Influence of recumbency on the pulmonary shunt in sevoflurane-anaesthetised sheep / Influência do decúbito na ocorrência de shunt pulmonar em ovinos anestesiados com sevoflurano

This study assessed the impact of different recumbency on sevoflurane-anaesthetised sheep. Seven female sheep were premedicated with 0.1 mg.kg-1 butorfanol and subsequently administered a combination of 3 mg.kg-1 ketamine and 0.5 mg.kg-1 midazolam. Animals were maintained on sevoflurane anaesthesia with pressure-controlled ventilation (12 cm H2O peak inspiratory pressure) and ƒ of 10 mpm. During the anaesthetic procedure, animals underwent one out of three different recumbency: dorsal, left lateral, or right lateral positions. Treatments lasted 120 min with a 48-h washout period in between the treatments. Arterial and central venous blood samples were withdrawn for blood gas and electrolytes analysis and pulmonary shunt fraction (Qs/Qt) CaO2, CcvO2, and CcO2 were calculated accordingly. Results showed that Qs/Qt greatly decreased from 0 to 120 min in all the groups (dorsal: 69.3% to 27.3%; left lateral: 59.1% to 25.0%; right lateral: 67.2% to 32.4%). CaO2, CcvO2 and CcO2 improved over time points, with no difference among treatments. PaO2 and PAO2 showed higher values for 60 and 120 min compared to the 0 min value in all groups, with no differences among treatments as well. PaCO2 and ETCO2 in the lateral groups were higher than those in the dorsal group at 120 min. Pressure-controlled ventilation improved gas exchanges in sheep, thereby reducing pulmonary shunt. Recumbency did not interfere with pulmonary shunt, nevertheless, special attention must be paid to lateral recumbency.

O estudo avaliou o impacto de diferentes decúbitos em ovelhas anestesiadas com sevoflurano. Sete ovelhas foram pré-medicadas com 0,1 mg.kg-1 de butorfanol e induzidas à anestesia com 3 mg.kg-1 de cetamina e 0,5 mg.kg-1 de midazolam. Os animais foram mantidos em anestesia por sevofluorano, em ventilação mecânica controlada por pressão, com pico inspiratório em 12 cm H2O e f de 10 mpm, sendo mantidos por 120 minutos. Durante esse período os animais foram submetidos a um dos três tratamentos: decúbito dorsal, lateral esquerdo ou lateral direito, com intervalo de no mínimo 48 horas entre eles. Amostras de sangue arterial e venoso central foram colhidas para análise de gases sanguíneos e eletrólitos, bem como para cálculo da fração de shunt pulmonar (Qs/Qt), CaO2, CcvO2 e CcO2. Os resultados mostraram que Qs/Qt diminuiu expressivamente de 0 a 120 minutos em todos os grupos (dorsal: 69,3% para 27,3%; lateral esquerdo: 59,1% para 25,0%; lateral direito: 67,2% para 32,4%). Os índices de CaO2, CcvO2 e CcO2 melhoraram ao longo do tempo, sem diferença entre tratamentos. PaO2 e PAO2 apresentaram valores maiores, em todos os grupos, nos minutos 60 e 120 em comparação ao momento 0, não havendo diferenças entre tratamentos. PaCO2 e ETCO2 apresentaram maiores valores nos grupos laterais em comparação ao grupo dorsal ao final do procedimento. Conclui-se que a ventilação controlada por pressão melhorou as trocas gasosas em ovelhas anestesiadas com sevoflurano, reduzindo o shunt pulmonar. O decúbito não interferiu na formação de shunt pulmonar, porém, deve ser dada atenção especial aos decúbitos laterais.

Bypass ileal seguido de tiflostomia no tratamento de abdomen agudo em equino / Ileal bypass followed by tiflostomy to treat acute abdomen in a horse

Background: Equine gastrointestinal colic cases represent one of the diseases with higher morbidity and mortality. Short and long term survivals are commonly correlated with the colic causes, being considered 50 % the survival rate of horses referred to surgery because of small intestine strangulative causes. The jejuno-caecostomy technique is recommended in cases of ileum necrosis or ischemia that indicates ileum removal. The survival rate after this procedure is low, being even lower than others common terminal-terminal enteroanastomoses. This study reports a case of jejuno-caecostomy followed by tiflopexy and tiflostomy performed in a colic horse. Case: A 12-year-old mare, mangalarga breed, with a history of acute abdomen during 18 h was referred to the FZEA-USP equine hospital. According to the owner, the animal suffered previous episodes of colic that had been solved without treatment. On this occasion, the owner, without veterinary advice, had administered 10 mL of flunixin meglumine, but the animal did not show improvement. During the examination, the patient presented tachycardia, tachypnea, toxemic mucosa, a large amount of enterogastric reflux, and it was possible to observe distended small intestine during rectal palpation. The horse was referred to surgery; it was possible to identify necrosis of the ileum and 30 cm of the aboral segment of the jejunum, caused by strangulation due to a pedunculated lipoma localized in the medial band of the caecum. Latero-lateral jejuno-caecostomy was performed between the medial and dorsal bands of the caecum, using polyglactin 910, nº 2.0, potassium penicillin 30.000 IU / kg, every 6 h, gentamicin 6.6 mg / kg, every 24 h, flunixin meglumine 1.1 mg / kg, every 12 h and maintenance fluid therapy were performed post operatively. The animal had ileus and severe enterogastric reflux for five days postoperatively, showing severe signs of endotoxemia, and parenteral hydration seemed to be not enough. So it was...

Urolitíase obstrutiva em equino / Obstructive urolithiasis in horse

Background: Obstructive urinary tract disease in horses is a rare and low prevalence pathology in the species, but potentially severe. It is an emergency condition that presents variable clinical signs and depends on the anatomical locationof the obstruction. The bladder calculus are the most common followed by the urethra and less commonly seen are thekidney or ureteral. The main crystalloid component of uroliths in horses is calcium carbonate. The higher prevalence ofurolithiasis in male horses is justified by some anatomical differences between genders. The urethra of males is narrowerand longer than that of females. The tissue injury is the most important factor for the development of uroliths in horses.Desquamation of epithelial cells, presence of leukocyte and necrotic cell debris are relevant contributors to crystal growth.Urinary stasis favors nucleation by increasing the chance of contact between crystalloid material and urinary epithelium.Once crystal growth has begun, the urine alkalinity of the equines favors the crystallization and further deposition of othercomponents, especially calcium carbonate. Typical clinical signs of urolithiasis include tenesmus, dysuria, strangury andpolaquiuria. Hematuria is often present, mainly observed after exercise and at the end of urination. In addition signs ofcolic are quite frequent in the acute bladder and urethral urolithiasis due to bladder distension. Upper urinary tract surgerymay be technically challenging due to limited structural exposure, especially in adult horses The prognosis for horses withurolithiasis depends on the location of the urolith and the degree of renal injury that occurred.Case: This report aims to describe a rare case of obstructive urolithiasis in a 8-year-old castrated male horse with 24 hevolution. The horse was expressing signs of abdominal pain and during the transretal examination through palpation...

Bypass ileal seguido de tiflostomia no tratamento de abdomen agudo em equino / Ileal bypass followed by tiflostomy to treat acute abdomen in a horse

Background: Equine gastrointestinal colic cases represent one of the diseases with higher morbidity and mortality. Short and long term survivals are commonly correlated with the colic causes, being considered 50 % the survival rate of horses referred to surgery because of small intestine strangulative causes. The jejuno-caecostomy technique is recommended in cases of ileum necrosis or ischemia that indicates ileum removal. The survival rate after this procedure is low, being even lower than others common terminal-terminal enteroanastomoses. This study reports a case of jejuno-caecostomy followed by tiflopexy and tiflostomy performed in a colic horse. Case: A 12-year-old mare, mangalarga breed, with a history of acute abdomen during 18 h was referred to the FZEA-USP equine hospital. According to the owner, the animal suffered previous episodes of colic that had been solved without treatment. On this occasion, the owner, without veterinary advice, had administered 10 mL of flunixin meglumine, but the animal did not show improvement. During the examination, the patient presented tachycardia, tachypnea, toxemic mucosa, a large amount of enterogastric reflux, and it was possible to observe distended small intestine during rectal palpation. The horse was referred to surgery; it was possible to identify necrosis of the ileum and 30 cm of the aboral segment of the jejunum, caused by strangulation due to a pedunculated lipoma localized in the medial band of the caecum. Latero-lateral jejuno-caecostomy was performed between the medial and dorsal bands of the caecum, using polyglactin 910, nº 2.0, potassium penicillin 30.000 IU / kg, every 6 h, gentamicin 6.6 mg / kg, every 24 h, flunixin meglumine 1.1 mg / kg, every 12 h and maintenance fluid therapy were performed post operatively. The animal had ileus and severe enterogastric reflux for five days postoperatively, showing severe signs of endotoxemia, and parenteral hydration seemed to be not enough. So it was...(AU)

Urolitíase obstrutiva em equino / Obstructive urolithiasis in horse

Background: Obstructive urinary tract disease in horses is a rare and low prevalence pathology in the species, but potentially severe. It is an emergency condition that presents variable clinical signs and depends on the anatomical locationof the obstruction. The bladder calculus are the most common followed by the urethra and less commonly seen are thekidney or ureteral. The main crystalloid component of uroliths in horses is calcium carbonate. The higher prevalence ofurolithiasis in male horses is justified by some anatomical differences between genders. The urethra of males is narrowerand longer than that of females. The tissue injury is the most important factor for the development of uroliths in horses.Desquamation of epithelial cells, presence of leukocyte and necrotic cell debris are relevant contributors to crystal growth.Urinary stasis favors nucleation by increasing the chance of contact between crystalloid material and urinary epithelium.Once crystal growth has begun, the urine alkalinity of the equines favors the crystallization and further deposition of othercomponents, especially calcium carbonate. Typical clinical signs of urolithiasis include tenesmus, dysuria, strangury andpolaquiuria. Hematuria is often present, mainly observed after exercise and at the end of urination. In addition signs ofcolic are quite frequent in the acute bladder and urethral urolithiasis due to bladder distension. Upper urinary tract surgerymay be technically challenging due to limited structural exposure, especially in adult horses The prognosis for horses withurolithiasis depends on the location of the urolith and the degree of renal injury that occurred.Case: This report aims to describe a rare case of obstructive urolithiasis in a 8-year-old castrated male horse with 24 hevolution. The horse was expressing signs of abdominal pain and during the transretal examination through palpation...(AU)

Encarceramento em forame epiplóico em equino: relato de caso / The epiploic incarceration in horses: case report / Encarcelamiento en forame epiplóico en equinos: estúdio de caso

O encarceramento em forame epiplóico em equinos é observado em 2-10% das cólicas encaminhadas para a cirurgia, causando um comprometimento vascular que pode levar a necessidade de ressecção do segmento de alça intestinal afetado ou, até mesmo, eutanásia do animal. Um equino, macho, castrado, 400 kg, 5 anos de idade, da raça Mangalarga foi admitido com sinais de cólica, que tinha duração de 24 horas. Após os exames pertinentes, foi indicada a cirurgia, a qual foi negada pelo proprietário. Após tentativa de manutenção da vida do animal, foi indicada a eutanásia, sendo diagnosticado encarceramento de íleo no forame epiplóico na necropsia. Foi avaliado que o animal possuiria um bom prognóstico caso a laparotomia fosse realizada.

The epiploic incarceration in horses is observed in 2-10% of the cramps referred for surgery, causing vascular impairment that may lead to the need for resection of the affected intestinal segment or even euthanasia of the animal. A horse, 400 kg, male, 5-year-old, Mangalarga was admitted with signs of colic, which lasted 24 hours. After the pertinent examinations, the surgery was indicated, which was denied by the owner. After trying to maintain the life of the animal, euthanasia was indicated, being diagnosed incarceration of ileus in the epiploic foramen at necropsy. It was evaluated that the animal would have a good prognosis if the laparotomy was performed.

El encarcelamiento en foramen epiplóico en equinos se observa en el 2-10% de los cólicos derivados a la cirugía, generando un compromiso vascular que puede llevar a la necesidad de resección del segmiento de las asas intestinales afectadas o, y incluso, la eutanasia del animal. Un equino, macho, castrado, 400 kg, 5 anos de edad, de la raza Mangalarga fue admitido con seriales de cólico, que tenía una duración de 24 horas. Después de los exámenes pertinentes, fue indicada la cirugía, la cual fue negada por el propietario. Después de un intento de mantenimiento de la vida del animal, fue indicada la eutanasia, siendo diagnosticado encarcelamiento de íleo en el foramen epiplóico en la necropsia. Se evaluó que el animal tendría un buen pronóstico si se realizaba la laparotomía.

Encarceramento em forame epiplóico em equino: relato de caso / The epiploic incarceration in horses: case report / Encarcelamiento en forame epiplóico en equinos: estúdio de caso

O encarceramento em forame epiplóico em equinos é observado em 2-10% das cólicas encaminhadas para a cirurgia, causando um comprometimento vascular que pode levar a necessidade de ressecção do segmento de alça intestinal afetado ou, até mesmo, eutanásia do animal. Um equino, macho, castrado, 400 kg, 5 anos de idade, da raça Mangalarga foi admitido com sinais de cólica, que tinha duração de 24 horas. Após os exames pertinentes, foi indicada a cirurgia, a qual foi negada pelo proprietário. Após tentativa de manutenção da vida do animal, foi indicada a eutanásia, sendo diagnosticado encarceramento de íleo no forame epiplóico na necropsia. Foi avaliado que o animal possuiria um bom prognóstico caso a laparotomia fosse realizada.(AU)

The epiploic incarceration in horses is observed in 2-10% of the cramps referred for surgery, causing vascular impairment that may lead to the need for resection of the affected intestinal segment or even euthanasia of the animal. A horse, 400 kg, male, 5-year-old, Mangalarga was admitted with signs of colic, which lasted 24 hours. After the pertinent examinations, the surgery was indicated, which was denied by the owner. After trying to maintain the life of the animal, euthanasia was indicated, being diagnosed incarceration of ileus in the epiploic foramen at necropsy. It was evaluated that the animal would have a good prognosis if the laparotomy was performed.(AU)

El encarcelamiento en foramen epiplóico en equinos se observa en el 2-10% de los cólicos derivados a la cirugía, generando un compromiso vascular que puede llevar a la necesidad de resección del segmiento de las asas intestinales afectadas o, y incluso, la eutanasia del animal. Un equino, macho, castrado, 400 kg, 5 anos de edad, de la raza Mangalarga fue admitido con seriales de cólico, que tenía una duración de 24 horas. Después de los exámenes pertinentes, fue indicada la cirugía, la cual fue negada por el propietario. Después de un intento de mantenimiento de la vida del animal, fue indicada la eutanasia, siendo diagnosticado encarcelamiento de íleo en el foramen epiplóico en la necropsia. Se evaluó que el animal tendría un buen pronóstico si se realizaba la laparotomía.(AU)

Trombose de ramos da artéria mesentérica cranial consequente à torção uterina em égua: relato de caso / Thrombosis of branches of the cranial mesenteric artery in consequence of uterine twist in a mare: case report / Trombosis del ramas de la arteria mesentérica craneal resultado del útero entorsión en una yegua: presentación de un caso

O presente relato de caso trata de um infarto intestinal associado com trombose da artéria mesentérica cranial, sem obstrução estrangulativa do intestino. Uma égua sem raça definida (SRD), 8 anos de idade foi admitida no Hospital Veterinário da Faculdade de Zootecnia e Engenharia de Alimentos, com desconforto abdominal há cerca de 72 horas. Devido ao grau de dor e achados laboratoriais optou-se em realizar laparotomia exploratória. Aproximadamente 12 horas após a cirurgia o animal apresentou novamente dor abdominal aguda, vindo a óbito na sala de indução anestésica. Durante a necropsia, observou-se necrose em alguns segmentos do jejuno, de todo o ceco e colón ventral direito. Trombose de ramos da artéria mesentérica cranial foi considerada devido ao processo de isquemia e reperfusão e a síndrome da resposta inflamatória sistêmica (SIRS). (AU)

The present case report deals with an intestinal infarction associated with thrombosis of the cranial mesenteric artery, without strangulate intestinal obstruction. A non-defined breed mare, 8 years old, was admitted to the Veterinary Hospital of the Faculty of Animal Science and Food Engineering, with abdominal discomfort for about 72 hours. Due to the degree of pain and laboratory findings, an exploratory laparotomy was performed. Approximately 12 hours after surgery, the animal showed again acute abdominal pain, and died in the anesthetic induction room. During necropsy, necrosis was observed in some segments of the jejunum, through out the cecum and right ventral colon. Thrombosis of branches of the cranial mesenteric artery was considered due to the ischemia and reperfusion process and the systemic inflammatory response syndrome(SIRS). (AU)

El presente caso trata un infarto intestinal asociado a trombosis de la arteria mesentérica craneal sin obstruccióne strangulativa del intestino. Una yegua mestiza, de 8 anos de edad fue admitida em el Hospital Veterinario de la Facultad de Ciencia Animal e Ingeniería de Alimentos de la Universidad de São Paulo, campus Fernando Costa, Pirassununga, com mal estar abdominal durante las últimas 72 horas. Debido al grado de dolor y hallazgos de laboratorio se decidió realizar una laparotomía exploratoria. Aproximadamente 12 horas después de la cirugía el animal presentó nuevamente dolor abdominal agudo, hasta su posterior muerte en la sala de inducción anestésica. Durante la necropsia se observo necrosis em algunos segmentos del yeyuno, todo el ciego y el colon ventral derecho. Ramas trombosis de la arteria mesentérica craneal se considero debido al proceso de la isquemia y la repercusión y el síndrome de respuesta inflamatoria sistémica (SIRS).(AU)

Trombose de ramos da artéria mesentérica cranial consequente à torção uterina em égua: relato de caso / Thrombosis of branches of the cranial mesenteric artery in consequence of uterine twist in a mare: case report / Trombosis del ramas de la arteria mesentérica craneal resultado del útero entorsión en una yegua: presentación de un caso

O presente relato de caso trata de um infarto intestinal associado com trombose da artéria mesentérica cranial, sem obstrução estrangulativa do intestino. Uma égua sem raça definida (SRD), 8 anos de idade foi admitida no Hospital Veterinário da Faculdade de Zootecnia e Engenharia de Alimentos, com desconforto abdominal há cerca de 72 horas. Devido ao grau de dor e achados laboratoriais optou-se em realizar laparotomia exploratória. Aproximadamente 12 horas após a cirurgia o animal apresentou novamente dor abdominal aguda, vindo a óbito na sala de indução anestésica. Durante a necropsia, observou-se necrose em alguns segmentos do jejuno, de todo o ceco e colón ventral direito. Trombose de ramos da artéria mesentérica cranial foi considerada devido ao processo de isquemia e reperfusão e a síndrome da resposta inflamatória sistêmica (SIRS).

The present case report deals with an intestinal infarction associated with thrombosis of the cranial mesenteric artery, without strangulate intestinal obstruction. A non-defined breed mare, 8 years old, was admitted to the Veterinary Hospital of the Faculty of Animal Science and Food Engineering, with abdominal discomfort for about 72 hours. Due to the degree of pain and laboratory findings, an exploratory laparotomy was performed. Approximately 12 hours after surgery, the animal showed again acute abdominal pain, and died in the anesthetic induction room. During necropsy, necrosis was observed in some segments of the jejunum, through out the cecum and right ventral colon. Thrombosis of branches of the cranial mesenteric artery was considered due to the ischemia and reperfusion process and the systemic inflammatory response syndrome(SIRS).

El presente caso trata un infarto intestinal asociado a trombosis de la arteria mesentérica craneal sin obstruccióne strangulativa del intestino. Una yegua mestiza, de 8 anos de edad fue admitida em el Hospital Veterinario de la Facultad de Ciencia Animal e Ingeniería de Alimentos de la Universidad de São Paulo, campus Fernando Costa, Pirassununga, com mal estar abdominal durante las últimas 72 horas. Debido al grado de dolor y hallazgos de laboratorio se decidió realizar una laparotomía exploratoria. Aproximadamente 12 horas después de la cirugía el animal presentó nuevamente dolor abdominal agudo, hasta su posterior muerte en la sala de inducción anestésica. Durante la necropsia se observo necrosis em algunos segmentos del yeyuno, todo el ciego y el colon ventral derecho. Ramas trombosis de la arteria mesentérica craneal se considero debido al proceso de la isquemia y la repercusión y el síndrome de respuesta inflamatoria sistémica (SIRS).