Surgical correction of esophageal stenosis by right aortic arch persistence in two cats

Background: Vascular ring anomaly is considered a hereditary change. It occurs when the fourth right aortic arch persists instead of the fourth left aortic arch, forming a vascular ring that compress the esophagus causing esophageal dilatation cranial to the compression site. Diagnosis is based upon anamnesis, physical examination, clinical signs and complementary exams (radiograph, complete blood count and biochemical tests). The clinical treatment is inadequate, since the dilatation persists and tends to progress causing irreversible tissue injury. Surgical correction is indicated and consists of the arterial ligament resection and correction of the esophageal stenosis. Case: The objective of the current study is to report two case of persistence of right aortic arch in two cats referred to the Veterinary Hospital of the Federal University of Santa Maria. On physical examination the patients were alert, in good nutritional status, adequately hydrated and presented normal colored mucous membranes. Each animal underwent radiography and esophagogram with barium sulphate. The exam demonstrated partial esophageal dilation cranial to the cardiac silhouette, suggestive of vascular ring anomaly. An exploratory thoracotomy was performed in order to achieve the definitive diagnosis. The arterial ligament was resected and esophageal stenosis corrected. Anesthesia, surgery and the [...]

Surgical correction of esophageal stenosis by right aortic arch persistence in two cats

Background: Vascular ring anomaly is considered a hereditary change. It occurs when the fourth right aortic arch persists instead of the fourth left aortic arch, forming a vascular ring that compress the esophagus causing esophageal dilatation cranial to the compression site. Diagnosis is based upon anamnesis, physical examination, clinical signs and complementary exams (radiograph, complete blood count and biochemical tests). The clinical treatment is inadequate, since the dilatation persists and tends to progress causing irreversible tissue injury. Surgical correction is indicated and consists of the arterial ligament resection and correction of the esophageal stenosis. Case: The objective of the current study is to report two case of persistence of right aortic arch in two cats referred to the Veterinary Hospital of the Federal University of Santa Maria. On physical examination the patients were alert, in good nutritional status, adequately hydrated and presented normal colored mucous membranes. Each animal underwent radiography and esophagogram with barium sulphate. The exam demonstrated partial esophageal dilation cranial to the cardiac silhouette, suggestive of vascular ring anomaly. An exploratory thoracotomy was performed in order to achieve the definitive diagnosis. The arterial ligament was resected and esophageal stenosis corrected. Anesthesia, surgery and the [...](AU)

Laparoscopic-assisted prepubic urethrostomy in a cat with urethral stenosis / Uretrostomia pré-púbica videoassistida em um felino com estenose uretral

Urethrostomy is a surgical technique used in cases of partial or total obstruction of the urethra, and the laparoscopic approach may be a treatment option. Due to the scarcity of studies involving the technique, this paper reports the case of laparoscopic-assisted pre-pubic urethrostomy (hybrid laparoscopic) in a cat with urethral stricture. A five-years-old cat presenting recurrent feline lower urinary tract disease (FLUTD) had undergone to perineal urethrostomy two years and nine months ago. After this procedure, the patient underwent another four corrective surgeries without success. Laboratory tests (blood count and biochemical) and image diagnosis were realized. The patient was subjected to laparoscopic-assisted pre-pubic urethrostomy and it was achieved therapeutic success and adequate patient quality of life. It is concluded that this technique is feasible and safe in cats, making it a possible choice of surgical treatment for urethral stricture.(AU)

A uretrostomia é técnica cirúrgica utilizada em casos de obstrução parcial ou total da uretra, e na abordagem laparoscópica pode ser uma opção de tratamento. Devido à escassez de estudos envolvendo essa técnica, este trabalho relata o caso de uretrostomia pré-púbica videoassistida (laparoscópica híbrida) em um felino com estenose uretral. O paciente de cinco anos de idade apresentando histórico de doença do trato urinário inferior dos felinos (DTUIF) recorrente, havia sido submetido a uretrostomia perineal há dois anos e nove meses. Depois desse procedimento, o paciente passou por mais quatro cirurgias corretivas sem sucesso. Após realização de exames laboratoriais (hemograma e bioquímicos) e de imagem, o animal foi submetido a uretrostomia pré-púbica laparoscópica híbrida, obtendo-se sucesso terapêutico e possibilitando ao paciente adequada qualidade de vida. Conclui-se que esta técnica é viável e segura em gatos, tornando-a uma possível escolha de tratamento cirúrgico para estenose uretral.(AU)

Triggers for blood transfusion / Gatilhos para transfusão sanguínea

Anemia is an important condition that is found in the internal medicine, either in humans and animals, especially in critically ill patients. The clinical signs of anemia are usually related to a poor tissue oxygenation or the compensatory mechanisms associated with it. Blood transfusion aims to prevent hypoxic damage in critically ill patients. However, once the blood transfusion is associated to some risks, it should just be done if really necessary. Several factors influence blood transfusion decision. The aim of this study was to review the major studies about transfusion triggers. Among laboratory tests, the hemoglobin (Hb) is the main trigger but it depends on patient age and concomitant disease. In addition, electrocardiogram (ECG) and serum lactate with Hb can help to decide when to transfuse.

A anemia é uma importante afecção encontrada na medicina e na clínica de animais de companhia, principalmente nos pacientes críticos. As alterações clínicas da anemia geralmente estão relacionadas à menor oxigenação dos tecidos ou aos mecanismos compensatórios a ela associados. A transfusão sanguínea tem o objetivo de impedir os danos de hipóxia causados pela anemia em pacientes criticamente enfermos. Porém, uma vez que a transfusão está sujeita a diversos riscos, ela só deve ser realizada quando realmente necessária. Diversos fatores influenciam a decisão para realização da transfusão sanguínea. O objetivo deste trabalho foi fornecer uma revisão dos principais estudos realizados sobre possíveis gatilhos transfusionais. Entre os exames laboratoriais, o valor de hemoglobina (Hb) é o principal gatilho, variando de acordo com idade do paciente e doenças concomitantes. Além disso, o eletrocardiograma e a dosagem sérica de lactato, associados à Hb, podem ajudar na decisão de quando transfundir.

Laparoscopic-assisted prepubic urethrostomy in a cat with urethral stenosis / Uretrostomia pré-púbica videoassistida em um felino com estenose uretral

Urethrostomy is a surgical technique used in cases of partial or total obstruction of the urethra, and the laparoscopic approach may be a treatment option. Due to the scarcity of studies involving the technique, this paper reports the case of laparoscopic-assisted pre-pubic urethrostomy (hybrid laparoscopic) in a cat with urethral stricture. A five-years-old cat presenting recurrent feline lower urinary tract disease (FLUTD) had undergone to perineal urethrostomy two years and nine months ago. After this procedure, the patient underwent another four corrective surgeries without success. Laboratory tests (blood count and biochemical) and image diagnosis were realized. The patient was subjected to laparoscopic-assisted pre-pubic urethrostomy and it was achieved therapeutic success and adequate patient quality of life. It is concluded that this technique is feasible and safe in cats, making it a possible choice of surgical treatment for urethral stricture.

A uretrostomia é técnica cirúrgica utilizada em casos de obstrução parcial ou total da uretra, e na abordagem laparoscópica pode ser uma opção de tratamento. Devido à escassez de estudos envolvendo essa técnica, este trabalho relata o caso de uretrostomia pré-púbica videoassistida (laparoscópica híbrida) em um felino com estenose uretral. O paciente de cinco anos de idade apresentando histórico de doença do trato urinário inferior dos felinos (DTUIF) recorrente, havia sido submetido a uretrostomia perineal há dois anos e nove meses. Depois desse procedimento, o paciente passou por mais quatro cirurgias corretivas sem sucesso. Após realização de exames laboratoriais (hemograma e bioquímicos) e de imagem, o animal foi submetido a uretrostomia pré-púbica laparoscópica híbrida, obtendo-se sucesso terapêutico e possibilitando ao paciente adequada qualidade de vida. Conclui-se que esta técnica é viável e segura em gatos, tornando-a uma possível escolha de tratamento cirúrgico para estenose uretral.

Laparoscopic-assisted prepubic urethrostomy in a cat with urethral stenosis / Uretrostomia pré-púbica videoassistida em um felino com estenose uretral

Urethrostomy is a surgical technique used in cases of partial or total obstruction of the urethra, and the laparoscopic approach may be a treatment option. Due to the scarcity of studies involving the technique, this paper reports the case of laparoscopic-assisted pre-pubic urethrostomy (hybrid laparoscopic) in a cat with urethral stricture. A five-years-old cat presenting recurrent feline lower urinary tract disease (FLUTD) had undergone to perineal urethrostomy two years and nine months ago. After this procedure, the patient underwent another four corrective surgeries without success. Laboratory tests (blood count and biochemical) and image diagnosis were realized. The patient was subjected to laparoscopic-assisted pre-pubic urethrostomy and it was achieved therapeutic success and adequate patient quality of life. It is concluded that this technique is feasible and safe in cats, making it a possible choice of surgical treatment for urethral stricture.

A uretrostomia é técnica cirúrgica utilizada em casos de obstrução parcial ou total da uretra, e na abordagem laparoscópica pode ser uma opção de tratamento. Devido à escassez de estudos envolvendo essa técnica, este trabalho relata o caso de uretrostomia pré-púbica videoassistida (laparoscópica híbrida) em um felino com estenose uretral. O paciente de cinco anos de idade apresentando histórico de doença do trato urinário inferior dos felinos (DTUIF) recorrente, havia sido submetido a uretrostomia perineal há dois anos e nove meses. Depois desse procedimento, o paciente passou por mais quatro cirurgias corretivas sem sucesso. Após realização de exames laboratoriais (hemograma e bioquímicos) e de imagem, o animal foi submetido a uretrostomia pré-púbica laparoscópica híbrida, obtendo-se sucesso terapêutico e possibilitando ao paciente adequada qualidade de vida. Conclui-se que esta técnica é viável e segura em gatos, tornando-a uma possível escolha de tratamento cirúrgico para estenose uretral.

Laparoscopic-assisted prepubic urethrostomy in a cat with urethral stenosis / Uretrostomia pré-púbica videoassistida em um felino com estenose uretral

Urethrostomy is a surgical technique used in cases of partial or total obstruction of the urethra, and the laparoscopic approach may be a treatment option. Due to the scarcity of studies involving the technique, this paper reports the case of laparoscopic-assisted pre-pubic urethrostomy (hybrid laparoscopic) in a cat with urethral stricture. A five-years-old cat presenting recurrent feline lower urinary tract disease (FLUTD) had undergone to perineal urethrostomy two years and nine months ago. After this procedure, the patient underwent another four corrective surgeries without success. Laboratory tests (blood count and biochemical) and image diagnosis were realized. The patient was subjected to laparoscopic-assisted pre-pubic urethrostomy and it was achieved therapeutic success and adequate patient quality of life. It is concluded that this technique is feasible and safe in cats, making it a possible choice of surgical treatment for urethral stricture.

A uretrostomia é técnica cirúrgica utilizada em casos de obstrução parcial ou total da uretra, e na abordagem laparoscópica pode ser uma opção de tratamento. Devido à escassez de estudos envolvendo essa técnica, este trabalho relata o caso de uretrostomia pré-púbica videoassistida (laparoscópica híbrida) em um felino com estenose uretral. O paciente de cinco anos de idade apresentando histórico de doença do trato urinário inferior dos felinos (DTUIF) recorrente, havia sido submetido a uretrostomia perineal há dois anos e nove meses. Depois desse procedimento, o paciente passou por mais quatro cirurgias corretivas sem sucesso. Após realização de exames laboratoriais (hemograma e bioquímicos) e de imagem, o animal foi submetido a uretrostomia pré-púbica laparoscópica híbrida, obtendo-se sucesso terapêutico e possibilitando ao paciente adequada qualidade de vida. Conclui-se que esta técnica é viável e segura em gatos, tornando-a uma possível escolha de tratamento cirúrgico para estenose uretral.