Polineuropatia motora em cão adulto / Motor polyneuropathy in an adult dog

Background: Nonambulatory flaccid tetraparesis can be the result of diseases of the peripheral nervous system and it is characterized by generalized lower motor neuron (LMN) signs, as weakness, tetraparesis/tetraplegia, decreased muscle tone and reflexes. The term polyneuropathy is used for dysfunction of multiple peripheral nerves. In Brazil, there are several etiologies for polyneuropathy in dogs, such as acute idiopathic polyradiculoneuritis, botulism and myasthenia gravis. Toxoplasma gondii is an uncommon cause of LMN diseases in dogs. The aim of this report was to describe a case of flaccid tetraplegia toxoplasmosis in an adult dog with a Toxoplasma gondii serology with a markedly elevated IgG titer of 1:4096. Case: A 4-year-old intact mongrel male dog, weighing 19.6 kg, was referred to the Veterinary Medical Teaching Hospital of the Universidade Estadual de Londrina (UEL) with a 5-day history of weakness that progressed to tetraparesis. Physical examination revealed no significant changes other than the dull and unkempt coat. Neurologic examination revealed severe tetraparesis that was worse in the pelvic limbs, with decreased muscle tone in all four limbs. Postural reactions and the interdigital reflex were absent in all four limbs, as was the patellar reflex, but pain perception was present. There were no clinical signs of dysfunction on examination of the cranial nerves. Laboratory tests were performed, and creatine kinase was elevated (819 U/L). Blood was drawn to look for antibodies to Toxoplasma gondii and Neospora caninum class IgG using the indirect immunofluorescence technique. The antibody titer for Toxoplasma gondii (IgG) was 1:4096. A chest radiograph was performed to look for megaesophagus, and a pulmonary pattern suggestive of mild diffuse pneumonia was observed. Treatment was performed with sulfamethoxazole and trimethoprim, and the dog's condition improved slightly. Discussion: Based on lower motor neuron findings, the neurologic lesion was localized in the nerve roots, peripheral nerves, neuromuscular junctions, or muscles. The most important diseases in the list of differential diagnoses were immune-mediated or infectious polyradiculoneuritis (toxoplasmosis, neosporosis), myasthenia gravis, toxic polyneuropathy (botulism, chronic organophosphate poisoning), and paraneoplastic polyneuropathy. Among these differential diagnoses, polyradiculoneuritis is one of the most common. It is an idiopathic inflammatory disease. Exposure to raccoon saliva (in the U.S.), vaccination, or infection have been proposed as precipitating causes, but the triggers of this disease remain unknown. Serology for neosporosis was negative, while IgG titers for toxoplasmosis were 1:4096. In a previous study, dogs with acute polyradiculoneuritis were more likely to have T. gondii IgG serum antibody titers than dogs without neurologic signs. Infection with the protozoa T. gondii and N. caninum can cause intense polyradiculoneuritis in dogs accompanied by myositis, especially in puppies. One treatment trial was based on the administration of sulfonamide-trimethoprim with pyrimethamine, whose efficacy in the treatment of toxoplasmosis in dogs has also been reported in the literature. Neurologic deficits improved slightly, and there is a possibility that certain signs may not disappear completely because of the permanent damage caused by inflammation of the nervous system, as observed in the present case. The case had the limitation that it was not possible to perform other laboratory tests to demonstrate histopathologically the presence of Toxoplasma gondii organisms in muscles or nerves. Recovery of normal function is less likely in protozoan polyradiculoneuritis than in noninfectious polyradiculoneuritis. Thus, in the present case, the main suspicion was polyradiculoneuritis secondary to toxoplasmosis. Although it is a rare condition, it is important to consider toxoplasmosis in dogs with LMN-type tetraparesis or tetraplegia.

Artéria subclávia direita aberrante em cão - aspectos clínicos e de imagem / Aberrant right subclavian artery in a dog - clinical and imaging aspects

Background: Aberrant right subclavian artery is only rarely observed in veterinary medicine. Some animals may present postprandial regurgitation and progressive weight loss, which is considered an incidental finding unrelated to clinical alterations. Advanced imaging techniques such as thoracic CT scan, magnetic resonance imaging (MRI) and contrast angiography are used for the accurate detection of lesions, anatomical changes and specific information about vascular rings. This paper describes the clinical changes, imaging exams and therapeutic approach in a female dog with megaesophagus induced by an aberrant right subclavian artery. Case: A 2-month-old female bull terrier, weighing 1.6 kg, with a history of regurgitation immediately or a few minutes after a meal, diarrhea, polyphagia, progressive emaciation and apathy for 45 days, was treated at a University Veterinary Hospital. The dog's physical examination revealed 7% dehydration and body condition score 1 (scale 1 to 5), but no cardiac or pulmonary alterations upon auscultation. The hematological analysis and renal and hepatic serum enzymes were within the normal range for the species. In view of the presumptive clinical diagnosis of vascular anomaly, suggested by the contrast X-ray examination, a chest tomography was performed, which revealed altered aortic arch shape and contours, and a posterior aneurysm in the area of abnormal connection of the right subclavian artery. The patient was released with a prescription for conservative dietary management for megaesophagus. Within two weeks, the patient returned with a report of a good response to the prescribed therapy, absence of vomiting and diarrhea, and an increase in body weight. Surgical correction was recommended, but has not been performed so far, but conservative treatment for megaesophagus was continued. No further episodes of regurgitation were identified during the nine-month follow-up period. Discussion: In the case reported here, the right subclavian artery is considered anatomically atypical because it arises directly from the aortic arch. This vascular anomaly passes on to the right pectoral limb, dorsal to the esophagus, contracting it in its dorsal aspect. It tends to affect purebred dogs, occurring more frequently in Irish setters, German shepherds and Labrador retrievers, although it has been described in other breeds such as the bull terrier documented here and mixed breed dogs. Vascular ring anomalies may not cause clinical changes in animals and represent only incidental findings, or they may lead to gastrointestinal changes resulting from esophageal stricture, contributing to megaesophagus and clinical signs of esophageal obstruction, especially in recently weaned puppies. Such alterations were observed in this case, with the dog presenting regurgitation, immediately or a few minutes after a meal, megaesophagus, diarrhea and progressive weight loss. A CT scan was performed to confirm the type and location of the vascular anomaly and diagnostic accuracy, as recommended in the literature. Dietary therapy is one of the approaches adopted for patients presenting with regurgitation resulting from megaesophagus secondary to vascular anomalies. The dog in this report responded well to the medical therapy; nevertheless, the treatment of choice to correct the esophageal obstruction caused by this anomaly is surgical sectioning of the aberrant vessel by right intercostal thoracotomy, given that the degree of esophageal dilation and dysfunction tends to increase over time. However, at this time, the animal's owner decided to suspend the recommended surgical procedure.

Concurrent hiatal hernia and megaesophagus secondary to a nasopharyngeal polyp in a 6-month-old cat

Background: Nasopharyngeal polyps are benign and inflammatory masses assumed to arise from the middle ear or the eustachian tube with extension into the pharynx. The most common clinical signs associated with nasopharyngeal polyps include respiratory stertor, dyspnea, and otic discharge. Neurological signs, including head tilt, facial nerve paralysis, and ataxia, might indicate concurrent involvement of the middle or inner ear. The objective of the current report is to describe a case of a feline nasopharyngeal polyp with a concurrent hiatal hernia and megaesophagus, both spontaneously resolved after removal of the polyp. Case: A 6-month-old female intact domestic shorthair cat was presented for evaluation of lethargy, anorexia, and upper respiratory signs, such as stridor, stertor, and dyspnea. A thoracic radiography revealed esophageal dilation caudal to the cardiac silhouette, suggestive of megaesophagus with gaseous filtration. An esophagram confirmed a hiatal hernia and megaesophagus. Computed tomography revealed a nasopharyngeal mass adjacent to the soft palate and a soft-tissue density in the right tympanic bulla. A tentative diagnosis of a nasopharyngeal polyp was made. After the ventral bulla osteotomy, the nasopharyngeal mass was removed by a gentle traction avulsion technique. Six days after the surgery, hiatal hernia and megaesophagus were spontaneously resolved. Based on histopathologic exam, the mass was found to be an inflammatory nasopharyngeal polyp. Two months after surgery, the owner reported that the patient's condition had returned to baseline with a good appetite, and the thoracic radiography was within normal limit. Discussion: For successful treatment of a nasopharyngeal polyp, traction avulsion of the polyp with or without a ventral bulla osteotomy is recommended. However, in patients with otitis media, a ventral bulla osteotomy followed by traction avulsion of the polyp is recommended in order to reduce the rate of polyp recurrence. Common clinical signs of a nasopharyngeal polyp are stertor, stridor, dyspnea, dysphagia, and open-mouth breathing, which are identified in a chronic upper airway obstruction. A hiatal hernia secondary to a nasopharyngeal polyp has not been reported so far. However, a relationship between chronic upper airway obstruction and hiatal hernias has been proposed previously. Moreover, hiatal hernia resolved spontaneously after removal of the nasopharyngeal polyp suggests that the occurrence of the hiatal hernia was secondary to the nasopharyngeal polyp. In addition to the hiatal hernia, megaesophagus was also identified in the present case. Megaesophagus secondary to a chronic upper airway obstruction from a nasopharyngeal obstruction has been reported. However, megaesophagus is also thought to occur secondary to hiatal hernias. Therefore, in the current study, it is unclear whether the megaesophagus was solely a result of the obstructive nature of the nasopharyngeal polyp or a combination of the hiatal hernia and the nasopharyngeal polyp. In conclusion, any cat with clinical signs of an upper airway obstruction and a concurrent hiatal hernia and megaesophagus should be thoroughly investigated for a nasopharyngeal polyp, as well as other gastrointestinal and systemic causes. Furthermore, this case suggests that the prognosis for a concurrent hiatal hernia and megaesophagus is good in cats if the nasopharyngeal polyp is properly removed.

Megaesôfago em muar / Megaesophagus in mule

Background: Megaesophagus is a chronic dilation of the esophagus rarely found in horses. It’s a non-specific disease that is associated with several causes, and esophageal hypomotility is the dysfunction that most commonly results in organ dilation. In the literature, there are few reports of megaesophagus in horses and, to date, no cases in mule have been reported. The objective of this work is to describe a case of a donkey with thoracic megaesophagus. Case: A 16 year-old donkey, castrated male, mixed breed weighing 195 kg, was referred for clinical care with a history of 5 days of anorexia. On physical examination, apathy, cachexia, 8% dehydration, moderate enophthalmos, ptialism, bilateral nasal discharge, dry and bristling hair were observed. Due to the poor general condition, a nasogastric tube was chosen to perform enteral nutrition, however, it was not possible to progress the tube to the stomach. In order to confirm the suspicion of a possible esophageal obstruction, gastroscopy was performed, where it was possible to observe an esophageal dilation filled with bulky food located in the thoracic portion of the esophagus. In an attempt to stimulate esophageal motility, in order to promote the progression of the material present in the region of dilation, intramuscular metoclopramide was administered (two applications every 6 h), however the treatment had no effect. Due to the unfavorable prognosis and financial limitations of the owner, euthanasia was performed, which was followed by autopsy and histopathological examination. At necropsy, a marked dilation of the esophagus was observed in the thoracic portion, which was filled with approximately 500 grams of bulky food (grass). In the mucosa of this area...

Megaesôfago em muar / Megaesophagus in mule

Background: Megaesophagus is a chronic dilation of the esophagus rarely found in horses. Its a non-specific disease that is associated with several causes, and esophageal hypomotility is the dysfunction that most commonly results in organ dilation. In the literature, there are few reports of megaesophagus in horses and, to date, no cases in mule have been reported. The objective of this work is to describe a case of a donkey with thoracic megaesophagus. Case: A 16 year-old donkey, castrated male, mixed breed weighing 195 kg, was referred for clinical care with a history of 5 days of anorexia. On physical examination, apathy, cachexia, 8% dehydration, moderate enophthalmos, ptialism, bilateral nasal discharge, dry and bristling hair were observed. Due to the poor general condition, a nasogastric tube was chosen to perform enteral nutrition, however, it was not possible to progress the tube to the stomach. In order to confirm the suspicion of a possible esophageal obstruction, gastroscopy was performed, where it was possible to observe an esophageal dilation filled with bulky food located in the thoracic portion of the esophagus. In an attempt to stimulate esophageal motility, in order to promote the progression of the material present in the region of dilation, intramuscular metoclopramide was administered (two applications every 6 h), however the treatment had no effect. Due to the unfavorable prognosis and financial limitations of the owner, euthanasia was performed, which was followed by autopsy and histopathological examination. At necropsy, a marked dilation of the esophagus was observed in the thoracic portion, which was filled with approximately 500 grams of bulky food (grass). In the mucosa of this area...(AU)

Spirocerca lupi (Spirurida: Spirocercidae) infection associated to secondary megaesophagus and obstructive process in a senile dog / Infecção por Spirocerca lupi (Spirurida: Spirocercidae) associada a megaesôfago secundário e processo obstrutivo em um cão senil

Spirocerca lupi is a nematode parasite that can be found in the esophagus and aorta of carnivores, including humans. Affected animals may develop mild to severe lesions, depending on the degree of infection, route of larval migration and the inflammatory response. The present work describes the occurrence of S. lupi in a 16-year old male Chow Chow dog, presenting a chronic esophagus infection, associated with a critical obstruction. After the identification of the parasite egg by faecal exam, the patient was treated with milbemycin in combination with praziquantel P.O., in days zero, seven and 28 after the diagnose. An esophagogram was also performed, confirming the secondary megaesophagus. The team of clinicians decide to perform a euthanasia due to the complication of the patient"s condition, even after the anthelmintic treatment. This report is important as it describes a case after 18 years of epidemiological silence in the Metropolitan region of Curitiba, PR, Brazil. The present data aims to raise awareness about the prevalence of this zoonotic disease and the importance of a specific clinical and radiographic diagnose in dogs. It is noteworthy to report the difficulty to reduce the size of the associated esophagus mass even after a potent anthelmintic treatment.

Spirocerca lupi é um parasito nematoide que pode ser encontrado no esôfago e na aorta de carnívoros, incluindo humanos. Os animais afetados pela doença podem desenvolver de lesões leves a graves, dependendo do grau de infecção, migração larval e resposta inflamatória. O presente trabalho descreve a ocorrência do parasito em um cão Chow Chow de 16 anos de idade, com infecção crônica, apresentando megaesôfago secundário associado a uma crítica obstrução do órgão. Após a identificação do ovo do parasito, foi realizado tratamento antiparasitário oral com a combinação de milbemicina e praziquantel, nos dias zero, sete e 28 após o diagnóstico. Também foi realizado esofagograma, confirmando o megaesôfago secundário. A equipe médica decidiu pela eutanásia do cão devido a sua complicação da condição clínica quando o paciente retornou, mesmo após o tratamento com anti-helmíntico. Este relato é importante porque descreve um caso após 18 anos de silêncio epidemiológico na região metropolitana de Curitiba, Paraná, Brasil. Os presentes dados visam conscientizar sobre a prevalência dessa doença zoonótica e a importância de um diagnóstico clínico e radiográfico específico em cães. É digno de nota relatar a dificuldade em reduzir o tamanho da massa esofágica associada, mesmo após um tratamento anti-helmíntico potente.

Spirocerca lupi (Spirurida: Spirocercidae) infection associated to secondary megaesophagus and obstructive process in a senile dog / Infecção por Spirocerca lupi (Spirurida: Spirocercidae) associada a megaesôfago secundário e processo obstrutivo em um cão senil

Spirocerca lupi is a nematode parasite that can be found in the esophagus and aorta of carnivores, including humans. Affected animals may develop mild to severe lesions, depending on the degree of infection, route of larval migration and the inflammatory response. The present work describes the occurrence of S. lupi in a 16-year old male Chow Chow dog, presenting a chronic esophagus infection, associated with a critical obstruction. After the identification of the parasite egg by faecal exam, the patient was treated with milbemycin in combination with praziquantel P.O., in days zero, seven and 28 after the diagnose. An esophagogram was also performed, confirming the secondary megaesophagus. The team of clinicians decide to perform a euthanasia due to the complication of the patient"s condition, even after the anthelmintic treatment. This report is important as it describes a case after 18 years of epidemiological silence in the Metropolitan region of Curitiba, PR, Brazil. The present data aims to raise awareness about the prevalence of this zoonotic disease and the importance of a specific clinical and radiographic diagnose in dogs. It is noteworthy to report the difficulty to reduce the size of the associated esophagus mass even after a potent anthelmintic treatment.(AU)

Spirocerca lupi é um parasito nematoide que pode ser encontrado no esôfago e na aorta de carnívoros, incluindo humanos. Os animais afetados pela doença podem desenvolver de lesões leves a graves, dependendo do grau de infecção, migração larval e resposta inflamatória. O presente trabalho descreve a ocorrência do parasito em um cão Chow Chow de 16 anos de idade, com infecção crônica, apresentando megaesôfago secundário associado a uma crítica obstrução do órgão. Após a identificação do ovo do parasito, foi realizado tratamento antiparasitário oral com a combinação de milbemicina e praziquantel, nos dias zero, sete e 28 após o diagnóstico. Também foi realizado esofagograma, confirmando o megaesôfago secundário. A equipe médica decidiu pela eutanásia do cão devido a sua complicação da condição clínica quando o paciente retornou, mesmo após o tratamento com anti-helmíntico. Este relato é importante porque descreve um caso após 18 anos de silêncio epidemiológico na região metropolitana de Curitiba, Paraná, Brasil. Os presentes dados visam conscientizar sobre a prevalência dessa doença zoonótica e a importância de um diagnóstico clínico e radiográfico específico em cães. É digno de nota relatar a dificuldade em reduzir o tamanho da massa esofágica associada, mesmo após um tratamento anti-helmíntico potente.(AU)

Aberrant right subclavian artery in a dog - case report / [Ectopia de artéria subclávia direita em cão - relato de caso]

The brachiocephalic trunk and the left subclavian artery originate from the aortic arch, and both supply blood to the head, neck, and thoracic limbs. Anatomical variations, such as an aberrant right subclavian artery, are congenital conditions rarely observed in dogs, Thus, the objective of the present report was to describe a case of aberrant right subclavian artery in a 9-year-old Dalmatian. However, this anomaly was a finding in which the patient was asymptomatic during its 9 years of life and only at this age did he exhibit signs including sialorrhea, vomiting, hyporexia, and noisy deglutition. Blood count, biochemical profile, and thoracic radiography led to a diagnosis of megaesophagus and aspiration pneumonia. Despite the recommended treatment, the patient did not respond well; as such, the owner elected to euthanize the animal. On necropsy, the right subclavian artery originated directly from the aortic arch, followed a route from left to right dorsally to the esophagus, and then formed an impression of the vascular path over the muscular wall of the esophagus. The esophagus, in turn, exhibited a flaccid wall and dilation in the caudal portion to the vascular path made by the ectopic position of the right subclavian artery.(AU)

O tronco braquiocefálico e a artéria subclávia esquerda emergem do arco aórtico e são responsáveis por fazerem o suprimento sanguíneo para cabeça, pescoço e membros torácicos. Variações anatômicas, como a ectopia da artéria subclávia direita, são alterações congênitas raramente encontradas em cães, cujas alterações do sistema digestivo acontecem em pacientes recém-desmamados e não em adultos. Assim, o objetivo deste relato é descrever um caso de ectopia da artéria subclávia direita em uma cadela, Dálmata, de nove anos de idade. No entanto, essa anomalia foi um achado do qual o paciente foi assintomático durante os nove anos de vida e somente com essa idade apresentou sinais como sialorreia, vômito, hiporexia e deglutição ruidosa. O hemograma e os perfis bioquímicos, associados à radiografia torácica, levaram a um diagnóstico de megaesôfago e pneumonia aspirativa. Mesmo seguindo o tratamento recomendado, houve piora clínica do quadro e o animal foi submetido à eutanásia. À macroscopia, a artéria subclávia direita originava-se direto do arco aórtico, fazia um percurso da esquerda para a direita dorsalmente ao esôfago e, então, formava uma impressão do trajeto vascular sobre a parede muscular do esôfago. O esôfago, por sua vez, apresentava parede flácida e dilatação na porção caudal ao trajeto vascular feito pela posição ectópica da artéria subclávia direita.(AU)

Barium sulphate aspiration pneumonia in a cat with megaesophagus and dextroposition of the aortic arch: case report / Pneumonia aspirativa por sulfato de barrio em gato com megaesôfago e destroposição de arco da aorta: relato de caso

A six-month-old female cat suffered aspiration of an abundant amount of barium sulfate during a radiographic procedure for the diagnosis of megaesophagus. Latero-lateral contrast radiography revealed severe dilation of the thoracic esophagus cranial to the base of the heart. Persistence of the right aortic arch was suspected and later confirmed during corrective surgery. Accumulation of barium sulfate, used as a contrast agent, was clearly observed in the lumen of the bronchi, bronchioles, and alveoli in the radiographic image. Days after the surgery, the animal developed severe respiratory distress, which resulted in death. Cytology results and histology analysis using polarized light demonstrated that the lumen of bronchi, bronchioles, and alveoli exhibited evident histiocytic infiltration with cytoplasm filled by abundant amorphous refractive granular material consistent with barium sulfate. In this report, we describe the anatomical, cytological, histopathological (using polarized light), and x-ray findings of a case of barium sulfate aspiration pneumonia in a cat resulting from the use of this contrast medium for the diagnosis of megaesophagus secondary to persistent right aortic arch.(AU)

Uma gata de seis meses aspirou grande quantidade de sulfato de bário durante procedimento radiográfico para diagnóstico de megaesôfago. Contraste radiográfico látero-lateral revelou dilatação de esôfago torácico até a base do coração. Persistência do arco aórtico direito foi confirmada durante cirurgia corretiva. Acúmulo de sulfato de bário, utilizado como agente de contraste, foi observado no lúmen de brônquios, bronquíolos e alvéolos à imagem radiográfica. Dias após a cirurgia o animal desenvolveu insuficiência respiratória grave e evoluiu para óbito. Resultado de citologia e histologia utilizado luz polarizada demonstrou que lúmen de brônquios, bronquíolos e alvéolos mostraram infiltração histológica com citoplasma cheio de material refratário granular amorfo compatível com sulfato de bário. Nesse relatório, descrevemos achados anatômicos, citológicos, histopatológicos e radiográficos de um caso de pneumonia aspirativa em gata resultante do uso desse meio de contraste para diagnóstico de megaesôfago secundário a persistência do arco aórtico direito.(AU)

Barium sulphate aspiration pneumonia in a cat with megaesophagus and dextroposition of the aortic arch: case report / Pneumonia aspirativa por sulfato de barrio em gato com megaesôfago e destroposição de arco da aorta: relato de caso

A six-month-old female cat suffered aspiration of an abundant amount of barium sulfate during a radiographic procedure for the diagnosis of megaesophagus. Latero-lateral contrast radiography revealed severe dilation of the thoracic esophagus cranial to the base of the heart. Persistence of the right aortic arch was suspected and later confirmed during corrective surgery. Accumulation of barium sulfate, used as a contrast agent, was clearly observed in the lumen of the bronchi, bronchioles, and alveoli in the radiographic image. Days after the surgery, the animal developed severe respiratory distress, which resulted in death. Cytology results and histology analysis using polarized light demonstrated that the lumen of bronchi, bronchioles, and alveoli exhibited evident histiocytic infiltration with cytoplasm filled by abundant amorphous refractive granular material consistent with barium sulfate. In this report, we describe the anatomical, cytological, histopathological (using polarized light), and x-ray findings of a case of barium sulfate aspiration pneumonia in a cat resulting from the use of this contrast medium for the diagnosis of megaesophagus secondary to persistent right aortic arch.(AU)

Uma gata de seis meses aspirou grande quantidade de sulfato de bário durante procedimento radiográfico para diagnóstico de megaesôfago. Contraste radiográfico látero-lateral revelou dilatação de esôfago torácico até a base do coração. Persistência do arco aórtico direito foi confirmada durante cirurgia corretiva. Acúmulo de sulfato de bário, utilizado como agente de contraste, foi observado no lúmen de brônquios, bronquíolos e alvéolos à imagem radiográfica. Dias após a cirurgia o animal desenvolveu insuficiência respiratória grave e evoluiu para óbito. Resultado de citologia e histologia utilizado luz polarizada demonstrou que lúmen de brônquios, bronquíolos e alvéolos mostraram infiltração histológica com citoplasma cheio de material refratário granular amorfo compatível com sulfato de bário. Nesse relatório, descrevemos achados anatômicos, citológicos, histopatológicos e radiográficos de um caso de pneumonia aspirativa em gata resultante do uso desse meio de contraste para diagnóstico de megaesôfago secundário a persistência do arco aórtico direito.(AU)

Esophageal diverticulum and megaesophagus in a dog and a cat

Background: Esophageal diverticula are pouch-like dilatations in the esophageal wall that rarely affect dogs and cats, and may have the megaesophagus as a base cause. The definitive method of diagnosis is the contrasting chest X-ray that will visualize the sacculation.Cases: Case 1. A feline male, mixed breed, with 40 days of life was seen with complaint of postprandial regurgitation that was repeated at each meal. On physical examination, the animal was below ideal weight, apathetic, with pale mucosa and bristly. It was suspected of megaesophagus, which was confirmed by contrasting thoracic lateral-lateral (LL) radiography, and the patient also had anterior partial esophageal dilation to the topographic image of the heart. The image was suggestive of persistence of the right aortic arch, and corrective surgery was indicated but it was not authorized by the tutors. Therefore, conservative dietary treatment was instituted. The animal remained stable for a period of one and a half years. After this period the patient returned with an aggravated condition of vomiting, anorexia and apathy. The same clinical condition was maintained in the chest X-ray. An esophageal flushing was indicated, which was not authorized by the tutors, being prescribed mucosal protector and antibiotic. The medication was maintained by the tutor and after 1 month of the initial care, the clinical condition worsened and the animal died. Case 2. A 6-month-old male Pinscher dog weighing 1 kg was seen with postprandial regurgitation complaint since the beginning of the weaning transition period. In the esophagography performed a compatible radiographic image was seen with a diverticulum of the cranial thoracic esophagus and congenital total megaesophagus. The treatment adopted was conservative. Twelve months after the initial care, the animal presented radiographically resolution of the diverticulum and megaesophagus and was in good health.[...]

Esophageal diverticulum and megaesophagus in a dog and a cat

Background: Esophageal diverticula are pouch-like dilatations in the esophageal wall that rarely affect dogs and cats, and may have the megaesophagus as a base cause. The definitive method of diagnosis is the contrasting chest X-ray that will visualize the sacculation.Cases: Case 1. A feline male, mixed breed, with 40 days of life was seen with complaint of postprandial regurgitation that was repeated at each meal. On physical examination, the animal was below ideal weight, apathetic, with pale mucosa and bristly. It was suspected of megaesophagus, which was confirmed by contrasting thoracic lateral-lateral (LL) radiography, and the patient also had anterior partial esophageal dilation to the topographic image of the heart. The image was suggestive of persistence of the right aortic arch, and corrective surgery was indicated but it was not authorized by the tutors. Therefore, conservative dietary treatment was instituted. The animal remained stable for a period of one and a half years. After this period the patient returned with an aggravated condition of vomiting, anorexia and apathy. The same clinical condition was maintained in the chest X-ray. An esophageal flushing was indicated, which was not authorized by the tutors, being prescribed mucosal protector and antibiotic. The medication was maintained by the tutor and after 1 month of the initial care, the clinical condition worsened and the animal died. Case 2. A 6-month-old male Pinscher dog weighing 1 kg was seen with postprandial regurgitation complaint since the beginning of the weaning transition period. In the esophagography performed a compatible radiographic image was seen with a diverticulum of the cranial thoracic esophagus and congenital total megaesophagus. The treatment adopted was conservative. Twelve months after the initial care, the animal presented radiographically resolution of the diverticulum and megaesophagus and was in good health.[...](AU)

Megaesôfago secondary to miastenia gravis: case report on a dog / Megaesôfago secundário à miastenia gravis: relato de caso em um cão

The megaesophagus a dilatation of the whole or some portions of esophagus, an unusual cat disease can be seen more frequently in dogs is classified as congenital or acquired. The acquired form usually presents in adult dogs from eight years of age, secondary to other disorders, mainly to diseases that cause neuromuscular changes like myasthenia gravis, hypoadrenocorticism and dysautonomia in cats. This report describes a case of megaesophagus secondary to myasthenia gravis in a male, nondefined canine with nine years of age, analyze the diagnosis and treatment methods of applied, bu in the present case, the diagnosis was concluded by thoracic radiography, in addition to the established therapy associated with patient management, which ensured the animal significant clinical improvement and life quality.

O megaesôfago, uma dilatação total ou de partes específicas do esôfago enfermidade incomum em gatos, porém vista com maior frequência em cães é classificada como congênita ou adquirida. A forma adquirida geralmente é observada em cães adultos a partir de oito anos de idade, secundariamente a outros distúrbios, principalmente a doenças que provocam alterações neuromusculares, como miastenia gravis, hipoadrenocorticismo e disautonomia nos gatos. Este relato descreve um caso de megaesôfago secundário à miastenia gravis em um canino, macho, sem raça definida e com nove anos de idade, além de discutir os métodos de diagnóstico e tratamentos dessa enfermidade. Nesse caso, o diagnóstico pôde ser concluído com o emprego da radiografia torácica, além da terapia instituída associada ao manejo do paciente, o que garantiu ao animal melhora clínica significativa e qualidade de vida.

Megaesôfago secondary to miastenia gravis: case report on a dog / Megaesôfago secundário à miastenia gravis: relato de caso em um cão

The megaesophagus a dilatation of the whole or some portions of esophagus, an unusual cat disease can be seen more frequently in dogs is classified as congenital or acquired. The acquired form usually presents in adult dogs from eight years of age, secondary to other disorders, mainly to diseases that cause neuromuscular changes like myasthenia gravis, hypoadrenocorticism and dysautonomia in cats. This report describes a case of megaesophagus secondary to myasthenia gravis in a male, nondefined canine with nine years of age, analyze the diagnosis and treatment methods of applied, bu in the present case, the diagnosis was concluded by thoracic radiography, in addition to the established therapy associated with patient management, which ensured the animal significant clinical improvement and life quality.(AU)

O megaesôfago, uma dilatação total ou de partes específicas do esôfago enfermidade incomum em gatos, porém vista com maior frequência em cães é classificada como congênita ou adquirida. A forma adquirida geralmente é observada em cães adultos a partir de oito anos de idade, secundariamente a outros distúrbios, principalmente a doenças que provocam alterações neuromusculares, como miastenia gravis, hipoadrenocorticismo e disautonomia nos gatos. Este relato descreve um caso de megaesôfago secundário à miastenia gravis em um canino, macho, sem raça definida e com nove anos de idade, além de discutir os métodos de diagnóstico e tratamentos dessa enfermidade. Nesse caso, o diagnóstico pôde ser concluído com o emprego da radiografia torácica, além da terapia instituída associada ao manejo do paciente, o que garantiu ao animal melhora clínica significativa e qualidade de vida.(AU)

Preservation of the vagus nerves in subtotal esophagectomy without thoracotomy

Purpose: To evaluate the outcome of transhiatal esophagectomy without thoracotomy and with preservation of the vagal trunks for the treatment of advanced megaesophagus. Methods: Between March 2006 and September 2017, it was performed 136 transhiatal esophagectomies without thoracotomy by laparoscopy, with preservation of the vagus nerves. All patients were evaluated pre and postoperatively for respiratory and nutritional aspects Post operatively, some surgical aspects were evaluated like radiology and endoscopy of the digestive tract. Results: Follow-up for 7 months to 12 years by clinical, radiologic, endoscopic and pH monitoring revealed satisfactory and encouraging outcomes of the procedure. Conclusion: The laparoscopic transhiatal esophagectomy is a feasible and safe technique with good postoperative outcomes.(AU)

Megaesófago segmental en ovino de la raza Dorper / Segmental megaesophagus in a sheep breed Dorper / Megaesofago segmentar em um ovino da raça Dorper

Un ovino adulto, macho, de la raza Dorper con histórico de regurgitación y timpanismo crónico postprandial fue sometido a exámenes de imagen. En el examen radiográfico simple de la región cervical y torácica se observó desvio ventral de la tráquea y presencia de gas en el área de proyección del esófago torácico. El esofagograma con sulfato de bario reveló retención del medio de contraste y dilatación moderada de la porción del esófago situada entre la cuarta y la novena vértebras torácicas. En la evaluación endoscópica se confirmó el diagnóstico de megaesófago segmentario, a medida que se verificó la distorsión de la porción torácica del esófago, acúmulo de fluidos y alimento y la hipomodidad en el área afectada, sin alteración de las mucosas o señal de estenosis.(AU)

An adult, male, Dorper sheep with a history of regurgitation and postprandial chronic tympanism underwent imaging examinations. In the simple radiographic examination of the cervical and thoracic region were observed a ventral deviation of the trachea and presence of gas in the area of projection of the thoracic esophagus. The barium sulphate esophagogram revealed contrast retention and moderate dilatation of the portion of the esophagus between the fourth and ninth thoracic vertebrae. In the endoscopic evaluation, the diagnosis of segmental megaesophagus was confirmed, as the thoracic portion of the esophagus was distended, fluid and food accumulation and hypomotility were present in the affected area, without any alteration of the mucosa or sign of stenosis.(AU)

Um ovino adulto, macho, da raça Dorper com histórico de regurgitação e timpanismo crônico pós-prandial foi submetido a exames de imagem. No exame radiográfico simples da região cervical e torácica foi observado desvio ventral da traqueia e presença de gás na área de projeção do esôfago torácico. O esofagograma com sulfato de bário revelou retenção do meio de contraste e dilatação moderada da porção do esôfago situada entre a quarta e a nona vértebras torácicas. Na avaliação endoscópica foi confirmado diagnóstico de megaesôfago segmentar, à medida que foram verificadas distensão da porção torácica do esôfago, acúmulo de fluído e alimento e hipomotilidade na área afetada, sem qualquer alteração das mucosas ou sinal de estenose.(AU)

Megaesófago segmental en ovino de la raza Dorper / Segmental megaesophagus in a sheep breed Dorper / Megaesofago segmentar em um ovino da raça Dorper

Un ovino adulto, macho, de la raza Dorper con histórico de regurgitación y timpanismo crónico postprandial fue sometido a exámenes de imagen. En el examen radiográfico simple de la región cervical y torácica se observó desvio ventral de la tráquea y presencia de gas en el área de proyección del esófago torácico. El esofagograma con sulfato de bario reveló retención del medio de contraste y dilatación moderada de la porción del esófago situada entre la cuarta y la novena vértebras torácicas. En la evaluación endoscópica se confirmó el diagnóstico de megaesófago segmentario, a medida que se verificó la distorsión de la porción torácica del esófago, acúmulo de fluidos y alimento y la hipomodidad en el área afectada, sin alteración de las mucosas o señal de estenosis.

An adult, male, Dorper sheep with a history of regurgitation and postprandial chronic tympanism underwent imaging examinations. In the simple radiographic examination of the cervical and thoracic region were observed a ventral deviation of the trachea and presence of gas in the area of projection of the thoracic esophagus. The barium sulphate esophagogram revealed contrast retention and moderate dilatation of the portion of the esophagus between the fourth and ninth thoracic vertebrae. In the endoscopic evaluation, the diagnosis of segmental megaesophagus was confirmed, as the thoracic portion of the esophagus was distended, fluid and food accumulation and hypomotility were present in the affected area, without any alteration of the mucosa or sign of stenosis.

Um ovino adulto, macho, da raça Dorper com histórico de regurgitação e timpanismo crônico pós-prandial foi submetido a exames de imagem. No exame radiográfico simples da região cervical e torácica foi observado desvio ventral da traqueia e presença de gás na área de projeção do esôfago torácico. O esofagograma com sulfato de bário revelou retenção do meio de contraste e dilatação moderada da porção do esôfago situada entre a quarta e a nona vértebras torácicas. Na avaliação endoscópica foi confirmado diagnóstico de megaesôfago segmentar, à medida que foram verificadas distensão da porção torácica do esôfago, acúmulo de fluído e alimento e hipomotilidade na área afetada, sem qualquer alteração das mucosas ou sinal de estenose.

Timoma canino associado à miastenia gravis / Canine thymoma associated to myasthenia gravis

Background: Thymomas are epithelial neoplasms of the thymus, although lymphocyte infiltration is common. Histological features are not sufficient to define its biological behaviour, which is dependent of clinical criteria of invasiveness and resectability. Myasthenia gravis may happen as a paraneoplastic syndrome in up to 47% of canine thymomas. This article aims at reporting a case of thymoma associated with myasthenia gravis in a dog, emphasizing the morphological, phenotypical and therapeutical aspects.Case: A 7-year-old, male Labrador, was presented with a history of acute dyspnea and exercise intolerance. The physical examination revealed a “red-brick” mucousa, tachycardia and cardiac and pulmonar hypofonese. Chest radiographs revealed an area of increased radiopacity in the cranial mediastinum without a plane of separation to the heart. The eccodopplercardiogram exam identified a poorly delimited mass adjacent to the base of the heart, measuring 9.5x6.8cm. Computed tomography demonstrated it as an expansive neoformation (9.5x6.5x7.8cm). Mass was removed through intercostal thoracotomy and the removed tissue was submitted to histopathology with a diagnosis compatible with type AB thymoma (mixed). Immunohistochemistry was positive for AE1/AE3 citokeratin in 90% of epithelial cells, confirming tumour origin. Tumour infiltrating lymphocytes were positive for CD79a (70%) and CD3 (20%). The proliferation index (Ki-67 imunolabeling) was 60%. About 45 days after surgery the patient was presented with generalized muscle weakness and regurgitation, with confirmed megaesophagus on chest X-ray. Treatment with pyridostigmine was initiated because of suspected myasthenia gravis, and complete remission of the neurological signs occurred within a month. A chemotherapeutic protocol with carboplatin was then instituted. After four sessions, a new thoracic radiograph revealed tumour recurrence in the cranial mediastinum.[...]

Timoma canino associado à miastenia gravis / Canine thymoma associated to myasthenia gravis

Background: Thymomas are epithelial neoplasms of the thymus, although lymphocyte infiltration is common. Histological features are not sufficient to define its biological behaviour, which is dependent of clinical criteria of invasiveness and resectability. Myasthenia gravis may happen as a paraneoplastic syndrome in up to 47% of canine thymomas. This article aims at reporting a case of thymoma associated with myasthenia gravis in a dog, emphasizing the morphological, phenotypical and therapeutical aspects.Case: A 7-year-old, male Labrador, was presented with a history of acute dyspnea and exercise intolerance. The physical examination revealed a “red-brick” mucousa, tachycardia and cardiac and pulmonar hypofonese. Chest radiographs revealed an area of increased radiopacity in the cranial mediastinum without a plane of separation to the heart. The eccodopplercardiogram exam identified a poorly delimited mass adjacent to the base of the heart, measuring 9.5x6.8cm. Computed tomography demonstrated it as an expansive neoformation (9.5x6.5x7.8cm). Mass was removed through intercostal thoracotomy and the removed tissue was submitted to histopathology with a diagnosis compatible with type AB thymoma (mixed). Immunohistochemistry was positive for AE1/AE3 citokeratin in 90% of epithelial cells, confirming tumour origin. Tumour infiltrating lymphocytes were positive for CD79a (70%) and CD3 (20%). The proliferation index (Ki-67 imunolabeling) was 60%. About 45 days after surgery the patient was presented with generalized muscle weakness and regurgitation, with confirmed megaesophagus on chest X-ray. Treatment with pyridostigmine was initiated because of suspected myasthenia gravis, and complete remission of the neurological signs occurred within a month. A chemotherapeutic protocol with carboplatin was then instituted. After four sessions, a new thoracic radiograph revealed tumour recurrence in the cranial mediastinum.[...](AU)

Clinical, radiographic and pathological analyses of megaesophagus in sheep: case report / Análise clínica, radiológica e patológica de megaesôfago em ovino: caso clínico

The present report describes the case of a male adult Dorper sheep with abdominal distention. The animal had already presented several episodes of bloat. Ruminocentesis was performed and there was a lot of gas output. An attempt was made to pass an orogastric tube up to the rumen in order to remove the content, but there was no progression. Contrast radiograph revealed esophageal dilation, accumulation of contrast in the esophageal lumen and ventral displacement of the trachea, suggesting megaesophagus. The patient still had signs of pneumonia resulting from aspiration of regurgitated content. The animal was submitted to euthanasia and in necropsy, there was enlargement of esophageal diameter and food content inside. Microscopic examination showed edema at lamina propria and submucosa of the esophagus. Megaesophagus diagnosis was based on clinical signs associated with findings from contrast radiograph and post-mortem exam.(AU)

O presente relato descreve o caso de um ovino adulto Dorper com distensão abdominal. O animal já havia apresentado vários episódios de timpanismo. Inicialmente realizou-se rumenocentese devido à intensa produção de gás e, então, tentou-se passar uma sonda orogástrica para remover o conteúdo ruminal, mas não houve progressão. A radiografia contrastada revelou dilatação esofágica, acúmulo de contraste na luz do esôfago e deslocamento ventral da traqueia, sugerindo megaesôfago. O paciente ainda apresentava pneumonia resultante da aspiração de conteúdo regurgitado. O animal foi submetido à eutanásia e necropsia com observação de aumento do diâmetro esofágico e acúmulo de conteúdo alimentar na luz. O exame microscópico mostrou edema na lâmina própria e submucosa do esôfago. O diagnóstico de megaesôfago foi baseado nas manifestações clínicas associadas aos resultados da radiografia contrastada e exame post mortem.(AU)