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

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

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

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

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

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

Hydronephrosis in a bitch with ovarian remnant syndrome - postsurgical complications

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

Monocephalus dipygus dibrachius em cadela Shih Tzu / Monocephalus dipygus dibrachius in a Shih Tzu bitch

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.

Hydronephrosis in a dog related to ovariosalpingohysterectomy

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Uso de técnica adaptada para cavotomia em cão com feocromocitoma associado a trombo neoplásico / Adapted cavotomy technique for pheochromocytoma associated tumor thrombi in a dog

Background: In dogs pheochromocytoma usually compress and invade into the adjacent vessels and structures, whichmay lead to the occurrence of caudal vena caval tumor thrombi. The surgical approach in these cases requires adrenalectomy with caval thrombectomy. Conventionally, tourniquets and partial occlusion clamp are used to reduce intraoperativeblood loss, but in dogs with a large thrombus associated to a great local tumor invasion, the traditional technique may behindered. The aim of this study was to report the use of a purse-string suture during venotomy of the caudal vena cava forthrombectomy, as an alternative to tourniquet and partial occlusion clamp.Case: An 11-year-old male Daschound breed dog, was referred for evaluation because of the appearance of small blackenednodules in the ventral abdomen. During a search for metastatic lesions with abdominal ultrasound, the right adrenal wasidentified with significant volume increase, and presence of tumor-associate circular formation that appeared to invade thecaudal vena cava, suggestive of neoplastic invasion or thrombus. Abdominal computed tomography showed caudal venacava in its hepatic portion presenting considerable increase in diameter, with caudal dilation and presence of hypoattenuatingmaterial in its lumen. Right adrenal gland with rounded appearance and regular borders, heterogeneous parenchyma andjuxtaposed caudal vena cava suggesting invasion of this, confirming the sonographic findings. During exploratory celiotomy,adherence of the adrenal mass to the right renal vessels and invasion of the caudal vena cava were observed, leading to theneed of nephrectomy and venotomy for thrombectomy. To perform the venotomy, a Rumel tourniquet was placed looselyaround the vena cava only caudal to the invasion point of the tumor thrombus, cranially, tourniquet application was notpossible due to the presence of a large thrombus extending into the intrahepatic cava...

Uso de técnica adaptada para cavotomia em cão com feocromocitoma associado a trombo neoplásico / Adapted cavotomy technique for pheochromocytoma associated tumor thrombi in a dog

Background: In dogs pheochromocytoma usually compress and invade into the adjacent vessels and structures, whichmay lead to the occurrence of caudal vena caval tumor thrombi. The surgical approach in these cases requires adrenalectomy with caval thrombectomy. Conventionally, tourniquets and partial occlusion clamp are used to reduce intraoperativeblood loss, but in dogs with a large thrombus associated to a great local tumor invasion, the traditional technique may behindered. The aim of this study was to report the use of a purse-string suture during venotomy of the caudal vena cava forthrombectomy, as an alternative to tourniquet and partial occlusion clamp.Case: An 11-year-old male Daschound breed dog, was referred for evaluation because of the appearance of small blackenednodules in the ventral abdomen. During a search for metastatic lesions with abdominal ultrasound, the right adrenal wasidentified with significant volume increase, and presence of tumor-associate circular formation that appeared to invade thecaudal vena cava, suggestive of neoplastic invasion or thrombus. Abdominal computed tomography showed caudal venacava in its hepatic portion presenting considerable increase in diameter, with caudal dilation and presence of hypoattenuatingmaterial in its lumen. Right adrenal gland with rounded appearance and regular borders, heterogeneous parenchyma andjuxtaposed caudal vena cava suggesting invasion of this, confirming the sonographic findings. During exploratory celiotomy,adherence of the adrenal mass to the right renal vessels and invasion of the caudal vena cava were observed, leading to theneed of nephrectomy and venotomy for thrombectomy. To perform the venotomy, a Rumel tourniquet was placed looselyaround the vena cava only caudal to the invasion point of the tumor thrombus, cranially, tourniquet application was notpossible due to the presence of a large thrombus extending into the intrahepatic cava...(AU)

Effects of grape seed proanthocyanidin B2 pretreatment on oxidative stress and renal tubular epithelial cell apoptosis after renal ischemia reperfusion in mice

Purpose To investigate the effects of grape seed proanthocyanidin B2 (GSPB2) preconditioning on oxidative stress and apoptosis of renal tubular epithelial cells in mice after renal ischemia-reperfusion (RIR). Methods Forty male ICR mice were randomly divided into 4 groups: Group A: mice were treated with right nephrectomy. Group B: right kidney was resected and the left renal vessel was clamped for 45 minutes. Group C: mice were intraperitoneally injected with GSPB2 before RIR established. Group D: mice were intraperitoneally injected with GSPB2 plus brusatol before RIR established. Creatinine and urea nitrogen of mice were determined. Pathological and morphological changes of kidney were checked. Expressions of Nrf-2, HO-1, cleaved-caspase3 were detected by Western-blot. Results Compared to Group B, morphology and pathological damages of renal tissue were less serious in Group C. Western-blot showed that expressions of Nrf-2 and HO-1 in Group C were obviously higher than those in Group B. The expression of cleaved-caspase3 in Group C was significantly lower than that in Group B. Conclusion GSPB2 preconditioning could attenuate renal oxidative stress injury and renal tubular epithelial cell apoptosis by up-regulating expressions of Nrf-2 and HO-1 and down-regulating the expression of cleaved-caspase-3, but the protective effect could be reversed by brusatol.(AU)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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