Surgical complications associated with hemilaminectomy and intervertebral disc fenestration: prospective study of 64 dogs / Complicações associadas à hemilaminectomia toracolombar e fenestração de disco intervertebral: estudo prospectivo em 64 cães

Hemilaminectomy and intervertebral disc fenestration are commonly used to treat intervertebral disc extrusion (IVDE); however, they are associated with surgical complications. Sixty-four dogs were assessed during the intraoperative, immediate postoperative, and late postoperative periods to evaluate complications resulting from these surgical procedures. During this study, 15.62% (n=10) of the dogs presented with complications during at least one of the evaluations. Iatrogenic rhizotomy, access to the spinal canal contralateral to the lesion, and cardiorespiratory arrest were observed intraoperatively. Abdominal wall flaccidity, neurological worsening, hematoma, dehiscence, and superficial wound infections were observed during the immediate postoperative period. Adverse reactions to the surgical thread, scar adhesion, and superficial wound infection were the most frequent complications during the late postoperative period. Dogs that undergo hemilaminectomy and intervertebral disc fenestration because of IVDE may experience complications during the intraoperative, immediate postoperative, and late postoperative periods. However, these complications are often transitory and rarely cause death.

A hemilaminectomia e a fenestração do disco intervertebral são os procedimentos cirúrgicos geralmente empregados no tratamento da extrusão do disco intervertebral (EDIV), os quais podem desencadear complicações cirúrgicas. Foram avaliadas complicações em 64 cães nos períodos intra e pós-operatório imediato e tardio. Dos pacientes incluídos no estudo, 15,62% (n=10) apresentaram alguma ocorrência em pelo menos uma das etapas avaliadas. Das complicações, no período intraoperatório foram observadas rizotomia iatrogênica, abertura do canal vertebral contralateral e parada cardio-respiratória. No pós-operatório imediato foram verificadas a flacidez da parede abdominal lateral, piora neurológica, hematoma, deiscência de ferida cirúrgica e infecção superficial da ferida de pele. No pós-operatório tardio foram verificadas reação ao fio cirúrgico, aderência cicatricial e flacidez da parede abdominal lateral como problemas mais frequentes. Conclui-se que cães submetidos à hemilaminectomia e fenestração do disco intervertebral envolvido em decorrência da EDIV podem apresentar complicações nos períodos intraoperatório, pós-operatório imediato e tardio, sendo transitórias e com mínimas chances de ocasionar óbito.

Surgical complications associated with hemilaminectomy and intervertebral disc fenestration: Prospective study of 64 dogs / Complicações associadas à hemilaminectomia toracolombar e fenestração de disco intervertebral: estudo prospectivo em 64 cães

ABSTRACT: Hemilaminectomy and intervertebral disc fenestration are commonly used to treat intervertebral disc extrusion (IVDE); however, they are associated with surgical complications. Sixty-four dogs were assessed during the intraoperative, immediate postoperative, and late postoperative periods to evaluate complications resulting from these surgical procedures. During this study, 15.62% (n=10) of the dogs presented with complications during at least one of the evaluations. Iatrogenic rhizotomy, access to the spinal canal contralateral to the lesion, and cardiorespiratory arrest were observed intraoperatively. Abdominal wall flaccidity, neurological worsening, hematoma, dehiscence, and superficial wound infections were observed during the immediate postoperative period. Adverse reactions to the surgical thread, scar adhesion, and superficial wound infection were the most frequent complications during the late postoperative period. Dogs that undergo hemilaminectomy and intervertebral disc fenestration because of IVDE may experience complications during the intraoperative, immediate postoperative, and late postoperative periods. However, these complications are often transitory and rarely cause death.

RESUMO: A hemilaminectomia e a fenestração do disco intervertebral são os procedimentos cirúrgicos geralmente empregados no tratamento da extrusão do disco intervertebral (EDIV), os quais podem desencadear complicações cirúrgicas. Foram avaliadas complicações em 64 cães nos períodos intra e pós-operatório imediato e tardio. Dos pacientes incluídos no estudo, 15,62% (n=10) apresentaram alguma ocorrência em pelo menos uma das etapas avaliadas. Das complicações, no período intraoperatório foram observadas rizotomia iatrogênica, abertura do canal vertebral contralateral e parada cardio-respiratória. No pós-operatório imediato foram verificadas a flacidez da parede abdominal lateral, piora neurológica, hematoma, deiscência de ferida cirúrgica e infecção superficial da ferida de pele. No pós-operatório tardio foram verificadas reação ao fio cirúrgico, aderência cicatricial e flacidez da parede abdominal lateral como problemas mais frequentes. Conclui-se que cães submetidos à hemilaminectomia e fenestração do disco intervertebral envolvido em decorrência da EDIV podem apresentar complicações nos períodos intraoperatório, pós-operatório imediato e tardio, sendo transitórias e com mínimas chances de ocasionar óbito.

Protocolo anestésico em guaxinim submetido à colocefalectomia / Anesthesic protocol in a raccoon submitted to colocephalectomy

Em guaxinins, comumente se observa a presença de osteoartrites acometendo a articulação coxofemoral. Em carnívoros domésticos, o tratamento pode ser conservativo ou cirúrgico e, dentre as técnicas cirúrgicas, cita-se a colocefalectomia. Por ser um procedimento que provoca dor moderada a severa, um protocolo de anestesia balanceada se faz necessário, podendo associar a técnicas de bloqueio locorregional, como a epidural. Protocolos descritos para a espécie são limitados, porém comumente empregados para contenções químicas, avaliações físicas e exames de imagem. Portanto, o objetivo deste trabalho é relatar a o protocolo anestésico realizado em guaxinim (Procyon cancrivorus) submetido à colocefalectomia. Foram utilizados dexmedetomidina (5µg/kg), cetamina (5mg/kg) e diazepam (0,3mg/kg) por via intramuscular como medicação pré-anestésica, indução com propofol e manutenção por anestesia inalatória com isoflurano. Para execução da anestesia epidural, realizou-se uma abordagem na região lombossacral, sendo administrados bupivacaína (1mg/kg) e morfina (0,1mg/kg). Não houve intercorrências e os parâmetros fisiológicos mantiveram-se estáveis. Descartou-se a necessidade de resgate analgésico e a recuperação anestésica foi rápida. Dessa forma, conclui-se que o manejo anestésico proposto promoveu estabilidade hemodinâmica e recuperação satisfatórias para a espécie.

In raccoons, the presence of osteoarthritis affecting the hip joint is commonly observed. In domestic carnivores, the treatment can be conservative or surgical and, among the surgical techniques, colocephalectomy is mentioned. Since it is a procedure that causes moderate to severe pain, a balanced anesthesia protocol is necessary, which can be associated with locoregional block techniques such as the epidural. Protocols described for the species are limited, being commonly used for chemical restraints, physical assessments, and imaging exams. Therefore, this work aims to report the anesthetic protocol performed on a raccoon (Procyon cancrivorus) submitted to colocephalectomy. Dexmedetomidine (5µg/kg), ketamine (5mg/kg), and diazepam (0.3mg/kg) were used intramuscularly as pre-anesthetic medication, in addition to induction with propofol, and the maintenance by inhalational anesthesia with isoflurane. For epidural anesthesia, an approach was performed in the lumbosacral region, with the administration of bupivacaine (1mg/kg) and morphine (0.1mg/kg). There were no complications and the physiological parameters remained stable. The need for analgesic rescue was ruled out and the anesthetic recovery was fast. Thus, it is concluded that the proposed anesthetic management promoted hemodynamic stability and a satisfactory recovery for the species.

Gastroesophageal foreign bodies in dogs - endoscopy and surgical removal

Background: Gastroesophageal foreign bodies (GFD) are commonly diagnosed in dogs and are considered an endoscopic emergency that, although not resulting in serious clinical sequelae or mortality, can compromise the health and well-being of the patient. The use of the digestive endoscopy for the diagnosis and treatment of GFD can be a valuable and viable alternative. There are cases of GFD in dogs for which the indicated treatment is surgery, which can be performed using minimally invasive or conventional techniques, associated or not with flexible endoscopy. The objective of this work is to describe 16 cases of GFD removal in dogs demonstrating the efficiency of upper digestive endoscopy. Cases: Of the 16 GFD cases, 63% (10/16) were male and 37% (6/16) female. Most aged under 1 year (63%), puppies (5/16) and juveniles (5/16). The patient with the lowest body weight was a miniature pinscher weighing 0.8 kg (Case 14) and the heaviest was an American Pit Bull Terrier weighing 28 kg (Case 11), the mean body weight of patients diagnosed with GFD was 10.2 ± 6.7 kg. Small and medium breeds were more affected, 44.7% (7/16) and 44.7% (7/16), respectively, and large breeds (Golden Retrievier and Bull Terrier), from cases 1 and 4, the least affected, 12.6% (2/16) of the cases. The 16 patients underwent a 12 h food fast and a 4 h water fast, as gastrointestinal emptying in these cases of GFD can be influenced by these foreign bodies. All underwent general inhalation anesthesia with monitoring of physiological parameters (temperature, heart rate, respiratory rate, oxygen saturation and blood pressure) before, during and after EGD, being positioned in left lateral decubitus. The 16 canine patients with suspected GFD underwent EGD for diagnostic confirmation and removal of foreign bodies. Five esophageal FB were diagnosed, 31% (5/16), and 11 gastric FB, 69% (11/16). The most frequently diagnosed foreign bodies were bone and tissue, 37.5% (6/16) and 31% (5/16). Other foreign bodies were materials such as plastics, metals, rubber, foam and stone. Of the 16 cases of GFD, EGD efficiently treated 88% (14/16) without the need for hospitalization, with only supportive treatment for the remission of complications caused by the presence of foreign bodies in the gastroesophageal tract. The main complications related to the presence of GFD were esophagitis in 25% (4/16) of cases, gastritis in 38% (6/16) and both alterations in 13% (2/16). Discussion: In this work, we can observe that more than a third of the clinical cases of treated dogs were diagnosed with GFD, demonstrating that these cases are common in the veterinary clinic. Most of these animals were males less than 1 year old. The improvement of learning in this category can lead these animals to exacerbated oral exploration of new objects. Most FBs were found in the stomach because they were of adequate size, consistency and shape for their passage through the esophagus, whereas esophageal FBs were all bone fragments of rigid consistency with diameters and sizes larger than the esophageal lumen. The interval between the ingestion of the object and the veterinary care can be decisive for the removal of the FB in the esophagus or stomach. Most gastric FBs removed were fabrics and plastics, flexible objects that can pass through the esophageal lumen more easily. Removal of GFD by endoscopy was performed with a high success rate, with only 2 cases being resolved by esophagostomy and gastrotomy. Flexible endoscopy proved to be an efficient technique for removing treated GFD, which can help remove FB during esophagotomy and be associated with rigid endoscopy. Patients recovered quickly and without complications, but it is important to emphasize that inadequate maneuvers and conducts can determine other outcomes. The use of endoscopy for GFD removal needs to be more popularized, as it can ensure better results for dogs treated with GFD.

Surgical correction of metatarsal angular deviation in a Thoroughbred filly using wedge metatarsal ostectomy: a case report / Correção cirúrgica de desvio angular metatársico em uma potra Puro-Sangue utilizando ostectomia em cunha: um relato de caso

This study describes a corrective procedure for a metatarsal angular malformation using wedge ostectomy in a 41-day-old Thoroughbred filly. A 41.6 °angular malformation of the metatarsus was corrected with wedge ostectomy of the left hindlimb in association with a type II external fixator and methyl methacrylate resin. The animal was subjected to the surgical procedure under general anesthesia. The filly was placed in dorsal recumbency with the left hind limb free for manipulation. A bone saw was used for the wedge ostectomy, while the bars for external fixation were placed using a drill. A Kirschner pin and acrylic resin were then applied. Radiographic images obtained immediately after surgery confirmed a total malformation reduction of 32.6 (from 41.6° to 9°). With medication and a Robert Jones bandage, intensive postoperative care was instituted to ensure that the animal adapted properly to the linear external fixator without overloading the pins and connection bars. No postoperative complications were observed. On the day after surgery, the filly was standing and walking with no signs of pain. After 180 days, total osseous calcification was achieved, and the implants were removed during the second surgery. The filly demonstrated adequate locomotion, performed all the movements, and ran without any difficulty in the paddock. The remaining discrete angular deviations were partially corrected using hoof trimming.

O objetivo desse estudo é descrever o procedimento de correção da malformação de desvio angular metatársico, utilizando ostectomia em cunha, em uma potra puro-sangue de 41 dias de idade. Uma malformação metatársica angular de 41.6º foi corrigida com a técnica de ostectomia em cunha, em associação com fixador externo tipo II e resina de metilmetacrilato, no membro pélvico esquerdo. O animal foi submetido à cirurgia sob protocolo de anestesia geral. A potra foi posicionada em decúbito dorsal, com o membro pélvico esquerdo livre para manipulação. Para a realização da ostectomia em cunha, foi utilizada uma serra óssea. Para a instalação das barras do fixador externo, uma furadeira foi utilizada e, para fixá-los, pinos de Kirschner e resina acrílica foram aplicados. Logo após a cirurgia, imagens radiográficas foram obtidas para confirmar a redução total de 32,6º (de 41,6º para 9º) de angulação. Para garantir que o animal se adaptasse ao fixador externo linear e não sobrecarregasse os pinos e barras, foram instituídos cuidados pós-operatórios intensos, com medicações e bandagem de Robert Jones. Não houve complicações no pós-operatório. No dia seguinte à cirurgia, a potra estava em pé, caminhando e sem sinais de dor. Após 180 dias, alcançou total calcificação óssea e os implantes puderam ser removidos em um segundo tempo cirúrgico. A potra demonstrou locomoção adequada, realizando todos os movimentos normais e pôde correr pelo pasto sem dificuldades. Um discreto desvio angular remanescente foi parcialmente corrigido por casqueamento.

Short-term outcomes of trochlear recession surgery combined with "Watermelon" autograft for treatment of canine medial patellar luxation: a case series / Resultados a curto prazo da cirurgia de recessão trocolear combinada com o auto-enxerto "Melancia" para tratamento da luxação patelar medial canina: uma série de casos

The aim of this study was to present a novel surgical method for correction of medial patellar luxation in small-breed dogs with trochlear dysplasia and marked hypoplasia of the medial femoral condyle. The "Watermelon" approach was applied together with trochlear wedge recession or trochlear block recession and consisted in increasing the height of the medial condyle with an osteochondral autograft resembling a watermelon slice, placed into an additional slot in the medial femoral condyle to prevent the postoperative reluxation of the patella. The study cohort included 19 dogs (25 joints) from small breeds (Pinscher, Pomeranian, and Chihuahua) with second-grade medial patellar luxation. Fourteen joints were submitted to wedge recession surgery combined with "Watermelon" grafting, and 11 joints: to block recession surgery with "Watermelon" grafting. The sulcus-deepening trochleoplasty combined with "Watermelon" grafting was clinically successful and with low percentage of minor postoperative complications. The mean duration of anesthesia was significantly longer for block recession combined with "Watermelon" (P<0.001), but the recovery period was shorter (P<0.05).

O objetivo deste estudo foi apresentar um novo método cirúrgico para correção da luxação patelar medial em cães de raça pequena com displasia troquelar e hipoplasia marcada do côndilo femoral medial. A abordagem "Melancia" foi aplicada juntamente com a recessão da cunha trocolear ou recessão do bloco trocolear e consistiu em aumentar a altura do côndilo medial com um auto-enxerto osteocondral parecido com uma fatia de melancia, colocado em uma fenda adicional no côndilo femoral medial para evitar o relaxamento pós-operatório da patela. A coorte do estudo incluiu 19 cães (25 juntas) de raças pequenas (Pinscher, Pomeranian, e Chihuahua) com luxação patelar medial de segundo grau. Catorze juntas foram submetidas à cirurgia de recessão em cunha combinada com enxerto de "melancia", e 11 juntas: para bloquear a cirurgia de recessão com enxerto de "melancia". A trocleoplastia de "melancia" combinada com o enxerto de "melancia" foi clinicamente bem sucedida e com baixo percentual de pequenas complicações pós-operatórias. A duração média da anestesia foi significativamente maior para a recessão em bloco combinada com "Melancia" (P<0,001), mas o período de recuperação foi mais curto (P<0,05).

Abomasal impaction in a goat - surgical approach

Background: The abomasum is glandular and has a bagpipe shape, with a capacity of 1 to 2 liters. It has a very acidic content with a pH ranging from 1.5 to 3, and although disturbances in this organ are uncommon in small ruminants, abomasal emptying defect is probably the most common abomasal problem in goats. The etiology of an abomasal emptying defect is unknown, however, abomasal impaction is the main cause of this condition. Since this disorder is associated with poor prognosis and information in goats is scarce, the aim of this report is to describe the success of abomasotomy as a treatment for abomasal impaction in goats, as well as to describe the clinical and laboratory aspects of this disease. Case: A 8-month-old male Anglo-Nubian goat, weighing 33 kg, presented with apathy and decreased appetite for 4 days due to digestive disorder. According to history, the diet consisted of crushed hay ad libitum and 300 g of ration bran. Clinical findings were apathy, pale mucous membranes, ruminal hypomotility, decreased fecal output, tense abdomen with distention of the ventral quadrants and loss of rumen stratification. The increase in chloride ion concentration (67 mEq/L) observed in the ruminal fluid analysis was indicative of abomasal-ruminal reflux, compatible with metabolic acidosis, as well as the dense hyperechogenic content in the ventral field of the left and right abdomen corresponding to the location of the entire abomasum on transabdominal ultrasound. Thus, clinical, laboratory and ultrasound findings were indicative of impaction of the abomasum, and the goat underwent exploratory laparotomy through the left flank, which revealed a distended and compacted abomasum. Differently from reports in the literature, due to severe distension of the abomasum, abomasotomy through the right flank was chosen to reverse the condition, followed by constant monitoring and supportive therapy with antimicrobial and analgesic medication. The goat defecated normally on the second postoperative day, however, on auscultation, there was persistence of abomasal emptying failure, suggesting a situation of posterior functional stenosis. With the suspicion of type III vagal indigestion, the atropine test, along with radiographic examination of the chest and abdomen were performed, and did not reveal any changes. In order to restore abomasal motility, intensive therapy with prokinetic drugs (bromopride, metoclopramide and promethazine) was associated, and on the fifth day the animal returned to normal appetite, abomasal motility and fecal production. The goat was discharged after 14 days of intensive care with recommendations to provide good quality food and water. Discussion: Abomasal impaction is rarely reported in goats, commonly resulting in animal death before or even a few days after surgical correction. The diagnosis of abomasal impaction was based on clinical, laboratory and ultrasound findings, and should be differentiated from other diseases that progress with abdominal distention and gradual weight loss, such as functional stenosis; duodenal obstruction; vagal nerve disorder; abomasite; generalized peritonitis, and granuloma associated with Actinobacillus lignieresii. Surgical correction by right paralombar access associated with visceral emptying and supportive therapy of impaction abomasal was performed and considered successful, without relapses and secondary complications long-term.

Pyometra in a tiger (Panthera tigris)

Background: Captive tigers can live a long life, around 26 years. Among the diseases described some of non-infectious origin are quite common, such as chronic kidney disease, spondylosis, and biliary cysts or tumors. On the other hand, pyometra has been frequently reported in lions, who have a higher risk of developing the disease than tigers and leopards. Pyometra is a disease with few descriptions in tigers and it may be related to the physiological features of the species. The animal is listed as Endangered on the International Union for the Conservation of Nature Red List of Threatened. The present report aims to describe the diagnosis and treatment of pyometra in a captive tigress. Case: A 7-year-old entire female tiger (Panthera tigris) weighing 140 kg was presented with a 3-day history of anorexia and prostration. For clinical examinations, collection of laboratory and imaging tests, the patient initially underwent dissociative anesthesia to allow catheterization of the cephalic vein and intravenous general anesthesia for orotracheal intubation followed by anesthetic maintenance in isoflurane. On general physical examination, the animal had normal colored mucosa, vital parameters within normal limits, and a body condition score of 6 on a scale of 9. There was no presence of vulvar secretion. The blood count and the biochemical exams showed values within the normal range for the species. The chest X-ray in the right and left views did not demonstrate pulmonary abnormalities. Ultrasonographic examination of the abdomen showed distension of the uterine body and horns, which have intraluminal hyperechoic fluid content without flocculation. Based on the imaging exam, the diagnosis was suggestive of pyometra. Exploratory celiotomy was performed via ventral midline, confirming the condition, which was treated by ovariohysterectomy. The surgical technique was performed as described for therapeutic ovariohysterectomy in dogs and cats. Culture of uterine content identified Escherichia coli. The histological analysis identified diffuse endometritis associated with follicular cysts. The tiger had complete recovery without any complications. The patient was releasing 13 days after the surgical procedure and in the last contact four months after the surgery, it was in perfect health conditions. Discussion: Pyometra in large exotic felids has been occasionally reported, mainly in animals more than 10 years of age. Although the tigress in the report is estimated to be seven years old. The patient in question started with anorexia and prostration and as there was already a history of cystic endometrial hyperplasia, a possible pyometra was suspected, despite being uncommon in the species. There was not vaginal discharge. The definitive diagnosis was by means of ultrasound examination and ovariohysterectomy was performed. Abdominal surgery for these large felids is complex, due to the intra-abdominal volume the flank approach or by laparoscopic is suggested, however in this case a ventral midline incision was performed without intercurrences and complications in the post-operative period. The surgical technique like that used in small animals was effective for the treatment of pyometra in the tigress with the use of ovariohysterectomy. Culture of uterine content identified Escherichia coli, which has been the most commonly isolated pathogen in pyometra of large felids. It was concluded that, as in bitches with pyometra, early diagnosis and surgical treatment is ideal for the patient's recovery.

Síndrome da feminização em cão com sertolioma / Feminization syndrome in a dog with Sertoli cell tumor

Background: The uncontrolled multiplication of Sertoli cells causes Sertoli cell tumor or Sertolioma. Because of this, the level of estrogen in the bloodstream increases rapidly and approximately 25% of dogs with this tumor develop feminization syndrome. Testicular neoplasms are more common in dogs than cats, and are often found in elderly patients. This work aims to describe the clinical signs of the feminization syndrome and the treatment instituted in a canine diagnosed with sertolioma. Case: A 18-year-old male canine, 19.5 kg of body mass, with an increase in testicular volume for about 2 years, was treated at the University Veterinary Hospital. On clinical examination, a matte and brittle coat, alopecia on the hind limbs and gynecomastia were observed. Also noted, non-harmonious aspect of the scrotum, pendular foreskin, atrophied right testicle and hyperplastic left, scrotal hyperthermia and absence of pain. In addition, as a result of the hyperestrogenism resulting from the neoplasm, the paraneoplastic syndrome of feminization, the patient also presented galactorrhea, pendular foreskin, atrophy of the penis and the contralateral testicle, dermatopathies, such as bilateral symmetrical alopecia of the flanks, easily removable hair and variable hyperpigmentation. Rectal body temperature of 38.6°C, clear lung auscultation and muffled cardiac auscultation. The results of laboratory tests showed changes such as thrombocytopenia, platelet counts below the reference levels, platelet count of 163,000/uL. There were no alterations that represented metastases in the imaging exams, such as in the chest X-ray in three incidences and in the abdominal ultrasonography. Then, we opted for the surgical procedure of orchiectomy, with the traditional technique of three clamps, associated with total ablation of the scrotum. Samples were sent to the histopathology laboratory and the diagnosis of sertolioma was confirmed. At 10, 30 and 90 days after the operation, the patient was reassessed for possible recurrences or alterations, but there were no complications or recurrence after the procedure. Discussion: Neoplasms of the male reproductive system are common in dogs. Sertolioma is considered one of the most frequent neoplasms in elderly dogs and that results in systemic clinical signs. This is in line with the 18-year-old dog described in the present report. In addition, it may result in clinical signs resulting from hyperestrogenism resulting from the neoplasm that is called paraneoplastic feminization syndrome. The characteristics of this syndrome are: gynecomastia, galactorrhea, pendular foreskin, atrophy of the penis and contralateral testicle, associated with dermatopathies, such as symmetrical bilateral alopecia. All these clinical signs were present. The diagnosis is made through complete anamnesis, complete clinical examination and complementary examination such as ultrasound help in the presumptive diagnosis, but only with histopathology can it be confirmed. In the clinical approach, histopathology was performed to close the diagnosis. Treatment is behind orchiectomy and total ablation of the scrotum, which was performed in the reported case. The treatment of choice was easy to apply, in addition to improving the patient's quality of life, promoting rapid post-surgical healing and an early return to normal life. However, for the effectiveness of the technique, the early diagnosis and collaboration of tutors is fundamental.

Hérnia diafragmática peritôniopericárdica congênita em uma gata / Congenital peritoniopericardial diaphragmatic hernia in a female kitten

Background: Peritoneopericardial diaphragmatic hernia is a rare pathogenesis of congenital origin, which occurs due to a failure in the communication between the diaphragm and the pericardium during embryogenesis. Symptoms may be non-existent or non-specific, depending on the herniated organ involved and, in most cases, the diagnosis is incidental. Regarding the most indicated treatment, there are still divergences in the literature concerning the indication of conservative or surgical treatment. This study reports the case of a feline peritoneopericardial hernia, for which surgical correction was the treatment of choice. Case: A 3-month-old female kitten, no defined racial pattern, was referred to the Veterinary Hospital of the Federal Rural University of Pernambuco for treatment of a peritoneopericardial diaphragmatic hernia. This condition was diagnosed through radiographic examination after the patient having been submitted to pediatric castration and presented anesthetic complications in the transsurgery. Blood count, biochemical profile and Doppler echocardiogram were performed, which showed no significant changes. To obtain a better study and surgical planning, computed tomography was performed to observe the heart located cranially in the pericardial cavity. Caudally to the heart, hepatic parenchyma located in the pericardial cavity was observed; and hepatic vessels presenting slightly enlarged dimensions. These tomographic findings suggested peritoneopericardial diaphragmatic hernia; being the liver present in the pericardial cavity and signs of congestion in the hepatic parenchyma. Due to the likelihood of future worsening of the hernia, surgical correction was performed, with an abdominal midline incision in the preumbilical region to reposition the liver to its normal anatomy, followed by diaphragm reconstitution through a herniorrhaphy. After the surgical procedure, the patient was referred for observation in internment and, after 15 days, the skin sutures were removed. Complete correction of the hernial defect was observed on radiography performed 30 days after the surgical procedure. However, the examination showed the presence of deviation/ deformity in the topography of the sternum and costal cartilages, with slight cardiac displacement to the right hemithorax, suggesting the presence of pectus excavatum. Discussion: Peritoneopericardial diaphragmatic hernia is considered rare and, despite being one of the most common causes of congenital pericardial anomaly in felines, it has a low prevalence ranging from 0.06% to 1.45%. They are usually diagnosed from two years of age, with prevalence for older animals. However, due to having presented anesthetic changes, the patient of this case report could be diagnosed early. Among the most common organs that migrate to the thoracic cavity, the liver is the most commonly observed, which is also the hernia content of the present report. Peritoneopericardial hernia is often diagnosed through radiography and ultrasound, and these imaging tests proved to be sufficient for the diagnosis in this report. However, computed tomography was important for providing a better study of case and for the adoption of median celiotomy as a treatment. Associations with other malformations are described in the literature, with pectus excavatum being the most common and also observed in this report. Peritoneopericardial diaphragmatic hernia is a rare anomaly, rarely reported in the literature and with divergences regarding its treatment. The adoption of early surgical treatment performed in this report showed satisfactory evolution and the possibility of a favorable prognosis.

Lesão traumática facial em cão - reconstrução cirúrgica com retalho de transposição rotacional / Facial traumatic injury in a dog - surgical reconstruction with rotational transposition flap

Background: Bite injuries are commonly found in small animal clinics, especially in male dogs, due to their habits of fighting and territorial disputes. In general, the lesions are treated with the use of compresses and bandages, however, it is extremely important to carefully evaluate the site, in order to carry out the appropriate treatment. In cases of tissue loss, an increasingly used practice is reconstructive surgery, which launches alternatives for treatment through flaps and skin grafts, promoting healing and satisfactory aesthetic repair. This report describes the case of a dog with a facial bite, treated with reconstructive surgery. Case: A 5-year-old male mixed-breed dog, with a body mass of 5 kg, was treated and submitted to a physical examination, due to the owner's complaint that he had been attacked by another dog, causing a bite on the face. On physical examination, the animal showed normal vital parameters, except for mild hyperthermia due to rectal temperature (39.5°C). On the face, it was possible to observe a lacerative lesion in the temporomandibular and masseteric regions, with loss of skin and muscle, in addition to having an aspect of infection and necrosis. To describe the hematological profile, a blood count was performed, showing no changes. In the biochemical tests, the present alteration was a slight increase in Alkaline Phosphatase (393.8 IU/L). Surgical treatment was indicated through facial reconstruction with a skin graft. After performing the antisepsis, the lesion was debrided, the edges were regularized and the injured tissue was curetted. For reconstruction of the defect, we used a flap obtained through a perpendicular incision at the base of the ear, in a caudal direction, and this flap was pulled and transposed over the wound. Flap synthesis was performed with 3-0 nylon thread. After surgery, a compressive bandage was performed, which was removed after 24 h. It was indicated to avoid exertion in the area and to return in 10 days for the evaluation of the surgery and removal of the stitches. Discussion: Traumatic injuries in animals are being increasingly reported, with male and non-neutered dogs being the most prevalent patients. This report is in line with other studies, with the patient's profile being a male dog, with an average age, in line with the literature. In general, in certain types of wounds, the affected animals can develop sepsis and even progress to death, however, in this case the patient did not show changes in vital parameters and in hematological tests. Reconstructive surgeries are performed with the aim of correcting skin defects and knowledge of the available techniques is important. It is also necessary to carry out a good planning, in order to avoid complications in the trans and postoperative period. In the present case, we chose to use a flap obtained through an incision perpendicular to the base of the ear, transposing it over the wound, in addition to relieving tissue tension through skin divulsion, increasing its elastic potential. The use of bandages is considered extremely important for the success of the surgical procedure, as it provides an efficient barrier against infections, trauma and adhesions. However, we emphasize the need to use ointments, gauzes and bandages concomitantly, in order to have the desired success in the postoperative period. In addition to proper surgical techniques, pain management and infection control are important for patient recovery. It is important to use non-steroidal anti-inflammatory drugs and opioids to obtain analgesia, in addition to antibiotic therapy before and after surgery. The reported case demonstrated that lesions in dogs with skin loss can be reconstructed using skin flaps, with an excellent recovery and good prognosis, as was the case with the patient in this report.

Resposta metabólica ao trauma cirúrgico / Metabolic response to surgical trauma

Os efeitos do trauma cirúrgico no organismo, os quais são amplamente estudados pela medicina humana e veterinária, resultam em uma complexa resposta neuroendócrina e imunológica, desencadeadas para restabelecer a homeostase e preservar a vida. A resposta metabólica ao trauma é caracterizada pelo aumento da secreção de hormônios hipofisários, ativação do sistema nervoso simpático e secreção de citocinas pró-inflamatórias. Essa resposta tem por objetivo manter a perfusão tecidual, controlar a proliferação de microrganismos e mobilizar substratos para garantir a integridade das funções celulares e promover reparação tecidual. Diferentes fatores podem influenciar a intensidade da resposta do organismo ao trauma, incluindo magnitude e duração dos estímulos, enfermidades ou eventos traumáticos pré-existentes, protocolos anestésicos e técnicas cirúrgicas utilizadas. Respostas metabólicas exacerbadas ocasionam complicações pós-operatórias, tempo prolongado de recuperação dos pacientes e óbito. Através da identificação dos principais eventos relacionados à resposta metabólica ao trauma cirúrgico, é possível atuar de forma a reduzir os danos associados, melhorando a qualidade e minimizando os riscos do período pós-operatório. Sendo assim, este trabalho tem como objetivo apresentar uma revisão descrevendo a fisiopatologia e as consequências da resposta metabólica ao trauma cirúrgico, em suas diferentes formas e origens, no período perioperatório.

The effects of surgical trauma on the organism, which are widely studied by human and veterinary medicine, result in a complex neuroendocrine and immune responses triggered to restore homeostasis and preserve life. The metabolic response to trauma is characterized by increased secretion of hypophyseal hormones, activation of the sympathetic nervous system, and secretion of pro-inflammatory cytokines. This response aims to maintain tissue perfusion, control the proliferation of microorganisms, and mobilize substrates to ensure the integrity of cellular functions and promote tissue repair. Different factors can influence the intensity of the organism's response to trauma, including magnitude and duration of stimuli, pre-existing infirmities or traumas, anaesthetic protocols, and surgical techniques applied. Exacerbated metabolic responses can cause post-operative complications, prolonged recovery time, and death. By identifying the main events related to the metabolic response to surgical trauma, it is possible to act to reduce the associated damages, improving quality and minimizing the risks of the postoperative period. Thus, the present paper aims to present a review describing the physiopathology and the consequences of the metabolic response to surgical trauma, in its different forms and origins, in the perioperative period.

Chronic expanding hematoma secondary to excision of recurrent myxomas in a bitch

Background: Expanding chronic hematoma is a relatively common postoperative complication in humans, not in dogs, nevertheless, is important understand this condition because it may affect the animal's health. A hematoma could be formed within hours and usually stabilizes spontaneously with the reabsorption of its content. However, occasionally the hematoma slowly expands, becomes encapsulated and forms a mass, causing a chronic expanding hematoma. Possibly skin and adipose tissue are displaced secondary to trauma, causing the formation of blood-filled cysts surrounded by a fibrous capsule. The aim of this document is to present the first report of a postsurgical chronic expanding hematoma in dog. Case: A case of chronic expanding hematoma secondary to excision of recurrent myxoma in a bitch was described. Physical examination showed a hard, firm, non-mobile mass enclosed within the deep muscular layers. This mass was between the sternum and the cranial abdomen, similar to previous lesions excised by another veterinarian. Fine needle aspiration indicated the presence of blood. Radiology demonstrated that the bone-cartilage tissue was not involved. Due to the size of the mass, a skin stretching pre-suturing technique using self-adhesive tape was applied around the mass 48 h before surgery. The mass was removed with wide excision margins and portions of the affected muscles, but a large wound with great tension was created; consequently, a parallel to the wound incision and the thoraco-lumbar vertebrae was made. Six months after surgery, the animal presented recurrence of the same lesion, which was also removed. The bleeding times were within the normal range, but the animal was diagnosed with hyperadrenocorticism. After both surgeries histopathological exam revealed a hematoma, that had thrombosis and granulation tissue with fibrosis and severe panniculitis, in addition of multifocal, chronic, moderate lymphohistiocytic myositis; all these changes were compatible with a chronic expanding hematoma. Discussion: Chronic expanding hematoma is a mass that grows slowly secondary to hemorrhage and does not exhibit elements of malignancy. However, it can occasionally be confused for a soft-tissue neoplasm. It has been reported frequently in humans but not in small animals. The first case was reported in 2002: 5 puppies with a cervical hematoma classified as a chronic expanding hematoma was described. In addition, 3 cases were reported: 1 cat with perirenal chronic expanding hematoma; 1 bitch with intra-abdominal presentation, and 1 cat with this pathology on the right pelvic limb after an intramuscular injection. The etiology of chronic expansive hematoma is unidentified in dogs, nevertheless, it is stipulated that is not an inflammatory process as previously assumed, but rather a neoplastic process. As in other cases, it was difficult to determine the origin of the chronic expanding hematoma. The coagulation times and platelets count were within ranges. Similarly, it is very complicated to relate hyperadrenocorticism with chronic expanding hematoma because dogs with Cushing's disease generally present hypercoagulopathies. Myxomas are associated with endocrinopathies in humans and dogs, therefore, hyperadrenocorticism is possibly related with this neoplasia. Myxomas have an expansive growth pattern, contrasting with myxosarcomas, which are infiltrating; Although in the present case the skin mass appeared to be invasive, both macroscopical and histopathological appearance of it corresponded to a well-shaped capsule compatible with chronic expanding hematoma. In summary, to the best of our knowledge, this is the first report of a post-surgical chronic expanding hematoma in a dog.

Lateral patellar luxation and Ehlers Danlos Syndrome (EDS) in a dog

Background: Ehlers Danlos Syndrome (EDS) is a rare genetic disease characterized by a deficiency in collagen synthesis,which can result in joint laxity. Patellar luxation is one of the main orthopedic conditions that affect the canine knee joint,with limited descriptions of its association with EDS in dogs. The purpose of this report is to describe the surgical management and postoperative evolution of a 1-year-old Chow Chow dog with grade II patellar luxation, tibial valgus and EDS.Case: A 1-year-old Chow Chow dog was referred to the University Veterinary Hospital due to lameness of the left pelvicfor 3 months. At the orthopedic examination were verified severe lameness and lateral deviation of the left stifle joint during the ambulation of the animal. Additionally, it was verified bilateral hyperextension of the tibiotarsal joint and grade IIpatellar luxation of both pelvic limbs with painful hyperextension of the left stifle joint. Radiographic evaluation showedlateral displacement of the patella from both femoral trochlear groove, and a valgus deviation of the proximal left tibialshaft. In addition, it was verified cutaneous hyperextensibility and an extensibility index suggestive of EDS. The animalwas submitted to trochlear block resection technique and medial imbrication, followed by corrective tibial osteotomy.Furthermore, skin biopsies of the scapular and lumbar folds were performed during the corrective tibial osteotomy. Thesamples were sent for histopathological examination, which revealed fragmented and unorganized collagen fibers in thedermis. Histopathological findings were compatible with EDS. The absence of lameness and correct positioning of thepatella in the trochlear sulcus were verified in the post-surgical follow-up. Complete bone consolidation of the closingwedge osteotomy to correct the tibial...

Lateral patellar luxation and Ehlers Danlos Syndrome (EDS) in a dog

Background: Ehlers Danlos Syndrome (EDS) is a rare genetic disease characterized by a deficiency in collagen synthesis,which can result in joint laxity. Patellar luxation is one of the main orthopedic conditions that affect the canine knee joint,with limited descriptions of its association with EDS in dogs. The purpose of this report is to describe the surgical management and postoperative evolution of a 1-year-old Chow Chow dog with grade II patellar luxation, tibial valgus and EDS.Case: A 1-year-old Chow Chow dog was referred to the University Veterinary Hospital due to lameness of the left pelvicfor 3 months. At the orthopedic examination were verified severe lameness and lateral deviation of the left stifle joint during the ambulation of the animal. Additionally, it was verified bilateral hyperextension of the tibiotarsal joint and grade IIpatellar luxation of both pelvic limbs with painful hyperextension of the left stifle joint. Radiographic evaluation showedlateral displacement of the patella from both femoral trochlear groove, and a valgus deviation of the proximal left tibialshaft. In addition, it was verified cutaneous hyperextensibility and an extensibility index suggestive of EDS. The animalwas submitted to trochlear block resection technique and medial imbrication, followed by corrective tibial osteotomy.Furthermore, skin biopsies of the scapular and lumbar folds were performed during the corrective tibial osteotomy. Thesamples were sent for histopathological examination, which revealed fragmented and unorganized collagen fibers in thedermis. Histopathological findings were compatible with EDS. The absence of lameness and correct positioning of thepatella in the trochlear sulcus were verified in the post-surgical follow-up. Complete bone consolidation of the closingwedge osteotomy to correct the tibial...(AU)

Hydronephrosis in a bitch with ovarian remnant syndrome - postsurgical complications

Background: Elective ovariohysterectomy (OH) is minimally invasive, but when performed incorrectly, it can lead to postsurgical complications, such as stump pyometra, ovarian remnant syndrome and foci of adhesion generated by tissue reactions to threads and materials used in vessel hemostasis. The formation of adhesions and successive surgeries predisposes patients to other diseases, such as ureteral obstruction and hydronephrosis. Thus, we reported a case of hydronephrosis in a bitch submitted to conventional OH, followed by ovariectomy (OV) due to ovarian remnant syndrome and consequent intraperitoneal adhesions caused by successive surgical interventions. Case: A 11-year-old mixed breed medium size bitch with a history of stump pyometra and ovarian remnant syndrome (SOR) was treated at the Veterinary Hospital-HV of UFPA after 2 previous surgeries. It had been spayed using conventional OH and underwent ovariectomy OV approximately 4 years ago, as it showed signs of estrus after the first surgery, characterizing SOR. On physical examination, its abdomen was distended especially in the left hemiabdomen, with no palpable pain. Ultrasonography showed a cavity in the topographic area of the left kidney, with anechoic content, thin walls, and defined contour. There were nonvascularized tubular structures, suggesting hydroureter and severe hydronephrosis. Exploratory celiotomy was performed, showing the intense presence of abdominal adhesions, followed by an incision in the abdominal midline from the xiphoid process in a caudal direction to the pubis, thereby showing the left kidney. After vesical drainage of 900 mL of renal filtrate, atrophy of the renal parenchyma and preservation of the renal capsule was considered, resulting in its complete resection, followed by the synthesis of the abdominal wall. In the postoperative period, the patient was properly monitored and obtained a satisfactory outcome manifested by a complete recovery. After vesical drainage of 900 mL of renal filtrate, atrophy of the renal parenchyma and preservation of the renal capsule only was considered, resulting in its complete resection, followed by the synthesis of the abdominal wall. In the postoperative period, the patient was properly monitored and obtained a satisfactory outcome manifested by a complete recovery. After vesical drainage of 900 mL of renal filtrate, renal parenchymal atrophy and preservation of the renal capsule only was adopted. Discussion: The choice of the conventional OH technique, followed by the failure to perform, favored the formation of adhesions only diagnosed late. Less invasive alternatives achieved less long-term damage. Excessive intracavitary manipulation and reaction to the nylon suture thread favored the development of these adhesions, and consequently, unilateral obstruction of the left ureter, hydroureter, hypertrophy, and destruction of the renal parenchyma, led the patient to undergo a third surgery, namely, unilateral nephrectomy. In this case, no changes were observed in serum levels, leaving only a subtle abdominal enlargement with hydronephrosis installed silently. There was no possibility of carrying out initial surgical planning, as the affected kidney, making unilateral nephrectomy necessary. Currently, the patient has normal renal function in the contralateral organ, with no clinical or laboratory changes because the affected kidney was not functional, making unilateral nephrectomy necessary. Currently, the patient has normal renal function with no clinical or laboratory changes because the affected kidney was not functional, making unilateral nephrectomy necessary. Currently, the patient has normal renal function in the contralateral organ, with no clinical or laboratory changes.

Partial hemipelvectomy: an alternative for improving dogs' life quality / Hemipelvectomia parcial: alternativa para melhoria na qualidade de vida em cães

Partial hemipelvectomy refers to the surgical removal of a pelvic segment, which is performed for pelvic bone neoplasms, severe fractures, or poor bone union. This study presents the cases of seven dogs, six of which have neoplasms involving the hip joint and one with severe pelvic canal narrowing due to a poorly consolidated trauma. Partial caudal hemipelvectomy was performed for all the dogs to improve the quality of life and delay euthanasia. Of the seven cases, six required the use of a polypropylene mesh for the pelvic wall closure, with 85.71% of them acquiring manageable complications in the postoperative period. Despite these complications, an overall improvement in the quality of life was reported to be significant in the operated animals due to the removal of the cause of pain or discomfort. Thus, it was concluded that partial hemipelvectomyis beneficial for dogs with pelvic conditions. Furthermore, the main complication due to the lack of a pelvic wall for primary occlusion was circumvented by using a polypropylene mesh, showing that possible complications in this procedure can be appropriately managed.

A hemipelvectomia parcial consiste na remoção de segmento pélvico, indicada para neoplasmas com envolvimento de ossos da pelve, fraturas graves ou má união óssea. Esse trabalho apresenta sete pacientes caninos, dos quais seis portadores de neoplasmas envolvendo a articulação coxofemoral e um com grave estreitamento do canal pélvico, resultado de traumatismo mal consolidado. Com o intuito de fornecer qualidade de vida aos cães e postergar a eutanásia, todos foram operados pela técnica de hemipelvectomia parcial média a caudal. Dos sete pacientes, seis necessitaram do uso de tela de polipropileno para fechamento da parede pélvica e apresentaram 85,71% de complicações manejáveis no pós-operatório. No entanto, a melhora na qualidade de vida dos animais operados foi significativa, tendo sido removida a causa da dor ou desconforto desencadeado pela alteração anatômica local. Conclui-se que a técnica é benéfica aos pacientes, tendo como principal complicação, a falta de parede pélvica para oclusão primária, contornada com uso de tela de polipropileno pelos autores.

Uteropexy in sheep as potential method for prevention of uterine torsion

Background: Uterine torsion is one of many causes of dystocia in sheep. Failure in performing of wright-time diagnostic procedures and treatment by certain obstetric procedures, can result with death of both fetus and ewe. There is sufficient knowledge about risk factors which could contribute to the occurrence of uterine torsion in sheep, but there is insufficient knowledge about measures for prevention of uterine torsion. The aim of this study was to evaluate the effects of performing incorporative uteropexy as potential method for prevention of uterine torsion. Cases: This research was part of the experimental research of changes in the anterior presentation in sheep fetuses due to their ventro-sacral position in the 2nd half of gestation. At the same sheep farm where afore mentioned research was conducted, the farmer has reported the death of 3 pregnant ewes. In all of 3 animals, torsion of the uterus was diagnosed by patho-anatomical examination. This study was conducted on 6 ewes. All of the animals were in the period around the 100th day of pregnancy at the time of clinical examination. The exact day of pregnancy was not determinated because of free mating in the herd. Confirmation of pregnancy in all of 6 ewes was performed by ultrasound examination. Uniparous pregnancy was found in all of 6 ewes. The entire surgical procedures were performed in the field conditions. Laparotomy was performed in the animals positioned in the left lateral recumbency. Surgical procedure of incorporative uteropexy was performed during the closure of muscle layers of abdominal wall. In need for experimental research of changes in the anterior presentation in sheep fetuses due to their ventro-sacral position in the 2nd half of gestation, 14 days after surgical procedures were conducted, all of sheep were positioned by assistants into a sitting position so that their trunks were vertical to the ground and kept in that position for 2 min. Ultrasound examination of surgical place of uteropexy confirmed that, in all of animals, uteruses were in place of surgical procedures. All of 6 ewes included in this study lambed naturally. One of 6 sheep was sent for economic exploitation on the 14th day after lambing. At the slaughter line, the abdominal wall was evaluated at the site where the incorporative uteropexy was performed. Patho-anatomical examination revealed tissue adhesions at the junction of the uterine horn with the abdominal wall. Discussion: Postsurgical tissue adhesions develop during normal healing process of tissue. According to our knowledge, previous studies do not mention effective measures that could contribute to the prevention of uterine torsion in sheep, but attention is focused on prompt diagnosis and treatment of the disease. According to the results of this study, postsurgical tissue adhesions were developed and confirmed by patho-anatomical examination in 1 sheep. Other 5 sheep were not economically exploited or sacrificed, and no studies were performed to establish the presence of postsurgical tissue adhesions. In conclusion, it could be said that incorporative uteropexy could be considered as preventive procedure in order to avoid the development of uterine torsion in ewes which have shown a history of this pathology, but also in ewes with identified risk factors for the disease. In future studies, it is necessary to identify more parameters which will contribute to identification of sheep which have high risk factors to obtain the torsion of uterus. Also, it is necessary to use non-invasive methods of clinical diagnostics, primary ultrasound diagnostic, to evaluate the area of incorporative uteropexy in order to assess newly formed tissue adhesions as well as to assess the vitality of fetus. It is necessary to follow the lambing process of ewes with incorporated uterus, and to provide medical assistance to the animals if complications occur during the lambing time.

Urethral reconstruction combined with modified urethrostomy in a cat after prepubic urethrostomy

Background: In cats, urethral obstruction is generally caused by various reasons, including feline idiopathic cystitis, urethral crystals, urethral trauma, mucous plug, congenital or acquired anatomical deformity, and urolithiasis, especially in male cats. Depending on the severity and duration of clinical signs, immediate management including conservative or surgical therapy for restoration of urethral patency is required. Repetitive urethral obstruction due to intraluminal plugs, obstruction that cannot be resolved by medical management, and urethral strictures, trauma, or neoplasia should be managed by surgery. When the penile or pelvic urethra is ruptured or not long enough to mobilize the pelvic urethra to the perineal skin by repetitive perineal urethrostomy, prepubic urethrostomy is indicated. Potential complications of prepubic urethrostomy include urinary incontinence, peristomal dermatitis. In such cases, management of the peristomal site or placement of an artificial urethral sphincter have been reported previously. However, to date, urethral reconstruction using pre-existing penis has not been reported after prepubic urethral stricture following prepubic urethrostomy. The objective of this report is to describe surgical procedure of the urethral reconstruction combined with modified perineal urethrostomy in a cat with prepubic urethral stricture after prepubic urethrosotmy. Case: A 3-year-old castrated Scottish straight cat presented with dysuria after prepubic urethrostomy. The owner reported that the patient was diagnosed with urethral rupture, had undergone prepubic urethrostomy 2 months prior to presentation, and had persistent dysuria despite repetitive surgical revision of the prepubic urethral stoma at a local hospital. On physical examination, the preputial orifice and the penis appeared grossly normal. On ultrasonography, pericystic and periurethral fat had an edematous, striated appearance with alternating hyperechoic and anechoic regions. A small amount of free fluid was visible around the urethra. Abdominal radiography revealed a mildly distended bladder and loss of serosal detail around the area of the urinary bladder neck, consistent with inflammation and free fluid observed on ultrasonography. The retrograde urethrogram showed no leakage in either sites of the prepubic urethral orifice or the penis. Hence, complete urethral reconstruction with modified perineal urethrostomy was performed. The patient had normal urination at the 15-month follow-up. Discussion: Prepubic urethrostomy is beneficial for the patients whose penile or pelvic urethra is ruptured or not long enough to mobilize the pelvic urethra to the perineum. Complications of prepubic urethrostomy include skin necrosis around the stoma; urinary incontinence; stricture of the urethral stoma due to several reasons such as surgical-site irritation; poor mucosa-skin apposition; failure to provide tension-free stoma; and failure to expose wider pelvic urethra. In these cases, surgical management of the level of prepubic urethral stoma has been recommended by previous studies. However, no studies have been reported urethral reconstruction using pre-existing penile urethra in a patient with prepubic urethral stricture so far. To the author's knowledge, this case is the first report describing urethral reconstruction in a cat with urethral stricture after prepubic urethrostomy.

Estabilização zigomática e retalho de avanço facial lateral em canino filhote / Zygomatic stabilization and lateral facial advancement flap in a puppy dog

O trauma é frequentemente relatado na rotina clínica de pequenos animais, podendo gerar fraturas de componentes ósseos e lesões de tecidos moles adjacentes. No presente trabalho, objetivou-se relatar o caso de um canino, macho, sem raça definida, de sete meses de idade, vítima de trauma craniomaxilofacial decorrente de mordedura, diagnosticado com fratura e deslocamento de osso zigomático, além de importante laceração de pele. O tratamento estabelecido baseou-se no debridamento da ferida, estabilização cirúrgica de arco zigomático com fios de Nylon e na sutura dos ferimentos de pele causados. Em um segundo tempo cirúrgico, foi realizada enucleação e recobrimento do defeito na órbita com malha cirúrgica de polipropileno, além de remoção de tecido exuberante e confecção de retalho subdérmico de avanço facial lateral para recobrimento do defeito cutâneo. A complicação evidenciada na primeira intervenção cirúrgica foi a deiscência das suturas de pele, enquanto no segundo tempo cirúrgico, não houve sinais de complicações. No pós-operatório, o paciente apresentou evolução clínica satisfatória, recebendo alta médica 21 dias após o segundo procedimento cirúrgico realizado. Tendo em vista a adequada evolução clínica, bem como os reduzidos efeitos colaterais, sugere-se que a conduta clínica e técnicas cirúrgicas adotadas para tratamento do paciente em questão foram efetivas.

Trauma is frequently reported in the small animal clinics, and can lead to fractures of cranial bone components and injuries to the adjacent soft tissues. In the present study, the objective was to report the case of a seven-month-old male mongrel dog, that had a craniomaxillofacial trauma resulting from a bite, characterized by zygomatic bone fracture and displacement, in addition to a major skin laceration. The stablished treatment was based on wound debridement, surgical stabilization of the zygomatic arch with nylon threads and in the suturing of skin wounds. In a second surgical procedure, enucleation was performed and a surgical polypropylene mesh was applied to cover the orbital defect, exuberant tissue was removed and a subdermal advancement flap was used to cover the skin defect. The complication observed in the first surgical intervention was dehiscence of the skin sutures, while in the second surgical procedure, there were no signs of complications. Postoperatively, the patient had a satisfactory clinical recovery, being discharged 21 days after the second surgical procedure. Considering the adequate clinical evolution and the reduced complications, it issuggestedthat the clinical conduct and surgical techniques adopted for the treatment of the patient in question were effective.