Hemodiálise veterinária: considerações do colégio brasileiro de nefrologia e urologia veterinárias / Veterinary hemodialysis: considerations of the brazilian college of veterinary nephrology and urology / Hemodiálisis veterinaria: consideraciones del colegio brasileño de nefrología y urología veterinaria

Sendo parte integrante do arsenal de opções terapêuticas na nefrologia veterinária, a hemodiálise aplicada aos animais se popularizou e avançou consideravelmente nos últimos anos, não só no mundo como no Brasil. Neste contexto, visando apresentar as características principais da hemodiálise,o Colégio Brasileiro de Nefrologia e Urologia Veterinárias (CBNUV), em nome da sua subcomissão de Técnicas Dialíticas, traz, neste documento, as informações necessárias para embasar os conhecimentos sobre o tema.(AU)

Being an integral part of the arsenal of therapeutic options in veterinary nephrology, hemodialysis applied to animals has become popular and has advanced considerably in recent years, not only in the world but in Brazil. In this context, intending to present the main characteristics of hemodialysis, the Colégio Brasileiro de Nephrologiae Urologia Veterinárias (CBNUV), on behalf of its subcommittee on Dialytic Techniques, brings, in this document, the necessary information to base knowledge on the subject.(AU)

Siendo parte integral del arsenal de opciones terapéuticas en nefrología veterinaria, la hemodiálisis aplicada a animales se popularizó y avanzó considerablemente en los últimos años, no solo en el mundo sino también en Brasil. En ese contexto, con el fin de presentar las principales características de la hemodiálisis, el Colégio Brasileiro de Nephrologia e Urologia Veterinárias (CBNUV), en representación de su subcomité de Técnicas Dialíticas, trae, en este documento, las informaciones necesarias para fundamentar el conocimiento sobre el tema.(AU)

Estudo ultrassonográfico da bexiga urinária de cães e correlações com achados clínicos e laboratoriais: estudo retrospectivo / Ultrasound study of dogs urinary bladder and correlations with clinical and laboratory findings: retrospective study

A ultrassonografia é um método de diagnóstico por imagem em crescimento na medicina veterinária por não ser invasivo, não requerer contenção química dos animais submetidos ao exame, apresentar resultados muito satisfatórios e de grande auxilio ao veterinário clínico para a obtenção de diagnósticos. No presente estudo, foram utilizados 29 cães apresentando alterações ultrassonográficas em bexiga urinária, afim de correlacionar as alterações de bexiga urinária com achados clínicos e laboratoriais. Com as análises experimentais, foi observado que não houveram correlações das alterações ultrassonográficas com exames clínicos (sinais clínicos) e laboratoriais (urinálise e mensuração de creatinina sérica), pois poucos animais apresentaram alterações nesses exames que indicassem afecções em bexiga urinária. Com isso, é possível concluir que o exame ultrassonográfico é um exame imprescindível para diagnosticar precocemente as diversas afecções em bexiga urinária de cães.

Ultrasonography is an imaging method that is growing in veterinary medicine, as it is not invasive, does not require sedative drugs, presents very satisfactory results and gives great assistance to the clinical veterinarian to obtain diagnoses. In the present study, 29 dogs presenting urinary bladder changes on ultrasound examination were used, and correlation with clinical, surgical and laboratory findings were made. With the experimental analyses, it was observed that there were no correlations between ultrasonographic alterations and clinical exams (clinical signs) and laboratory exams (urinalysis and measurement of serum creatinine), as few animals presented alterations in these exams that indicated pathologies in the urinary bladder. With this, it is possible to fulfill that the ultrasound exam is an essential exam for the early diagnosis of the various pathologies in the urinary bladder of dogs.

Estudo ultrassonográfico da bexiga urinária de cães e correlações com achados clínicos e laboratoriais: estudo retrospectivo / Ultrasound study of dogs urinary bladder and correlations with clinical and laboratory findings: retrospective study

A ultrassonografia é um método de diagnóstico por imagem em crescimento na medicina veterinária por não ser invasivo, não requerer contenção química dos animais submetidos ao exame, apresentar resultados muito satisfatórios e de grande auxilio ao veterinário clínico para a obtenção de diagnósticos. No presente estudo, foram utilizados 29 cães apresentando alterações ultrassonográficas em bexiga urinária, afim de correlacionar as alterações de bexiga urinária com achados clínicos e laboratoriais. Com as análises experimentais, foi observado que não houveram correlações das alterações ultrassonográficas com exames clínicos (sinais clínicos) e laboratoriais (urinálise e mensuração de creatinina sérica), pois poucos animais apresentaram alterações nesses exames que indicassem afecções em bexiga urinária. Com isso, é possível concluir que o exame ultrassonográfico é um exame imprescindível para diagnosticar precocemente as diversas afecções em bexiga urinária de cães.(AU)

Ultrasonography is an imaging method that is growing in veterinary medicine, as it is not invasive, does not require sedative drugs, presents very satisfactory results and gives great assistance to the clinical veterinarian to obtain diagnoses. In the present study, 29 dogs presenting urinary bladder changes on ultrasound examination were used, and correlation with clinical, surgical and laboratory findings were made. With the experimental analyses, it was observed that there were no correlations between ultrasonographic alterations and clinical exams (clinical signs) and laboratory exams (urinalysis and measurement of serum creatinine), as few animals presented alterations in these exams that indicated pathologies in the urinary bladder. With this, it is possible to fulfill that the ultrasound exam is an essential exam for the early diagnosis of the various pathologies in the urinary bladder of dogs.(AU)

A transversal study of biochemical profile, urinalysis, UPC, electrolytes and blood pressure in dogs with chronic kidney disease

Background: Chronic kidney disease (CKD) affects both dogs and cats, mainly elderly animals, due to tubulointerstitialinflammation associated with the increase of fibrosis through the excess deposition of extracellular matrix (ECM) whichleads to decrease glomerular filtration. Many different underlying renal diseases can affect the kidneys of dogs such ascongenital or acquired in origin. Therefore, the main objective of this transversal study was to evaluate the epidemiologythrough clinical and laboratory evaluation of 225 client-owned dogs with CKD.Materials, Methods & Results: Complete blood count (CBC), urinalysis, and biochemical profile were retrospectivelyselected and evaluated from 225 client-owned dogs with CKD of both sexes, different ages, and breeds from the patientpopulation of the Nephrology and Urology Small Animal Service of the Teaching Hospital of the School of VeterinaryMedicine and Animal Science - São Paulo State University from 2011 to 2017. All dogs were divided in groups according to the International Renal Interest Society (IRIS) CKD grading and statistical analysis was performed according toKruskal-Wallis non-parametric test complemented with Dunn’s multiple comparisons test, and analysis of variance for themodel with a factor complemented with the test of multiple comparisons of Tukey. In this retrospective study, we observedthat most dogs in all groups were elderly (≥ 9 years old). CBC demonstrated lower RBC’s (P < 0.005), hemoglobin (P <0.001), hematocrit (Ht%) [P < 0.001] at the highest stage of the disease. However, urinary specific gravity (USG) did notdemonstrate significant differences between the disease stages, but urinary protein: creatinine ratio (UPC) was statistically different (P < 0.01) between IRIS-CKD stages 1 and 4. Furthermore, serum phosphate concentrations demonstrated...

A transversal study of biochemical profile, urinalysis, UPC, electrolytes and blood pressure in dogs with chronic kidney disease

Background: Chronic kidney disease (CKD) affects both dogs and cats, mainly elderly animals, due to tubulointerstitialinflammation associated with the increase of fibrosis through the excess deposition of extracellular matrix (ECM) whichleads to decrease glomerular filtration. Many different underlying renal diseases can affect the kidneys of dogs such ascongenital or acquired in origin. Therefore, the main objective of this transversal study was to evaluate the epidemiologythrough clinical and laboratory evaluation of 225 client-owned dogs with CKD.Materials, Methods & Results: Complete blood count (CBC), urinalysis, and biochemical profile were retrospectivelyselected and evaluated from 225 client-owned dogs with CKD of both sexes, different ages, and breeds from the patientpopulation of the Nephrology and Urology Small Animal Service of the Teaching Hospital of the School of VeterinaryMedicine and Animal Science - São Paulo State University from 2011 to 2017. All dogs were divided in groups according to the International Renal Interest Society (IRIS) CKD grading and statistical analysis was performed according toKruskal-Wallis non-parametric test complemented with Dunns multiple comparisons test, and analysis of variance for themodel with a factor complemented with the test of multiple comparisons of Tukey. In this retrospective study, we observedthat most dogs in all groups were elderly (≥ 9 years old). CBC demonstrated lower RBCs (P < 0.005), hemoglobin (P <0.001), hematocrit (Ht%) [P < 0.001] at the highest stage of the disease. However, urinary specific gravity (USG) did notdemonstrate significant differences between the disease stages, but urinary protein: creatinine ratio (UPC) was statistically different (P < 0.01) between IRIS-CKD stages 1 and 4. Furthermore, serum phosphate concentrations demonstrated...(AU)

Symptomatic orthotopic ureterocele in a dog

Background: Ureteroceles are cystic dilatations of the terminal ureter and is a rare diagnosed condition in dogs. They can be classified as orthotopic when it is entirely within the bladder and the ureteral orifice emerges normally or ectopic if the ureteral orifice is not in the normal position in the trigone. Orthotopic are usually clinically silent. Ureterocele can contribute to lower urinary tract disease leading to infections and loss of the renal function. As long as this injury can arise slowly, it might be underdiagnosed in companion animals. This case aims to report a case of a bitch with diagnosed symptomatic orthotopic ureterocele efficacious surgical treatment. Case: A 5-month-old female mixed breed was referred to the veterinary hospital, with a major complaint of urinary incontinence since the birth date after the first attendance in a colleague who have suspected of ureterocele considering ultrasound report of a vesicle of 1.4 x 1.5 cm in lefts ureter bladder’s insertion topography with ipsilateral hydroureter and renal dilatation. Beside the urinary dysfunction, the animal presented good general status and normal vital signs. Complete blood count and biochemical analysis were within normal ranges. A new ultrasound exam and Computerized Urotomography with contrast gave the definitive diagnosis of left orthotopic ureterocele with twisted hydroureter (proximal 1.29 cm and distally 0.98 cm) and hydronephrosis (3.32 cm). The marsupialization was chosen scientifically based to correct the ureterocele and the patient presented good general condition since then with prompt improvement of clinical signs. The patient was submitted to serial image exams in six weeks following up to check the consequent urinary tract dilatation from the previous disease regression. After the last follow up animal received...

Symptomatic orthotopic ureterocele in a dog

Background: Ureteroceles are cystic dilatations of the terminal ureter and is a rare diagnosed condition in dogs. They can be classified as orthotopic when it is entirely within the bladder and the ureteral orifice emerges normally or ectopic if the ureteral orifice is not in the normal position in the trigone. Orthotopic are usually clinically silent. Ureterocele can contribute to lower urinary tract disease leading to infections and loss of the renal function. As long as this injury can arise slowly, it might be underdiagnosed in companion animals. This case aims to report a case of a bitch with diagnosed symptomatic orthotopic ureterocele efficacious surgical treatment. Case: A 5-month-old female mixed breed was referred to the veterinary hospital, with a major complaint of urinary incontinence since the birth date after the first attendance in a colleague who have suspected of ureterocele considering ultrasound report of a vesicle of 1.4 x 1.5 cm in lefts ureter bladders insertion topography with ipsilateral hydroureter and renal dilatation. Beside the urinary dysfunction, the animal presented good general status and normal vital signs. Complete blood count and biochemical analysis were within normal ranges. A new ultrasound exam and Computerized Urotomography with contrast gave the definitive diagnosis of left orthotopic ureterocele with twisted hydroureter (proximal 1.29 cm and distally 0.98 cm) and hydronephrosis (3.32 cm). The marsupialization was chosen scientifically based to correct the ureterocele and the patient presented good general condition since then with prompt improvement of clinical signs. The patient was submitted to serial image exams in six weeks following up to check the consequent urinary tract dilatation from the previous disease regression. After the last follow up animal received...(AU)

Urachal cyst in a bitch

Background: The urachus is a tubular structure continuous with the urinary bladder and the allantois in foetal mammals.It serves as a communication between these two structures. At birth, it loses its function and undergoes atrophy by fibrousproliferation within the lumen. When this atrophy process fails at some point, congenital anomalies of the urachus occur.These anomalies are rare in animals, and to our knowledge, the urachal cyst has not yet been described in dogs. The presentwork is unique in that it reports a case of this congenital defect in a dog. Our aim is to increase awareness and to discussthe clinical presentation, the imaging techniques used, and the final diagnosis of this anomaly.Case: A 3-year-old bitch Pit Bull was presented for veterinary assistance to investigate recurrent pseudopregnancy and anirregular estrous cycle. The animal presented in good bodily condition, and the white blood count and clinical biochemistrywere normal. At ultrasound, 2 tubular structures, filled by an echogenic fluid mimicking uterine topography, were foundextending through the umbilical and hypogastric regions. No alterations in structure, echogenicity or echotexture of theother organs were observed, including the ovaries and uterus. On exploratory laparotomy, a cystic structure was found,with 2 segments: the larger one was on the left side, attached to the apex of the bladder by its caudal portion; the otherwas on the right side, attached to the spleen by its cranial portion and to the apex of the bladder by its caudal portion inconnection with the left segment. The ovaries, uterus and uterine horns showed no macroscopic alterations. The structurewas removed, and after analysis (macroscopic morphology, wall histopathology and biochemistry of the contained fluid),it was...

Urachal cyst in a bitch

Background: The urachus is a tubular structure continuous with the urinary bladder and the allantois in foetal mammals.It serves as a communication between these two structures. At birth, it loses its function and undergoes atrophy by fibrousproliferation within the lumen. When this atrophy process fails at some point, congenital anomalies of the urachus occur.These anomalies are rare in animals, and to our knowledge, the urachal cyst has not yet been described in dogs. The presentwork is unique in that it reports a case of this congenital defect in a dog. Our aim is to increase awareness and to discussthe clinical presentation, the imaging techniques used, and the final diagnosis of this anomaly.Case: A 3-year-old bitch Pit Bull was presented for veterinary assistance to investigate recurrent pseudopregnancy and anirregular estrous cycle. The animal presented in good bodily condition, and the white blood count and clinical biochemistrywere normal. At ultrasound, 2 tubular structures, filled by an echogenic fluid mimicking uterine topography, were foundextending through the umbilical and hypogastric regions. No alterations in structure, echogenicity or echotexture of theother organs were observed, including the ovaries and uterus. On exploratory laparotomy, a cystic structure was found,with 2 segments: the larger one was on the left side, attached to the apex of the bladder by its caudal portion; the otherwas on the right side, attached to the spleen by its cranial portion and to the apex of the bladder by its caudal portion inconnection with the left segment. The ovaries, uterus and uterine horns showed no macroscopic alterations. The structurewas removed, and after analysis (macroscopic morphology, wall histopathology and biochemistry of the contained fluid),it was...(AU)

Simulated training of a laparoscopic vesicourethral anastomosis

Purpose: To develop a model and curriculum for simulated training of an effective and well accepted laparoscopic vesicourethral anastomosis (VUA). Methods: Experimental longitudinal study of quantitative character. The sample consisted of 12 general surgery residents and 6 urology residents (R3). The training consisted of making twelve VUAs on synthetic organs. The training was divided into four sessions and accompanied by an instructor who performed positive feedback. The evaluation of the anastomoses considered the time and the analysis of the operative technique through the global evaluation scale Objective Structured Assessment of Technical Skills (OSATS). Results: Residents showed a reduction in operative time and evolution in the surgical technique statistically significant (p<0.01). The best-rated items were the facilitator positive feedback and the fact that the training was carried out at the teaching hospital premises. Conclusions: The proposed training model was well accepted and proved to be effective in reducing operative time and improving laparoscopic skills. The training should be fractionated (4 sessions in 3 weeks), repetitive (12 anastomoses) and have positive feedback.(AU)

Feline Pandoras Syndrome: A Bibliographic Review / Síndrome De Pandora Em Felinos: Revisão De Literatura / Síndrome De Pandora En Felinos: Revisión De Literatura

Pandora"s syndrome is a multifactorial disorder in which other systemic aetiologies may influence clinical signs in a target organ. In cats with chronic and idiopathic lower urinary tract disease, diagnosis requires a criteria of exclusion and must fulfil at least four other criteria as a confirmation of the diagnostic. Fundamental treatment of the syndrome is based on the elimination of stress factors as well as environmental enrichment.(AU)

A síndrome de Pandora é uma doença de caráter multifatorial onde outras etiologias sistêmicas podem influenciar sinais clínicos em um órgão alvo. Em gatos com doença do trato urinário inferior crônicas e idiopáticas, o diagnóstico além de ser por exclusão, deve preencher no mínimo três outros critérios para que a síndrome seja ocorrente. Seu tratamento fundamental baseia-se na eliminação de fatores estressantes bem como o enriquecimento ambiental.(AU)

El síndrome de Pandora es un disturbio multifatorial, en el cual otras etiologías pueden influenciar en signos clínicos en un órgano diana. En los gatos con enfermedad del tracto urinario inferior crónica e idiopática, el diagnostico requiere criterios de exclusión y debe completar al menos otros cuatro criterios para su confirmación. El tratamiento fundamental de esta síndrome es basado en la eliminación de los factores de estrés, además de enriquecimiento ambiental.(AU)

Feline Pandoras Syndrome: A Bibliographic Review / Síndrome De Pandora Em Felinos: Revisão De Literatura / Síndrome De Pandora En Felinos: Revisión De Literatura

Pandora"s syndrome is a multifactorial disorder in which other systemic aetiologies may influence clinical signs in a target organ. In cats with chronic and idiopathic lower urinary tract disease, diagnosis requires a criteria of exclusion and must fulfil at least four other criteria as a confirmation of the diagnostic. Fundamental treatment of the syndrome is based on the elimination of stress factors as well as environmental enrichment.

A síndrome de Pandora é uma doença de caráter multifatorial onde outras etiologias sistêmicas podem influenciar sinais clínicos em um órgão alvo. Em gatos com doença do trato urinário inferior crônicas e idiopáticas, o diagnóstico além de ser por exclusão, deve preencher no mínimo três outros critérios para que a síndrome seja ocorrente. Seu tratamento fundamental baseia-se na eliminação de fatores estressantes bem como o enriquecimento ambiental.

El síndrome de Pandora es un disturbio multifatorial, en el cual otras etiologías pueden influenciar en signos clínicos en un órgano diana. En los gatos con enfermedad del tracto urinario inferior crónica e idiopática, el diagnostico requiere criterios de exclusión y debe completar al menos otros cuatro criterios para su confirmación. El tratamiento fundamental de esta síndrome es basado en la eliminación de los factores de estrés, además de enriquecimiento ambiental.

ESTUDO DA PROTEINÚRIA EM CÃES COM DOENÇA RENAL CRÔNICA

A progressão da doença renal crônica (DRC) pode estar envolvida com a ocorrência de proteinúria, porém seus mecanismos fisiopatológicos não estão totalmente esclarecidos. Considerando que a mensuração da proteinúria pode ser usada para diagnóstico, monitoração e tratamento da DRC, buscou-se com o presente estudo correlacionar esse parâmetro com outras variáveis implicadas a doença, como pressão arterial sistólica, densidade urinária e dosagem de creatinina, albumina e fosfato séricos em um grupo de animais controle e nos diferentes estádios da DRC. Para isso foi realizado um estudo prospectivo, onde foram selecionados pacientes caninos hígidos e com DRC naturalmente adquirida que passaram por avaliação clínica no Serviço de Nefrologia e Urologia da Unesp Jaboticabal, tais condições eram estabelecidas por exames clínicos, laboratoriais e de imagem. Não houve restrição quanto à raça, gênero ou idade. Para as avaliações do estudo foi realizada aferição de pressão arterial sistólica, ultrassonografia do trato urinário, hemograma e urinálise, determinação das concentrações séricas de ureia, creatinina, proteína total, albumina, cálcio total e fósforo e determinação da concentração urinária de creatinina e proteína total. Todos os pacientes com DRC que participaram do estudo receberam o tratamento adequado. Para análise dos resultados foi utilizada estatística descritiva e para comparar se os parâmetros analisados tinham diferença estatística entre o grupo controle e os estádios foi utilizado o teste de Kruskal Wallis e Dunn para comparação múltipla. Para correlacionar cada variável foi utilizado o Teste de Spearman. A razão proteína creatinina urinária não mostrou correlação com as outras variáveis testadas. Animais com DRC tiveram valores maiores de pressão arterial sistólica, porém não houve diferença significativa entre os estádios. Tanto a proteinúria, como a pressão arterial se comportaram como variáveis independentes entre si e entre as outras variáveis, indo contra o senso comum de associação entre ambas as variáveis.

The progression of chronic kidney disease (CKD) may be involved with the occurrence of proteinuria, but its pathophysiological mechanisms are not fully understood. To analyze that the measurement of the protein can be used for diagnosis, monitoring and treatment of CKD, we sought to correlate this parameter with other variables involved in the disease, such as systolic blood pressure, urinary density and creatinine, albumin measurement and serum phosphates in a group of control animals and in the different stages of CKD. For this, a prospective study was carried out, in which healthy canine patients with naturally acquired CKD were selected and underwent clinical evaluation at the Nephrology and Urology Service of Unesp Jaboticabal, such conditions were constituted by clinical, laboratory and imaging exams. There was no restriction on race, gender or age. For the evaluations of the study, measurement of systolic blood pressure, ultrasound of the urinary tract, complete blood count and urinalysis, determination of the serum standards of urea, creatinine, total protein, albumin, total calcium and phosphorus and determination of the urinary concentration of creatinine and total protein . All patients with RDC who participated in the study received adequate treatment. For the analysis of the results obtained by descriptive statistics and to compare whether the comparison parameters with the difference between the control group and the stages, the Kruskal Wallis and Dunn test was used for multiple comparison. To correlate each variable, it was used in the Spearman test. The urinary creatinine protein ratio does not show a correlation with other tested variables. Animals with CKD had higher values of systolic blood pressure, but there was no difference between the stages. Both proteinuria and blood pressure behaved as independent variables among themselves and among the other variables, going against the common sense of association between both variables.

FRAGILIDADE OSMÓTICA ERITROCITÁRIA E RETICULOCITOMETRIA EM CÃES ACOMETIDOS POR DOENÇA RENAL CRÔNICA

A anemia é considerada um dos fatores para avaliar progressão da doença renal e diminuição da qualidade de vida do paciente. Conforme a doença renal progride, ocorre aumento gradativo na produção de toxinas urêmicas que reduz a meia vida dos eritrócitos circulantes por interferir na estabilidade da membrana eritrocitária. Para tanto, utiliza-se a contagem de reticulócitos para classificar a anemia como regenerativa ou não regenerativa. Objetivou-se neste estudo avaliar a resistência da membrana das hemácias, utilizando-se do teste de Fragilidade Osmótica Eritrocitária (FOE) em cães com doença renal crônica (DRC) e avaliação de reticulócitos. Foram avaliados 43 cães provenientes da rotina do Serviço de Nefrologia e Urologia do Hospital Veterinário Governador Laudo Natel da Faculdade de Ciências Agrárias e Veterinárias - UNESP - campus Jaboticabal. As referidas unidades experimentais foram distribuídas em três grupos, quais sejam, G0 (n=13), composto por cães hígidos e G1, DRC estádios 1 e 2 (n=14) e G2, DRC estádios 3 e 4 (n=16), classificados de acordo com o recomendado pela International Renal Interest Society. A fim de definir os critérios de inclusão dos cães foram feitos, além do exame físico, a avaliação de pressão arterial, hemograma, contagem de reticulócitos, exames bioquímicos, urinálise e relação proteína/creatinina urinária (UP/C). Para execução do teste de FOE as hemácias foram diluídas em concentrações decrescentes de cloreto de sódio e analisadas por citometria de fluxo. As concentrações de creatinina sérica (sCr), ureia sérica (sUreia), fosfato sérico (sP) e UP/C foram superiores no grupo G2 quando comparado ao G0 (p<0,05). Com relação às variáveis hematológicas, foram observadas diferença estatística entre o número de hemácias (p<0,009), hematócrito (p<007) e hemoglobina (p<0,007), que decresceu conforme a doença renal avançava. A FOE e os reticulócitos apesar de terem variado individualmente, dependendo do estádio da DRC de cada paciente, não apresentaram diferença estatística quando comparado aos animais controle e doentes, e tampouco quando foram confrontados os diferentes estádios de cães com DRC (p>0,05).Os resultados obtidos neste estudo demonstram, portanto que, embora a reticulocitometria seja fiadora da contagem de reticulócitos, a contabilização manual de reticulócitos ainda é uma opção segura e somente com a FOE não é possível predizer alterações na membrana do eritrócito em cães com DRC.

Anemia is considered one of the factors to assess the kidney disease progress and the decrease in patient's quality of life. As kidney disease progresses, there is a gradual increase in urinary toxin production that shortens the circulating erythrocyte half-life by interfering with erythrocyte membrane stability. To do this, use a reticulocyte count to classify anemia as regenerative or non-regenerative. The objectives of this study were to evaluate the resistance of the red blood cells, using the Erythrocyte Osmotic Fragility test in dogs with chronic kidney disease (CKD) and to evaluate reticulocytes. Forty-three dogs were charged, followed by the routine of the Nephrology and Urology Service of the Governor Laudo Natel Veterinary Hospital of the Faculty of Agricultural and Veterinary Sciences - UNESP - Campus Jaboticabal. The experimental units were divided into three groups, namely, G0 (n = 13), consisting of healthy dogs and G1, CKD stages 1 and 2 (n = 14) and G2, CKD stages 3 and 4 (n = 16), classification proposed by the International Renal Interest Society. In order to define the inclusion criteria of dogs made, in addition to physical examination, an assessment of blood pressure, blood count, reticulocyte count, biochemical tests, urinalysis, and urinary protein/creatinine ratio. To perform the erythrocyte osmotic fragility test, red blood cells were diluted in decreasing sodium chloride filters (0.9 to 0.0%) and analyzed by flow cytometry. As creatinine serum concentration (sCr), serum urea (sUL), serum phosphorus (sP) and urinary protein/creatinine ratio. were higher in group G2 when compared to G0 (p <0.05). Regarding hematological variables, statistical differences were observed between the number of red blood cells (p <0.009), hematocrit (p <007) and hemoglobin (p <0.007), which decreased according to the advanced kidney disease. A cross-referenced FOE despite varying the number of participants, depending on each patient's CKD stage, shows no statistical difference when it shows control animals and damage, and shows when it is confronted with different cases of dogs with CKD (p> 0, 05) The results obtained in this study demonstrate, therefore, that although reticulocytometry is a guarantor of reticulocyte counting, manual reticulocyte counting is still a safe option and only with FOE it is not possible to predict changes in the erythrocyte membrane in dogs with CKD.

DIMETILARGININA SIMÉTRICA (SDMA) EM GATOS COM DOENÇA DO TRATO URINÁRIO INFERIOR OBSTRUTIVA

A doença do trato urinário inferior de felinos (DTUIF) corresponde a uma série de afecções que podem acometer a bexiga e a uretra desses animais. A forma obstrutiva é a consequência mais prevalente e mais grave dentre outras DTUIF, podendo levar o animal a azotemia pós-renal, redução da taxa de filtração glomerular (TFG) e a lesão renal aguda (LRA), que caso não seja tratada de forma eficiente, pode evoluir para doença renal crônica (DRC), uma doença frequente na população geriátrica felina. A creatinina sérica (sCr) é o biomarcador de TFG mais utilizado na clínica veterinária, porém apresenta baixa sensibilidade e diversos fatores que podem afetar seus valores. A dimetilarginina simétrica (SDMA) é um biomarcador mais recente na medicina veterinária que vem apresentado maior precocidade na detecção da perda da função renal e menor interferência de fatores extrarrenais, porém poucos são os trabalhos que determinam valores de SDMA em lesão renal de gatos. Este trabalho visou avaliar os valores de SDMA e compará-los com a sCr, ureia, dados hemogasométricos, escore clínico e tempo de obstrução de gatos com DTUIF obstrutiva. Os animais foram alocados em dois grupos experimentais, sendo 17 animais do grupo obstruído (GO) e 13 animais sadios para grupo controle (GC). As amostras foram coletadas antes da desobstrução (M0) e durante o tratamento clínico, nos momentos 12, 24 e 48 horas (M12, M24 e M48). Resultados obtidos demonstraram que no M48 do GO, 50% dos gatos obstruídos apresentavam valores de SDMA acima da normalidade, enquanto para sCr apenas 29,41% dos gatos apresentavam elevados. Quando comparado os diversos momentos de GO com GC, SDMA apresentou mais momentos de diferença estatística do que sCr. O SDMA apresentou correlação forte com sCr, ureia e potássio nos diferentes momentos de GO e forte correlação com tempo de obstrução e escore clínico em M0. A concordância do SDMA com sCr, ureia e potássio foi pobre a leve em M12 e M48, no M24 a concordância foi substantiva. Sugere-se que SDMA é biomarcador mais sensível para avaliar função renal em animais com DTUIF obstrutiva. Além disso, o tempo de obstrução interfere no estado clínico e valores de SDMA.

Feline lower urinary tract disease (FLUTD) is a series of conditions that can affect the bladder and urethra of these animals. The obstructive form is the most prevalent and most serious consequence among other FLUTD, which can lead to post-renal azotemia and reduced glomerular filtration rate (GFR) and acute kidney injury (AKI), which if not treated effectively, can progress to chronic kidney disease (CKD), a common disease in the feline geriatric population. Serum creatinine (sCr) is the biomarker of GFR most commonly used in veterinary pratice, but it has low sensitivity and there are several factors that may affect its values. Symmetrical dimethylarginine (SDMA) is a newer biomarker in veterinary medicine that has been shown to be more precocious in detecting loss of renal function and less interference of extrarenal factors, but there are few studies determining SDMA values in feline kidney injury. This work aimed to evaluate SDMA values and to correlate them with sCr, urea, hemogasometric data, clinical score and duration of obstruction of felines with obstructive DTUIF. The animals were allocated into two experimental groups, 17 animals from the obstructed group (GO) and 13 healthy animals for control group (GC). Samples were collected before clearance (M0) and during clinical treatment at 12, 24 and 48 hours (M12, M24 and M48). The results obtained were that in GO M48, 50% of obstructed cats had SDMA values above normal, while for sCr only 29.41% of cats were elevated. When comparing the different moments of GO with CG, SDMA presented more moments of statistical difference than sCr. SDMA showed a strong correlation with sCr, urea and potassium at different times of GO and a strong correlation with obstruction time and clinical score at M0. The concordance of SDMA with sCr, urea and potassium was poor to mild in M12 and M48, in M24 the agreement was substantive. It is suggested that SDMA is the most sensitive biomarker for assessing renal function in animals with obstructive FLUTD. In addition, obstruction time interferes with clinical status and SDMA values.

Uso de arco cirúrgico nos procedimentos ortopédicos em aves / Use of surgical arch in orthopedic procedures in birds / Uso de arco quirúrgico en los procedimientos ortopédicos en aves

Os exames radiográficos são uma importante ferramenta para auxiliar o médico veterinário na pesquisa de doenças que afetam os animais, o arco cirúrgico é um equipamento de raios-X no qual é possível produzir imagens em tempo real, são normalmente utilizados em procedimentos das especialidades cirúrgicas, como cirurgia geral, urologia, ortopedia, vascular, neurológicas, entre outros. Utilizamos o arco cirúrgico nos procedimentos intraoperatório de osteossíntes em uma Calopsita e um Coleirinha que foram atendidos no HOVET com fratura de fêmur.(AU)

Radiographic examinations are an important tool to assist the veterinarian in researching diseases that affect animais, the surgical arch is an X-ray equipment in which it is possible to produce images in real time, they are usually used in procedures of the surgical specialties, such as general surgery, urology, orthopedics, vascular, neurological, among others. We used the surgical arch in the intraoperative procedures of osteosynthesis in a calopsita and coleirinha that were attended in the HOVET with fracture of the femur.(AU)

Los exámenes radiográficos son una importante herramienta para ayudar al médico veterinario en la investigación de enfermedades que afectan aios animales, el arco quirúrgico es un equipo de rayos X en el cual es posible producir imágenes en tiempo real, son normalmente utilizados en procedimientos de las especialidades quirúrgicas, como cirugía general, urología, ortopedia, vascular, neurológicas, entre otros. Utilizamos el arco quirúrgico en los procedimientos intraoperatorio de osteosíntes en una calopsita y un coleccionista que fueron asistidos en el HOVET con fractura de fémur.(AU)

Uso de arco cirúrgico nos procedimentos ortopédicos em aves / Use of surgical arch in orthopedic procedures in birds / Uso de arco quirúrgico en los procedimientos ortopédicos en aves

Os exames radiográficos são uma importante ferramenta para auxiliar o médico veterinário na pesquisa de doenças que afetam os animais, o arco cirúrgico é um equipamento de raios-X no qual é possível produzir imagens em tempo real, são normalmente utilizados em procedimentos das especialidades cirúrgicas, como cirurgia geral, urologia, ortopedia, vascular, neurológicas, entre outros. Utilizamos o arco cirúrgico nos procedimentos intraoperatório de osteossíntes em uma Calopsita e um Coleirinha que foram atendidos no HOVET com fratura de fêmur.

Radiographic examinations are an important tool to assist the veterinarian in researching diseases that affect animais, the surgical arch is an X-ray equipment in which it is possible to produce images in real time, they are usually used in procedures of the surgical specialties, such as general surgery, urology, orthopedics, vascular, neurological, among others. We used the surgical arch in the intraoperative procedures of osteosynthesis in a calopsita and coleirinha that were attended in the HOVET with fracture of the femur.

Los exámenes radiográficos son una importante herramienta para ayudar al médico veterinario en la investigación de enfermedades que afectan aios animales, el arco quirúrgico es un equipo de rayos X en el cual es posible producir imágenes en tiempo real, son normalmente utilizados en procedimientos de las especialidades quirúrgicas, como cirugía general, urología, ortopedia, vascular, neurológicas, entre otros. Utilizamos el arco quirúrgico en los procedimientos intraoperatorio de osteosíntes en una calopsita y un coleccionista que fueron asistidos en el HOVET con fractura de fémur.

New kidney immobilization method for percutaneous renal biopsy technique in cats: Operational aspects and complications / Novo método de imobilização do rim para biopsia renal percutânea em gatos: Aspectos operacionais e complicações

PURPOSE: Evaluate a new immobilization kidney method for collecting blind percutaneous renal biopsies (RB) in healthy cats. METHODS: Ten cats were biopsied by a modified blinded percutaneous technique using semi-automated needles. Were evaluated the operational aspects of the technique, its complications, and the quality of the obtained samples. The evaluation included physical examination, hemogram, urinalysis, abdominal ultrasound, renal function, and histopathology of the biopsy specimens. RESULTS: The developed technique was fast and easy to perform; it required two operators, and the right kidney was elected for specimen collection. After the RB, a decrease in hematocrit levels was observed in addition to hematuria and perirenal transient hematoma; however, no clinical consequences were observed, and normal parameters were restored within 48 hrs. There were no major complications or deaths, alterations in the physical examination or renal function, or signs of infection. Of the samples, 95 percent revealed the presence of renal tissue, and in 100 percent of the cats the samples were of diagnostic quality. CONCLUSION: The technique was easily performed, provided adequate material for diagnosis with minimal transient complications.(AU)

OBJETIVO: Avaliar um novo método de imobilização do rim para coleta de biopsia renal (BR) percutânea às cegas em gatos hígidos. MÉTODOS: Dez gatos foram biopsiados por uma técnica de biopsia percutânea às cegas modificada, com uso de agulha semi-automática. Foram avaliados os aspectos operacionais da técnica, complicações e a qualidade das amostras obtidas. A avaliação incluiu exame físico, hemograma, urinálise, ultrassonografia abdominal, função renal e análise histopatológica do espécime de biopsia. RESULTADOS: A técnica foi de fácil realização; foram requeridos dois operadores, e o rim direito foi eleito para a coleta da BR. Após a BR, diminuição do hematócrito foi observada, em conjunto com hematúria e hematoma peri-renal transitório; entretanto, não foram observadas conseqüências clínicas, e os parâmetros normais foram restabelecidos em 48 horas. Não ocorreram complicações maiores ou óbitos, alterações ao exame físico, função renal ou sinais de infecção. Das amostras obtidas, 95 por cento revelaram presença de tecido renal, e em 100 por cento dos gatos as amostras apresentaram qualidade para diagnóstico. CONCLUSÃO: A técnica foi realizada facilmente, forneceu material adequado para diagnóstico, com complicações clínicas mínimas.(AU)

REVISÃO SISTEMÁTICA DA USABILIDADE EM DISPOSITIVOS MÉDICOS

Introdução: O sistema de cuidados com a saúde depende da tecnologia médica, que vem crescendo com a sua complexidade funcional e a preocupação com o projeto e desenvolvimento de novos dispositivos médicos (DM). A incidência de eventos adversos em pacientes faz com que o Brasil se destaque negativamente, onde parte desses eventos poderiam ser prevenidos, e ainda possui relação direta com erros de utilização, onde poderiam ser minimizados com a participação do usuário no projeto (user-centered design) do DM. Neste aspecto em particular, o Brasil ainda não se apercebeu da relação entre eventos adversos e o processo de fabricação de DM. Objetivo: Este trabalho realizou uma revisão sistemática de publicações em Usabilidade de DM. Resultados: Após a aplicação dos critérios de inclusão e exclusão, finalizamos com 145 (cento e quarenta e cinco) publicações, para responder à seis questões, obtivemos na: Questão 1: Onde está sendo a APLICAÇÃO dos estudos em Engenharia de Usabilidade? Obtendo 49% (71 de 144) dos artigos que aplicaram os estudos de Usabilidade em Apenas Hardware, e 14,5% (21 de 144) para Apenas Software, 6,9% (10 de 144) nos Processos e 2,1% (3 de 144) avaliaram Software e Processos, e para Hardware e Software concomitantemente 11 de 144 (7,6%); Hardware e Processos, 6 de 144 (4,1%), e Hardware, Software e Processos 0,7% (1 de 144). Questão 2: Quais os OBJETIVOS DOS ESTUDOS mais utilizados pelos pesquisadores? 22,4% (44 de 196) dos artigos aplicaram ainda no período de Desenvolvimento do Produto (Formativo), contra 32,1% (63 de 196) executadas após fabricação na Avaliação do Produto (Somativo). Para Testes Clínicos Experimentais cerca 28,6% (56 de 196). Dos artigos que aproveitaram da análise do Gerenciamento de Risco, 6,6% (13 de 196), e no Gerenciamento de Falhas 12 de 196 (6,1%), e os que utilizaram Educação, Capacitação ou Treinamento 4,1% (8 de 196). Questão 3: Quais a PRINCIPAIS TÉCNICAS de Usabilidade empregadas? Para a Análise de Tarefas 31,6% (62 de 196), e para a Simulação de Cenários/ Ambientes Clínicos Simulados, 18,5% (36 de 196). Para os que aplicaram Questionários nas avaliações 12,8% (25 de 196), e para as Entrevistas 8,2% (16 de 196). Utilizaram-se da Engenharia de Fatores Humanos 7,7% (15 de 196). E a técnica Grupos Focais e Análise Cognitiva igualmente 11 de 196 (5,6%). E em Outros, 10 de 196 (5,1%). Para as Heurísticas e Interação Homem-Máquina, igualmente 5 de 196 (2,6%), Questão 4: Qual o PÚBLICO-ALVO? Em 64,9 % (96 de 148) aplicaram seus estudos atendendo os Pacientes/Usuários Leigos, de forma geral, e dentre estes 60,8% (90 de 96) exclusivamente os Pacientes/Usuários Leigos (sem restrição) e 4,1% (6 de 96) para Deficientes/Idosos. Aplicaram Usabilidade para Médicos/Residentes 13,5% (20 de 148), para Técnicos/Auxiliares/Estudantes, 8,8% (13 de 148), aos Enfermeiros 7,4% (11 de 148). E os Não Especificados 8 de 148 (5,4%). Questão 5: Quais as ESPECIALIDADES encontradas? Das especialidades, destaca-se a Gastroenterologia com 9 de 54 (16,7%), as Imagens/Medicina Nuclear 7 de 54 (13%), para a Anestesiologia 7,4% (4 de 54), na Fisioterapia/Reabilitação 4 de 54 (7,4%), na área Respiratória/Pulmonar 7,4% (4 de 54). No Diagnóstico, na Endocrinologia e na Neurologia foram igualmente 5,6% (3 de 54). Para a Urologia 5,6% (3 de 54), na Cardiologia 3,7% (2 de 54), em Nefrologia 2 de 54 (3,7%), na Oftalmologia, Oncologia e Ortopedia/Geriatria/Reumatologia igualmente 3,7% (2 de 54). E a Dermatologia, Hematologia, Odontologia e Veterinária, receberam igualmente 1,9% (1 de 54). E finalizando a Questão 6: Quais os LOCAIS DE APLICAÇÃO? No local EAS (Estabelecimentos de Assistência a Saúde), foram 48% (36 de 75). Para os estudos em Homecare 25% (19 de 75). No local Cirurgia/Cuidados Intensivos, o número foi de 8% (6 de 75). Na Emergência/Pronto Socorro, 7% (5 de 75), e para a Telemedicina, 5% (4 de 75). Para o Laboratório de Análises Clínicas foram 4% (3 de 75) e no Ambulatório e o Laboratório de Eletrônica/Automação foram igualmente 1% (1 de 75) dos artigos revisados.

Introduction: The system depends of health care on medical technology, which has been growing with its functional complexity and concern for the design and development of new medical devices [1]. The incidence of adverse events in patients causes Brazil to stand out negatively, where part of these events could be prevented, and also has direct relation to misuse, which could be minimized with the user's participation in the project development (user-centered design) of the MD. In this particular aspect, Brazil still does not realize the relationship between adverse events and the MD manufacturing process. Objective: This study performed a systematic review of publications in Usability of MD. Results: After application of the inclusion and exclusion criteria, we completed with 145 (one hundred and fortyfive) publications to answer six questions, we obtained in: Question 1: Where is the APPLICATION of studies in Usability Engineering? Getting 49% (71 of 144) of items that applied the study Usability in Hardware Only, and 14.5% (21 of 144) for Only Software 6.9% (10 of 144) in Processes Only and 2.1% (3 144) evaluated Software and Processes, and hardware and software concurrently 11 of 144 (7.6%); Hardware and procedures, 6 of 144 (4.1%), and Hardware, Software and Processes 0.7% (1 144). Question 2: What STUDY OBJECTIVES most used by researchers? 22.4% (44 of 196) of the articles also applied in product development period (Formative) against 32.1% (63 of 196) performed after manufacturing in Product Evaluation (summative). For Clinical Trials Experimental about 28.6% (56 of 196). Articles that took the analysis of Risk Management, 6.6% (13 of 196), and Fault Management 12 196 (6.1%), and those using education, training or training 4,1% (8 of 196). Question 3: What the Usability MAIN TECHNICAL employed? For Task Analysis 31.6% (62 of 196), and the Scenario Simulation / Clinical Environments Simulated, 18.5% (36 of 196). For those who applied questionnaires in evaluations 12.8% (25 of 196), and the Interviews 8.2% (16 of 196). They used the human factors engineering 7,7% (15 of 196). And the focus groups technique and Cognitive Analysis also 11 of 196 (5.6%). And other 10 196 (5.1%). For Heuristics and Interaction Human Machine, also 5 of 196 (2.6%) Question 4: What is TARGET? In 64.9% (96 of 148) applied his studies attending the patients / users Laity, in general, and among these 60.8% (90 of 96) exclusively Patients / Users Laity (unconstrained) and 4.1 % (6 of 96) to Defientes / Seniors. Usability applied to Physicians / Residents 13.5% (20 of 148) for technicians / assistants / students, 8.8% (13 of 148), the Nurses 7.4% (11 of 148). And Unspecified 8 of 148 (5.4%). Question 5: What SPECIALTIES found? Of specialties stands out Gastroenterology with 9 of 54 (16.7%) Images / Nuclear Medicine 7 of 54 (13%) for Anesthesiology 7.4% (4 of 54) in Physical Therapy / Rehabilitation 4 of 54 (7.4%), in the area Respiratory / Pulmonary 7.4% (4 of 54). On the Diagnostics in Endocrinology and Neurology it was also 5.6% (3 of 54). For Urology 5.6% (3 of 54) in Cardiology 3.7% (2 of 54) in Nephrology 2 of 54 (3.7%), in ophthalmology, orthopedics and Oncology / Geriatrics / Rheumatology also 3 7% (2 of 54). And Dermatology, Hematology, Dentistry and Veterinary, also received 1.9% (1 of 54). And ending the Question 6: What APPLICATION LOCATIONS? On site EAS (Health Care Institutions) were 48% (36 of 75). For studies in homecare 25% (19 of 75). On-site Surgery / Intensive Care, the figure was 8% (6 of 75). In Emergency / First Aid, 7% (5 of 75), and Telemedicine, 5% (4 of 75). For the Clinical Analysis Laboratory were 4% (3 of 75) and at the Clinic and the Laboratory of Electronics / Automation were also 1% (1 of 75) articles.

Persistência de úraco em felino: relato de caso / Urachus persistence in a cat: case report

O úraco consiste em um canal por onde é eliminada a urina fetal, provindo da vesícula urinária em formaçãodo feto para a placenta materna. Normalmente ele está fechado ao nascimento. Quando ocorrea persistência do úraco, ficando funcionalmente patente, verifica-se a perda urinária através da cicatrizumbilical. A afecção é rara em felinos. Relata-se o caso de um felino macho, de raça persa, com 13 mesesde idade, atendido com sinais de doença do trato urinário inferior e extravasamento de líquido serossanguinolentoatravés do umbigo. O paciente foi submetido a exames laboratoriais e cistografia de contrastepositivo com o diagnóstico de úraco persistente, com cistite e infecção bacteriana urinária secundária. Otratamento foi a correção cirúrgica, com a extirpação do úraco e suas inserções, além da terapia adicionalpara a inflamação e infecção das vias urinárias inferiores.(AU)

The urachus is a channel through which urine is eliminated from the fetus to the placenta. Usually it isclosed at birth. When there is persistence of the urachus, being functionally patent, there is loss of urinethrough the umbilicus. The condition is rare in cats. We report the case of a male cat, persian breed, with13 months of age, attended with signs of lower urinary tract disease and serosanguineous fluid leakagethrough the umbilicus. The patient underwent laboratory tests and positive contrast cystography and thediagnosis was of persistent urachus with cystitis and urinary secondary bacterial infection. The treatmentwas surgical, with excision of the urachus and their insertions, as well as additional therapy for inflammationand lower urinary tract infection.(AU)