Characterization of uterine involution using B-mode ultrasonography, color Doppler and elastography (acoustic radiation force impulse) for assessing postpartum in Santa Inês ewes.

The aim of this study was to investigate uterine involution using ultrasonography techniques during postpartum. Postpartum ultrasonography evaluation (B-mode, color Doppler and Acoustic Radiation Force Impulse elastography) of the uterus was performed by transabdominal approach at immediate after birth and sequentially every 48 hours, during 30 days. The uterine echotexture did not present significant variations (P >0.05) being homogeneous in most evaluations; echogenicity of the uterus increased along the evaluation period (P =0.0452). Progressive and remarkable decrease of the total uterine diameter (UD) were observed (P <0.0001), especially during the first days postpartum. The thickness of uterine wall gradually decreased, as well the endometrial, myometrium and lumen diameters (P <0.0001). Uterine blood flow was assessed by Doppler and decreased during postpartum period, being significantly lower (P=0.0225) on the 30th day of postpartum. Uterine parenchyma presented as homogeneous dark areas (not deformable) on qualitative ultrasound elastography and the means shear velocity values of the uterine wall on quantitative elastography did not differ. This is the first study that evaluate the stiffness of uterine wall in healthy ewes, providing baseline data about quantitative and qualitative stiffness of the normal uterus, and it may be a useful tool for early diagnosis of uterine alterations during the postpartum period, using the reference parameter established for the assessment of uterine integrity during postpartum period.

Clinical and ultrasound variables for early diagnosis of septic acute kidney injury in bitches with pyometra.

The aetiology of septic acute kidney injury (AKI) is not completely elucidated. Early identification of AKI in septic patients is considered to improve survival rate since it allows rapid treatment onset. We evaluated clinical, haematological, urinary, B-mode, spectral Doppler, and contrast-enhanced ultrasound variables in 20 bitches with pyometra as sepsis models and 12 healthy controls. All animals with pyometra presented some degree of renal damage on histological examination; however, sequential organ failure assessment (SOFA) classified only 40% cases with sepsis. AKI derived from systemic infection was identified in 57% of cases with hypoperfusion and in 22% with inflammation, being an affection of multifactorial origin. Among the evaluated parameters, urinary protein/creatinine ratio >0.15, serum albumin <2.94 mg/dL, time-averaged minimum velocity <21.5 cm/s, renal length/aorta diameter ratio >5.93, pulsatility index >1.53, haematocrit <45%, time-averaged maximum velocity <45.7 cm/s, haemoglobin <16 g/dL, leukocytes >12.53 × 103/uL, and cortical contrast peak intensity <69%, in the order of accuracy, are significant indicators of septic AKI with an accuracy >80%. Thus, AKI is a very prevalent condition in septic patients, derived mainly from changes in renal perfusion and inflammation. Additionally, reviewing the SOFA score parameters is suggested to identify renal failure.

Quantitative ultrasound elastography and biometry of the bitch uterus in the early puerperium after vaginal delivery and caesarean section.

Elastography is an actual imaging method used to qualitatively and quantitatively evaluate the elastic properties of tissues. The aim of this study was to evaluate and compare uterine tissue biometry and stiffness during post-partum period in brachycephalic bitches (n = 12) after c-section (GCS; n = 8) or normal delivery (GNB; n = 4). These animals were evaluated daily by abdominal ultrasound from the day of delivery until the 10th day post-partum; measuring uterine diameter, myometrial and endometrial thickness (mm) and shear wave velocity (SWV; m/s), by B-mode and ARFI (acoustic radiation force impulse) elastography, respectively. Uterine diameter was higher (p = .012) in animals submitted to c-section (15.26 ± 4.73 mm) than in normal birth (12.53 ± 2.64 mm) during the first 7 days post-partum. Uterine thickness gradually involuted in both groups (p < .0001), the myometrium during the first 9 days (p = .005) and the endometrium during the first 6 days (p = .003). The myometrial and endometrial SWVs were similar between types of delivery (p = .7846 and .8273) and presented a gradual increase (p = .411; .0043, respectively), during the first 10 days post-partum. It was concluded that bitches with normal delivery had smaller uterine thickness and faster puerperal involution than submitted to c-section, while uterine tissue stiffness was similar between delivery types and increased gradually during post-partum.

Ultrasonography methods for predicting malignancy in canine mammary tumors.

The aim of this study was to evaluate and compare the efficacy of B-mode, Doppler, contrast-enhanced ultrasonography (CEUS), and Acoustic Radiation Force Impulse (ARFI) elastography in predicting malignancy in canine mammary masses. This was a prospective cohort study from 2014 to 2016, which included 153 bitches with one or more mammary masses. A total of 300 masses were evaluated by ultrasonography (B-mode, Doppler, CEUS, and ARFI) and subsequently classified as benign or malignant by histopathology. Each ultrasound parameters studied were compared between benign and malignant masses by Chi-square or Student tests and differences were considered significant when P < 0.01. For the variables that proved significant differences were estimated the cut-off point, sensitivity, specificity, accuracy, and area under curve (AUC) by receiver-operating characteristic curve (ROC) analysis in a logistic regression model using histopathological classification as reference, to assess and compare diagnostic performance of each technique. Out of 300 mammary masses evaluated 246 were classified as malignant and 54 as benign. B-mode measurements showed sensitivity 67.9%, and specificity 67.6% as malignancy predictors on canine mammary masses; Doppler indexes systolic (>21.2 m/s) and diastolic velocity (>4.8 m/s) sensitivity 79.2% and specificity 70.8%; CEUS wash-out time (<80.5 s) sensitivity 80.2% and specificity 16.7%; and ARFI elastography shear velocity (SWV > 2.57 m/s) sensitivity 94.7% and specificity 97.2% In conclusion B-mode and Doppler ultrasound evaluations may assist in malignancy prediction of canine mammary masses with moderate sensitivity and specificity, already the SWV was an great accurate predictor. Therefore, ARFI elastography exam inclusion in veterinary clinic oncology and research is highly recommended, since it allows fast, non-invasive, and complication-free malignancy prediction of canine mammary masses.

Hemodynamic gestational adaptation in bitches / Adaptação hemodinâmica gestacional em cadelas

ABSTRACT: Throughout pregnancy, maternal hemodynamic adaptation is needed to ensure proper uterine perfusion and fetal development. When the uteroplacental vascular system is formed, starting with reduced resistance to uterine arterial flow, this results in decreased total vascular resistance, an activation of neuroendocrine vasoactive peptides, an increase in circulating blood and changes in the cardiovascular system morphophysiology to respond to the increasing demands of uterine perfusion. There has been considerable study of hemodynamic adaptation in pregnant women and this assessment has become a diagnostic tool for fatal obstetric disorders. However, in bitches the available information in this regard is limited; therefore a parallel was drawn between other species of animals and women, in order to subsidize the paucity of information about this process and facilitate the understanding of maternal-fetal hemodynamic adaptation in pregnant bitches. This review and literature analysis aimed/ to discuss morphophysiological cardiovascular adaptations during pregnancy and the possible disorders that can affect this process in pregnant female dogs.

RESUMO: Durante a gestação, a adaptação hemodinâmica materna é necessária para garantir adequada perfusão uterina e desenvolvimento fetal. A formação de um leito vascular uteroplacentário a partir da redução na resistência ao fluxo da artéria uterina reflete na diminuição da resistência vascular total, ativação de fatores neuroendócrinos vasoativos, aumento do volume de sangue circulante e modificações na morfofisiologia do sistema cardiovascular para responder as demandas crescentes de perfusão uterina. Em mulheres gestantes o estudo da adaptação hemodinâmica encontra-se bastante desenvolvido e esta avaliação tem se convertido em uma ferramenta diagnóstica de desordens obstétricas que podem comprometer a relação do binômio materno-fetal. Não obstante, em cadelas a informação disponível a este respeito é limitada e por isso traçou-se um paralelo entre outras espécies de animais e mulheres, de maneira que subsidiassem a carência de informações a este respeito e facilitassem o processo de compreensão da adaptação hemodinâmica materno-fetal em cadelas gestantes. Esta revisão e análise da literatura visa abordar a adaptação morfofisiológica cardiovascular frente à gestação e as possíveis desordens que possam acometer este processo em cães.

Hiperplasia fibroepitelial felina: relato de casos

A hiperplasia mamária felina é considerada uma alteração no desenvolvimento do tecido mamário, sendo caracterizada, pelo rápido crescimento da glândula mamária. Acomete aos felinos, fêmeas e machos, que tenham sido expostos a um estímulo hormonal endógeno ou exógeno. A importância do diagnóstico dessa patologia, está em obter um diferencial para neoplasias mamárias. Seu tratamento pode ser clínico, retirando-se a causa ou utilizando-se um antagonista da progesterona como o Aglepristone, associados a medicamentos de suporte. Ou ainda cirúrgico com a ovariohisterectomia e, em casos mais graves, a mastectomia.

Feline mammary hyperplasia is considered a change in the development of mammary tissue and is characterized by rapid growth of the mammary gland. Affects female and male cats, that have been exposed to an endogenous or exogenous hormonal stimulation. The importance of diagnosing this condition, is to obtain a diferencial for mammary neoplasms. The treatment can be clinical, removing the cause, or using a progesterone antagonist as Aglepristone, associated to drugs support.Or with surgical ovariohysterectomy, and in more severe cases, a mastectomy.