Artéria subclávia direita aberrante em cão - aspectos clínicos e de imagem / Aberrant right subclavian artery in a dog - clinical and imaging aspects

Background: Aberrant right subclavian artery is only rarely observed in veterinary medicine. Some animals may present postprandial regurgitation and progressive weight loss, which is considered an incidental finding unrelated to clinical alterations. Advanced imaging techniques such as thoracic CT scan, magnetic resonance imaging (MRI) and contrast angiography are used for the accurate detection of lesions, anatomical changes and specific information about vascular rings. This paper describes the clinical changes, imaging exams and therapeutic approach in a female dog with megaesophagus induced by an aberrant right subclavian artery. Case: A 2-month-old female bull terrier, weighing 1.6 kg, with a history of regurgitation immediately or a few minutes after a meal, diarrhea, polyphagia, progressive emaciation and apathy for 45 days, was treated at a University Veterinary Hospital. The dog's physical examination revealed 7% dehydration and body condition score 1 (scale 1 to 5), but no cardiac or pulmonary alterations upon auscultation. The hematological analysis and renal and hepatic serum enzymes were within the normal range for the species. In view of the presumptive clinical diagnosis of vascular anomaly, suggested by the contrast X-ray examination, a chest tomography was performed, which revealed altered aortic arch shape and contours, and a posterior aneurysm in the area of abnormal connection of the right subclavian artery. The patient was released with a prescription for conservative dietary management for megaesophagus. Within two weeks, the patient returned with a report of a good response to the prescribed therapy, absence of vomiting and diarrhea, and an increase in body weight. Surgical correction was recommended, but has not been performed so far, but conservative treatment for megaesophagus was continued. No further episodes of regurgitation were identified during the nine-month follow-up period. Discussion: In the case reported here, the right subclavian artery is considered anatomically atypical because it arises directly from the aortic arch. This vascular anomaly passes on to the right pectoral limb, dorsal to the esophagus, contracting it in its dorsal aspect. It tends to affect purebred dogs, occurring more frequently in Irish setters, German shepherds and Labrador retrievers, although it has been described in other breeds such as the bull terrier documented here and mixed breed dogs. Vascular ring anomalies may not cause clinical changes in animals and represent only incidental findings, or they may lead to gastrointestinal changes resulting from esophageal stricture, contributing to megaesophagus and clinical signs of esophageal obstruction, especially in recently weaned puppies. Such alterations were observed in this case, with the dog presenting regurgitation, immediately or a few minutes after a meal, megaesophagus, diarrhea and progressive weight loss. A CT scan was performed to confirm the type and location of the vascular anomaly and diagnostic accuracy, as recommended in the literature. Dietary therapy is one of the approaches adopted for patients presenting with regurgitation resulting from megaesophagus secondary to vascular anomalies. The dog in this report responded well to the medical therapy; nevertheless, the treatment of choice to correct the esophageal obstruction caused by this anomaly is surgical sectioning of the aberrant vessel by right intercostal thoracotomy, given that the degree of esophageal dilation and dysfunction tends to increase over time. However, at this time, the animal's owner decided to suspend the recommended surgical procedure.

Pectus excavatum and Pectus carinatum in dogs

Background: Deformities of the anterior thoracic wall are called pectus: pectus excavatum and pectus carinatum. Pectusexcavatum is characterised by dorsal deviation of the caudal region of the sternum while pectus carinatum consists ofprotrusion of the sternum and/or adjacent cartilage. Both defects may remain symptom-free, but respiratory and cardiacabnormalities have been reported. Another deformity observed in dogs is the swimming dog syndrome, which consists ofthe lateral opening of the thoracic and pelvic limbs, associated with the pedalling movement. These disorders are frequentlyreported in medical practice, are considered rare among canines. This report aims to describe a case of pectus excavatumassociated with the swimming dog syndrome (Case 1) and another case of pectus carinatum (Case 2).Cases: Case 1. An approximately 45-day-old male American Pitbull canine had difficulty standing. Physical examinationrevealed hyperextension of the thoracic and pelvic limb joints and flattening of the thorax. After radiographic examination, pectus excavatum and the swimming dog syndrome were confirmed. The conservative treatment with splinting andhydrotherapy was chosen. At the 3-month follow-up, slight improvement in the limbs and irregular and unsatisfactorygrowth of the thorax leading to episodes of dyspnoea were observed. Case 2. A female Pug, approximately 2 months old,had a thorax deformity. Physical examination revealed thorax protrusion, confirmed on radiography as pectus carinatum.Conservative therapy was provided using compressive bandage. One month later, the tutor reported improvement in thecondition and absence of respiratory changes.Discussion: Pectus deformities has low incidence, and cases to pectus carinatum, there is a sexual predisposition, that is,males are more predisposed, differing from Case 2, a female dog. In the cases of pectus excavatum, no genetic alterationwas directly related to its occurrence...(AU)

Pectus excavatum and Pectus carinatum in dogs

Background: Deformities of the anterior thoracic wall are called pectus: pectus excavatum and pectus carinatum. Pectusexcavatum is characterised by dorsal deviation of the caudal region of the sternum while pectus carinatum consists ofprotrusion of the sternum and/or adjacent cartilage. Both defects may remain symptom-free, but respiratory and cardiacabnormalities have been reported. Another deformity observed in dogs is the swimming dog syndrome, which consists ofthe lateral opening of the thoracic and pelvic limbs, associated with the pedalling movement. These disorders are frequentlyreported in medical practice, are considered rare among canines. This report aims to describe a case of pectus excavatumassociated with the swimming dog syndrome (Case 1) and another case of pectus carinatum (Case 2).Cases: Case 1. An approximately 45-day-old male American Pitbull canine had difficulty standing. Physical examinationrevealed hyperextension of the thoracic and pelvic limb joints and flattening of the thorax. After radiographic examination, pectus excavatum and the swimming dog syndrome were confirmed. The conservative treatment with splinting andhydrotherapy was chosen. At the 3-month follow-up, slight improvement in the limbs and irregular and unsatisfactorygrowth of the thorax leading to episodes of dyspnoea were observed. Case 2. A female Pug, approximately 2 months old,had a thorax deformity. Physical examination revealed thorax protrusion, confirmed on radiography as pectus carinatum.Conservative therapy was provided using compressive bandage. One month later, the tutor reported improvement in thecondition and absence of respiratory changes.Discussion: Pectus deformities has low incidence, and cases to pectus carinatum, there is a sexual predisposition, that is,males are more predisposed, differing from Case 2, a female dog. In the cases of pectus excavatum, no genetic alterationwas directly related to its occurrence...

Hemangioma cavernoso cerebral em cão / Cerebral cavernous hemangioma in a dog

Background: Cerebral cavernous hemangioma is a rare neoplasm of vascular origin in the brain, characterized by abnormally dilated vascular channels surrounded by endothelium without muscle or elastic fibers. Presumptive diagnosis isperformed by magnetic resonance or computed tomography (CT) scanning and can be confirmed by histopathology. Theprognosis of intracranial cavernous hemangioma is poor, with progression of clinical signs culminating in spontaneousdeath or euthanasia. The purpose of this paper is to report a case of cerebral cavernous hemangioma in a dog, presentingthe clinical findings, tomographic changes, and pathological findings.Case: This case involved a 2-year-old medium sized mixed breed female dog presenting with apathy, hyporexia, ataxia,bradycardia, dyspnea, and seizure episodes for three days. Hemogram and serum biochemistry of renal and hepatic function and urinalysis did not reveal any visible changes. CT scanning was also performed. The scans revealed a hyperdensenodule of 15.9 x 14 mm, with well defined borders, and a hypodense halo without post-contrast enhancement and masseffect in the right parietal lobe was observed in both transverse and coronal sections. Based on the image presented in theCT scans, the nodule was defined as a hemorrhagic brain lesion. The animal died after a seizure. The right telencephalonwas subjected to necropsy, which revealed a reddish-black wel-defined nodule 1.7 cm in diameter extending from theheight of the piriform lobe to the olfactory trine at the groove level and extending towards the lateral ventricle, with slightcompression and deformation of the thalamus but no other macroscopic alterations in the other organs. The histopathologyindicated that this nodular area in the encephalus contained moderate, well-delimited but unencapsulated cellularity, composed of large vascular spaces paved with endothelial cells filled with erythrocytes, some containing eosinophilic fibrillarmaterial ...

Hemangioma cavernoso cerebral em cão / Cerebral cavernous hemangioma in a dog

Background: Cerebral cavernous hemangioma is a rare neoplasm of vascular origin in the brain, characterized by abnormally dilated vascular channels surrounded by endothelium without muscle or elastic fibers. Presumptive diagnosis isperformed by magnetic resonance or computed tomography (CT) scanning and can be confirmed by histopathology. Theprognosis of intracranial cavernous hemangioma is poor, with progression of clinical signs culminating in spontaneousdeath or euthanasia. The purpose of this paper is to report a case of cerebral cavernous hemangioma in a dog, presentingthe clinical findings, tomographic changes, and pathological findings.Case: This case involved a 2-year-old medium sized mixed breed female dog presenting with apathy, hyporexia, ataxia,bradycardia, dyspnea, and seizure episodes for three days. Hemogram and serum biochemistry of renal and hepatic function and urinalysis did not reveal any visible changes. CT scanning was also performed. The scans revealed a hyperdensenodule of 15.9 x 14 mm, with well defined borders, and a hypodense halo without post-contrast enhancement and masseffect in the right parietal lobe was observed in both transverse and coronal sections. Based on the image presented in theCT scans, the nodule was defined as a hemorrhagic brain lesion. The animal died after a seizure. The right telencephalonwas subjected to necropsy, which revealed a reddish-black wel-defined nodule 1.7 cm in diameter extending from theheight of the piriform lobe to the olfactory trine at the groove level and extending towards the lateral ventricle, with slightcompression and deformation of the thalamus but no other macroscopic alterations in the other organs. The histopathologyindicated that this nodular area in the encephalus contained moderate, well-delimited but unencapsulated cellularity, composed of large vascular spaces paved with endothelial cells filled with erythrocytes, some containing eosinophilic fibrillarmaterial ...(AU)

Megaesófago segmental en ovino de la raza Dorper / Segmental megaesophagus in a sheep breed Dorper / Megaesofago segmentar em um ovino da raça Dorper

Un ovino adulto, macho, de la raza Dorper con histórico de regurgitación y timpanismo crónico postprandial fue sometido a exámenes de imagen. En el examen radiográfico simple de la región cervical y torácica se observó desvio ventral de la tráquea y presencia de gas en el área de proyección del esófago torácico. El esofagograma con sulfato de bario reveló retención del medio de contraste y dilatación moderada de la porción del esófago situada entre la cuarta y la novena vértebras torácicas. En la evaluación endoscópica se confirmó el diagnóstico de megaesófago segmentario, a medida que se verificó la distorsión de la porción torácica del esófago, acúmulo de fluidos y alimento y la hipomodidad en el área afectada, sin alteración de las mucosas o señal de estenosis.(AU)

An adult, male, Dorper sheep with a history of regurgitation and postprandial chronic tympanism underwent imaging examinations. In the simple radiographic examination of the cervical and thoracic region were observed a ventral deviation of the trachea and presence of gas in the area of projection of the thoracic esophagus. The barium sulphate esophagogram revealed contrast retention and moderate dilatation of the portion of the esophagus between the fourth and ninth thoracic vertebrae. In the endoscopic evaluation, the diagnosis of segmental megaesophagus was confirmed, as the thoracic portion of the esophagus was distended, fluid and food accumulation and hypomotility were present in the affected area, without any alteration of the mucosa or sign of stenosis.(AU)

Um ovino adulto, macho, da raça Dorper com histórico de regurgitação e timpanismo crônico pós-prandial foi submetido a exames de imagem. No exame radiográfico simples da região cervical e torácica foi observado desvio ventral da traqueia e presença de gás na área de projeção do esôfago torácico. O esofagograma com sulfato de bário revelou retenção do meio de contraste e dilatação moderada da porção do esôfago situada entre a quarta e a nona vértebras torácicas. Na avaliação endoscópica foi confirmado diagnóstico de megaesôfago segmentar, à medida que foram verificadas distensão da porção torácica do esôfago, acúmulo de fluído e alimento e hipomotilidade na área afetada, sem qualquer alteração das mucosas ou sinal de estenose.(AU)

Megaesófago segmental en ovino de la raza Dorper / Segmental megaesophagus in a sheep breed Dorper / Megaesofago segmentar em um ovino da raça Dorper

Un ovino adulto, macho, de la raza Dorper con histórico de regurgitación y timpanismo crónico postprandial fue sometido a exámenes de imagen. En el examen radiográfico simple de la región cervical y torácica se observó desvio ventral de la tráquea y presencia de gas en el área de proyección del esófago torácico. El esofagograma con sulfato de bario reveló retención del medio de contraste y dilatación moderada de la porción del esófago situada entre la cuarta y la novena vértebras torácicas. En la evaluación endoscópica se confirmó el diagnóstico de megaesófago segmentario, a medida que se verificó la distorsión de la porción torácica del esófago, acúmulo de fluidos y alimento y la hipomodidad en el área afectada, sin alteración de las mucosas o señal de estenosis.

An adult, male, Dorper sheep with a history of regurgitation and postprandial chronic tympanism underwent imaging examinations. In the simple radiographic examination of the cervical and thoracic region were observed a ventral deviation of the trachea and presence of gas in the area of projection of the thoracic esophagus. The barium sulphate esophagogram revealed contrast retention and moderate dilatation of the portion of the esophagus between the fourth and ninth thoracic vertebrae. In the endoscopic evaluation, the diagnosis of segmental megaesophagus was confirmed, as the thoracic portion of the esophagus was distended, fluid and food accumulation and hypomotility were present in the affected area, without any alteration of the mucosa or sign of stenosis.

Um ovino adulto, macho, da raça Dorper com histórico de regurgitação e timpanismo crônico pós-prandial foi submetido a exames de imagem. No exame radiográfico simples da região cervical e torácica foi observado desvio ventral da traqueia e presença de gás na área de projeção do esôfago torácico. O esofagograma com sulfato de bário revelou retenção do meio de contraste e dilatação moderada da porção do esôfago situada entre a quarta e a nona vértebras torácicas. Na avaliação endoscópica foi confirmado diagnóstico de megaesôfago segmentar, à medida que foram verificadas distensão da porção torácica do esôfago, acúmulo de fluído e alimento e hipomotilidade na área afetada, sem qualquer alteração das mucosas ou sinal de estenose.

Pythium insidiosum colitis in a dog: treatment and clinical outcome / Colite por Pythium insidiosum em um cão: tratamento e evolução clínica

The aim of this report is to describe the clinical, pathological and imaging findings and treatment of colitis caused by Pythium insidiosum in a canine presenting haematochezia and progressive weight loss. Through imaging, a thickening of the transverse and descending colon was observed. Histopathological analysis of the large intestine fragment revealed the presence of hyphae, confirmed by immunohistochemistry and PCR as P. insidiosum. Antifungal treatment with itraconazole implemented after partial surgical resection, resulted in control of the disease.(AU)

O objetivo deste relato é descrever os achados clínico-patológicos, de imagem e o tratamento de colite por Pythium insidiosum em canino apresentando hematoquezia e emagrecimento progressivo. Nos exames de imagem, foram observados espessamento do cólon transverso e descendente. Análise histopatológica de fragmento do intestino grosso revelou a presença de hifas, confirmado pela imuno-histoquímica e PCR como P. insidiosum. Terapia antifúngica com itraconazol foi instituída pós-ressecção cirúrgica parcial, obtendo-se controle da doença.(AU)

Desvio facial (wry nose) em um equino adulto / Wry nose in an adult equine

Background: Wry Nose (Campylorrhinus lateralis) is a congenital shortening and deviation of the maxillae, premaxillae, nasal bones, vomer, and nasal septum that affects mainly foals. Intrauterine positioning as an etiology of this deformity is highly unlikely. Clinically, varying degree of premaxillar deviation is noticeable upon inspection of the foal's head. The deviation usually results in malocclusion, with no contact between the incisors of the mandible and maxilla. Some foals experience breathing difficulties or have increased respiratory sounds. This condition will not self-correct, and a decision should be made to treat the foal using reconstructive techniques or to euthanize it to prevent it from suffering. The objective of this work was to describe a case of wry nose in an adult male equine. Case: A 4-year-old, 300 kg, male SRD equine was submitted for necropsy. There was no history of respiratory problems and trouble with mastication or prehension of food. Three days before death the horse showed clinical sings characterized by no ingestion of food and water, changing behavior and locomotion, weakness, and not respond to calls, seemingly oblivious to the environment evolving into permanent recumbency and death after about 24 h of the decline. The horse was treated by a veterinarian who suspected of leucoencephalomalacea. The animal died 24 h after her condition worsened. Macroscopically, the main lesion observed was in the nose. The nasal septum was deviated to the left with the sigmoid appearance and a dorsal hump on the right side of the nasal bone. The radiographs of dorsoventral view of the jaws showing premaxillae deviated approximately 90 degrees to the left. The left premaxillae was shorter than the right premaxilla, thus creating a lesser and greater curvature of the premaxilla. Macroscopic and Microscopic lesions in the brain were not observed discarding the possibility of leucoencephalomalacea and other neurological diseases of infectious origin. Discussion: Wry nose is a relatively rare disease and have being reported in foals. In our study, it was not possible to determine the cause of this abnormality, but a computed tomography study has been associated this deformity with an underdeveloped pregnant uterus during the second half of pregnancy witch the narrow tip of the uterine horns provides only limited space for the developing cranial half of the fetus. Although the disease have been reported in young animals in which the surgical procedure in moderate to severe cases it is recommended, in the present case, the equine was four years old indicating that there is a possibility of the animal to reach adulthood, but with their commitment to quality of life. Several diseases, such as cystic degeneration, malformation of normal tissue, abscesses, fractures and neoplasms may cause thickening, malformation or deviation of the nasal septum in horse producing similar clinical sings. In the present case, the macroscopic lesions and radiography exam were useful to determinate the exact site, extent and nature of the involvement of the lesion. Despite the owner to report a clinical picture indicative of neurological disease, histological analysis of the brain ruled out this possibility. These findings indicate that wry nose disease should be kept in mind when investigating causes of deviation of the nasal septum in equines.