Anestesia intravenosa parcial (AIVP) em uma lobo-guará (Chrysocyon brachyurus) neonata / Partial intravenous anesthesia (PIVA) in a neonate maned wolf (Chrysocyon brachyurus)

Background: The maned wolf (Chrysocyon brachyurus) is the largest canid in South America and the only representative of its genus. The scientific literature presents studies referring to the management and anaesthesia of the species but is scarce in case of emergency procedures, and to date, there are no reports of anaesthesia for emergency procedures in a neonatal maned wolf. Thus, this study aimed to report xenotransfusion and emergency anaesthesia for thoracic limb amputation in an approximately 8-days-old maned wolf pup. Case: A maned wolf pup, approximately 8-day-old, with a history of an accident with an agricultural machine, was referred to the Veterinary Hospital of the Federal University of Paraná - Palotina Sector (HVP - UFPR) with a grade III open fracture of left radius and ulna. At the physical evaluation, bullous rales were observed in the right caudal lobe on pulmonary auscultation, hypoglycemia and severe dehydration, the latter being determined by the occurrence of enophthalmos, increased capillary refill time and skin turgor (3 s). The hemogram revealed regenerative hypochromic macrocytic anaemia, thrombocytopenia and leukopenia, and the chest radiograph showed alveolar pattern opacification, associated with the presence of air bronchograms in the caudal lobes, more evident on the right side, suggestive of pulmonary contusion. Considering the laboratory alterations and the need for amputation of the thoracic limb, xenotransfusion was chosen before the anaesthetic procedure. The animal was pre-medicated with methadone 0.2 mg/kg and anaesthetic induction was performed with propofol titrated to effect, requiring 10 mg/kg. This was followed by endotracheal intubation and anaesthetic maintenance using the partial intravenous technique with an infusion of 5 µg/kg/h of remifentanil and Isoflurane vaporised through a non-rebreathing system in oxygen at 0.6. Anaesthetic monitoring included heart rate and electrocardiogram tracing, respiratory rate, oxyhemoglobin saturation, end-tidal partial pressure of carbon dioxide, systemic blood pressure by the oscillometric method, and oesophageal body temperature. Although the blood tests after the transfusion showed an increase in hematocrit, changes suggestive of a delayed hemolytic reaction because of the transfusion were also noticed. Discussion: Preanesthetic stabilisation is critical, as anaesthesia of unstable patients may result in a higher risk of anaesthetic complications. Critically ill patients may present systemic imbalances that can trigger pharmacokinetic and pharmacodynamic changes of anaesthetics and analgesics. Neonates have several marked physiological differences, since some organs are still immature, have a high body volume of water, and present a reduced amount of total fat and concentrations of circulating proteins, making it necessary to adjust protocols and doses used for these patients. Blood transfusion between the same species is always the best option, though xenotransfusion becomes an option when there is no homologous donor available. However, it can present a great risk to life, as there is a lack of studies regarding the blood typing of the species and blood compatibility tests. We concluded that there was an increase in hematocrit after 24 h of xenotransfusion and, even with signs of delayed hemolytic reaction observed in the blood test, the patient did not show specific clinical signs of transfusion reaction. The pup was sensitive to methadone but required a high dose of propofol for anaesthetic induction. The use of methadone as a pre-anaesthetic agent and the infusion of remifentanil provided adequate analgesia based on the parameters evaluated.

Estabilização de ombro em um gato ­ Relato de caso / Shoulder estabilization in a cat ­ Case report

A estabilidade da articulação do ombro é garantida por ligamentos, cápsula articular, tendões e músculos, contudo traumas podem causar falência dos mecanismos estabilizadores, com consequente luxação ou instabilidade articular. Objetivou-se relatar o caso de instabilidade medial e lateral de ombro direito em felino sem raça definida, atendido com queixa de claudicação aguda de membro torácico secundária a trauma por confronto com outro animal. Inicialmente foi realizado tratamento clínico por meio de imobilização articular. Contudo, devido ao insucesso da técnica, procedeu-se para o tratamento cirúrgico de estabilização articular com prótese ligamentar sintética. No pós-operatório imediato, evidenciou-se ausência de crepitações e instabilidade articular. Após oito dias da cirurgia, o paciente apresentou retorno total às funções de apoio do membro e sem sinais de dor ou redução de movimentos. Concluiu-se que, embora de reduzida ocorrência, a instabilidade de origem traumática do ombro configura-se como um diferencial para claudicação aguda de membro torácico e que o tratamento cirúrgico pode ser necessário, mostrando-se eficiente na resolução de tais casos com o acesso e técnica de estabilização propostos.

The stability of the shoulder joint is granted by ligaments, joint capsule, tendons and muscles. However, traumatic injuries can cause failure of the stabilization mechanisms, which leads to articular luxation or instability. The aim of the paper is to report a case of medial and lateral right shoulder joint instability in a mixed-breed cat, presenting acute forelimb lameness after a fight trauma with another cat. Initially, it was recommended a conservative treatment through articular immobilization. However, the technique was unsuccessful, and the surgery treatment was performed, to stabilize the joint with synthetic ligament prosthetic. In the postoperative period, no crepitation or instability were identified. After eight days of surgery, the patient returned totally to the normal function of the forelimb, without movement restriction or pain. It was concluded that, although rare, the traumatic shoulder joint instability is a differential diagnosis for acute forelimb lameness and the surgical treatment can be necessary, showing a good result in the resolution of these injuries with the surgical approach and stabilization method proposed.

Estabilização zigomática e retalho de avanço facial lateral em canino filhote / Zygomatic stabilization and lateral facial advancement flap in a puppy dog

O trauma é frequentemente relatado na rotina clínica de pequenos animais, podendo gerar fraturas de componentes ósseos e lesões de tecidos moles adjacentes. No presente trabalho, objetivou-se relatar o caso de um canino, macho, sem raça definida, de sete meses de idade, vítima de trauma craniomaxilofacial decorrente de mordedura, diagnosticado com fratura e deslocamento de osso zigomático, além de importante laceração de pele. O tratamento estabelecido baseou-se no debridamento da ferida, estabilização cirúrgica de arco zigomático com fios de Nylon e na sutura dos ferimentos de pele causados. Em um segundo tempo cirúrgico, foi realizada enucleação e recobrimento do defeito na órbita com malha cirúrgica de polipropileno, além de remoção de tecido exuberante e confecção de retalho subdérmico de avanço facial lateral para recobrimento do defeito cutâneo. A complicação evidenciada na primeira intervenção cirúrgica foi a deiscência das suturas de pele, enquanto no segundo tempo cirúrgico, não houve sinais de complicações. No pós-operatório, o paciente apresentou evolução clínica satisfatória, recebendo alta médica 21 dias após o segundo procedimento cirúrgico realizado. Tendo em vista a adequada evolução clínica, bem como os reduzidos efeitos colaterais, sugere-se que a conduta clínica e técnicas cirúrgicas adotadas para tratamento do paciente em questão foram efetivas.

Trauma is frequently reported in the small animal clinics, and can lead to fractures of cranial bone components and injuries to the adjacent soft tissues. In the present study, the objective was to report the case of a seven-month-old male mongrel dog, that had a craniomaxillofacial trauma resulting from a bite, characterized by zygomatic bone fracture and displacement, in addition to a major skin laceration. The stablished treatment was based on wound debridement, surgical stabilization of the zygomatic arch with nylon threads and in the suturing of skin wounds. In a second surgical procedure, enucleation was performed and a surgical polypropylene mesh was applied to cover the orbital defect, exuberant tissue was removed and a subdermal advancement flap was used to cover the skin defect. The complication observed in the first surgical intervention was dehiscence of the skin sutures, while in the second surgical procedure, there were no signs of complications. Postoperatively, the patient had a satisfactory clinical recovery, being discharged 21 days after the second surgical procedure. Considering the adequate clinical evolution and the reduced complications, it issuggestedthat the clinical conduct and surgical techniques adopted for the treatment of the patient in question were effective.