Alternative use of endocavitary probe to guide minimally invasive partial nephrectomy: is it reasonable?

Purpose: To describe the use of endocavitary ultrasound probe as an auxiliary tool when performing partial nephrectomy in cases of endophytic renal tumors, to standardize the method, and to report the preliminary results achieved with this technique. Methods: Fifteen patients diagnosed with completely endophytic underwent partial nephrectomy with the use of an endocavitary ultrasound probe. This article describes the technique involved in partial nephrectomy and details the preparation of the endocavitary ultrasound probe to ensure its safe use. Results: All the patients had a RENAL score between 8 and 11. The median time of warm ischemia was 26 and 18 minutes for laparoscopic or robot-assisted surgery, respectively. The median duration of surgery was 150 minutes, and the median console time was 145 minutes for the laparoscopic and robot-assisted surgery groups, respectively. The median estimate of blood loss was 200 mL. Only three patients in the laparoscopic group had focal positive surgical margins. There were no cases of infection at the site of probe entry. Conclusions: Intraoperative use of an endocavitary ultrasound probe for partial nephrectomy is possible and a safe alternative to the excision of endophytic tumors when neither robotic probes nor laparoscopic probes are available.

Nefrectomia em um cão infectado por Dioctophyma renale - Mato Grosso do Sul, Brasilîpt / Nephrectomy in a dog infected with Dioctophyma renale - Mato Grosso do Sul, Brazil

Background: Dioctophymosis is caused by Dioctophyma renale, a parasite known as the giant kidney worm, that canparasitize the kidneys of domestic and wild animals. There are also reports of its occurrence in humans, thus revealing itszoonotic potential. In most cases, parasitized animals are asymptomatic. This parasite can cause atrophy or destroy therenal parenchyma, although ectopic locations may occur. The diagnosis is made through ultrasonography, based on thepresence of eggs in the urine, visualization of the parasite, or during necropsy. Therefore, the aim of this work was to reportthe case of a young dog infected with D. renale and subjected to nephrectomy in the state of Mato Grosso do Sul, Brazil.Case: A 6-month-old bitch with a clinical suspicion of hydronephrosis in the right kidney was referred to the VeterinaryHospital of Anhanguera-Uniderp University in the city of Campo Grande, MS. A physical examination of the patientrevealed an alteration in the urinary system. An abdominal ultrasound, urinalysis, complete blood count (CBC) tests andbiochemical profile were ordered. The erythrogram indicated erythrocytosis resulting from dehydration and loss of bodyfluids, while enzyme levels (creatinine, urea, alanine aminotransferase [ALT] and albumin) were within normal limits.The abdominal ultrasound showed the presence of a cylindrical and rounded structure characteristic of a nematode and inthe right kidney, and loss of renal parenchyma typical of D. renale infection. A urinalysis then revealed the presence ofhelminth eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affected rightkidney, which showed destruction of the renal parenchyma. One adult female and one adult male parasite were removedfrom inside the kidney, measuring approximately 50 cm and 35 cm in length. The patient was successfully treated, keptin hospital for observation, and returned two weeks later for reassessment of her...

Nefrectomia em um cão infectado por Dioctophyma renale - Mato Grosso do Sul, Brasilîpt / Nephrectomy in a dog infected with Dioctophyma renale - Mato Grosso do Sul, Brazil

Background: Dioctophymosis is caused by Dioctophyma renale, a parasite known as the giant kidney worm, that canparasitize the kidneys of domestic and wild animals. There are also reports of its occurrence in humans, thus revealing itszoonotic potential. In most cases, parasitized animals are asymptomatic. This parasite can cause atrophy or destroy therenal parenchyma, although ectopic locations may occur. The diagnosis is made through ultrasonography, based on thepresence of eggs in the urine, visualization of the parasite, or during necropsy. Therefore, the aim of this work was to reportthe case of a young dog infected with D. renale and subjected to nephrectomy in the state of Mato Grosso do Sul, Brazil.Case: A 6-month-old bitch with a clinical suspicion of hydronephrosis in the right kidney was referred to the VeterinaryHospital of Anhanguera-Uniderp University in the city of Campo Grande, MS. A physical examination of the patientrevealed an alteration in the urinary system. An abdominal ultrasound, urinalysis, complete blood count (CBC) tests andbiochemical profile were ordered. The erythrogram indicated erythrocytosis resulting from dehydration and loss of bodyfluids, while enzyme levels (creatinine, urea, alanine aminotransferase [ALT] and albumin) were within normal limits.The abdominal ultrasound showed the presence of a cylindrical and rounded structure characteristic of a nematode and inthe right kidney, and loss of renal parenchyma typical of D. renale infection. A urinalysis then revealed the presence ofhelminth eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affected rightkidney, which showed destruction of the renal parenchyma. One adult female and one adult male parasite were removedfrom inside the kidney, measuring approximately 50 cm and 35 cm in length. The patient was successfully treated, keptin hospital for observation, and returned two weeks later for reassessment of her...(AU)

Hydronephrosis in a dog related to ovariosalpingohysterectomy

Background: Hydronephrosis is the dilation of the pelvis and renal calyxes due to post-renal obstruction. The obstruction is often associated with extraluminal masses, blood clots and ureter ligation in castration procedures. Ureter ligation is reported as a malpractice. The renal function is reestablished if ligation is rapidly undone, but not for obstructions longer than four weeks. Often, clinical signs are results from months to years after the castration, when nephrectomy is the best therapeutic option. This paper aims to report a case of asymptomatic unilateral hydronephrosis in a 10-year-old dog caused by chronic ureter occlusion with Nylon 3.0 suture during an elective procedure. Case: A 10-year-old female pinscher dog, spayed 3 years ago was admitted at the Surgery Department of the Veterinary Hospital of the Federal University of Jataí (HV-UFJ). The animal was taken for periodontal treatment. In the physical and laboratory examination (complete blood count, hepatic and renal biochemical tests) no significant and noteworthy alterations were found. Ultrasonographic examination showed no changes in the topography and echotexture of the left kidney, however the right kidney was not visualized, with an anechoic structure suggestive of advanced and severe hydronephrosis. Therefore, exploratory laparotomy was proposed to identify the observed structure, with the periodontal treatment considered for a later time. So, a retroumbilical incision was made, followed by linea alba and the removal of simple isolated suture remaining from previous surgical procedure. In the cavity, the viscera were isolated and the left kidney was identified, observing preserved anatomy. On the other hand, the right kidney had altered topography and morphology, being exposed after release of adhesions in adjacent structures. The right renal artery and vein were dissected and a double ligature was made. Then, the right ureter was dissected, observing marked dilatation in the proximal portion and the presence of local ligation with Nylon 3.0. Right ureterectomy and right nephrectomy were performed. After nephrectomy, the capsule was ruptured, observing dark fluid in it and absence of tissue compatible with renal parenchyma. The material was preserved in 10% formaldehyde and sent for histopathological examination. Histopathology revealed risk of rupture of the renal capsule due to the advance of renal degeneration and complete absence of parenchyma. However, contrary to the severity of the histopathological, surgical and ultrasonographic findings, the patient did not present clinical signs at the time of diagnosis. Discussion: In the intraoperative evaluation, the cause of the hydronephrosis was verified to be in fact the ligation of the ureter, which may have been accidental or due to the malpractice of the veterinarian surgeon. Other possible causes such as adhesions and granulomas were ruled out because the Nylon 3.0 suture was found in the proximal portion of the right ureter. It is believed that the patient may have presented clinical signs of hydronephrosis that may have been confused by the tutors as postoperative complications, changes that if identified and performed in time, could have avoided the occurrence or worsening of hydronephrosis and subsequent nephrectomy. Clinically, the bitch did not show clinical signs presented in the literature as consistent with hydronephrosis such as polyuria, polydipsia, abdominalgia, external fistula and anorexia. Therefore, it is believed that this case is one of the first reports of the occurrence of severe hydronephrosis without typical clinical manifestations of hydronephrosis. This fact raises a warning about the thorough monitoring in the postoperative period by owners and veterinarians, in addition to highlighting concerns regarding the occurrence of medical malpractice versus surgical accidents.

Techniques of orthotopic renal transplantation. II. Size-matched porcine grafts in monkey recipients

ABSTRACT Purpose As a classical xenotransplantation model, porcine kidneys have been transplanted into the lower abdomen of non-human primates. However, we have improved upon this model by using size-matched grafting in the orthotopic position. The beneficial aspects and surgical details of our method are reported herein. Methods Donors were two newborn pigs (weighting 5 to 6 kg) and recipients were two cynomolgus monkeys (weighting, approximately, 7 kg). After bilateral nephrectomy, kidneys were cold-transported in Euro-Collins solution. The porcine kidney was transplanted to the site of a left nephrectomy and fixed to the peritoneum. Results Kidneys transplanted to the lower abdomen by the conventional method were more susceptible to torsion of the renal vein (two cases). In contrast, early-stage blood flow insufficiency did not occur in orthotopic transplants of theleft kidney. Conclusions Size-matched porcine-primate renal grafting using our method of transplanting tothe natural position of the kidneys contributes to stable post-transplant blood flow to the kidney.

Pionefrose unilateral em cão - relato de caso / Unilateral pyonephrosis in a dog - case report / Pionefrosis unilateral en perro - relato de caso

A pionefrose consiste em uma hidronefrose contaminada, associada à destruição do parênquima renal. Tem como causas o bloqueio ureteral ou uretral por urólitos, inflamação crônica, neoplasia e ureter ectópico, seguidos de contaminação. O diagnóstico é realizado através de exames de imagem, principalmente a ultrassonografia e também através de urinálise e urocultura. Em casos avançados o tratamento preconizado é a nefrectomia. O presente trabalho tem como objetivo relatar um caso de um cão com suspeita inicial de hidronefrose. O paciente passou por nefrectomia, no pós-operatório observou-se melhora do seu quadro clínico, porém permanecendo a anemia. O diagnóstico definitivo, realizado por exame histopatológico, revelou pionefrose, entretanto sua causa não foi estabelecida.(AU)

Pyonephrosis consists of a contaminated hydronephrosis associated with the destruction of the renal parenchyma. Its causes include ureter or urethra blockage by uroliths, chronic inflammation, neoplasm, and ectopic ureter, followed by contamination. The diagnosis is made through image exams, mainly ultrasound, and also through urinalysis and uroculture. In advanced cases, nephrectomy is the recommended treatment. The objective of this study is to report a case of a dog with initial suspicion of hydronephrosis. The patient underwent nephrectomy, and during the postoperative period, an improvement in the clinical scenario was observed, despite the persistent anemia. The definitive diagnosis, carried out by histopathological examination, revealed pyonephrosis; however, its cause was not established.(AU)

La pionefrosis es una hidronefrosis contaminada, asociada con la destrucción del parénquima renal. Sus causas son el bloqueo ureteral o uretral por urolitos, inflamación crónica, neoplasia y uréter ectópico, seguido de contaminación. El diagnóstico se realiza mediante exámenes de imágenes, principalmente ultrasonografía y también mediante análisis de orina y urocultivo. En casos avanzados el tratamiento recomendado es la nefrectomía. Este artículo tiene como objetivo informar un caso de un perro con sospecha inicial de hidronefrosis. El paciente se sometió a nefrectomía; después de la operación, su estado clínico mejoró, pero la anemia permaneció. El diagnóstico definitivo realizado por el examen histopatológico reveló pionfrosis, sin embargo, su causa no se ha establecido.(AU)

Pionefrose unilateral em cão - relato de caso / Unilateral pyonephrosis in a dog - case report / Pionefrosis unilateral en perro - relato de caso

A pionefrose consiste em uma hidronefrose contaminada, associada à destruição do parênquima renal. Tem como causas o bloqueio ureteral ou uretral por urólitos, inflamação crônica, neoplasia e ureter ectópico, seguidos de contaminação. O diagnóstico é realizado através de exames de imagem, principalmente a ultrassonografia e também através de urinálise e urocultura. Em casos avançados o tratamento preconizado é a nefrectomia. O presente trabalho tem como objetivo relatar um caso de um cão com suspeita inicial de hidronefrose. O paciente passou por nefrectomia, no pós-operatório observou-se melhora do seu quadro clínico, porém permanecendo a anemia. O diagnóstico definitivo, realizado por exame histopatológico, revelou pionefrose, entretanto sua causa não foi estabelecida.(AU)

Pyonephrosis consists of a contaminated hydronephrosis associated with the destruction of the renal parenchyma. Its causes include ureter or urethra blockage by uroliths, chronic inflammation, neoplasm, and ectopic ureter, followed by contamination. The diagnosis is made through image exams, mainly ultrasound, and also through urinalysis and uroculture. In advanced cases, nephrectomy is the recommended treatment. The objective of this study is to report a case of a dog with initial suspicion of hydronephrosis. The patient underwent nephrectomy, and during the postoperative period, an improvement in the clinical scenario was observed, despite the persistent anemia. The definitive diagnosis, carried out by histopathological examination, revealed pyonephrosis; however, its cause was not established.(AU)

La pionefrosis es una hidronefrosis contaminada, asociada con la destrucción del parénquima renal. Sus causas son el bloqueo ureteral o uretral por urolitos, inflamación crónica, neoplasia y uréter ectópico, seguido de contaminación. El diagnóstico se realiza mediante exámenes de imágenes, principalmente ultrasonografía y también mediante análisis de orina y urocultivo. En casos avanzados el tratamiento recomendado es la nefrectomía. Este artículo tiene como objetivo informar un caso de un perro con sospecha inicial de hidronefrosis. El paciente se sometió a nefrectomía; después de la operación, su estado clínico mejoró, pero la anemia permaneció. El diagnóstico definitivo realizado por el examen histopatológico reveló pionfrosis, sin embargo, su causa no se ha establecido.(AU)

Anestesia para nefrectomia em cão com Dioctophyma renale: relato de caso / Anesthesia for nephrectomy in a dog with Dioctophyma renale: case report

A dioctofimose em cães é uma doença parasitária registrada em vários estados do Brasil, incluindo o Rio Grande do Sul que afeta, principalmente, animais errantes que habitam áreas alagadas. A resolução do caso quando atinge apenas um rim é cirúrgica, sendo assim necessária à realização de anestesia geral para o procedimento de nefrectomia unilateral. Dessa forma, a busca por protocolos mais seguros que mantém a integridade renal é fundamental. O objetivo desse trabalho é relatar a anestesia para o procedimento de nefrectomia como tratamento de dioctofimose em um cão errante da cidade de Pelotas-RS. No presente caso, foi realizada medicação pré-anestésica, com acepromazina, cetamina associados amorfina, e indução com propofol. A manutenção do plano anestésico com isoflurano diluído em oxigênio a 100%, e foi ainda realizado o bloqueio epidural com bupivacaína e morfina para dessensibilização regional. Após o término do procedimento cirúrgico o paciente recebeu analgesia pós-operatória com meloxicam, tramadol e dipirona, e permaneceu na internação por 10 dias para monitoração da função renal e tratamento de doença dermatológica concomitante. O protocolo anestésico foi efetivo e sem maiores complicações, após alta médica foi levado para o canil da prefeitura, onde aguarda adoção.

Dioctophymosis in dogs is a parasitic disease registered in several states of Brazil, including Rio Grande do Sul, mainly wandering animals that live in flooded areas. The resolution of the case is only a surgical measure, so it is necessary to perform general anesthesia for the unilateral nephrectomy procedure. In this way, a search for other data that maintains the ri is fundamental. The purpose of this work is to report anesthesia for the nephrectomy procedure as a treatment of dioctosis in a wandering dog in the city of Pelotas, RS. In the present case, premedication with acepromazine, ketamine associated with morphine, and induction with propofol were performed. The maintenance of the anesthetic plan with isoflurane was diluted in 100% oxygen, and it was also performed with epidural block with bupivacaine and morphine for regional desensitization. After the end of the clinical procedure, the patient received postoperative analgesia with meloxicam, tramadol and dipyrone and remained in the hospital for 10 days to monitor renal function and the concomitant dermatology process. The anesthetic protocol was effective and without major complications, after being discharged to the health service, where it was installed.

Type II retrocaval ureter causing hydronephrosis in a cat: case report / Ureter retrocava tipo II causando hidronefrose em um gato: relato de caso

Retrocaval ureter (RU) is an abnormal embryonic development of the caudal vena cava (CVC) that leads the ureter to be entrapped dorsal to the CVC. In most cases there is no clinical impact; however, it can cause hydronephrosis. We report a rare case of type II symptomatic retrocaval ureter in a feline treated with nephroureterectomy. A 4-year-old, intact male, mixed breed cat was submitted to abdominal ultrasound and severe right hydronephrosis was diagnosed, with no signs of obstruction. We performed an exploratory celiotomy, in which a displacement of the right ureter dorsal to the CVC was observed. The animal was treated with ureteronephrectomy and recovered well. No intraluminal cause was found, and a urethral catheter could be easily inserted across the ureter length. The real clinical relevance of the RU is unknown, since it is a common find in post-mortem examination without kidney impact and, when significant, is often associated to other causes of ureteral obstructions, such as calculi and strictures. Additionally, in humans, type II RU seldom develops obstruction and hydronephrosis. In our case, due to absence of other causes of obstruction, probably mechanical compression of the CVC against the psoas muscle caused the hydronephrosis.(AU)

O ureter retrocava (UR) é originado por uma falha na formação embriológica da veia cava caudal (VCC), que leva ao aprisionamento do ureter dorsal à VCC. Na maioria dos casos, não há impacto clínico; entretanto, essa anomalia pode causar hidronefrose. Relata-se um raro caso de UR tipo II sintomático em um felino, tratado com nefroureterectomia. O referido animal, sem raça definida, macho intacto de quatro anos de idade, foi submetido à ultrassonografia abdominal, que revelou acentuada hidronefrose direita, sem sinais de obstrução. Realizou-se celiotomia exploratória, na qual foi possível observar o ureter direito dorsal à VCC. O animal foi tratado com nefroureterectomia e se recuperou satisfatoriamente. Nenhuma causa intraluminal foi encontrada e um cateter uretral pôde ser facilmente inserido por todo o comprimento do ureter. A real relevância clínica do UR é desconhecida, visto que é um achado comum em exames post mortem, sem impacto aos rins e, quando significante, frequentemente está associado a outras causas de obstrução ureteral, como cálculos e estenoses. Adicionalmente, em humanos, o UR tipo II raramente desenvolve obstrução e hidronefrose. Neste caso, devido à ausência de outros motivos de obstrução, acredita-se que a compressão mecânica da VCC contra o músculo psoas foi a causa da hidronefrose.(AU)

Type II retrocaval ureter causing hydronephrosis in a cat: case report / Ureter retrocava tipo II causando hidronefrose em um gato: relato de caso

Retrocaval ureter (RU) is an abnormal embryonic development of the caudal vena cava (CVC) that leads the ureter to be entrapped dorsal to the CVC. In most cases there is no clinical impact; however, it can cause hydronephrosis. We report a rare case of type II symptomatic retrocaval ureter in a feline treated with nephroureterectomy. A 4-year-old, intact male, mixed breed cat was submitted to abdominal ultrasound and severe right hydronephrosis was diagnosed, with no signs of obstruction. We performed an exploratory celiotomy, in which a displacement of the right ureter dorsal to the CVC was observed. The animal was treated with ureteronephrectomy and recovered well. No intraluminal cause was found, and a urethral catheter could be easily inserted across the ureter length. The real clinical relevance of the RU is unknown, since it is a common find in post-mortem examination without kidney impact and, when significant, is often associated to other causes of ureteral obstructions, such as calculi and strictures. Additionally, in humans, type II RU seldom develops obstruction and hydronephrosis. In our case, due to absence of other causes of obstruction, probably mechanical compression of the CVC against the psoas muscle caused the hydronephrosis.(AU)

O ureter retrocava (UR) é originado por uma falha na formação embriológica da veia cava caudal (VCC), que leva ao aprisionamento do ureter dorsal à VCC. Na maioria dos casos, não há impacto clínico; entretanto, essa anomalia pode causar hidronefrose. Relata-se um raro caso de UR tipo II sintomático em um felino, tratado com nefroureterectomia. O referido animal, sem raça definida, macho intacto de quatro anos de idade, foi submetido à ultrassonografia abdominal, que revelou acentuada hidronefrose direita, sem sinais de obstrução. Realizou-se celiotomia exploratória, na qual foi possível observar o ureter direito dorsal à VCC. O animal foi tratado com nefroureterectomia e se recuperou satisfatoriamente. Nenhuma causa intraluminal foi encontrada e um cateter uretral pôde ser facilmente inserido por todo o comprimento do ureter. A real relevância clínica do UR é desconhecida, visto que é um achado comum em exames post mortem, sem impacto aos rins e, quando significante, frequentemente está associado a outras causas de obstrução ureteral, como cálculos e estenoses. Adicionalmente, em humanos, o UR tipo II raramente desenvolve obstrução e hidronefrose. Neste caso, devido à ausência de outros motivos de obstrução, acredita-se que a compressão mecânica da VCC contra o músculo psoas foi a causa da hidronefrose.(AU)

Parasitismo por Dioctophyma renale em cão: aspectos clínico-cirúrgico / Parasitism by Dioctophyma renale in a dog: clinical and surgical aspects

Background: Dioctophimosis is a parasitic disease caused by Dioctophyma renale, more commonly known as “giantKidney worm,” and can be found in other organs or free in the abdominal cavity, which is related to the patient’s eatinghabits. Most of the animals affected are asymptomatic. The diagnosis is made through ultrasonography, finding eggs ofthe parasite in the urine, or necropsy. The treatment of choice is nephrectomy of the affected kidney. We aimed to reportthe accidental diagnosis of parasitism by D. renale in an 8-year-old dog, which was surgically treated by nephrectomy ofthe right kidney after evident destruction of the renal parenchyma on ultrasonography.Case: An 8-year-old Boxer female dog underwent a physical examination and showed a mass in the region of the left caudal thoracic breast, bilateral alopecia on flanks, and purulent ocular secretions. Laboratory tests of complete blood count(CBC) and serum biochemical profile, X-ray examination, and ultrasonography were requested. Anemia was observedon the erythrogram, and enzymes (creatinine, urea, alanine aminotransferase [ALT], and albumin) were within normallimits. There were no abnormalities on X-ray examination, and abdominal ultrasonography showed slight splenomegaly,enlarged left kidney, reduced corticomedullary region, measuring approximately 7.63 cm longitudinally. In the rightkidney, loss of the renal parenchyma, measuring approximately 5.49 cm in diameter and the presence of a cylindrical androunded structure, typical of D. renale infection. After this, a urinalysis was suggested, which revealed the presence ofthe helminthic eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affectedkidney as treatment. The kidney showed destruction of the renal parenchyma. A single parasite was removed, measuringapproximately 46 cm in length. The patient was successfully treated and was hospitalized for...

Parasitismo por Dioctophyma renale em cão: aspectos clínico-cirúrgico / Parasitism by Dioctophyma renale in a dog: clinical and surgical aspects

Background: Dioctophimosis is a parasitic disease caused by Dioctophyma renale, more commonly known as “giantKidney worm,” and can be found in other organs or free in the abdominal cavity, which is related to the patients eatinghabits. Most of the animals affected are asymptomatic. The diagnosis is made through ultrasonography, finding eggs ofthe parasite in the urine, or necropsy. The treatment of choice is nephrectomy of the affected kidney. We aimed to reportthe accidental diagnosis of parasitism by D. renale in an 8-year-old dog, which was surgically treated by nephrectomy ofthe right kidney after evident destruction of the renal parenchyma on ultrasonography.Case: An 8-year-old Boxer female dog underwent a physical examination and showed a mass in the region of the left caudal thoracic breast, bilateral alopecia on flanks, and purulent ocular secretions. Laboratory tests of complete blood count(CBC) and serum biochemical profile, X-ray examination, and ultrasonography were requested. Anemia was observedon the erythrogram, and enzymes (creatinine, urea, alanine aminotransferase [ALT], and albumin) were within normallimits. There were no abnormalities on X-ray examination, and abdominal ultrasonography showed slight splenomegaly,enlarged left kidney, reduced corticomedullary region, measuring approximately 7.63 cm longitudinally. In the rightkidney, loss of the renal parenchyma, measuring approximately 5.49 cm in diameter and the presence of a cylindrical androunded structure, typical of D. renale infection. After this, a urinalysis was suggested, which revealed the presence ofthe helminthic eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affectedkidney as treatment. The kidney showed destruction of the renal parenchyma. A single parasite was removed, measuringapproximately 46 cm in length. The patient was successfully treated and was hospitalized for...(AU)

Dioctophymatosis as cause of dyspnea in a dog / Dioctofimatose como causa de dispnéia em cão

Dioctophyme renale is a parasite of the nematode class that can infect various species, including humans and dogs. Usually, the parasite migrates to the right kidney of the definitive host. Although, aberrant migrations have been previously reported, they mainly occur without clinical manifestations. No reports of dyspnea secondary to D. renale infestation has been found in the reported literature. The aim of this paper is to report intense respiratory distress caused by the presence of the parasite in the thoracic cavity of a dog. Radiographic images revealed multiple circular structures with a cavity with a radiopaque, thick contour in the thorax, which raised the suspicion of pulmonary bullae. Ultrasound examination revealed nematode infestation in the right kidney, scrotum, and thoracic cavity. Subsequently, right nephrectomy, orchiectomy and trans-sternal thoracotomy were performed to remove the parasites. The patient exhibited recovery after the procedures.(AU)

Dioctophyme renale é um parasita da classe de nematoda que pode infectar diferentes espécies, incluindo humanos e cães. Normalmente, o parasita migra para o rim direito do hospedeiro definitivo. Embora migrações erráticas tenham sido relatadas anteriormente, estas geralmente ocorrem sem manifestações clínicas. Não foram encontrados relatos de dispnéia secundária à infestação de D. renale. O objetivo deste trabalho é relatar a presença do parasita na cavidade torácica de um cão, causando angústia respiratória. As imagens radiográficas revelaram a presença de múltiplas estruturas circulares com aspecto de cavidade e contorno espesso radiopaco no tórax, o que suscitou a suspeita de bullae pulmonar. O exame de ultra-som foi determinante na revelação de infestação múltipla por nematódeos, no rim direito, escroto e cavidade torácica. Posteriormente, como medida terapêutica, foram realizadas os procedimentos de nefrectomia direita, orquiectomia e toracotomia transesternal para remoçãodos parasitas. O paciente evoluiu clinicamente bem após os procedimentos.(AU)

Unilateral idiopathic renal hematuria in a dog / Hematúria renal idiopática unilateral em um cão

Idiopathic renal hematuria is diagnosed in situations where the cause of hematuria is not clear, even after ruling out all possible differential diagnoses. A 14-year-old female Cocker Spaniel with continuous hematuria as the only clinical sign for two months. Concomitant changes were ruled out by blood tests, urinalysis, and abdominal ultrasonography. It was evidenced that hematuria originated from the left kidney through ureteral catheterization and the diagnosis of idiopathic renal hematuria was determined by excluding other possible causes of renal hematuria. Idiopathic renal hematuria is a rarely reported disease but has great importance as a differential diagnosis in cases where the main clinical sign is hematuria.

A hematúria renal idiopática é diagnosticada em situações onde a razão da hematúria não é esclarecida, descartando-se todos os possíveis diagnósticos diferenciais. Um cão, fêmea, Cocker Spaniel com 14 anos de idade manifestou hematúria contínua como único sinal clínico, por dois meses. Foram descartadas alterações concomitantes, por meio de exames de sangue, urinálise e ultrassonografia abdominal. A hematúria proveniente do rim esquerdo foi evidenciada através de cateterização ureteral e o diagnóstico de hematúria renal idiopática foi obtido por meio da exclusão de outras possíveis causas de hematúria renal. A hematúria renal idiopática é uma doença pouco relatada, no entanto apresenta grande importância como diagnóstico diferencial nos casos onde o principal sinal clínico é a hematúria.

Unilateral idiopathic renal hematuria in a dog / Hematúria renal idiopática unilateral em um cão

Idiopathic renal hematuria is diagnosed in situations where the cause of hematuria is not clear, even after ruling out all possible differential diagnoses. A 14-year-old female Cocker Spaniel with continuous hematuria as the only clinical sign for two months. Concomitant changes were ruled out by blood tests, urinalysis, and abdominal ultrasonography. It was evidenced that hematuria originated from the left kidney through ureteral catheterization and the diagnosis of idiopathic renal hematuria was determined by excluding other possible causes of renal hematuria. Idiopathic renal hematuria is a rarely reported disease but has great importance as a differential diagnosis in cases where the main clinical sign is hematuria.(AU)

A hematúria renal idiopática é diagnosticada em situações onde a razão da hematúria não é esclarecida, descartando-se todos os possíveis diagnósticos diferenciais. Um cão, fêmea, Cocker Spaniel com 14 anos de idade manifestou hematúria contínua como único sinal clínico, por dois meses. Foram descartadas alterações concomitantes, por meio de exames de sangue, urinálise e ultrassonografia abdominal. A hematúria proveniente do rim esquerdo foi evidenciada através de cateterização ureteral e o diagnóstico de hematúria renal idiopática foi obtido por meio da exclusão de outras possíveis causas de hematúria renal. A hematúria renal idiopática é uma doença pouco relatada, no entanto apresenta grande importância como diagnóstico diferencial nos casos onde o principal sinal clínico é a hematúria.(AU)

Adenocarcinoma renal papilar em um cão - relato de caso / Papillar renal adenocarcinoma in a dog - case report

O trabalho teve como objetivo relatar um caso de adenocarcinoma renal papilar em um cão macho da raça labrador. O animal foi atendido em uma clínica veterinária de Campo Mourão – PR, com queixa principal de hematúria e perda de peso durante quatro meses. No exame físico o animal apresentou aumento de volume intra-abdominal localizado, de consistência firme e desconforto abdominal à palpação. No exame ultrassonográfico, evidenciou-se a presença de cristais, e pequenos cálculos vesicais urinários, inflamação da parede da vesícula urinária e visualizado uma massa localizada em quadrante abdominal caudal esquerdo em região mesogástrica de difícil delimitação e possivelmente envolvendo o rim esquerdo. Foi realizado o procedimento de laparotomia exploratória e na inspeção da cavidade observou-se significativo aumento de volume do rim esquerdo, realizando o procedimento de nefrectomia unilateral esquerda. Uma amostra deste rim foi enviada para análise histopatológica a um Laboratório de Patologia Animal. Nesta avaliação foram observadas células neoplásicas, características por serem poliédricas e exibirem núcleo grande oval, citoplasma pouco abundante eosinofílico, formam estruturas tubulares e projeções intraluminais papiliformes irregulares. O índice mitótico é de 1 – 2 fm./ 40x, observa-se também desmoplasia foco de necrose tumoral, sendo conclusivo de adenocarcinoma renal papilar. Conclui-se que o exame histopatológico é de suma importância para o diagnóstico desta neoplasia. E o adenocarcinoma renal papilar causa uma lesão grave no rim, podendo ocorrer metástase para outros órgãos e levar o animal a morte.

This study aimed to report a case of papillary renal adenocarcinoma in a male labrador dog. The animal was treated at a veterinary clinic in Campo Mourão - PR, with the main complaint of hematuria and weight loss for four months. On physical examination the animal showed localized intra-abdominal volume increase, firm consistency and abdominal discomfort on palpation. The ultrasound examination evinced the presence of crystals, and small urinary bladder stones, inflammation of the urinary bladder wall and it was visualized a mass located in the left caudal abdominal quadrant in the mesogastric region, hardly delimited and possibly involving the left kidney. Exploratory laparotomy and cavity inspection were performed, which significantly increased the volume of the left kidney, performing the left unilateral nephrectomy procedure. A sample of this kidney was sent for histopathological analysis at the Animal Pathology Laboratory. In this evaluation, neoplastic cells, polymer resources and large oval nucleus display, sparse eosinophilic cytoplasm, tubular forms and irregular papilliform intraluminal projections were observed. The mitotic index is 1 - 2 fm./40x, as well as focal desmoplasia of tumor necrosis. Being conclusive of renal papillary adenocarcinoma. To conclude that histopathological examination is extremely important for the diagnosis of this neoplasia. And renal papillary adenocarcinoma causes severe kidney damage, metastasis to other organs can lead to death.

Adenocarcinoma renal papilar em um cão - relato de caso / Papillar renal adenocarcinoma in a dog - case report

O trabalho teve como objetivo relatar um caso de adenocarcinoma renal papilar em um cão macho da raça labrador. O animal foi atendido em uma clínica veterinária de Campo Mourão PR, com queixa principal de hematúria e perda de peso durante quatro meses. No exame físico o animal apresentou aumento de volume intra-abdominal localizado, de consistência firme e desconforto abdominal à palpação. No exame ultrassonográfico, evidenciou-se a presença de cristais, e pequenos cálculos vesicais urinários, inflamação da parede da vesícula urinária e visualizado uma massa localizada em quadrante abdominal caudal esquerdo em região mesogástrica de difícil delimitação e possivelmente envolvendo o rim esquerdo. Foi realizado o procedimento de laparotomia exploratória e na inspeção da cavidade observou-se significativo aumento de volume do rim esquerdo, realizando o procedimento de nefrectomia unilateral esquerda. Uma amostra deste rim foi enviada para análise histopatológica a um Laboratório de Patologia Animal. Nesta avaliação foram observadas células neoplásicas, características por serem poliédricas e exibirem núcleo grande oval, citoplasma pouco abundante eosinofílico, formam estruturas tubulares e projeções intraluminais papiliformes irregulares. O índice mitótico é de 1 2 fm./ 40x, observa-se também desmoplasia foco de necrose tumoral, sendo conclusivo de adenocarcinoma renal papilar. Conclui-se que o exame histopatológico é de suma importância para o diagnóstico desta neoplasia. E o adenocarcinoma renal papilar causa uma lesão grave no rim, podendo ocorrer metástase para outros órgãos e levar o animal a morte.(AU)

This study aimed to report a case of papillary renal adenocarcinoma in a male labrador dog. The animal was treated at a veterinary clinic in Campo Mourão - PR, with the main complaint of hematuria and weight loss for four months. On physical examination the animal showed localized intra-abdominal volume increase, firm consistency and abdominal discomfort on palpation. The ultrasound examination evinced the presence of crystals, and small urinary bladder stones, inflammation of the urinary bladder wall and it was visualized a mass located in the left caudal abdominal quadrant in the mesogastric region, hardly delimited and possibly involving the left kidney. Exploratory laparotomy and cavity inspection were performed, which significantly increased the volume of the left kidney, performing the left unilateral nephrectomy procedure. A sample of this kidney was sent for histopathological analysis at the Animal Pathology Laboratory. In this evaluation, neoplastic cells, polymer resources and large oval nucleus display, sparse eosinophilic cytoplasm, tubular forms and irregular papilliform intraluminal projections were observed. The mitotic index is 1 - 2 fm./40x, as well as focal desmoplasia of tumor necrosis. Being conclusive of renal papillary adenocarcinoma. To conclude that histopathological examination is extremely important for the diagnosis of this neoplasia. And renal papillary adenocarcinoma causes severe kidney damage, metastasis to other organs can lead to death.(AU)

Nefrectomia em um cão Boiadeiro Australiano parasitado por Dioctophyma renale / Nephrectomy in an australian cattle dog parasitized by Dioctophyma renale

Background: Dioctophyma renale is a globally occurring nematode that parasites the kidneys, and to a lesser extent, can be found in other organs or free in the abdominal cavity. Has the capacity to destroy the renal parenchyma. For the most part, parasitized animals are asymptomatic. The diagnosis is made through urinalysis and ultrasonography. However most the cases are diagnosed only at necropsy. As treatment nephrectomy of the affected kidney is the technique of choice. Therefore, the aim of this work was to report the case of a dog, seven months old, treated surgically by nephrectomy of the right kidney due to the destruction of the renal parenchyma caused by D. renale.Case: A 7-month-old Australian Cattle Dog, with a history of hematuria, was attended in a Florianópolis Veterinary Hospital. At the physical examination of the patient, no change was found, being extremely active. Abdominal ultrasonography, urinalysis, CBC and biochemical profile were requested. Abdominal ultrasonography showed the presence of cylindrical and rounded structures, with a hyperechogenic wall and a hypoechogenic center, compatible with D. renale, located in the right kidney. Urinalysis revealed the presence of D. renale eggs. The erythrogram showed mild anemia and the leukogram showed neutrophilic leukocytosis. Calcium, creatinine, alkaline phosphatase, phosphorus, alanine aminotransferase and urea dosages showed values within normal limits. As treatment, nephrectomy of the right kidney was performed by laparotomy. The kidney was presented with destruction of the renal parenchyma and a single parasite was removed from its interior, measuring 54 cm in length. Histopathological analysis of the affected kidney revealed diffuse pronounced fibrous connective tissue proliferation, increased urinary space with decreased glomerular tuft and increased glomerular to tubule ratio. The nephrectomy was curative and ceased the patient’s hematuria.[...]

Nefrectomia em um cão Boiadeiro Australiano parasitado por Dioctophyma renale / Nephrectomy in an australian cattle dog parasitized by Dioctophyma renale

Background: Dioctophyma renale is a globally occurring nematode that parasites the kidneys, and to a lesser extent, can be found in other organs or free in the abdominal cavity. Has the capacity to destroy the renal parenchyma. For the most part, parasitized animals are asymptomatic. The diagnosis is made through urinalysis and ultrasonography. However most the cases are diagnosed only at necropsy. As treatment nephrectomy of the affected kidney is the technique of choice. Therefore, the aim of this work was to report the case of a dog, seven months old, treated surgically by nephrectomy of the right kidney due to the destruction of the renal parenchyma caused by D. renale.Case: A 7-month-old Australian Cattle Dog, with a history of hematuria, was attended in a Florianópolis Veterinary Hospital. At the physical examination of the patient, no change was found, being extremely active. Abdominal ultrasonography, urinalysis, CBC and biochemical profile were requested. Abdominal ultrasonography showed the presence of cylindrical and rounded structures, with a hyperechogenic wall and a hypoechogenic center, compatible with D. renale, located in the right kidney. Urinalysis revealed the presence of D. renale eggs. The erythrogram showed mild anemia and the leukogram showed neutrophilic leukocytosis. Calcium, creatinine, alkaline phosphatase, phosphorus, alanine aminotransferase and urea dosages showed values within normal limits. As treatment, nephrectomy of the right kidney was performed by laparotomy. The kidney was presented with destruction of the renal parenchyma and a single parasite was removed from its interior, measuring 54 cm in length. Histopathological analysis of the affected kidney revealed diffuse pronounced fibrous connective tissue proliferation, increased urinary space with decreased glomerular tuft and increased glomerular to tubule ratio. The nephrectomy was curative and ceased the patients hematuria.[...](AU)

Nefrectomia direita em cão parasitado por Dioctophyme renale: relato de caso / Right nephrectomy in dog parasited by Dioctophyme renale: case report

A dioctofimose, causada pelo nematódeo Dioctophyme renale, acomete frequentemente cães errantes e de hábitos alimentares pouco seletivos, podendo afetar também o homem. O parasita é grande, pode medir até cem centímetros de comprimento e se aloja geralmente no rim direito. O diagnóstico é obtido pela visualização dos ovos do D. renale durante o exame do sedimento urinário ou pelo achado do parasita à necropsia. O presente trabalho descreve um caso de parasitismo por este nematoide em cão atendido no Hospital Veterinário "Governador Laudo Natel" da Faculdade de Ciências Agrárias e Veterinárias, Jaboticabal, no qual a conduta terapêutica foi a realização de nefrectomia do rim acometido, devido à destruição do parênquima renal. A nefrectomia unilateral foi eficiente para a cura do paciente e eliminação do parasita.

Dioctophimosis, caused by the nematode Dioctophyme renale, frequently attacks erratic dogs and have poorly selective eating habits and, may also affects the man. The parasite is large, can be up to one meter long and usually is lodged to the right kidney. The diagnosis is obtained by the preview of D. renale eggs during the examination of the urinary sediment or by finding the parasite at necropsy. The present study describes a case of parasitism by this nematode in a dog attended at the "Governador Laudo Natel" Veterinary Hospital of the Faculdade de Ciências Agrárias e Veterinárias, Jaboticabal, in which the therapeutic management was the nephrectomy of the affected kidney, due to the destruction of the renal parenchyma. Unilateral nephrectomy was efficient for the cure of the patient and elimination of the parasite.