion criteria were for animals to be EIPH-positive in, at least, two consecutive post-exercise endoscopic exams and to receive 250mg of furosemide IV four hours before racing. Animals were randomly assigned into 3 groups: placebo, control, and PRP instillation. All 37 Thoroughbred racehorses included had EIPH endoscopic scores pre- and post- treatment compared by statistical analysis. The bleeding score from the group receiving PRP was significantly lower than in the control and placebo groups. No adverse effects were observed in any animal during or after the experiment. It was possible to conclude that the intrabronchial instillation of autologous PRP was effective in reducing EIPH scores in racehorses receiving furosemide and that this bioproduct can be considered as a promising coadjuvant in controlling EIPH in athletic horses.(AU)

A alta prevalência de hemorragia pulmonar induzida por exercício (HPIE) em cavalos atletas é um desafio de longa data para a indústria de corridas, além de figurar como grande preocupação sobre o bem-estar animal. As evidências experimentais e clínicas indicam que o uso do plasma rico em plaquetas (PRP) de fonte autógena é promissor na terapêutica de diversas lesões pulmonares. O presente estudo objetivou avaliar as mudanças após corrida no escore endoscópico de HPIE de 37 cavalos Puro-Sangue Inglês que receberam instilação intrabronquial de PRP autólogo. Os animais selecionados eram HPIE-positivos em, ao menos, dois exames endoscópicos consecutivos e recebiam 250mg de furosemida IV administrado quatro horas antes de cada corrida. Na comparação dos escores endoscópicos pré e pós-tratamento, verificou-se que o escore de HPIE do grupo tratado com PRP foi significantemente menor que o dos grupos controle e placebo. Nenhum efeito adverso foi observado nos animais durante ou após o experimento. Concluiu-se que a instilação intrabronquial de PRP autólogo foi efetiva na redução do escore de HPIE de cavalos de corrida usuários de furosemida e que este bioproduto pode ser considerado uma alternativa promissora no controle de HPIE em cavalos atletas.(AU)

Intoxicação de um canino por ingestão de Cannabis sativa / Intoxication of a canine by ingestion of Cannabis sativa

A Cannabis sativa, popularmente conhecida como "maconha", é uma planta que possui elevada solubilidade, absorção, distribuição e metabolização no organismo. Seu principal componente químico é a substância psicoativa delta-9-tetrahidrocanabiol e possui receptores com ampla distribuição anatômica, principalmente no sistema nervoso central, periférico e células do sistema imunológico, influenciando na ação de diferentes neurotransmissores e respostas imunomoduladoras. Seus efeitos dependem da quantidade de substância ingerida e os sinais clínicos acometem principalmente os sistemas neurológico, gastrointestinal e cardiovascular. O objetivo deste trabalho é relatar o caso de um canino, fêmea, sem raça definida, de dois meses de idade, acompanhada em uma clínica veterinária de Fortaleza/CE. O animal apresentava histórico de ingestão de maconha e sinais clínicos como ataxia, hiperestesia e desorientação, sendo assim, foi realizado o diagnóstico presuntivo baseado na anamnese, no exame físico e no laboratorial. Foi adotado um tratamento sintomático à base de fluidoterapia, furosemida e aspartato de L-Ornitina. O animal ficou internado durante 24h, apresentou boa resposta ao tratamento sem complicações secundárias, com redução dos sinais clínicos, e após isso recebeu alta.

Cannabis sativa, popularly known as "marijuana", is a plant that has high solubility, absorption, distribution and metabolization in the body. Its main chemical component is the psychoactive substance delta-9- tetrahydrocannabinol, which has receptors with wide anatomical distribution, mainly in the central, peripheral nervous system and cells of the immune system, influencing the action of different neurotransmitters and immunomodulatory responses. Its effects depend on the amount of substance ingested and the clinical signs mainly affect the neurological, gastrointestinal and cardiovascular systems. The objective of this work is to report the case of a canine, female, mixed breed, two months old, followed up at a veterinary clinic in Fortaleza / CE. The animal had a history of marijuana ingestion, and clinical signs such as ataxia, hyperesthesia and disorientation, thus making the presumptive diagnosis based on anamnesis, physical and laboratory examination. A symptomatic treatment based on fluid therapy, furosemide and L-Ornithine aspartate was adopted. The animal was hospitalized for 24 hours, presented a good response to treatment without secondary complications with reduced clinical signs, and after that he was discharged.

Clinical approach for treating dilated cardiomyopathy in a hog-nosed skunk (Conepatus chinga)

Background: Dilated cardiomyopathy (DCM) is a multifactorial disease characterized by systolic dysfunction of myocardium, affecting domestic animals like dogs, cats, and ferrets. It was sporadically described in non-domestic species, generally as a necropsy observation. The hog-nosed skunk (Conepatus chinga) is a small mammal, carnivore, belonging to the Mephitidae family, found in southern South America, and considered as concerned in a conservation status of the species. The goal of this issue is report the first clinical approach of dilated cardiomyopathy in a young hog-nosed skunk, elucidating the challenging aspects of the diagnostic, therapy, and clinical outcome. Case: A newborn hog-nosed skunk (Conepatus chinga) was found in a farm of southern Brazil in poor nutritional and behavioral conditions. Thirty days of nutritional supplementation based on cow's milk, fruits and insects were necessary to recover its body weight score and activity level. However, 2 months after adoption, the skunk showed acute dyspnea and abnormal breath sound, decreased appetite, and loss of weight. Firstly, these signs were associated with a possible pulmonary infection or other respiratory disease. However, the general cardiomegaly and pulmonary edema pattern observed on the thoracic radiography, changed the clinical approach, conducting the presumptive diagnosis to congestive heart failure (pulmonary edema) caused by an unknown cardiac disease as a dilated cardiomyopathy (CDM). An adequate physical, echocardiographic, electrocardiographic, and hematological evaluation was possible only after chemical restraint by sevofluorane. Systolic heart murmur and pulmonary cracking sounds were detected on thoracic auscultation. These findings associated to the echocardiography features of four chamber dilatation, systolic (fractional shortening-FS = 9% and ejection fraction-EF= 22%) and diastolic (mitral E/A ratio = 4.93) dysfunctions, and bilateral ventriculoatrial regurgitation (mitral and tricuspid) were highly correlated with DCM. Considering the etiologies of CDM described in domestic species and the poor nutritional condition previously observed in the case, nutritional and idiopathic etiologies of DCM were considered for this case. Therapy was based on furosemide at hospital (4 mg/kg subcutaneous, single doses) and home (2 mg/kg orally, BID), enalapril maleate (0.5 mg/kg orally, every 48 h), taurine supplementation (100 mg orally, SID), and pimobendan (0.5 mg/kg orally, BID). Clinical improvement was already observed on the second day of treatment, and monitored for 5 months, when the skunk was completely revaluated. The second echocardiographic exam showed improvement in systolic (FS = 20% and EF = 43%) and diastolic functions (mitral E/A ratio = 2.05), tricuspid regurgitation was not observed, and decrease the left atrial and ventricular dimensions were seen. Due to good clinical outcome, furosemide was gradually reduced until complete withdrawal without any clinical complications or worsening. After 30 months of therapy of pimobendan, taurine, and enalapril maleate, the skunk has good quality captive life without congestive heart failure recurrence. Discussion: The lack of information about DCM in hog-nosed skunk turns the clinical diagnosis and therapy challenging. However, the radiographic and echocardiographic features seamed to lead the same domestic animal patterns. The therapy based on decrease the cardiac overload, increase the myocardial inotropic function (pimobendan and taurine) resulted on excellent clinical and echocardiographic outcome. Although the etiologies of DCM in this species are not stablished, the diagnostic and therapeutic approaches applied resulted on excellent clinical results, and therefore may provide useful information about this cardiac condition in skunk species.

Hidrocefalia canina ­ relato de caso / Canine hydrocephalus ­ case report / Hidrocefalia canina ­ relato de caso

Hidrocefalia é o acúmulo de líquido cefalorraquidiano de origens diversas. Tal acúmulo gera aumento da pressão intracraniana e pode causar compressão e danos a tecidos neurológicos. Estes danos são a causa dos sinais clínicos associados a esta afecção. O presente artigo relata um caso de hidrocefalia em uma fêmea canina da raça Shih Tzu de 45 dias de idade. O animal apresentava alterações comportamentais, vocalização excessiva, incoordenação motora, aumento de volume craniano, oligodpsia entre outros. A cadela foi diagnosticada com hidrocefalia por meio de exames de imagem. Foi instituída terapia medicamentosa com acetazolamida e furosemida para controle paliativo da afecção. Ocorreu melhora do quadro clínico após o início da terapêutica e o animal, apresentou sobrevida de aproximadamente um ano.(AU)

Hydrocephalus is the accumulation of cerebrospinal fluid in the brain coming from diverse origins. Such accumulation generates an increase in intracranial pressure and may cause compression and damage to neurological tissues. These damages are the cause of the onset of clinical signs associated with the condition. This study reports a case of hydrocephalus in a 45-day-old Shi Tzu female dog. The animal presented behavioral alterations, excessive vocalization, motor incoordination, cranial volume increase, polydipsia, among other clinical signals. Imaging tests were used for diagnosing it with hydrocephalus. Drug therapy with acetazolamide and furosemide was introduced for palliative control of the condition. The clinical scenario improved after the initiation of therapy and the animal presented a survival of approximately one year.(AU)

Hidrocefalia es el acúmulo de líquido cefalorraquídeo de diversos orígenes. Dicha acumulación genera un aumento en la presión intracraneal y puede causar compresión y daños a los tejidos neurológicos. Estos daños son la causa de los signos clínicos asociados a esta afección. El presente artículo informa sobre un caso de hidrocefalia en una hembra canina de la raza Shih Tzu de 45 días de edad. El animal presentaba alteraciones de comportamiento, vocalización excesiva, falta de coordinación motora, aumento del volumen craneal, oligodipsia entre otros. La perra fue diagnosticada con hidrocefalia por pruebas de imágenes. Se instituyó medicamentos con acetazolamida y furosemida para control paliativo de la enfermedad. El cuadro clínico mejoró después del inicio de la terapia y el animal presentó sobrevida de aproximadamente un año.(AU)

Hidrocefalia canina ­ relato de caso / Canine hydrocephalus ­ case report / Hidrocefalia canina ­ relato de caso

Hidrocefalia é o acúmulo de líquido cefalorraquidiano de origens diversas. Tal acúmulo gera aumento da pressão intracraniana e pode causar compressão e danos a tecidos neurológicos. Estes danos são a causa dos sinais clínicos associados a esta afecção. O presente artigo relata um caso de hidrocefalia em uma fêmea canina da raça Shih Tzu de 45 dias de idade. O animal apresentava alterações comportamentais, vocalização excessiva, incoordenação motora, aumento de volume craniano, oligodpsia entre outros. A cadela foi diagnosticada com hidrocefalia por meio de exames de imagem. Foi instituída terapia medicamentosa com acetazolamida e furosemida para controle paliativo da afecção. Ocorreu melhora do quadro clínico após o início da terapêutica e o animal, apresentou sobrevida de aproximadamente um ano.(AU)

Hydrocephalus is the accumulation of cerebrospinal fluid in the brain coming from diverse origins. Such accumulation generates an increase in intracranial pressure and may cause compression and damage to neurological tissues. These damages are the cause of the onset of clinical signs associated with the condition. This study reports a case of hydrocephalus in a 45-day-old Shi Tzu female dog. The animal presented behavioral alterations, excessive vocalization, motor incoordination, cranial volume increase, polydipsia, among other clinical signals. Imaging tests were used for diagnosing it with hydrocephalus. Drug therapy with acetazolamide and furosemide was introduced for palliative control of the condition. The clinical scenario improved after the initiation of therapy and the animal presented a survival of approximately one year.(AU)

Hidrocefalia es el acúmulo de líquido cefalorraquídeo de diversos orígenes. Dicha acumulación genera un aumento en la presión intracraneal y puede causar compresión y daños a los tejidos neurológicos. Estos daños son la causa de los signos clínicos asociados a esta afección. El presente artículo informa sobre un caso de hidrocefalia en una hembra canina de la raza Shih Tzu de 45 días de edad. El animal presentaba alteraciones de comportamiento, vocalización excesiva, falta de coordinación motora, aumento del volumen craneal, oligodipsia entre otros. La perra fue diagnosticada con hidrocefalia por pruebas de imágenes. Se instituyó medicamentos con acetazolamida y furosemida para control paliativo de la enfermedad. El cuadro clínico mejoró después del inicio de la terapia y el animal presentó sobrevida de aproximadamente un año.(AU)

Acute Lung Injury Syndrome (TRALI) in a dog possibly triggered by blood transfusion

Background: Acute Lung Injury (ALI) and the Acute Respiratory Distress Syndrome (ARDS) are clinical syndromes, differing in severity, characterized by bilateral noncardiogenic pulmonary edema, usually associated with an underlying cause. Diagnosis is given by thoracic radiography and PaO2 /FiO2 ratio <300. The possible Transfusion Related Acute Lung Injury (TRALI) occurs when ALI or ARDS signs (i.e. hypoxemia and bilateral pulmonary infiltrates) are found in patients without preexisting ALI that have received transfusion in the last 72 h. This case report describes a case of a canine patient that developed possible TRALI after a forelimb amputation and a whole blood transfusion.Case: A 10-year-old female dog, with necrotic and infected bite injuries on left forelimb was initially treated conservatively with topical and systemics antibiotics. Eventually, a forelimb amputation was required, due to the soft tissue necrosis. Pre-operative complete blood count, serum biochemistry and venous blood gas analysis showed mild changes, including anemia, leukocytosis, metabolic acidosis, and increases in blood urea nitrogen, alkaline phosphatase, alanine transaminase. The patient was stable before surgery but required a post-operative whole blood transfusion to treat severe anemia. A crossmatch test was performed to reduce the possibility of transfusion reaction. Despite both surgery and hemotherapy went as expected, approximately eight hours after the transfusion, the patient developed deterioration of all vital signs, including hypotension and severe hypoxemia, with PaO2 /FiO2 <126 and oxyhemoglobin saturation (SpO2) < 90% on room air. Thoracic radiographies showed mixed pattern of bilateral pulmonary infiltration. The patients condition worsened with signs of respiratory failure, cyanosis and severe hemodynamic impairment. There was no improvement after administration of furosemide, hydrocortisone, vasoactives, supplemental oxygen and mechanical ventilation.[...](AU)

Systemic toxic reaction due to multiple honeybee stings in equine: Case report / Reação tóxica sistêmica devido a múltiplas ferroadas de abelha em equino: relato de caso

Accidents caused by insects of the Hymenoptera are rarely described in large animals. The attacks caused by honeybee (Apis mellifera) may cause severe consequences and its intensity changes according to the number of stings. Local and systemic reactions can occur, including progression to death. This report describes a case of honeybee attack on an equine, which took place in the city of Lages, in the state of Santa Catarina, Brazil. In the clinical assessment the horse showed apathy, anorexia, head and pectoral edemas, dyspnea, icteric mucosa, increased mandibular lymph nodes and darkened urine. The blood count showed anemia and serum biochemical tests suggested, muscular and hepatic lesions. The urinalysis test indicated hemoglobinuria and increased clotting time. Treatment included lactate Ringer's solution fluid therapy, furosemide, promethazine, corticosteroids and 20% mannitol solution. Hot and cold compresses were applied alternately on areas with edema. There was a satisfactory response to treatment and the animal was discharged after 30 days in veterinary hospital. The description of honeybee sting accidents in large animals is important because of the evolution that can lead to death. The early approach associated with appropriate treatment, avoiding the worsening of the lesions is fundamental for the recovery of the patient.(AU)

Os acidentes causados por insetos da ordem Hymenoptera são raramente descritos em grandes animais. Os ataques provocados por abelhas (Apis mellifera) causam consequências graves, e sua intensidade varia de acordo com a quantidade de ferroadas. Reações locais a sistêmicas podem ocorrer, incluindo a evolução para a morte. Este relato descreve um caso de ataque por abelhas em equino, ocorrido no município de Lages, SC. No exame clínico, o equino apresentava apatia, anorexia, edema de cabeça e região peitoral, dispneia inspiratória, mucosas ictéricas, linfonodos mandibulares aumentados e urina de coloração marrom-escura. O hemograma evidenciou anemia hemolítica, e os exames de bioquímica sérica sugeriram lesão muscular e lesão hepática. A urinálise demonstrou hemoglobinúria, e o tempo de coagulação apresentava-se aumentado. Como tratamento, foram administrados solução de ringer com lactato, furosemida, prometazina, corticosteroides e solução de manitol a 20%. Compressas quentes e frias foram aplicadas alternadamente sobre as áreas de edema. Houve adequada resposta ao tratamento instituído e o animal recebeu alta hospitalar após 30 dias de internamento. A descrição de casos de acidentes por picadas de abelhas em grandes animais é importante devido à evolução, que pode levar à morte. A abordagem precoce associada ao tratamento adequado, evitando o agravamento das lesões, é fundamental para a recuperação do paciente.(AU)

Acute Lung Injury Syndrome (TRALI) in a dog possibly triggered by blood transfusion

Background: Acute Lung Injury (ALI) and the Acute Respiratory Distress Syndrome (ARDS) are clinical syndromes, differing in severity, characterized by bilateral noncardiogenic pulmonary edema, usually associated with an underlying cause. Diagnosis is given by thoracic radiography and PaO2 /FiO2 ratio <300. The possible Transfusion Related Acute Lung Injury (TRALI) occurs when ALI or ARDS signs (i.e. hypoxemia and bilateral pulmonary infiltrates) are found in patients without preexisting ALI that have received transfusion in the last 72 h. This case report describes a case of a canine patient that developed possible TRALI after a forelimb amputation and a whole blood transfusion.Case: A 10-year-old female dog, with necrotic and infected bite injuries on left forelimb was initially treated conservatively with topical and systemics antibiotics. Eventually, a forelimb amputation was required, due to the soft tissue necrosis. Pre-operative complete blood count, serum biochemistry and venous blood gas analysis showed mild changes, including anemia, leukocytosis, metabolic acidosis, and increases in blood urea nitrogen, alkaline phosphatase, alanine transaminase. The patient was stable before surgery but required a post-operative whole blood transfusion to treat severe anemia. A crossmatch test was performed to reduce the possibility of transfusion reaction. Despite both surgery and hemotherapy went as expected, approximately eight hours after the transfusion, the patient developed deterioration of all vital signs, including hypotension and severe hypoxemia, with PaO2 /FiO2 <126 and oxyhemoglobin saturation (SpO2) < 90% on room air. Thoracic radiographies showed mixed pattern of bilateral pulmonary infiltration. The patient’s condition worsened with signs of respiratory failure, cyanosis and severe hemodynamic impairment. There was no improvement after administration of furosemide, hydrocortisone, vasoactives, supplemental oxygen and mechanical ventilation.[...]

Systemic toxic reaction due to multiple honeybee stings in equine: Case report / Reação tóxica sistêmica devido a múltiplas ferroadas de abelha em equino: relato de caso

Accidents caused by insects of the Hymenoptera are rarely described in large animals. The attacks caused by honeybee (Apis mellifera) may cause severe consequences and its intensity changes according to the number of stings. Local and systemic reactions can occur, including progression to death. This report describes a case of honeybee attack on an equine, which took place in the city of Lages, in the state of Santa Catarina, Brazil. In the clinical assessment the horse showed apathy, anorexia, head and pectoral edemas, dyspnea, icteric mucosa, increased mandibular lymph nodes and darkened urine. The blood count showed anemia and serum biochemical tests suggested, muscular and hepatic lesions. The urinalysis test indicated hemoglobinuria and increased clotting time. Treatment included lactate Ringer's solution fluid therapy, furosemide, promethazine, corticosteroids and 20% mannitol solution. Hot and cold compresses were applied alternately on areas with edema. There was a satisfactory response to treatment and the animal was discharged after 30 days in veterinary hospital. The description of honeybee sting accidents in large animals is important because of the evolution that can lead to death. The early approach associated with appropriate treatment, avoiding the worsening of the lesions is fundamental for the recovery of the patient.(AU)

Os acidentes causados por insetos da ordem Hymenoptera são raramente descritos em grandes animais. Os ataques provocados por abelhas (Apis mellifera) causam consequências graves, e sua intensidade varia de acordo com a quantidade de ferroadas. Reações locais a sistêmicas podem ocorrer, incluindo a evolução para a morte. Este relato descreve um caso de ataque por abelhas em equino, ocorrido no município de Lages, SC. No exame clínico, o equino apresentava apatia, anorexia, edema de cabeça e região peitoral, dispneia inspiratória, mucosas ictéricas, linfonodos mandibulares aumentados e urina de coloração marrom-escura. O hemograma evidenciou anemia hemolítica, e os exames de bioquímica sérica sugeriram lesão muscular e lesão hepática. A urinálise demonstrou hemoglobinúria, e o tempo de coagulação apresentava-se aumentado. Como tratamento, foram administrados solução de ringer com lactato, furosemida, prometazina, corticosteroides e solução de manitol a 20%. Compressas quentes e frias foram aplicadas alternadamente sobre as áreas de edema. Houve adequada resposta ao tratamento instituído e o animal recebeu alta hospitalar após 30 dias de internamento. A descrição de casos de acidentes por picadas de abelhas em grandes animais é importante devido à evolução, que pode levar à morte. A abordagem precoce associada ao tratamento adequado, evitando o agravamento das lesões, é fundamental para a recuperação do paciente.(AU)

Osteossarcoma axial intratorácico / Osteosarcoma axial intrathoracic

Background: Bone tumors have a challenging diagnosis and treatment. Osteosarcoma is the name given to a heterogeneous group of malignant, agressive and invasive tumors that often determine bone lysis. Almost all of the animals develop lung metastases, progressing to death. Usually affect the appendicular skeleton, but can also occurs in others areas, although these presentations are rare. Prognosis is always poor. The aim of this paper is to report a case of a dog with osteoblastic osteosarcoma of the sternum, which was diagnosed by computed tomography and histopathologic analysis after excisional biopsy.Case: A male Cocker Spaniel dog, weighing 25 kg, elderly, was examined at the Veterinary Hospital. As main complaint was reported soft swelling on the ventral cervical region causing dyspnea. The patient had previously been medicated with dexamethasone with a significant decrease in the swelling, however recurrence was observed with the cessation of the treatment. Due to the presence of heart murmur, patient underwent to chest radiography and eletrocardiography. Images showed a tumor in the sternal lymph node region, displacing the heart caudally, trachea and esophagus dorsally, causing cranial edema due to a compression of the venous return by the cranial vena cava and subsequent dyspnea. Furosemide (Lasix®) was administered during ambulatorial treatment and prescribed to home, with satisfactory results, with decreased edema and consequent improvement of respiratory symptoms. It was decided to perform computed tomography to better design of the chest structure. The structure located in cranial thoracic region measured about 10.5 cm long x 5.8 cm high x 8.4 cm wide. The patient was undergone to sternotomy to remove the mass that was closely adhered to the sternum and pericardium. The pericardectomy and sternum removal were not performed due to animal being old and present metabolic and cardiopulmonary conditions.[...]

Osteossarcoma axial intratorácico / Osteosarcoma axial intrathoracic

Background: Bone tumors have a challenging diagnosis and treatment. Osteosarcoma is the name given to a heterogeneous group of malignant, agressive and invasive tumors that often determine bone lysis. Almost all of the animals develop lung metastases, progressing to death. Usually affect the appendicular skeleton, but can also occurs in others areas, although these presentations are rare. Prognosis is always poor. The aim of this paper is to report a case of a dog with osteoblastic osteosarcoma of the sternum, which was diagnosed by computed tomography and histopathologic analysis after excisional biopsy.Case: A male Cocker Spaniel dog, weighing 25 kg, elderly, was examined at the Veterinary Hospital. As main complaint was reported soft swelling on the ventral cervical region causing dyspnea. The patient had previously been medicated with dexamethasone with a significant decrease in the swelling, however recurrence was observed with the cessation of the treatment. Due to the presence of heart murmur, patient underwent to chest radiography and eletrocardiography. Images showed a tumor in the sternal lymph node region, displacing the heart caudally, trachea and esophagus dorsally, causing cranial edema due to a compression of the venous return by the cranial vena cava and subsequent dyspnea. Furosemide (Lasix®) was administered during ambulatorial treatment and prescribed to home, with satisfactory results, with decreased edema and consequent improvement of respiratory symptoms. It was decided to perform computed tomography to better design of the chest structure. The structure located in cranial thoracic region measured about 10.5 cm long x 5.8 cm high x 8.4 cm wide. The patient was undergone to sternotomy to remove the mass that was closely adhered to the sternum and pericardium. The pericardectomy and sternum removal were not performed due to animal being old and present metabolic and cardiopulmonary conditions.[...](AU)

Utilização da furosemida em bolus e em infusão contínua em cães e gatos: revisão de literatura / Use of furosemide in bolus and in continuous infusion in dogs and cats: literature review

A furosemida é um potente diurético com ação no ramo espesso ascendente da alça de Henle. Em Medicina Veterinária é amplamente utilizada devido à rápida ação na remoção de fluidos intersticiais, média toxicidade e rápida excreção do organismo. É indicada no tratamento da retenção líquida inadequada, aumento da diurese, edema pulmonar, insuficiência cardíaca congestiva, síndrome nefrótica, doenças renais agudas e crônicas, ascites, edemas periféricos e pacientes irresponsivos a outros diuréticos ou anti-hipertensivos. A via de administração da furosemida endovenosa pode ser realizada sob a forma de bolus ou infusão contínua, com diferenças marcantes entre elas. Alterações hemodinâmicas, variações nas concentrações séricas e resistência diurética são desvantagens observadas na forma de bolus. Já sob a forma de infusão contínua, o aumento e a manutenção da diurese são vantagens observadas, mas com desequilíbrios hidroeletrolíticos mais evidenciados comparada à administração em bolus, necessitando de monitoramento constante. Atualmente, poucos são os estudos científicos na Medicina Veterinária que demonstram as diferenças específicas, com as indicações, benefícios ou efeitos deletérios orgânicos da utilização da furosemida intravenosa sob a forma de bolus ou infusão contínua. Assim, este trabalho busca promover uma atualização científica quanto às características farmacológicas, doses e efeitos da furosemida endovenosa nas diferentes formas de administração, visando a auxiliar a conduta terapêutica quando utilizada em cães e gatos.

The aim of this study was to evaluate the effects of finasteride treatment on prostatic and testicular hemodynamic and vascular variables in dogs with benign prostatic hyperplasia (BPH). Ten dogs aged between 5 and 13 years were selected and assigned to two experimental groups: dogs with BPH (BPH, n=5), and dogs with BPH treated with finasteride (BPH+F, n=5). Three monthly evaluations were performed (day 0 onset of finasteride treatment, day 30 and day 60). Testicular and prostatic volumes were measured through mode-B ultrasound; prostatic vascularization score (1-3) was measured with the color Doppler ultrasound; and the hemodynamic profile of the prostatic and testicular arteries was measured with spectral Doppler. A reduction of 35.2% in the prostate volume occured in the HPB+F group after 60 days of treatment, while in the HPB group, it increased 15.4%.Vascularization score on day 60 was higher in the BPH group (2.4±0.2) in comparison to the BPH+F group (1.6±0.2), suggesting that finasteride therapy reduces the angiogenesis caused by BPH. Regarding the spectral Doppler analysis, it was possible to observe higher pulsatility index of the testicular artery in the BPH group (2.1±0.2) compared to BPH+F (1.9±0.1), which is capable of reducing the efficiency of spermatogenesis. The remaining hemodynamic indexes presented no statistical difference. In conclusion, finasteride therapy reducesprostatic volume and vascularization. Moreover, the pulsatility index can be employed as an prognostic markerof BPH in dogs.

Utilização da furosemida em bolus e em infusão contínua em cães e gatos: revisão de literatura / Use of furosemide in bolus and in continuous infusion in dogs and cats: literature review

A furosemida é um potente diurético com ação no ramo espesso ascendente da alça de Henle. Em Medicina Veterinária é amplamente utilizada devido à rápida ação na remoção de fluidos intersticiais, média toxicidade e rápida excreção do organismo. É indicada no tratamento da retenção líquida inadequada, aumento da diurese, edema pulmonar, insuficiência cardíaca congestiva, síndrome nefrótica, doenças renais agudas e crônicas, ascites, edemas periféricos e pacientes irresponsivos a outros diuréticos ou anti-hipertensivos. A via de administração da furosemida endovenosa pode ser realizada sob a forma de bolus ou infusão contínua, com diferenças marcantes entre elas. Alterações hemodinâmicas, variações nas concentrações séricas e resistência diurética são desvantagens observadas na forma de bolus. Já sob a forma de infusão contínua, o aumento e a manutenção da diurese são vantagens observadas, mas com desequilíbrios hidroeletrolíticos mais evidenciados comparada à administração em bolus, necessitando de monitoramento constante. Atualmente, poucos são os estudos científicos na Medicina Veterinária que demonstram as diferenças específicas, com as indicações, benefícios ou efeitos deletérios orgânicos da utilização da furosemida intravenosa sob a forma de bolus ou infusão contínua. Assim, este trabalho busca promover uma atualização científica quanto às características farmacológicas, doses e efeitos da furosemida endovenosa nas diferentes formas de administração, visando a auxiliar a conduta terapêutica quando utilizada em cães e gatos.(AU)

The aim of this study was to evaluate the effects of finasteride treatment on prostatic and testicular hemodynamic and vascular variables in dogs with benign prostatic hyperplasia (BPH). Ten dogs aged between 5 and 13 years were selected and assigned to two experimental groups: dogs with BPH (BPH, n=5), and dogs with BPH treated with finasteride (BPH+F, n=5). Three monthly evaluations were performed (day 0 onset of finasteride treatment, day 30 and day 60). Testicular and prostatic volumes were measured through mode-B ultrasound; prostatic vascularization score (1-3) was measured with the color Doppler ultrasound; and the hemodynamic profile of the prostatic and testicular arteries was measured with spectral Doppler. A reduction of 35.2% in the prostate volume occured in the HPB+F group after 60 days of treatment, while in the HPB group, it increased 15.4%.Vascularization score on day 60 was higher in the BPH group (2.4±0.2) in comparison to the BPH+F group (1.6±0.2), suggesting that finasteride therapy reduces the angiogenesis caused by BPH. Regarding the spectral Doppler analysis, it was possible to observe higher pulsatility index of the testicular artery in the BPH group (2.1±0.2) compared to BPH+F (1.9±0.1), which is capable of reducing the efficiency of spermatogenesis. The remaining hemodynamic indexes presented no statistical difference. In conclusion, finasteride therapy reducesprostatic volume and vascularization. Moreover, the pulsatility index can be employed as an prognostic markerof BPH in dogs.(AU)

Tricuspid valve dysplasia in a domestic feline: case report / Displasia valvar tricúspide em um felino doméstico: relato de caso

Tricuspid valve dysplasia (TVD) is a congenital heart defect described in dogs and cats; however, in Brazil there are no reports of this condition in cats. Therefore, our goal was to report a case of TVD in a domestic cat. A four-year-old, female, domestic short hair cat that was seen at the Cardiology Service of the Veterinary Teaching Hospital, University of São Paulo, for apathy, appetite loss and dyspnea for five days. During physical examination, dyspnea with a restrictive respiratory pattern due to pleural effusion was observed. Thoracocentesis was performed and 450 mL of serosanguineous fluid was drained. Two-dimensional echocardiography in the right parasternal short-axis plane at the level of the papillary muscles showed right ventricular dilatation and paradoxical septal motion. On the left parasternal apical four-chamber view, significant dilatation of the right chambers, loss of mobility of the septal leaflet of the tricuspid valve and a thickened mural leaflet chordae with anomalous insertion were observed. Based on clinical and echocardiographic aspects, a diagnosis of TVD was given. Treatment was initiated with enalapril 0.5 mg/kg, furosemide 0.5 mg/kg and pimobendan 0.3 mg/kg every 12 hours, all per os. The patient experienced remission of clinical manifestations and survived for 50 days after diagnosis.(AU)

Displasia valvar tricúspide (DVT) é um defeito cardíaco congênito descrito em cães e gatos. Entretanto no Brasil ainda não há relato desta cardiopatia em felinos. Desta forma, objetivou-se relatar um caso de DVT em um felino doméstico. Uma gata de pelo curto, com quatro anos de idade foi atendida no Serviço de Cardiologia do Hospital Veterinário da Universidade de São Paulo, apresentando apatia, perda de apetite e dispneia há cinco dias. Durante o exame físico observou-se dispneia com padrão respiratório restritivo devido a presença de efusão pleural. Foram drenados 450 mL de líquido serosanguinolento por meio de toracocentese. O ecocardiograma no modo bidimensional, pela janela paraesternal direita, ao eixo curto transversal ao nível dos músculos papilares, revelou hipertrofia excêntrica do ventrículo direito e movimento septal paradoxal. Pela vista apical quatro câmaras, na janela paraesternal esquerda, observou-se importante remodelamento de câmaras cardíacas direitas. A valva tricúspide apresentou-se com perda de mobilidade de sua cúspide septal e espessamento de cordoalha tendínea da cúspide mural, com inserção anômala. Com base nos aspectos clínicos e ecocardiográficos, instituiu-se o dianóstico de DVT. Iniciou-se o tratamento com enalapril (0,5 mg/kg), furosemida (0,5 mg/kg) e pimobendan (0,3 mg/kg), pela via oral a cada 12 horas. O paciente apresentou remissão das manifestações clínicas, sobrevivendo por 50 dias após o diagnóstico.(AU)

Pacemaker implant in a dog with sick sinus syndrome

Background: Sick sinus syndrome is characterized by the presence of arrhythmias, including persistent sinus bradycardia, sinus arrest and paroxysmal atrial tachyarrhythmia. It commonly occurs in elderly dogs, especially miniature schnauzers; however, it is also detected in dachshunds and pugs. Reports of clinical signs by animal owners are not always clear and precise, which may result in erroneous interpretations by veterinarians; consequently, the use of inappropriate therapies. The present work aims to describe clinical aspects and findings from tests related to sick sinus syndrome (SSS) and presents the case of a female schnauzer with SSS. Case: A 10-year-old female dog (schnauzer, 8.6 kg) attended the Veterinary Hospital of the FMVZ-UNESP - Botucatu. The owner mentioned convulsive episodes, but a thorough medical history and patient assessment revealed that the dog exhibited episodes of syncope. During the physical examination, cardiac auscultation revealed the heart rate to be 56 beats per minute (bpm), and there was a presence of pauses. Also during cardiac auscultation, a holosystolic heart murmur was verified, with a focus on the mitral and tricuspid valves. The electrocardiogram showed the presence of sinus arrest with escape rhythms, pauses of 10 s and the presence of bradycardia-tachycardia syndrome. A Holter monitor was used to establish the diagnosis of SSS. The patient presented with significant episodes of syncope during outpatient care, and based on the clinical manifestation, drug therapy was initiated. The prescribed medications were aminophylline 20 mg/ kg TID, enalapril maleate 0.5 mg/kg BID, spironolactone 1 mg/kg SID and furosemide 2 mg/kg BID. After the start of treatment, there was a reduction in the frequency of episodes of syncope. Three weeks after diagnosis, a pacemaker device was implanted. Currently, clinical signs are absent. Discussion: Sinus node dysfunction is one of the main reasons for pacemaker implantation. […](AU)