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1.
Ciênc. Anim. (Impr.) ; 33(1): 10-18, jan.-mar. 2023. ilus
Artigo em Português | VETINDEX | ID: biblio-1434408

Resumo

Emergências obstétricas são comuns na rotina clínica de cães e gatos. Dentre as emergências obstétricas uma das mais importantes é a distocia. De modo geral, a distocia ocorre quando há falha no momento do parto ou na expulsão do feto, sendo que a causa mais comum de distocia nas duas espécies é a inércia uterina primária. Outra emergência obstétrica de ocorrência frequente em cadelas e gatas é a piometra. Esta doença é uma infecção que ocorre no útero, causada por alterações hormonais na fase do diestro dos animais. As duas enfermidades (distocia e piometra) podem ter o envolvimento de anticoncepcionais, tanto nas cadelas como nas gatas. Em relação ao tratamento, na maioria das vezes, as distocias em cadelas e gatas são abordadas por meio da realização de cesarianas. Em piometra, a terapêutica mais efetiva é a realização de ovariohisterectomia. Neste estudo, 43 cadelas e 20 gatas com emergências obstétricas foram monitoradas durante 90 dias. Entre as cadelas, 29 (67,44%; 29/43) apresentaram piometra e 13 (30,23%; 13/43) distocia. Além disso, uma cadela apresentou prolapso vaginal. Entre as gatas, 13 apresentaram distocia (65%; 13/20) e sete (35%; 7/20) piometra. Algumas dessas emergências obstétricas foram relacionadas ao uso de anticoncepcional. Assim, os clínicos veterinários devem desencorajar esta prática e incentivar a castração das fêmeas.


Obstetric emergencies are common in the clinical routine of dogs and cats. One of the most important obstetric emergencies is dystocia. In general, dystocia occurs when there is a failure at the parturition time or expulsion of the fetus, and the most common cause of dystocia in both species is primary uterine inertia. Another frequently occurring obstetric emergency in bitches and cats is piometra. This disease is an infection that occurs in the uterus caused by hormonal changes in the diestrus phase of animals. In both diseases (dystocia and pyometra), contraceptives can be involved in female dogs and cats. Regarding the treatment, most of the time, dystocias in bitches and cats are addressed through cesarean sections. In pyometra, the most effective therapy is to perform ovariohysterectomy. In the present study, 43 female dogs and 20 female cats with emergency obstetric were monitored during 90 days. Among bitches, 29 (67.44%; 29/43) had pyometra, and 13 (30.23%; 13/43) showed dystocia. In addition, one female dog presented vaginal prolapse. Among the cats, 13 had dystocia (65%; 13/20) and seven (35%; 7/20) pyometra. Some of these obstetric emergencies were related to contraceptive use. Thus, veterinary clinicians must discourage this practice and encourage the neutering of females.


Assuntos
Animais , Gatos , Cães , Doenças do Gato , Doenças do Cão , Distocia/veterinária , Emergências/veterinária , Hospitais Veterinários , Complicações do Trabalho de Parto/veterinária
2.
Acta sci. vet. (Impr.) ; 50(supl.1): Pub. 842, 2022. ilus
Artigo em Português | VETINDEX | ID: biblio-1415206

Resumo

Background: Congenital anomalies are structural, functional, or metabolic defects caused by a combination of environmental, genetic, or even iatrogenic factors. Genetic defects, which can be inherited, are more common in purebred dogs. Teratogenic factors such as radiation, toxins, chemical agents, infectious diseases, mechanical influences, drugs given to the mother, and nutrition can affect the litter during gestational development. The incomplete division of a fertilized egg results in monozygotic, conjoined or Siamese twins, which are animals with complete or incomplete duplications. This paper reports on an adult bitch with monocephalus dipygus dibrachius and the surgical procedures. Case: A 2-year-old female Shih Tzu weighing 5 kg was admitted to a veterinary clinic, presenting with swelling and myiasis near the anus and several development disorders, characterized by 2 pelvises, 2 anuses, 2 vulvas, 2 forelimbs and 6 hindlimbs. Her physiological parameters were otherwise normal. Only the dog's myiasis was treated at this time due to the owner's financial straits. After 5 months, the owner brought the bitch back to the veterinary clinic because the animal presented with fecaloma in 1 of the anuses. Radiography revealed numerous alterations: seven lumbar vertebrae with marked vertebral axis deviation, reduced disc space, as well as ankylosis and fused ventral spondylosis at L6 and L7. Two pelvises fused medially by the wings of the ileum, with slight deviation and thinning of pelvic bones. Four hip joints and medial joints with pelvic avulsion and bone remnants of the pelvic limbs. Acetabular tearing slightly flattened femoral head and thickened femoral neck. Caudal vertebrae and vertebral axis located in left pelvis. Left lateral patella inserted in the trochlear groove and lateral dislocation of right patella. Right patellofemoral joint with smooth surface, preserved intra-articular density and cranial displacement of the tibia relative to the femoral condyles (cranial cruciate ligament rupture). An ultrasound analysis revealed 2 bladders. Two months later surgery was performed due to recurrent complications. During laparotomy 2 uteruses, 2 bladders and bifurcation of the intestine were observed. Ovariosalpingohysterectomy was performed in both uterus and enterectomy of the problematic intestinal portion. After 2 days of the surgery, blood transfusion was performed. After 2 days of the transfusion, there was extravasation of yellow fluid from the surgical cut and abdominal palpation was indicative of bladder rupture, so the patient was sent to emergency surgery. Unilateral nephrectomy and ureterectomy, and ruptured bladder cystectomy were performed. The dog remained hospitalized for 24 days after surgery, before it was released. Discussion: The classification of conjoined twins is based on the location of the junction and the number of limbs. Monocephalus dipygus dibrachius was diagnosed based on the fact that the dog had 1 skull, 2 thoracic limbs and 4 pelvic limbs, as well as the corresponding genitourinary and gastrointestinal tract alterations. Imaging scans are extremely important for a proper diagnosis to ensure appropriate surgery planning. The bitch was the result of inbreeding between a male dog and its offspring, which probably contributed to this malformation. There are very few reports of surviving adult conjoined animals, and even fewer descriptions of successful surgical treatments. To the best of knowledge of the authors, there are no previous reports of a surviving adult dog suffering from this malformation.


Assuntos
Animais , Feminino , Cães , Gêmeos Unidos/cirurgia , Gêmeos Unidos/patologia , Anormalidades Congênitas/veterinária
3.
Rev. bras. reprod. anim ; 46(1): 3-16, Janeiro-Março 2022. graf, tab, ilus
Artigo em Português | VETINDEX | ID: biblio-1377960

Resumo

Ao nascimento, a assistência neonatal é essencial, visto que filhotes podem apresentar depressão clínica, bradicardia, apneia persistente ou desconforto respiratório devido à hipóxia, decorrente de uma asfixia prolongada no útero ou durante o parto, necessitando de intervenção imediata. A equipe de recepção ao neonato precisa estar treinada para os procedimentos de reanimação neonatal, que devem ser realizados com enfoque em prover calor ao recém-nascido e no suporte ventilatório e circulatório, mantendo as vias aéreas patentes e uma adequada perfusão tecidual. O conhecimento das características fisiológicas neonatais e das etapas a serem seguidas no protocolo de reanimação, são cruciais para o sucesso da intervenção e maior sobrevivência neonatal.(AU)


At birth, neonatal assistance is essential, since puppies may experience clinical depression, bradycardia, persistent apnea or respiratory discomfort due to hypoxia, resulting from prolonged asphyxia in the uterus or during delivery, requiring immediate intervention. The team needs to be trained in neonatal resuscitation procedures, which must be performed with a focus on providing heat to the newborn and on ventilatory and circulatory support, maintaining patent airways and adequate tissue perfusion. Knowledge of the neonatal physiological characteristics and the steps to be followed in the resuscitation protocol are crucial for the success of the intervention and greater neonatal survival.(AU)


Assuntos
Animais , Reanimação Cardiopulmonar/veterinária , Cuidados Críticos/métodos , Animais Recém-Nascidos/fisiologia , Gatos/fisiologia , Cães/fisiologia
4.
Ciênc. Anim. (Impr.) ; 32(2): 9-16, abr.-jun. 2022. ilus
Artigo em Português | VETINDEX | ID: biblio-1402049

Resumo

Emergências reprodutivas, como as piometras e distocias, são frequentes na rotina clínica de cadelas e gatas. A distocia ocorre quando há falha no momento do parto ou na expulsão do feto e sua causa mais comum, nas duas espécies, é a inércia uterina primária. A piometra é uma infecção que ocorre no útero, causada por alterações hormonais na fase do diestro dos animais. As duas enfermidades (distocia e piometra) podem ter o envolvimento de anticoncepcionais, tanto nas cadelas como nas gatas. Na maioria das vezes, as distocias, em cadelas e gatas, é abordada por meio da realização de cesarianas, enquanto para a piometra, a terapêutica mais efetiva é a realização de ovariohisterectomia. Desta forma, tendo em vista a deficiência na quantificação de emergências reprodutivas obstétricas em cadelas e gatas diagnosticadas em serviços veterinários do Brasil, este trabalho teve como objetivo relatar os achados obtidos através do monitoramento, durante 90 dias, de 43 cadelas e 20 gatas com emergências reprodutivas. Dentre as cadelas, 29 (67,44%; 29/43) apresentaram piometra, 13 (30,23%; 13/43) distocia e 1 prolápso vaginal. Dentre as gatas, 13 (65%; 13/20) apresentaram distocia e sete (35%; 7/20) piometra. Algumas das emergências reprodutivas foram relacionadas ao uso de anticoncepcional. Assim, os clínicos veterinários devem desencorajar esta prática e incentivar a castração das fêmeas.


Reproductive emergencies, such as pyometras and dystocias, are frequent in the clinical routine of female dogs and cats. Dystocia occurs when there is a failure during delivery or expulsion of the fetus, and its most common cause, in both species, is primary uterine inertia. Pyometra is an infection that occurs in the uterus caused by hormonal changes in the diestrous phase of animals. In both diseases (dystocia and pyometra), contraceptives can be involved in both female dogs and cats. Most of the time, dystocias, in female dogs and cats, is addressed through cesarean sections, while in pyometra, the most effective therapy is to perform ovariohysterectomy. Thus, given the deficiency in the quantification of obstetric reproductive emergencies in female dogs and cats diagnosed in veterinary services in Brazil, this study aimed to report the findings obtained by monitoring 43 female dogs and 20 female cats with reproductive emergencies for 90 days. Among bitches, 29 (67.44%; 29/43) presented pyometra, 13 (30.23%; 13/43) showed dystocia, and 1 had vaginal prolapse. Among the cats, 13 presented dystocia (65%; 13/20), and 7 (35%; 7/20) showed pyometra. Some reproductive emergencies were related to contraceptive use. Thus, veterinary clinicians must discourage this practice and encourage the castration of females


Assuntos
Animais , Feminino , Gatos , Cães , Distocia/veterinária , Piometra/veterinária , Infecções do Sistema Genital/veterinária , Estudos Retrospectivos
5.
Vet. zootec ; 29: 1-10, 2022.
Artigo em Português | VETINDEX | ID: biblio-1400571

Resumo

Piometra é uma doença que afeta o útero de fêmeas causando infecção e inflamação com acúmulo de grande quantidade de exsudato purulento ou mucopurulento. Ocorre em todas as espécies domésticas, sendo mais comum em cadelas e vacas. Sua importância em cada espécie está relacionada ao número de casos e sua severidade, dentro de suas particularidades. O objetivo com esta revisão foi reunir estudos referentes à piometra em fêmeas domésticas, incluindo a epidemiologia, sinais clínicos, diagnóstico e tratamento nas principais espécies acometidas.


Pyometra is a disease that affects the uterus of females causing infection and inflammation with an accumulation of large amounts of purulent or mucopurulent exudate. It occurs in all domestic species, being more common in bitches and cows. Its importance in each species is related to the number of cases and its severity, within its particularities. The objective of this review was to gather studies referring to pyometra in domestic females, including epidemiology, clinical signs, diagnosis, and treatment in the main species affected.


La piometra es una enfermedad que afecta el útero de las hembras causando infección e inflamación com acumulación de grandes cantidades de exudado purulento o mucopurulento. Ocurre en todas las espécies domésticas, siendo más frecuente en perras y vacas. Su importancia en cada especie está relacionada con el número de casos y su severidad, dentro de sus particularidades. El objetivo de esta revisión fue reunir estudios sobre piometra en hembras domésticas, incluyendo epidemiología, signos clínicos, diagnóstico y tratamiento en las principales especies afectadas.


Assuntos
Animais , Feminino , Gatos , Bovinos , Cães , Coelhos , Hiperplasia Endometrial/veterinária , Piometra/patologia , Piometra/veterinária , Infecções do Sistema Genital/veterinária , Cavalos
6.
Acta sci. vet. (Impr.) ; 50: Pub. 1871, 2022. ilus, tab, graf
Artigo em Inglês | VETINDEX | ID: biblio-1400654

Resumo

Background: Diagnostic ultrasound has revolutionized obstetric practice. Doppler techniques provided in vivo studies of the fetus-placental and uterus-placental circulations, in an increasingly precise manner. The assessment of fetal well-being is essential in obstetric practice, however, in veterinary medicine, there is a deficit of ultrasound parameters related to fetal distress. The main of this research was to determine the hemodynamic characteristics and behavior, through Doppler ultrasonography, of maternal-fetal vessels during the final third of gestation in bitches with fetuses under stress, as well as correlating them with each other and with fetal distress. Materials, Methods & Results: An observational, prospective study was carried out, in which 30 healthy bitches were examined, during the last third of pregnancy, with fetuses under fetal distress. Fetuses were evaluated in 2 stages: (1st): 50-54 days and (2nd): 55-60 days of gestation. All fetuses were calmly assessed, one by one, and fetal heart rate (FHR) was measured 5 times, for at least 3 min, to identify and confirm fetal distress. At least 3 fetuses were evaluated in each bitch and each measurement was performed in triplicate, setting a hemodynamic mean for each value evaluated. The flow pattern in the middle cerebral artery (MCA), internal carotid artery (ICA) and umbilical artery (UA) was evaluated. The analyzed vessel was initially visualized in B mode, followed by evaluation by color and spectral Doppler. The variables observed were: peak systolic velocity (PSV), end diastolic velocity (EDV) and the resistivity (RI) and pulsatility (PI) index, as well as the systole/diastole ratio (S/D). The analysis of RI and PI of the umbilical artery showed a statistically significant difference between the mean values found for the times studied, increasing from time 1 to time 2. For middle cerebral and internal carotid arteries, PI, RI and the relationship systole/diastole (S/D), showed a statistically significant difference between the mean values found for the times studied, decreasing from time 1 to time 2. Discussion: Fetal heart rate (HR) findings are considered normal above 200 beats per minute (bpm), only if preceded by acceleration and deceleration. This fact confirms the presence of fetal stress, by this parameter, for the fetuses in the present study. Corroborating the picture of fetal distress, another study concluded that HR tends to increase up to 20 days before delivery, a fact that did not occur in the study in question, where animals in the same gestational period were evaluated. Recent research has concluded that an elevated umbilical artery PI at 28 weeks of gestation, in the absence of fetal growth restriction or prematurity, is associated with some adverse cognitive findings in 12-year-olds children. In the present study, a progressive increase in this index was observed throughout the final third of pregnancy. Although the pups were not monitored after birth, this data serves as a warning for veterinarians, and can be useful in the assessment and diagnosis of possible postnatal nervous alterations. Like what was found in the present study, a study reported that from the 4th week to birth, the PSV of the umbilical artery (UA) increased almost linearly, with high significance. For the middle cerebral arteries, the PI showed a statistically significant difference between the mean values found for the times studied, however, decreasing throughout the final third of pregnancy.


Assuntos
Animais , Feminino , Gravidez , Cães , Sofrimento Fetal/veterinária , Sofrimento Fetal/diagnóstico por imagem , Monitorização Hemodinâmica/veterinária , Troca Materno-Fetal/fisiologia , Ultrassonografia Doppler/veterinária
7.
Ciênc. Anim. (Impr.) ; 32(2): 28-37, abr.-jun. 2022. ilus
Artigo em Português | VETINDEX | ID: biblio-1402091

Resumo

A ovariosalpingohisterectomia (OSH), que consiste na retirada cirúrgica de ovários, tubas uterinas e útero, é um dos procedimentos cirúrgicos mais realizados em cadelas na rotina veterinária. É utilizado para evitar prenhez indesejada e no tratamento e profilaxia de enfermidades reprodutivas. Classicamente, na técnica de ligadura do pedículo ovariano e coto uterino na OSH em cadelas e gatas, são empregadas três pinças para expor a área de ligadura, por isso, a técnica é conhecida como técnica das três pinças. Sendo assim, o objetivo deste estudo foi propor uma técnica diferente para executar tais ligaduras, reduzindo o tempo do procedimento por meio da diminuição do número de pinças usadas para a exposição dos locais a serem feitas as ligaduras. Desta forma, o experimento foi conduzido com 20 cadelas hígidas submetidas à OSH. Os animais foram divididos em dois grupos: animais submetidos ao procedimento de ligadura pela técnica das três pinças e animais submetidos a ligadura pela técnica proposta neste estudo. A abertura da cavidade abdominal, para expor as estruturas a serem ligadas, foi a mesma para as duas técnicas (laparotomia mediana ventral). Foi mensurado, por meio de cronômetro digital, o tempo despendido na realização de todas as cirurgias. Não ocorreram óbitos e não houve dificuldades na execução das duas técnicas. Além disso, no transoperatório, não houve intercorrências dignas de nota. Os resultados demonstraram que o tempo de execução foi estatisticamente menor para a técnica proposta, indicando a aplicação preferencial deste procedimento para realização de OSH em cadelas.


The ovariohysterectomy (OH), which consists of the surgical removal of ovaries, uterine tubes, and uterus, is one of the most common surgical procedures performed on bitches in the veterinary routine. It is used to prevent unwanted pregnancy and in the treatment and prophylaxis of reproductive diseases. Classically, in the technique of ligation of the ovarian pedicle and uterine stump in OH in bitches and cats, three clamps are used to expose the ligature area, that is why the technique is known as the three clamps technique. Thus, this study aimed to propose a different technique to perform such ligatures, reducing the procedure time by reducing the number of clamps used to expose the sites to be ligated. Therefore, the experiment was carried out with twenty healthy bitches submitted to OH. The animals were divided into two groups: animals submitted to the ligation procedure using the three clamps technique and animals submitted to ligation using the technique proposed in this study. The opening of the abdominal cavity, to expose the structures to be ligated, was the same for both techniques (ventral median laparotomy). The time spent performing all surgeries was measured using a digital timer. There were no deaths and there were no difficulties in performing both techniques. Besides, in the transoperative period, there were no noteworthy complications. The results demonstrated that the execution time was statistically shorter for the proposed technique, indicating the preferential application of this procedure for performing OH in bitches.


Assuntos
Animais , Feminino , Cães , Instrumentos Cirúrgicos/veterinária , Ovariectomia/métodos , Constrição , Procedimentos Cirúrgicos em Ginecologia/veterinária
8.
Acta sci. vet. (Impr.) ; 49(suppl.1): Pub.603-Jan 4, 2021. ilus
Artigo em Português | VETINDEX | ID: biblio-1458466

Resumo

Background: Pyometra or pyometritis is a serious and common condition of intact female dogs characterized by the inflammation of the uterus with a buildup of purulent exudate. It may be classified as open or closed. If untreated, pyometracan lead to uterine rupture and sepsis. Pyometra may also predispose to uterine torsion, defined as a rotation of one orboth uterine horns around its longitudinal axis. Uterine torsion in female dogs is rare, and usually with late pregnancy orparturition. This case report describes the clinical presentation and therapeutic management of uterine torsion correlatedwith open pyometra in a non-gravid bitch with no history of exogenous progesterone exposure.Case: A 10-year-old intact Yorkshire Terrier bitch weighing 3.2 kg was referred to a veterinary clinic in Porto Alegre,Brazil, with a 7 day history of prostration, anorexia, polydipsia, and sanguinopurulent vulvar discharge. Physical examination revealed pronounced abdominal tenderness. On abdominal ultrasonography, the uterus was enlarged and filled withcellular anechoic content, suggestive of pyometra. A complete blood count showed mild microcytic normochromic anemiaand leukocytosis. The animal was stabilized and an urgent ovariohysterectomy was performed. Preanesthetic analgesiaconsisted of subcutaneous methadone 0.3 mg/kg. Anesthesia was induced with propofol 3 mg/kg i.v. and maintained withinhaled isoflurane. During the procedure, significant enlargement of the left uterine horn and slight enlargement of theright uterine horn were observed. In addition, a torsion was identified near the left ovary, with copious sanguinopurulentsecretion. The animal remained under observation and fluid therapy for 48 h after the procedure and was discharged topostoperative follow-up. After discharge, the following treatment was medicine, local cleaning and rest for 14 days. Concluding...


Assuntos
Feminino , Animais , Cães , Cães/cirurgia , Histerectomia/veterinária , Piometra/veterinária , Retroversão Uterina/veterinária , Anemia/veterinária , Leucocitose/veterinária , Ultrassonografia/veterinária
9.
Acta sci. vet. (Online) ; 49(suppl.1): Pub. 603, 8 fev. 2021. ilus
Artigo em Português | VETINDEX | ID: vti-30141

Resumo

Background: Pyometra or pyometritis is a serious and common condition of intact female dogs characterized by the inflammation of the uterus with a buildup of purulent exudate. It may be classified as open or closed. If untreated, pyometracan lead to uterine rupture and sepsis. Pyometra may also predispose to uterine torsion, defined as a rotation of one orboth uterine horns around its longitudinal axis. Uterine torsion in female dogs is rare, and usually with late pregnancy orparturition. This case report describes the clinical presentation and therapeutic management of uterine torsion correlatedwith open pyometra in a non-gravid bitch with no history of exogenous progesterone exposure.Case: A 10-year-old intact Yorkshire Terrier bitch weighing 3.2 kg was referred to a veterinary clinic in Porto Alegre,Brazil, with a 7 day history of prostration, anorexia, polydipsia, and sanguinopurulent vulvar discharge. Physical examination revealed pronounced abdominal tenderness. On abdominal ultrasonography, the uterus was enlarged and filled withcellular anechoic content, suggestive of pyometra. A complete blood count showed mild microcytic normochromic anemiaand leukocytosis. The animal was stabilized and an urgent ovariohysterectomy was performed. Preanesthetic analgesiaconsisted of subcutaneous methadone 0.3 mg/kg. Anesthesia was induced with propofol 3 mg/kg i.v. and maintained withinhaled isoflurane. During the procedure, significant enlargement of the left uterine horn and slight enlargement of theright uterine horn were observed. In addition, a torsion was identified near the left ovary, with copious sanguinopurulentsecretion. The animal remained under observation and fluid therapy for 48 h after the procedure and was discharged topostoperative follow-up. After discharge, the following treatment was medicine, local cleaning and rest for 14 days. Concluding...(AU)


Assuntos
Animais , Feminino , Cães , Piometra/veterinária , Retroversão Uterina/veterinária , Histerectomia/veterinária , Cães/cirurgia , Ultrassonografia/veterinária , Anemia/veterinária , Leucocitose/veterinária
10.
R. bras. Reprod. Anim. ; 45(1): 3-11, jan.-mar. 2021. ilus
Artigo em Inglês | VETINDEX | ID: vti-763426

Resumo

The ultrasonographic exam is of great value in animal reproduction and veterinary obstetrics, because it allows gestational diagnosis and monitoring, as well as the evaluation of the female reproductive system, providing diagnosis of the reproductive state and estrous phase of females. One of the techniques that has been employed in the field of theriogenology is the Doppler Mode, which allows qualitative and quantitative evaluation of the hemodynamics of reproductive organs. Several studies were carried out in attempt to elucidate the ultrasonographic aspect of the uterus and ovaries of bitches during the different phases of the estrous cycle in B mode and Doppler mode. The objective of the present study is to review the information present in the literature regarding the sonographic changes of the reproductive organs of bitches during the different hormonal phases.(AU)


O exame ultrassonográfico tem grande importância na reprodução animal e obstetrícia veterinária, pois permite o diagnóstico e acompanhamento gestacional, bem como a avaliação do sistema reprodutor, proporcionando o diagnóstico do status reprodutivo e fase do ciclo estral. Uma das técnicas ultrassonográficas que vêm sendo empregadas no ramo da teriogenologia é o modo Doppler, que permite avaliações qualitativas e quantitativas da hemodinâmica dos órgãos da reprodução. Diversos estudos foram realizados na tentativa de elucidar o aspecto ultrassonográfico do útero e dos ovários das cadelas durante as diferentes fases do ciclo estral ao modo-B e ao modo Doppler. O presente trabalho tem como objetivo revisar as informações presentes na literatura a respeito das mudanças ultrassonográficas dos órgãos reprodutores da cadela durante as diferentes fases hormonais.(AU)


Assuntos
Animais , Feminino , Cães , Cães/anatomia & histologia , Cães/fisiologia , Útero , Ovário , Ciclo Estral , Hemodinâmica
11.
Rev. bras. reprod. anim ; 45(1): 3-11, jan.-mar. 2021. ilus
Artigo em Inglês | VETINDEX | ID: biblio-1492633

Resumo

The ultrasonographic exam is of great value in animal reproduction and veterinary obstetrics, because it allows gestational diagnosis and monitoring, as well as the evaluation of the female reproductive system, providing diagnosis of the reproductive state and estrous phase of females. One of the techniques that has been employed in the field of theriogenology is the Doppler Mode, which allows qualitative and quantitative evaluation of the hemodynamics of reproductive organs. Several studies were carried out in attempt to elucidate the ultrasonographic aspect of the uterus and ovaries of bitches during the different phases of the estrous cycle in B mode and Doppler mode. The objective of the present study is to review the information present in the literature regarding the sonographic changes of the reproductive organs of bitches during the different hormonal phases.


O exame ultrassonográfico tem grande importância na reprodução animal e obstetrícia veterinária, pois permite o diagnóstico e acompanhamento gestacional, bem como a avaliação do sistema reprodutor, proporcionando o diagnóstico do status reprodutivo e fase do ciclo estral. Uma das técnicas ultrassonográficas que vêm sendo empregadas no ramo da teriogenologia é o modo Doppler, que permite avaliações qualitativas e quantitativas da hemodinâmica dos órgãos da reprodução. Diversos estudos foram realizados na tentativa de elucidar o aspecto ultrassonográfico do útero e dos ovários das cadelas durante as diferentes fases do ciclo estral ao modo-B e ao modo Doppler. O presente trabalho tem como objetivo revisar as informações presentes na literatura a respeito das mudanças ultrassonográficas dos órgãos reprodutores da cadela durante as diferentes fases hormonais.


Assuntos
Feminino , Animais , Cães , Ciclo Estral , Cães/anatomia & histologia , Cães/fisiologia , Hemodinâmica , Ovário , Útero
12.
Rev. bras. reprod. anim ; 45(4): 426-429, out.-dez. 2021.
Artigo em Inglês | VETINDEX | ID: biblio-1492691

Resumo

Endometritis refers to an inflammation of the uterine mucosa that does not extend beyond the stratum spongiosum. Recent studies indicate it is a common finding in 30-50% of bitches suffering from infertility/subfertility. This disorder is subclinical, and its diagnosis involves sampling the uterus, whether it is by performing a cytology from flushing the organ or histology on collected uterine biopsies. Its pathophysiology remains unclear in 2021. Some cases are associated with cystic endometrial hyperplasia, which leads to disruption in the uterine clearance mechanisms after breeding ; while other appear as a pure inflammatory process. While we don’t have all the answers yet, there is no doubt today that these disorders must be included in the differential diagnosis of infertility in the bitch. The work that has already been done on this topic already offers some idea on how to approach these cases in our veterinary clinics.


Assuntos
Feminino , Animais , Cães , Doenças Uterinas/diagnóstico , Endometrite/diagnóstico , Endometrite/veterinária , Infertilidade/diagnóstico
13.
Acta sci. vet. (Impr.) ; 49(suppl.1): Pub.633-Jan 4, 2021. ilus
Artigo em Português | VETINDEX | ID: biblio-1458493

Resumo

Background: Rectal tumors are uncommon in dogs and cats. The clinical signs result from intra- and extraluminal compression. Diagnosis and treatment of rectal tumors are challenging due to their intraplevic location. Owing to considerable bonesuperposition, computed tomography is the best exam to evaluate the tumor and plan surgery; however, poor availabilityand high costs may hinder its use. The objective of this case report is to describe the successful use of a combination ofdiagnostic techniques, namely transrectal ultrasound, transrectal fine-needle aspiration, and colonoscopy, for diagnosisand surgery planning in a case of intrapelvic intestinal leiomyoma in a dog.Case: A 13-year-old female mongrel dog with tenesmus, low stool production, and hematochezia for two months was presented for examination. During this two-month period, a symptomatic treatment was administered, but there was no clinicalimprovement. In the clinical evaluation revealed a painless mass on the left dorsolateral region, at a depth of around 4 cm,with considerable luminal reduction. Abdominal ultrasound revealed a mass close to the descending colon; however, bonesuperposition precluded identification of its origin or delimitation of its boundaries. The patient was subjected to transrectalultrasound imaging, colonoscopy, and cytological examination of fine-needle aspiration biopsy material collected under generalanesthesia. The mass was located at the final portion of the descending colon; it was extraluminal, and measured around 7 x7 cm. The integrity of the intestinal wall was preserved. Next, radiographic examination of the thorax using three projections(ventrodorsal, left lateral, and right lateral) was performed to check for metastases, and no alteration was detected. Cytologysuggested presence of leiomyoma. The patient underwent exploratory laparotomy with pubic osteotomy for intrapelvic access...


Assuntos
Feminino , Animais , Cães , Leiomioma/veterinária , Neoplasias Retais/veterinária , Colonoscopia/veterinária , Cães/cirurgia , Ultrassonografia/veterinária
14.
Acta sci. vet. (Online) ; 49(suppl.1): Pub. 633, 26 abr. 2021. ilus
Artigo em Português | VETINDEX | ID: vti-31898

Resumo

Background: Rectal tumors are uncommon in dogs and cats. The clinical signs result from intra- and extraluminal compression. Diagnosis and treatment of rectal tumors are challenging due to their intraplevic location. Owing to considerable bonesuperposition, computed tomography is the best exam to evaluate the tumor and plan surgery; however, poor availabilityand high costs may hinder its use. The objective of this case report is to describe the successful use of a combination ofdiagnostic techniques, namely transrectal ultrasound, transrectal fine-needle aspiration, and colonoscopy, for diagnosisand surgery planning in a case of intrapelvic intestinal leiomyoma in a dog.Case: A 13-year-old female mongrel dog with tenesmus, low stool production, and hematochezia for two months was presented for examination. During this two-month period, a symptomatic treatment was administered, but there was no clinicalimprovement. In the clinical evaluation revealed a painless mass on the left dorsolateral region, at a depth of around 4 cm,with considerable luminal reduction. Abdominal ultrasound revealed a mass close to the descending colon; however, bonesuperposition precluded identification of its origin or delimitation of its boundaries. The patient was subjected to transrectalultrasound imaging, colonoscopy, and cytological examination of fine-needle aspiration biopsy material collected under generalanesthesia. The mass was located at the final portion of the descending colon; it was extraluminal, and measured around 7 x7 cm. The integrity of the intestinal wall was preserved. Next, radiographic examination of the thorax using three projections(ventrodorsal, left lateral, and right lateral) was performed to check for metastases, and no alteration was detected. Cytologysuggested presence of leiomyoma. The patient underwent exploratory laparotomy with pubic osteotomy for intrapelvic access...(AU)


Assuntos
Animais , Feminino , Cães , Leiomioma/veterinária , Neoplasias Retais/veterinária , Cães/cirurgia , Colonoscopia/veterinária , Ultrassonografia/veterinária
15.
Ciênc. rural (Online) ; 51(10): 1-6, 2021. tab, ilus
Artigo em Inglês | VETINDEX | ID: biblio-1480225

Resumo

Leishmania infantum causes canine leishmaniasis. Using parasitological and molecular analyses, we identified L. infantum in the reproductive organs of male and female dogs. Using histochemistry, immunohistochemistry, and PCR, we examined tissue samples from the reproductive organs of 8 male dogs and 16 female dogs diagnosed with leishmaniasis. Despite the absence of macroscopic or microscopic lesions in these organs, we observed L. infantum amastigotes in tissue samples from the testis and the uterus. PCR and sequencing of these tissues revealed sequences that matched 100% with L. infantum DNA available at GenBank. The presence of L. infantum amastigotes and DNA in testicular and uterine tissue samples suggested that these organs can harbor the parasite without associated macroscopic or microscopic lesions, and this can be especially important in the vertical and venereal transmission of leishmaniasis in dogs.


Leishmania infantum é agente etiológico da leishmaniose canina. Por meio de análises parasitológicas e moleculares, a presença do parasita foi investigada em órgãos reprodutivos de cães machos e fêmeas. Amostras de tecidos dos órgãos reprodutivos de 8 cães machos e 16 fêmeas diagnosticados com leishmaniose foram avaliadas por histoquímica, imunohistoquímica e PCR. Apesar de não terem sido observadas lesões macroscópicas ou microscópicas nos órgãos reprodutivos desses cães, formas amastigotas de L. infantum foram observadas em amostras teciduais do testículo e útero. A PCR e o sequenciamento do DNA extraído desses tecidos revelaram sequências 100% idênticas a L. infantum depositadas no GenBank. Nossos resultados sugerem que os testículos e o útero podem abrigar o parasita, sem associação com lesões macroscópicas ou microscópicas, o que pode ter uma grande importância na transmissão venérea e vertical da leishmaniose entre cães.


Assuntos
Animais , Cães , Doenças do Cão/parasitologia , Leishmaniose/diagnóstico , Leishmaniose/genética , Leishmaniose/sangue , Leishmaniose/veterinária
16.
Ci. Rural ; 51(10): 1-6, 2021. tab, ilus
Artigo em Inglês | VETINDEX | ID: vti-32150

Resumo

Leishmania infantum causes canine leishmaniasis. Using parasitological and molecular analyses, we identified L. infantum in the reproductive organs of male and female dogs. Using histochemistry, immunohistochemistry, and PCR, we examined tissue samples from the reproductive organs of 8 male dogs and 16 female dogs diagnosed with leishmaniasis. Despite the absence of macroscopic or microscopic lesions in these organs, we observed L. infantum amastigotes in tissue samples from the testis and the uterus. PCR and sequencing of these tissues revealed sequences that matched 100% with L. infantum DNA available at GenBank. The presence of L. infantum amastigotes and DNA in testicular and uterine tissue samples suggested that these organs can harbor the parasite without associated macroscopic or microscopic lesions, and this can be especially important in the vertical and venereal transmission of leishmaniasis in dogs.(AU)


Leishmania infantum é agente etiológico da leishmaniose canina. Por meio de análises parasitológicas e moleculares, a presença do parasita foi investigada em órgãos reprodutivos de cães machos e fêmeas. Amostras de tecidos dos órgãos reprodutivos de 8 cães machos e 16 fêmeas diagnosticados com leishmaniose foram avaliadas por histoquímica, imunohistoquímica e PCR. Apesar de não terem sido observadas lesões macroscópicas ou microscópicas nos órgãos reprodutivos desses cães, formas amastigotas de L. infantum foram observadas em amostras teciduais do testículo e útero. A PCR e o sequenciamento do DNA extraído desses tecidos revelaram sequências 100% idênticas a L. infantum depositadas no GenBank. Nossos resultados sugerem que os testículos e o útero podem abrigar o parasita, sem associação com lesões macroscópicas ou microscópicas, o que pode ter uma grande importância na transmissão venérea e vertical da leishmaniose entre cães.(AU)


Assuntos
Animais , Cães , Doenças do Cão/parasitologia , Leishmaniose/sangue , Leishmaniose/diagnóstico , Leishmaniose/genética , Leishmaniose/veterinária
17.
R. bras. Ci. Vet. ; 28(3): 167-173, 2021. graf, tab
Artigo em Inglês | VETINDEX | ID: vti-765274

Resumo

Hematological and serum biochemical characteristics and prevalence of microorganisms in the uterine content of bitches with pyometra were described, according to type and age. This study was carried out at the Veterinary Medicine Hospital Renato Rodenburg de Medeiros Netto of the UFBA with 132 patients diagnosed with pyometra through imaging and laboratory tests, divided into two groups: Group 1 - less than eight years (n=72) and Group 2 - more than eight years (n=60). Both groups were submitted to Ovariohysterectomy (OH), in which blood and uterine lumen secretion samples were collected. The highest incidence of pyometra was found in bitches under 8 years (54.5%), Poodle breed (31.8%) and mixed-breed (27.3%). Open pyometra represented 80.3% of all cases. The death rate (6.0%) did not show significant difference between the types. Anemia (73.0%), thrombocytopenia (41.2%) and leukocytosis (77.0%) were observed. Urea and ALP were above the reference values in 41.8% and 52.2% of each group, respectively, while ALT (94.0%) and creatine (82%) remained normal in most animals. Serum biochemistry did not show significant differences (P<0.05). Escherichia coli and Klebsiella sp. grew in 33.3% and 16.7% of the samples, respectively. Therefore, no significant hematological and serum biochemical differences were observed in bitches with pyometra in both age categories.(AU)


Descreveu-se características hematológicas, bioquímicas séricas e prevalência de microrganismos no conteúdo uterino de cadelas com piometra, de acordo com o tipo e idade. Realizou-se este estudo no Hospital de Medicina Veterinária Renato Rodenburg de Medeiros Netto da UFBA com 132 pacientes diagnosticadas com piometra, por exames de imagem e laboratoriais, divididas em dois grupos: Grupo 1 menos de oito anos (n=72) e Grupo 2 mais de oito anos (n=60), submetidas a Ovariectomia (OH), quando se coletou amostras de sangue e secreção do lúmen uterino. A incidência maior deu-se em cadelas abaixo de 8 anos (54,5%), da raça Poodle (31,8%) e sem raça definida (SRD) (27,3%), sendo 80,3% de piometra aberta. A taxa de óbito (6,0%) não apresentou diferença significativa entre os tipos. Observou-se a ocorrência de anemia (73,0%), trombocitopenia (41,2%) e leucocitose (77,0%). Os valores de ureia e FA estiveram acima dos valores de referência em 41,8% e 52,2% das cadelas respectivamente, enquanto a ALT (94,0%) e a creatina (82%) mantiveram-se dentro dos valores de referência na maioria dos animais. A bioquímica sérica não apresentou diferenças significativas (P<0,05). Observou-se crescimento de Escherichia coli e Klebsiella sp. em 33,3% e 16,7% das amostras, respectivamente. Sendo assim, não se observou diferenças significativas hematológicas e na bioquímica sérica de cadelas com piometra nas categorias de idade.(AU)


Assuntos
Animais , Cães , Cães/sangue , Piometra/classificação , Piometra/diagnóstico , Contagem de Células Sanguíneas/veterinária , Biomarcadores/análise , Biomarcadores/sangue , Útero , Infecções Bacterianas
18.
Rev. bras. ciênc. vet ; 28(3): 167-173, jul./set. 2021. graf, tab
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1491719

Resumo

Hematological and serum biochemical characteristics and prevalence of microorganisms in the uterine content of bitches with pyometra were described, according to type and age. This study was carried out at the Veterinary Medicine Hospital Renato Rodenburg de Medeiros Netto of the UFBA with 132 patients diagnosed with pyometra through imaging and laboratory tests, divided into two groups: Group 1 - less than eight years (n=72) and Group 2 - more than eight years (n=60). Both groups were submitted to Ovariohysterectomy (OH), in which blood and uterine lumen secretion samples were collected. The highest incidence of pyometra was found in bitches under 8 years (54.5%), Poodle breed (31.8%) and mixed-breed (27.3%). Open pyometra represented 80.3% of all cases. The death rate (6.0%) did not show significant difference between the types. Anemia (73.0%), thrombocytopenia (41.2%) and leukocytosis (77.0%) were observed. Urea and ALP were above the reference values in 41.8% and 52.2% of each group, respectively, while ALT (94.0%) and creatine (82%) remained normal in most animals. Serum biochemistry did not show significant differences (P<0.05). Escherichia coli and Klebsiella sp. grew in 33.3% and 16.7% of the samples, respectively. Therefore, no significant hematological and serum biochemical differences were observed in bitches with pyometra in both age categories.


Descreveu-se características hematológicas, bioquímicas séricas e prevalência de microrganismos no conteúdo uterino de cadelas com piometra, de acordo com o tipo e idade. Realizou-se este estudo no Hospital de Medicina Veterinária Renato Rodenburg de Medeiros Netto da UFBA com 132 pacientes diagnosticadas com piometra, por exames de imagem e laboratoriais, divididas em dois grupos: Grupo 1 – menos de oito anos (n=72) e Grupo 2 – mais de oito anos (n=60), submetidas a Ovariectomia (OH), quando se coletou amostras de sangue e secreção do lúmen uterino. A incidência maior deu-se em cadelas abaixo de 8 anos (54,5%), da raça Poodle (31,8%) e sem raça definida (SRD) (27,3%), sendo 80,3% de piometra aberta. A taxa de óbito (6,0%) não apresentou diferença significativa entre os tipos. Observou-se a ocorrência de anemia (73,0%), trombocitopenia (41,2%) e leucocitose (77,0%). Os valores de ureia e FA estiveram acima dos valores de referência em 41,8% e 52,2% das cadelas respectivamente, enquanto a ALT (94,0%) e a creatina (82%) mantiveram-se dentro dos valores de referência na maioria dos animais. A bioquímica sérica não apresentou diferenças significativas (P<0,05). Observou-se crescimento de Escherichia coli e Klebsiella sp. em 33,3% e 16,7% das amostras, respectivamente. Sendo assim, não se observou diferenças significativas hematológicas e na bioquímica sérica de cadelas com piometra nas categorias de idade.


Assuntos
Animais , Cães , Biomarcadores/análise , Biomarcadores/sangue , Contagem de Células Sanguíneas/veterinária , Cães/sangue , Piometra/classificação , Piometra/diagnóstico , Útero , Infecções Bacterianas
19.
Rev. bras. ciênc. vet ; 28(3): 167-173, jul./set. 2021. il.
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1366793

Resumo

Hematological and serum biochemical characteristics and prevalence of microorganisms in the uterine content of bitches with pyometra were described, according to type and age. This study was carried out at the Veterinary Medicine Hospital Renato Rodenburg de Medeiros Netto of the UFBA with 132 patients diagnosed with pyometra through imaging and laboratory tests, divided into two groups: Group 1 - less than eight years (n=72) and Group 2 - more than eight years (n=60). Both groups were submitted to Ovariohysterectomy (OH), in which blood and uterine lumen secretion samples were collected. The highest incidence of pyometra was found in bitches under 8 years (54.5%), Poodle breed (31.8%) and mixed-breed (27.3%). Open pyometra represented 80.3% of all cases. The death rate (6.0%) did not show significant difference between the types. Anemia (73.0%), thrombocytopenia (41.2%) and leukocytosis (77.0%) were observed. Urea and ALP were above the reference values in 41.8% and 52.2% of each group, respectively, while ALT (94.0%) and creatine (82%) remained normal in most animals. Serum biochemistry did not show significant differences (P<0.05). Escherichia coli and Klebsiella sp. grew in 33.3% and 16.7% of the samples, respectively. Therefore, no significant hematological and serum biochemical differences were observed in bitches with pyometra in both age categories.


Descreveu-se características hematológicas, bioquímicas séricas e prevalência de microrganismos no conteúdo uterino de cadelas com piometra, de acordo com o tipo e idade. Realizou-se este estudo no Hospital de Medicina Veterinária Renato Rodenburg de Medeiros Netto da UFBA com 132 pacientes diagnosticadas com piometra, por exames de imagem e laboratoriais, divididas em dois grupos: Grupo 1 ­ menos de oito anos (n=72) e Grupo 2 ­ mais de oito anos (n=60), submetidas a Ovariectomia (OH), quando se coletou amostras de sangue e secreção do lúmen uterino. A incidência maior deu-se em cadelas abaixo de 8 anos (54,5%), da raça Poodle (31,8%) e sem raça definida (SRD) (27,3%), sendo 80,3% de piometra aberta. A taxa de óbito (6,0%) não apresentou diferença significativa entre os tipos. Observou-se a ocorrência de anemia (73,0%), trombocitopenia (41,2%) e leucocitose (77,0%). Os valores de ureia e FA estiveram acima dos valores de referência em 41,8% e 52,2% das cadelas respectivamente, enquanto a ALT (94,0%) e a creatina (82%) mantiveram-se dentro dos valores de referência na maioria dos animais. A bioquímica sérica não apresentou diferenças significativas (P<0,05). Observou-se crescimento de Escherichia coli e Klebsiella sp. em 33,3% e 16,7% das amostras, respectivamente. Sendo assim, não se observou diferenças significativas hematológicas e na bioquímica sérica de cadelas com piometra nas categorias de idade.


Assuntos
Animais , Cães , Doenças do Cão , Piometra/veterinária , Bioquímica , Fatores Etários , Hiperplasia Endometrial/veterinária , Testes Hematológicos/veterinária
20.
Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 24(2, cont.): e2405, jul-dez. 2021. ilus
Artigo em Português | LILACS, VETINDEX | ID: biblio-1352310

Resumo

A castração em fêmeas pode ser feita pela ovariectomia (retirada dos ovários), ou ovariohisterectomia (retirada dos ovários e do útero). Essa última técnica é a mais recomendada em cães e gatos, devido à prevenção de afecções que podem ocorrer posteriormente no útero. Dentre essas complicações pode-se encontrar sangramento por ligadura mal feita em coto, hidroureter, hidronefrose, piometra de coto, formação de tratos sinusais, aderência, obstrução crônica, incontinência urinária, retenção abdominal de compressas cirúrgicas, transcecção de parte do ureter e ovário remanescente. Em cadelas castradas, a causa mais comum da formação de tratos sinusais é a presença de reação tecidual ao redor do fio de sutura. O presente estudo teve como objetivo relatar um caso de uma cadela sem raça definida, 8,7 kg, seis anos, que deu entrada no Hospital Veterinário de Uberaba, MG com queixa principal a presença de ferida no flanco direito sendo tratada há nove meses, porém sem sucesso. Já haviam feito uso de vários antibióticos sistêmicos e antinflamatorios esteroidais e não esteroidais. Diante do caso observado, foram realizados exames laboratoriais e de imagem. Perante o resultado do exame de imagem, a principal suspeita foi a formação de trato sinusal com comunicação com a cavidade abdominal devido a uma reação ao fio de algodão utilizado na ovariohisterectomia.(AU)


Female animals can be castrated by ovariectomy (removal of the ovaries), or ovariohysterectomy (removal of the ovaries and uterus). The latter is the most recommended in dogs and cats due to the prevention of conditions that may subsequently occur in the uterus. Among these complications, one can find bleeding by poor ligation in the stump, hydroureter, hydronephrosis, stump pyometra, formation of sinus tracts, adherence, chronic obstruction, urinary incontinence, abdominal retention of surgical compresses, transection of part of the ureter and remaining ovary. In castrated bitches, the most common cause of the formation of sinus tracts is the presence of tissue reaction around the suture thread. This study aimed at reporting a case of a mixed breed, six-year-old dog, 8.7 kg that was admitted to the Veterinary Hospital of Uberaba with the main complaint of the presence of a wound on the right flank being unsuccessfully treated for nine months. Several systemic antibiotics and steroidal and non-steroidal anti-inflammatory drugs had already been used. In view of the observed case, laboratory and imaging exams were performed. In view of the result of the imaging examination, the main suspicion was the formation of a sinus tract with communication to the abdominal cavity due to a reaction to the cotton thread used in the ovariohysterectomy.(AU)


La castración en hembras se puede realizar mediante ovariectomía (extirpación de los ovarios) u ovario histerectomía (extirpación de los ovarios y del útero). Esa última técnica es la más recomendada en perros y gatos, debido a la prevención de afecciones que pueden presentarse posteriormente en el útero. Entre estas complicaciones se puede encontrar hemorragias por ligadura mal realizada en muñón, hidruréter, hidronefrosis, piometra de muñón, formación de tractos sinusales, adherencia, obstrucción crónica, incontinencia urinaria, retención abdominal de compresas quirúrgicas, transección de parte del uréter y ovario remanente. En las perras castradas, la causa más común de formación de trayectos sinusales es la presencia de reacción tisular alrededor del hilo de sutura. El presente estudio tuvo como objetivo reportar el caso de una perra sin raza definida, de 8,7 kg, de seis años de edad, que ingresó en el Hospital Veterinario de Uberaba, MG con el principal síntoma de presencia de una herida en el flanco derecho siendo tratada durante nueve meses, pero sin éxito. Ya habían usado varios antibióticos sistémicos y medicamentos antiinflamatorios esteroides y no esteroides. A la vista del caso observado, se realizaron exámenes de laboratorio y de imagen. A la vista del resultado del examen de imagen, la principal sospecha fue la formación de un tracto sinusal con comunicación con la cavidad abdominal debido a una reacción al hilo de algodón utilizado en el ovario histerectomía.(AU)


Assuntos
Animais , Feminino , Cães , Ovário , Suturas , Ovariectomia , Castração , Cães/cirurgia , Piometra , Antibacterianos
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