Tratamento cirúrgico bem sucedido de quilotórax idiopático em gato / Successful surgical treatment of idiopathic chylothorax in a cat

Background: Chylothorax in cats represents a challenge due to the possibility of involvement of multiple etiologies and the harmful consequences resulting of the presence of the chylous effusion in the thorax. The causes include neoplasms in the thoracic cavity, heart disease and thoracic injuries. It is imperative that clinical nutritional and therapeutic and / or surgical management be immediate and directed to the treatment of the cause. The objective of this work was to report a case of idiopathic chylothorax in a domestic cat solved through surgical intervention and dietary maintenance applied.Case: A 4-year-old male cat, fed with diet for the age range of adult cats, was attended at the Veterinary Hospital of the Federal Rural University of Rio de Janeiro (HV - UFRRJ), with clinical complaint of difficulty breathing, inappetence, prostration and weight loss. In the clinical examination was verified intense tachypnea, presence of heart murmur, normocorated mucosae, dehydration 7%. The animal was sedated to be submitted to radiographic examination of the thorax with pethidine and midazolam. Thoracic radiographs on the lateral, ventral-dorsal and orthostatic positions were realized and severe pleural effusion was observed in both hemitorax with drainage of 180 mL of lactescent fluid from the right hemithorax and 120 mL of left hemithorax liquid. Through analysis of cavity liquids the effusion was classified as chylous effusion. The hemogram showed a neutrophilic leukocytosis. Serum cholesterol and triglyceride concentrations (28 mg/ dL and 43 mg/dL, respectively) were lower than the concentrations of the cavity liquid (67 mg/dL and 722 mg/dL, respectively). Ultrasound examination revealed no mass in the thoracic cavity and no changes in the pulmonary parenchyma. The echocardiographic examination was also performed and did not reveal any cardiac alterations.[...]

Tratamento cirúrgico bem sucedido de quilotórax idiopático em gato / Successful surgical treatment of idiopathic chylothorax in a cat

Background: Chylothorax in cats represents a challenge due to the possibility of involvement of multiple etiologies and the harmful consequences resulting of the presence of the chylous effusion in the thorax. The causes include neoplasms in the thoracic cavity, heart disease and thoracic injuries. It is imperative that clinical nutritional and therapeutic and / or surgical management be immediate and directed to the treatment of the cause. The objective of this work was to report a case of idiopathic chylothorax in a domestic cat solved through surgical intervention and dietary maintenance applied.Case: A 4-year-old male cat, fed with diet for the age range of adult cats, was attended at the Veterinary Hospital of the Federal Rural University of Rio de Janeiro (HV - UFRRJ), with clinical complaint of difficulty breathing, inappetence, prostration and weight loss. In the clinical examination was verified intense tachypnea, presence of heart murmur, normocorated mucosae, dehydration 7%. The animal was sedated to be submitted to radiographic examination of the thorax with pethidine and midazolam. Thoracic radiographs on the lateral, ventral-dorsal and orthostatic positions were realized and severe pleural effusion was observed in both hemitorax with drainage of 180 mL of lactescent fluid from the right hemithorax and 120 mL of left hemithorax liquid. Through analysis of cavity liquids the effusion was classified as chylous effusion. The hemogram showed a neutrophilic leukocytosis. Serum cholesterol and triglyceride concentrations (28 mg/ dL and 43 mg/dL, respectively) were lower than the concentrations of the cavity liquid (67 mg/dL and 722 mg/dL, respectively). Ultrasound examination revealed no mass in the thoracic cavity and no changes in the pulmonary parenchyma. The echocardiographic examination was also performed and did not reveal any cardiac alterations.[...](AU)

Uso de anfotericina B por via intralesional associada ao itraconazol oral para tratamento de recidiva de esporotricose nasal em um gato - relato de caso / Intralesional use of amphotericin B associated with oral itraconazole for the treatment of recurrent nasal sporotrichosis in a cat - case report / Anfotericina B intralesional e itraconazole oral en el tratamiento de un cuadro recidivante de esporotricosis nasal en un gato - relato de caso

A esporotricose nasal é uma afecção de difícil resolução clínica, muitas vezes refratária ao tratamento e possivelmente recidivante em gatos. Neste caso, a anfotericina B foi utilizada por via intralesional em associação ao itraconazol (100 mg/gato/via oral a cada 24 horas) em felino com recidiva de esporotricose nasal. Durante o tratamento foram realizados exames laboratoriais para garantir a segurança do protocolo utilizado. O novo biomarcador para função renal SDMA IDEXXTM foi empregado antes e após o término do protocolo para monitorar a função renal. Os efeitos adversos encontrados foram edema e desconforto no local de aplicação. O tempo total de tratamento foi de três meses e não se observou efeito tóxico renal. Dessa maneira o protocolo utilizado mostrou-se eficaz e seguro no tratamento da esporotricose nasal.

Nasal sporotrichosis is a condition of difficult clinical resolution, which is commonly refractory to treatment and recurrent in cats. In this report, amphotericin B was used intralesionaliy in combination with oral itraconazole (100 mg/per catloral each 24 h) in order to treat a cat with relapse of nasal sporotrichosis. During the treatment, laboratory tests were performed to ensure the safety of the protocol used. The new biomarker for renal function SDMA IDEXX was used before and after the end of the protocol to monitor renal function. Adverse effects were edema and local discomfort. Total treatment duration was 3 months, and no renal toxic effect was observed. This protocol therefore proved to be effective and safe to treat nasal sporotrichosis.

La esporotricosis nasal es una afección de difícil manejo clínico que en muchas ocasiones resulta refractaria a los tratamientos y con importantes tasas de recidiva en gatos. En el presente caso, la anfotericina B se utilizó por vía intralesional en asociación con itraconazole (100 mg/gato/PO/24hs) en un gato con recidiva de esporotricosis nasal. Durante el tratamiento se realizaron exámenes de laboratorio a fin de garantizar la seguridad del protocolo utilizado. Se utilizó un nuevo biomarcador para función renal (SDMA IDEXXTM) antes y después del protocolo terapéutico. Los efectos adversos encontrados fueron edema y molestias en el lugar de aplicación. EI tiempo total de tratamiento fue de tres meses, sin que se hayan observado efectos tóxicos a nivel renal. Así, el protocolo usado se mostró eficiente y seguro para el tratamiento de la esporotricosis nasal.

Uso de anfotericina B por via intralesional associada ao itraconazol oral para tratamento de recidiva de esporotricose nasal em um gato - relato de caso / Intralesional use of amphotericin B associated with oral itraconazole for the treatment of recurrent nasal sporotrichosis in a cat - case report / Anfotericina B intralesional e itraconazole oral en el tratamiento de un cuadro recidivante de esporotricosis nasal en un gato - relato de caso

A esporotricose nasal é uma afecção de difícil resolução clínica, muitas vezes refratária ao tratamento e possivelmente recidivante em gatos. Neste caso, a anfotericina B foi utilizada por via intralesional em associação ao itraconazol (100 mg/gato/via oral a cada 24 horas) em felino com recidiva de esporotricose nasal. Durante o tratamento foram realizados exames laboratoriais para garantir a segurança do protocolo utilizado. O novo biomarcador para função renal SDMA IDEXXTM foi empregado antes e após o término do protocolo para monitorar a função renal. Os efeitos adversos encontrados foram edema e desconforto no local de aplicação. O tempo total de tratamento foi de três meses e não se observou efeito tóxico renal. Dessa maneira o protocolo utilizado mostrou-se eficaz e seguro no tratamento da esporotricose nasal.(AU)

Nasal sporotrichosis is a condition of difficult clinical resolution, which is commonly refractory to treatment and recurrent in cats. In this report, amphotericin B was used intralesionaliy in combination with oral itraconazole (100 mg/per catloral each 24 h) in order to treat a cat with relapse of nasal sporotrichosis. During the treatment, laboratory tests were performed to ensure the safety of the protocol used. The new biomarker for renal function SDMA IDEXX was used before and after the end of the protocol to monitor renal function. Adverse effects were edema and local discomfort. Total treatment duration was 3 months, and no renal toxic effect was observed. This protocol therefore proved to be effective and safe to treat nasal sporotrichosis.(AU)

La esporotricosis nasal es una afección de difícil manejo clínico que en muchas ocasiones resulta refractaria a los tratamientos y con importantes tasas de recidiva en gatos. En el presente caso, la anfotericina B se utilizó por vía intralesional en asociación con itraconazole (100 mg/gato/PO/24hs) en un gato con recidiva de esporotricosis nasal. Durante el tratamiento se realizaron exámenes de laboratorio a fin de garantizar la seguridad del protocolo utilizado. Se utilizó un nuevo biomarcador para función renal (SDMA IDEXXTM) antes y después del protocolo terapéutico. Los efectos adversos encontrados fueron edema y molestias en el lugar de aplicación. EI tiempo total de tratamiento fue de tres meses, sin que se hayan observado efectos tóxicos a nivel renal. Así, el protocolo usado se mostró eficiente y seguro para el tratamiento de la esporotricosis nasal.(AU)