Tumor neuroendócrino em coração de cão / Neuroendocrine tumor involving the heart of a dog

Background: Neuroendocrine tumors are epithelial tumors with predominant neuroendocrine differentiation. Ectopic thyroid carcinoma develops in the ectopic thyroid parenchyma, in the anterior mediastinum, being an important differential diagnosis of paraganglioma, although occurring less frequently than the same. The cells invade the mediastinal fat reaching the adventitia of the aorta. There is a possibility of metastatic formations in the lung, kidneys, and pancreas. A supporting treatment was provided. The present study proposes the exposition and description of a case of neuroendocrine tumor in the heart, considering the rarity of the involvement of this tumor in the canine species. Case: A 9-year-old American Bulldog male canine was treated at home in the city of Rio de Janeiro. On clinical examination, dyspnea, edema of the hind limbs and an increase in abdominal volume were observed. With the suspicion of congestive heart failure, mainly on the right, cardiac exams were requested. Because it was an aggressive animal, sedation was performed with a combination of tiletamine and zolazepam. During cardiac auscultation, the presence of S4 was noticed, characterizing a gallop rhythm. No alterations were observed on the electrocardiographic examination. The echocardiogram showed a tumor mass in the atrium and dilation of the venous return vessels. The tumor enveloped 80% of the atrium of a 9-year-old male American Bulldog. The abdominocentesis procedure was performed to drain abdominal free fluid. Furosemide, enalapril and digoxin were prescribed as a treatment. Three months after the start of treatment, the animal presented intense dyspnea that culminated in the death of the patient, who later had the body sent for necropsy and subsequent tissue collection for histopathological analysis. Based on the immunohistochemical markers chromogranin and synaptophysin, the work here presented describes a case of a neuroendocrine tumor suggestive of paraganglioma involving a dog's heart. Discussion: Brachycephalic dogs, such as Boxers, Bulldogs and Boston Terriers, are predisposed to the development of paragangliomas. The genetic predisposition is related to hyperplasia of the carotid bodies generated by chronic hypoxia, resulting from obstructive processes in the airways. As the reported dog is an American Bulldog, the possibility of the tumor in question was reinforced. Paragangliomas are more frequent in males from nine to thirteen years of age, commonly associated with other endocrine neoplasms. It is also an important marker present in paragangliomas. In contrast to the literature, the report points to a neuroendocrine tumor suggestive of paraganglioma, without eliminating the possibility of an ectopic thyroid tumor, because although TTF-1 appears in most thyroid tumors, not all of them are present, although it is very suggestive. Treatment in question, attributed to the control of right congestive heart failure, although with little effect, denotes that the obstructive process of the return pathway, even with the use of drugs that prevent congestion, did not delay the evolution of the disease. However, it is observed that the treatment resources for these tumors, whether by surgical or chemotherapy option, also have few answers. The lack of literature on ectopic thyroid tumors influences the diagnosis of paraganglioma. Thus, clinical and complementary findings, mainly along with immunohistochemistry, were essential in the diagnosis of neuroendocrine tumor. After 3 months of the start of the treatment, the animal died.

Risk of arrhythmias in dogs with structural heart disease / Potencial arrítmico de cardiopatias em cães

Presently, pet life expectancy is becoming longer and several diseases inherent to age have been diagnosed, with heart disease being a frequent finding. Although various heart diseases have different pathophysiologies, many morphological and hemodynamic changes can predispose patients to arrhythmias. The presence of arrhythmias can worsen the underlying heart disease and predispose patients to develop new alterations, making arrhythmia detection important for establishing adequate therapeutic protocols and a better prognosis. The present study aimed to determine the arrhythmias most frequently found in dogs treated at the Cardiology and Respiratory Diseases Service (SCDR) of the Small Animals Sector of the Veterinary Hospital of the Federal Rural University of Rio de Janeiro (UFRRJ), during the period from January to 2014 to December 2017, relating them to sex, age group, size, and the presence or absence of heart disease. A total of 586 medical records of dogs treated with SCDR-UFRRJ were retrospectively evaluated. Of these, 15.4% had arrhythmias, 95.6% had diagnoses of heart disease, 61.1% (55/90) were diagnosed with mitral valve disease, and 27.8% (25/90) had dilated cardiomyopathies. The most frequent rhythm disturbances were premature ventricular complexes associated with chronic degenerative mitral valve disease or dilated cardiomyopathy. Statistical analysis confirmed the risk of a cardiac patient developing rhythm or conduction alterations (OR, 4.46; p = 0.0003). In conclusion, the pathophysiology of heart failure can lead to the development of rhythm and conduction disorders.

Com a maior expectativa de vida dos animais de estimação, diversas enfermidades inerentes a idade têm sido diagnosticadas, sendo as cardiopatias um achado frequente. Apesar das diferentes cardiopatias terem fisiopatologias distintas, diversas alterações morfológicas e hemodinâmicas podem ocorrer predispondo ao aparecimento de arritmias. A presença de arritmias pode agravar a doença cardíaca de base e predispor ao desenvolvimento de novas alterações, tornando-se importante a sua detecção para instituição de protocolos terapêuticos adequados e melhor prognóstico da doença. O presente estudo teve como objetivo determinar as arritmias mais frequentemente encontradas em cães atendidos no Serviço de Cardiologia e Doenças Respiratórias (SCDR) do Setor de Pequenos Animais do Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro (UFRRJ), no período de janeiro de 2014 a dezembro de 2017, relacionando-as com sexo, faixa etária, porte e presença ou não de cardiopatias. De maneira retrospectiva, foram avaliados 586 prontuários de cães atendidos no SCDR-UFRRJ. Destes, 15.4% apresentavam alguma arritmia e 95,6% apresentavam diagnostico de alguma cardiopatia, sendo 61.1% (55/90) diagnosticados com endocardiose de mitral e 27.8% (25/90) com cardiomiopatia dilatada. O distúrbio de ritmo mais frequente foram os complexos ventriculares prematuros associados a doença valvar degenerativa crônica de mitral ou a cardiomiopatia dilatada. Na análise estatística, o risco de um paciente cardiopata desenvolver alterações de ritmo ou de condução foi confirmado (OR: 4,46; p=0,0003). Conclui-se que a fisiopatologia da insuficiência cardíaca pode levar ao desenvolvimento de distúrbios de ritmo e também distúrbios de condução.

Nutraceticals for dissolving nephrolites in cats

Background: Nephrolithiasis is a condition frequently observed in felines, with or without concomitant chronic kidneydisease, constituting the major cause of ureteral obstruction and causing progressive damage to the renal parenchyma. About90% of nephrolites are composed of calcium oxalate, which cannot dissolve, and its incidence has increased substantiallyin recent years, along with its recurrence. There are functional foods known as nutraceuticals provides health benefits suchas renoprotection. Due to these benefits and the high prevalence of nephrolithiasis in feline species, the present study aimedto evaluate the efficacy of the association of some nutraceuticals in the dissolution of nephrolites.Materials, Methods & Results: The included cats had an ultrasound diagnosis of nephrolithiasis that, on clinical examination, showed: (i) the absence of previous or concomitant treatment for urinary infections and/or vesical and renal lithiasis;(ii) absence of genitourinary clinical manifestations; (iii) absence of obstructive processes; and (iv) absence of concomitantureterolithiasis. We separated 51 cats with nephrolithiasis into 2 groups: control (n = 12) and study (n = 39). The controlgroup received a placebo and the study group, nutraceuticals (magnesium chelate, resveratrol, vitamin K2, docosahexaenoicacid, and eicosapentaenoic acid). Laboratory tests (blood and urine) and abdominal imaging (ultrasound) were performedat day 0 and 30 days after enrollment. Monitoring the therapeutic efficacy in both groups was performed on day 30 for theCG and on days 30, 60, and 90 for the EG. The CG cats, after this step, were referred to surgery or to the EG, with priorauthorization from their tutors. The diameter of nephrolites was significantly different before and after treatment, indicating a reduction in nephroliths over time. During the use of the nutraceutical formulation by the EG and use of placebo...

Brachycephalic syndrome in dogs - endoscopic findings in the airways

Background: Brachycephalic dogs have several abnormalities in the airways, which generate clinical manifestations that impair the quality of life of these animals. Primary alterations promote airflow obstruction and increase intraluminal negative pressure, causing secondary alterations due to a cycle of inflammation with consequent obstruction. With the onset of inflammation and other alterations in the airways, clinical manifestations can be observed, such as snoring, reverse sneezing, coughing, dyspnea, cyanosis, syncope, and vomiting. Endoscopic examination of the airways allows visualization and diagnosis of morphological changes in these animals. This study aimed to evaluate the endoscopic findings of the airways and determine the quantitative and qualitative assessment of the severity of clinical manifestations in 14 dogs with brachycephalic syndrome (BS). Materials, Methods & Results: Historical and anamnesis data and clinical, respiratory, and digestive manifestations were collected from the owners' reports. The clinical manifestations were classified as mild, moderate, or severe. All animals were subjected to endoscopy of the airways, and image findings were grouped according to the anatomical site where they were observed, then the abnormalities were correlated with the severity of the clinical manifestations. When comparing the frequency of endoscopic abnormalities with the severity of clinical manifestations, it is interesting to observe that animals with severe disease more frequently presented the following alterations: prolongation and thickening of the soft palate, laryngeal changes, presence of hyperemia, lymphoid hyperplasia and polyps in the nasopharynx, hypoplasia and presence of tracheal secretion and thickening of the dorsal tracheal muscle; bronchial collapse, hypoplasia of the main bronchi and bronchial hyperemia and the presence of aberrant nasal turbinates. Comparison between the means of nonparametric variables was performed using the Mann-Whitney test, with a 5% significance level. Discussion: A higher frequency of French Bulldog dogs included in the study was observed, probably due to their greater popularity, although any brachycephalic dog may be affected by BS. Considering that nostril stenosis is a congenital alteration, which is usually diagnosed early, and since the animals included in the study were dogs referred for the rhinoplasty procedure the higher frequency of young dogs in the study was not surprising. The results revealed a significant difference in the endoscopic findings with the severity of the clinical manifestations in different variables, such as prolongation and thickening of the soft palate, eversion of the laryngeal saccules, presence of laryngeal inflammation and collapse, presence of polyps or lymphoid hyperplasia in the nasopharynx, thickening of the dorsal muscle of the trachea, polyps in the trachea and hypoplasia in addition to bronchial hyperemia. The larynx was the most affected anatomical site, with alterations present in 92.8% of the evaluated dogs. Based on these findings, it can be concluded that airway obstruction caused by primary alterations can cause secondary alterations, with consequent clinical manifestations in brachycephalic dogs it is possible to suggest that dogs with this syndrome may present severe manifestations of the disease, regardless of age. Furthermore, it can be concluded that in this study, dogs with BS had frequent laryngeal alterations and that alterations in the main bronchi were present in all animals with severe manifestations of the disease.

Unilateral atrial ectopic rhythm in a golden retriever

Background: Atrial ectopic rhythm is a type of supraventricular arrhythmia, originating in two distinct points in the atrialregion. In the electrocardiographic (ECG) tracing, it is represented by independent depolarizations of sinus P waves andectopic P waves. The occurrence of this disorder is rare, and the diagnosis criteria are the presence of the described waveswithin the basal rhythm. In humans, there have been reports related to severe heart failure with an unfavorable prognosis.The present report aimed to describe the clinical case of a dog with unilateral atrial ectopic rhythm without any underlying cardiac disorder.Case: A 8-year-old male golden retriever was brought to a veterinary clinic for a preoperative evaluation for lipoma removalin the right forelimb. On clinical examination, the owner stated that the patient was active, with no signs of easy fatigueor cough. The canine displayed normophagy, normodipsia, normoquezia, and normouria. On physical examination, hedemonstrated a lymphatic temperament with tachypnea. The temperature and capillary filling time were within the normalrange, with a normokinetic pulse. Cardiac auscultation revealed a mild grade I/VI murmur in mitral focus and an 80-bpmheart rate. Respiratory auscultation revealed the presence of harshy lung sounds. The cough reflex was positive; the Piparotetest, negative. The blood test showed no noticeable changes in blood count and serum biochemistry. Systemic systolicblood pressure was 120 mmHg. On radiographic examination, no evidence of heart or lung abnormalities were identified.After the clinical evaluation, an ECG examination was performed; a unilateral atrial ectopic rhythm was observed withdifferent frequencies between atrial and ventricular rhythm and with P (164°) and P waves (80°). On echocardiographic...

Unilateral atrial ectopic rhythm in a golden retriever

Background: Atrial ectopic rhythm is a type of supraventricular arrhythmia, originating in two distinct points in the atrialregion. In the electrocardiographic (ECG) tracing, it is represented by independent depolarizations of sinus P waves andectopic P waves. The occurrence of this disorder is rare, and the diagnosis criteria are the presence of the described waveswithin the basal rhythm. In humans, there have been reports related to severe heart failure with an unfavorable prognosis.The present report aimed to describe the clinical case of a dog with unilateral atrial ectopic rhythm without any underlying cardiac disorder.Case: A 8-year-old male golden retriever was brought to a veterinary clinic for a preoperative evaluation for lipoma removalin the right forelimb. On clinical examination, the owner stated that the patient was active, with no signs of easy fatigueor cough. The canine displayed normophagy, normodipsia, normoquezia, and normouria. On physical examination, hedemonstrated a lymphatic temperament with tachypnea. The temperature and capillary filling time were within the normalrange, with a normokinetic pulse. Cardiac auscultation revealed a mild grade I/VI murmur in mitral focus and an 80-bpmheart rate. Respiratory auscultation revealed the presence of harshy lung sounds. The cough reflex was positive; the Piparotetest, negative. The blood test showed no noticeable changes in blood count and serum biochemistry. Systemic systolicblood pressure was 120 mmHg. On radiographic examination, no evidence of heart or lung abnormalities were identified.After the clinical evaluation, an ECG examination was performed; a unilateral atrial ectopic rhythm was observed withdifferent frequencies between atrial and ventricular rhythm and with P (164°) and P waves (80°). On echocardiographic...(AU)

Recurrent spontaneous pneumothorax in a Maltese dog with endogenous lipoid pneumonia

Background: Pneumothorax is a clinical condition which can cause respiratory distress. It can have as its origin traumatic causes or even classified as spontaneous, mainly related to diseases of the lung parenchyma. Lipoid pneumonia is rarely described in dogs, and it is characterized by globules of lipid in the alveolar spaces. Endogenous lipoid pneumonia (EnLP) occurs when lesions on pulmonary cells release cholesterol and other lipids in the alveoli. There is no clinical approach established for EnLP in veterinary patients. The aim of this report is to describe a case of a young Maltese dog, with recurrent spontaneous pneumothorax in which EnLP was diagnosed post mortem. Case: A 2-year-old sexually intact male Maltese dog was evaluated for restrictive dyspnea. Clinicopathologic findings included cyanotic, muffled chest auscultation with hypersonic thoracic percussion. Chest x-ray demonstrated an increase in pleuropulmonary radio transparency and a floating-looking heart, indicating pneumothorax. Complete blood counts and biochemical panel results were normal. Dirofilaria immitis antigen test results were negative. Computed tomography demonstrated slightly hyper-expanded pulmonary fields, with slightly enlarged reticular marking with areas of mild multicentric panlobular emphysema and a fracture on the sixth left rib. The treatment was focused on improving the breathing pattern through sedation, supplementation with oxygen, and thoracentesis. Owing to the reserved prognosis of the case, the unknown etiology of the recurrent pneumothorax, and the clinical worsening of the patient, the owner opted for euthanasia. Necropsy displayed multiple, circular whitish areas in the lungs, distributed over the surface of all lobes. Histopathological examination revealed pulmonary tissue with the subpleural micronodular foci, multifocal to coalescent, with a moderate accumulation of foamy intra-alveolar macrophages, occasionally multinucleate, associated with cholesterol crystals compatible with endogenous lipid pneumonia. Discussion: The patient presented with clinical signs and physical examination characteristics of pneumothorax at the first visit. After the pneumothorax diagnosis, and clinical stabilization of the patient. No predisposing factor for the formation of the pneumothorax was identified as the radiography revealed only bronchitis and blood tests were normal, the patient was thus discharged after 24 h, with the recommendations for observing the breathing pattern. Initially, spontaneous pneumothorax was suspected. The antibiotics were administered since bacterial pneumonia, although not confirmed on chest x-ray, is the main cause of pneumothorax in dogs is lung parenchyma disease. With the worsening of the clinical condition of the patient, CT was performed and did not demonstrate any findings that would justify the presence of pneumothorax. Despite the placement of the chest tube for facilitating the management of thoracentesis, there was no stabilization of the condition, enhancing the frequency of centesis procedures, which led to the decision to euthanize. The microscopic examination of the pulmonary alterations was decisive for the diagnostic conclusion. The visualization of the accumulation of foamy intra-alveolar macrophages, occasionally multinucleate, associated with cholesterol crystals, was responsible for the diagnosis of EnLP. This condition is rarely described in dogs and as in the present report, it is a noninfectious inflammatory condition, characterized by intra- or extracellular globules of lipid in the alveolar spaces. In the present report, although it was not possible to determine the etiology of EnLP, we can conclude that although rare, it can affect dogs and can generate severe clinical repercussions.

Disfunção miocárdica secundária a sepse em cão: relato de caso / Myocardial dysfunction secondary to sepsis in dog: case report

A redução do empenho do miocárdio é um achado frequente em casos de sepse ou choque séptico, sendo a piometra uma das principais causas de sepse em cães. No presente trabalho relata-se um caso de sepse secundária à piometra levando à disfunção miocárdica em um canino, fêmea, da raça White West Highland Terrier, de dez anos de idade com histórico de prostração e hiporexia. Ao exame físico foi observada presença de secreção vulvar purulenta, abdômen abaulado e tenso à palpação. Foram realizados exames complementares, incluindo hemograma com resultado compatível com quadro infeccioso, bioquímica revelando hipocalemia e hipocalcemia, e exames de imagem. Observou-se por meio do exame ultrassonográfico presença de grande quantidade de líquido com celularidade em cornos e corpo uterino, compatível com piometra. Alterações compatíveis com sepse foram observadas durante o atendimento e estabilização do animal. No exame ecocardiográfico foi observado aumento dos diâmetros sistólico e diastólico do ventrículo esquerdo com diminuição da fração de encurtamento e ejeção, compatível com disfunção sistólica do ventrículo esquerdo. A referida paciente recebeu alta médica após correção cirúrgica e estabilização dos parâmetros clínicos, incluindo a disfunção sistólica, sendo relatado óbito sete dias após. Sugere-se que a causa mortis tenha sido a disfunção sistólica causada pela sepse. Conclui-se que a disfunção miocárdica é um fator determinante de prognóstico em casos de sepse, o que ressalta a importância de seu diagnóstico e tratamento precoce.

The reduction of myocardial commitment is a frequent finding in cases of sepsis or septic shock, and piometra is one of the main causes of sepsis in dogs. In the present study, the case of sepsis secondary to piometra is reported leading to myocardial dysfunction in a canine, female, of the 10-year-old White West Highland Terrier with a history of prostration and hyporexia. On physical examination, the presence of purulent vulvar secretion, bulging abdomen and taut palpation was observed. Complementary tests were performed, including blood count, biochemistry and imaging tests. It was observed through ultrasound examination the presence of a large amount of fluid with cellularity in horns and uterine body, compatible with piometra. Alterations compatible with sepsis were observed during the care and stabilization of the animal. On echocardiographic examination, an increase in systolic and diastolic diameters of the left ventricle was observed with decreased shortening and ejection fraction, compatible with systolic dysfunction of the left ventricle. The patient received medical discharge after surgical correction and stabilization of clinical parameters, and died seven days later. It is suggested that the cause of death was systolic dysfunction caused by sepsis. It is concluded that myocardial dysfunction is a prognostic determinant factor in cases of sepsis, emphasizing the importance of its diagnosis and early treatment.

Disfunção miocárdica secundária a sepse em cão: relato de caso / Myocardial dysfunction secondary to sepsis in dog: case report

A redução do empenho do miocárdio é um achado frequente em casos de sepse ou choque séptico, sendo a piometra uma das principais causas de sepse em cães. No presente trabalho relata-se um caso de sepse secundária à piometra levando à disfunção miocárdica em um canino, fêmea, da raça White West Highland Terrier, de dez anos de idade com histórico de prostração e hiporexia. Ao exame físico foi observada presença de secreção vulvar purulenta, abdômen abaulado e tenso à palpação. Foram realizados exames complementares, incluindo hemograma com resultado compatível com quadro infeccioso, bioquímica revelando hipocalemia e hipocalcemia, e exames de imagem. Observou-se por meio do exame ultrassonográfico presença de grande quantidade de líquido com celularidade em cornos e corpo uterino, compatível com piometra. Alterações compatíveis com sepse foram observadas durante o atendimento e estabilização do animal. No exame ecocardiográfico foi observado aumento dos diâmetros sistólico e diastólico do ventrículo esquerdo com diminuição da fração de encurtamento e ejeção, compatível com disfunção sistólica do ventrículo esquerdo. A referida paciente recebeu alta médica após correção cirúrgica e estabilização dos parâmetros clínicos, incluindo a disfunção sistólica, sendo relatado óbito sete dias após. Sugere-se que a causa mortis tenha sido a disfunção sistólica causada pela sepse. Conclui-se

The reduction of myocardial commitment is a frequent finding in cases of sepsis or septic shock, and piometra is one of the main causes of sepsis in dogs. In the present study, the case of sepsis secondary to piometra is reported leading to myocardial dysfunction in a canine, female, of the 10-year-old White West Highland Terrier with a history of prostration and hyporexia. On physical examination, the presence of purulent vulvar secretion, bulging abdomen and taut palpation was observed. Complementary tests were performed, including blood count, biochemistry and imaging tests. It was observed through ultrasound examination the presence of a large amount of fluid with cellularity in horns and uterine body, compatible with piometra. Alterations compatible with sepsis were observed during the care and stabilization of the animal. On echocardiographic examination, an increase in systolic and diastolic diameters of the left ventricle was observed with decreased shortening and ejection fraction, compatible with systolic dysfunction of the left ventricle. The patient received medical discharge after surgical correction and stabilization of clinical parameters, and died seven days later. It is suggested that the cause of death was systolic dysfunction caused by sepsis. It is concluded that myocardial dysfunction is a prognostic determinant factor in cases of sepsis, emphasizing the importance of its diagnosis and early treatment.(AU)

Disfunção miocárdica secundária a sepse em cão: relato de caso / Myocardial dysfunction secondary to sepsis in dog: case report

A redução do empenho do miocárdio é um achado frequente em casos de sepse ou choque séptico, sendo a piometra uma das principais causas de sepse em cães. No presente trabalho relata-se um caso de sepse secundária à piometra levando à disfunção miocárdica em um canino, fêmea, da raça White West Highland Terrier, de dez anos de idade com histórico de prostração e hiporexia. Ao exame físico foi observada presença de secreção vulvar purulenta, abdômen abaulado e tenso à palpação. Foram realizados exames complementares, incluindo hemograma com resultado compatível com quadro infeccioso, bioquímica revelando hipocalemia e hipocalcemia, e exames de imagem. Observou-se por meio do exame ultrassonográfico presença de grande quantidade de líquido com celularidade em cornos e corpo uterino, compatível com piometra. Alterações compatíveis com sepse foram observadas durante o atendimento e estabilização do animal. No exame ecocardiográfico foi observado aumento dos diâmetros sistólico e diastólico do ventrículo esquerdo com diminuição da fração de encurtamento e ejeção, compatível com disfunção sistólica do ventrículo esquerdo. A referida paciente recebeu alta médica após correção cirúrgica e estabilização dos parâmetros clínicos, incluindo a disfunção sistólica, sendo relatado óbito sete dias após. Sugere-se que a causa mortis tenha sido a disfunção sistólica causada pela sepse. Conclui-se

The reduction of myocardial commitment is a frequent finding in cases of sepsis or septic shock, and piometra is one of the main causes of sepsis in dogs. In the present study, the case of sepsis secondary to piometra is reported leading to myocardial dysfunction in a canine, female, of the 10-year-old White West Highland Terrier with a history of prostration and hyporexia. On physical examination, the presence of purulent vulvar secretion, bulging abdomen and taut palpation was observed. Complementary tests were performed, including blood count, biochemistry and imaging tests. It was observed through ultrasound examination the presence of a large amount of fluid with cellularity in horns and uterine body, compatible with piometra. Alterations compatible with sepsis were observed during the care and stabilization of the animal. On echocardiographic examination, an increase in systolic and diastolic diameters of the left ventricle was observed with decreased shortening and ejection fraction, compatible with systolic dysfunction of the left ventricle. The patient received medical discharge after surgical correction and stabilization of clinical parameters, and died seven days later. It is suggested that the cause of death was systolic dysfunction caused by sepsis. It is concluded that myocardial dysfunction is a prognostic determinant factor in cases of sepsis, emphasizing the importance of its diagnosis and early treatment.

Update on Dirofilaria immitis epidemiology in South America and Mexico: literature review / Atualização sobre a epidemiologia de Dirofilaria immitis na América do Sul e no México: revisão de literatura

Dirofilaria immitis (Leidy, 1856; Raillet & Henry 1911) is a parasite that is widely disseminated around the globe, with a higher prevalence in warm, humid climates. The first report of its occurrence in South America is from 1878 in Brazil. At that time, reports were scarce and difficult to retrieve ­ therefore, gathering them will facilitate record-keeping over time. Four databases were searched (Scopus, MEDLINE, LILACS, and PubMed) and the search keywords were "Dirofilaria" or "heartworm" and the countries' names. Four countries lacked reports (Bolivia, Ecuador, French Guiana, and Uruguay) and other three (Suriname, Guyana, and Paraguay) had only old reports. Chile was the only country in which studies were conducted over time, and no infected dogs were registered. For the other six countries (Mexico, Peru, Colombia, Venezuela, Argentina, and Brazil), reports showed that the infection frequency varied over time and with the surveyed area. Therefore, the information indicates that D. immitis is established, and veterinarians must institute preventive programs to optimally care for their patients and protect the health of their families.(AU)

Dirofilaria immitis é um nematoide de ampla distribuição geográfica, que ocorre com maior frequência em áreas quentes e úmidas do planeta. O primeiro registro de sua ocorrência na América do Sul foi realizado em 1878, no Brasil. Naquela época os registros eram poucos e raramente de fácil obtenção, razão pela qual reuni-los facilitará a recuperação da memória ao longo dos anos. Quatro bases de dados (Scopus, MEDLINE, LILACS e PubMed) foram estudadas utilizando-se as palavras-chave "Dirofilaria" ou "heartworm", os nomes dos países da América do Sul e o México. Nenhum registro foi encontrado para quatro países (Bolívia, Equador, Guiana Francesa e Uruguai) e para outros três (Suriname, Guiana e Paraguai) os registros eram antigos. Apenas o Chile é o território onde houve estudos registrados com ausência do parasita. Os outros países (México, Peru, Colômbia, Venezuela, Argentina e Brasil) apresentam registros com frequência variável no tempo ou no espaço. Assim, as informações reunidas indicam que infecções por D. immitis ocorrem na maior parte da América do Sul e no México e que os médicos veterinários devem instituir programas preventivos para garantir cuidados médicos de qualidade aos pacientes e para proteger a saúde destes e de suas famílias.(AU)

Update on Dirofilaria immitis epidemiology in South America and Mexico: literature review / Atualização sobre a epidemiologia de Dirofilaria immitis na América do Sul e no México: revisão de literatura

Dirofilaria immitis (Leidy, 1856; Raillet & Henry 1911) is a parasite that is widely disseminated around the globe, with a higher prevalence in warm, humid climates. The first report of its occurrence in South America is from 1878 in Brazil. At that time, reports were scarce and difficult to retrieve ­ therefore, gathering them will facilitate record-keeping over time. Four databases were searched (Scopus, MEDLINE, LILACS, and PubMed) and the search keywords were "Dirofilaria" or "heartworm" and the countries' names. Four countries lacked reports (Bolivia, Ecuador, French Guiana, and Uruguay) and other three (Suriname, Guyana, and Paraguay) had only old reports. Chile was the only country in which studies were conducted over time, and no infected dogs were registered. For the other six countries (Mexico, Peru, Colombia, Venezuela, Argentina, and Brazil), reports showed that the infection frequency varied over time and with the surveyed area. Therefore, the information indicates that D. immitis is established, and veterinarians must institute preventive programs to optimally care for their patients and protect the health of their families.(AU)

Dirofilaria immitis é um nematoide de ampla distribuição geográfica, que ocorre com maior frequência em áreas quentes e úmidas do planeta. O primeiro registro de sua ocorrência na América do Sul foi realizado em 1878, no Brasil. Naquela época os registros eram poucos e raramente de fácil obtenção, razão pela qual reuni-los facilitará a recuperação da memória ao longo dos anos. Quatro bases de dados (Scopus, MEDLINE, LILACS e PubMed) foram estudadas utilizando-se as palavras-chave "Dirofilaria" ou "heartworm", os nomes dos países da América do Sul e o México. Nenhum registro foi encontrado para quatro países (Bolívia, Equador, Guiana Francesa e Uruguai) e para outros três (Suriname, Guiana e Paraguai) os registros eram antigos. Apenas o Chile é o território onde houve estudos registrados com ausência do parasita. Os outros países (México, Peru, Colômbia, Venezuela, Argentina e Brasil) apresentam registros com frequência variável no tempo ou no espaço. Assim, as informações reunidas indicam que infecções por D. immitis ocorrem na maior parte da América do Sul e no México e que os médicos veterinários devem instituir programas preventivos para garantir cuidados médicos de qualidade aos pacientes e para proteger a saúde destes e de suas famílias.(AU)