Accuracy evaluation of two portable blood glucose meters in feline patients using whole blood samples / Avaliação da acurácia de dois glicosímetros portáteis em amostras de sangue total de pacientes felinos

ABSTRACT: Using portable blood glucose meters (PBGMs) to measure blood glucose (BG) concentration is a common procedure in veterinary practice. Our objective was to evaluate the analytical and clinical accuracy of a human PBGM (Accu-Chek Performa®), (AC) and a veterinary PBGM (GlucoCalea®), (GC) in feline patients. Central venous blood samples were collected from 48 cats at a Brazilian Veterinary teaching hospital. Two devices from each model were used and compared to a reference method (RM). Analytical accuracy was assessed according to ISO 15197:2013 requirements for human PBGMs. Data were compared using Wilcoxon's nonparametric test and represented by Bland-Altman plots. Hematocrit's effect on BG measurements was evaluated by the Spearman correlation coefficient. Clinical accuracy was determined using error grid analysis (EGA). Values of BG were significantly higher in all PBGMs compared to the RM. Although ISO's analytical accuracy requirements could not be met by any of the devices, AC meters were more accurate than GC meters. All AC measurements - but not GC ones - were within zones A and B of the EGA, meeting ISO requirements for clinical accuracy. Significant hematocrit interference was observed in all devices. Therefore, AC showed greater accuracy compared to GC using feline whole blood samples.

RESUMO: O uso de glicosímetros portáteis (GPs) para aferição da glicemia é um procedimento comum na rotina clínica veterinária. O objetivo deste trabalho é avaliar a acurácia analítica e clínica de um GP humano (Accu-Chek Performa®), (AC) e um GP veterinário (GlucoCalea®), (GC) em gatos. Amostras de sangue venoso central foram coletadas de 48 gatos atendidos em um hospital veterinário-escola no Brasil. Foram utilizados dois GPs de cada modelo e comparados a um método de referência (MR). A acurácia analítica foi avaliada de acordo com os requisitos estipulados pela ISO 15197:2013 para GPs de uso humano. Os dados foram comparados pelo teste não-paramétrico de Wilcoxon e representados em gráficos de Bland-Altman. O efeito do hematócrito sobre os valores de glicemia foi avaliado pelo coeficiente de correlação de Spearman. A acurácia clínica foi avaliada pela análise da grade de erros (AGE). Em comparação com o MR, os valores de glicemia foram maiores em todos os GPs avaliados. Nenhum deles atendeu aos requisitos da ISO quanto à acurácia analítica, mas o AC mostrou-se mais acurado que o GC. Todos os valores de glicemia obtidos pelos GPs humanos - mas não pelos GPs veterinários - estiveram dentro das zonas A e B da AGE, demonstrando acurácia clínica de acordo com as exigências da ISO. A interferência do hematócrito da amostra mostrou-se significativa em todos os aparelhos testados. Portanto, o AC apresentou maior acurácia quando comparado ao GC em amostras de sangue total em felinos.

Accuracy evaluation of two portable blood glucose meters in feline patients using whole blood samples / Avaliação da acurácia de dois glicosímetros portáteis em amostras de sangue total de pacientes felinos

Using portable blood glucose meters (PBGMs) to measure blood glucose (BG) concentration is a common procedure in veterinary practice. Our objective was to evaluate the analytical and clinical accuracy of a human PBGM (Accu-Chek Performa®), (AC) and a veterinary PBGM (GlucoCalea®), (GC) in feline patients. Central venous blood samples were collected from 48 cats at a Brazilian Veterinary teaching hospital. Two devices from each model were used and compared to a reference method (RM). Analytical accuracy was assessed according to ISO 15197:2013 requirements for human PBGMs. Data were compared using Wilcoxon's nonparametric test and represented by Bland-Altman plots. Hematocrit's effect on BG measurements was evaluated by the Spearman correlation coefficient. Clinical accuracy was determined using error grid analysis (EGA). Values of BG were significantly higher in all PBGMs compared to the RM. Although ISO's analytical accuracy requirements could not be met by any of the devices, AC meters were more accurate than GC meters. All AC measurements - but not GC ones - were within zones A and B of the EGA, meeting ISO requirements for clinical accuracy. Significant hematocrit interference was observed in all devices. Therefore, AC showed greater accuracy compared to GC using feline whole blood samples.

O uso de glicosímetros portáteis (GPs) para aferição da glicemia é um procedimento comum na rotina clínica veterinária. O objetivo deste trabalho é avaliar a acurácia analítica e clínica de um GP humano (Accu-Chek Performa®), (AC) e um GP veterinário (GlucoCalea®), (GC) em gatos. Amostras de sangue venoso central foram coletadas de 48 gatos atendidos em um hospital veterinário-escola no Brasil. Foram utilizados dois GPs de cada modelo e comparados a um método de referência (MR). A acurácia analítica foi avaliada de acordo com os requisitos estipulados pela ISO 15197:2013 para GPs de uso humano. Os dados foram comparados pelo teste não-paramétrico de Wilcoxon e representados em gráficos de Bland-Altman. O efeito do hematócrito sobre os valores de glicemia foi avaliado pelo coeficiente de correlação de Spearman. A acurácia clínica foi avaliada pela análise da grade de erros (AGE). Em comparação com o MR, os valores de glicemia foram maiores em todos os GPs avaliados. Nenhum deles atendeu aos requisitos da ISO quanto à acurácia analítica, mas o AC mostrou-se mais acurado que o GC. Todos os valores de glicemia obtidos pelos GPs humanos - mas não pelos GPs veterinários - estiveram dentro das zonas A e B da AGE, demonstrando acurácia clínica de acordo com as exigências da ISO. A interferência do hematócrito da amostra mostrou-se significativa em todos os aparelhos testados. Portanto, o AC apresentou maior acurácia quando comparado ao GC em amostras de sangue total em felinos.

Pelve extrarrenal em uma gata - diagnóstico por cintilografia / Extrarenal pelvis in a cat - diagnosis by scintigraphy

Background: In people, extrarenal pelvis is a normal anatomical variant, characterized by the protusion of the pelvis out of the renal hilum, which can be associated with other anomalies, or predispose to stasis or infection. While other diagnostic imaging methods provide anatomical and morphological information about the kidney, scintigraphy allows to determine the renal function and has greater sensitivity in the detection of functional alterations. The aim of this work is to report the case of an asymptomatic cat diagnosed with extrarenal pelvis detected by scintigraphy, which presented alterations in laboratory and renal imaging tests, and absence of associated obstructive process. Case: A 7-year-old mixed-breed female cat was evaluated for a routine health assessment at the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS). When performing the imaging and laboratory tests, renal alterations compatible with chronic kidney disease were found in the abdominal ultrasonography examination and in serum creatinine levels. Therefore, it was decided to perform scintigraphy evaluation to better assess renal function. Dynamic renal scintigraphy with 99mTcDTPA revealed an evident concentration of the radiotracer in the left kidney with effective elimination only after the diuretic stimulus. The right kidney exhibited less concentration of the radiotracer but showed effective elimination before the diuretic stimulus. Image analysis suggested the presence of an extrarenal pelvis on the left side. The relative renal uptake was 68% for the left kidney and 32% for the right kidney. The glomerular filtration rate was 1.65 mL/min/kg. Static renal scintigraphy with 99mTcDMSA revealed irregularity in the distribution of the radiotracer in both kidneys, showing less activity in the caudal pole of the left kidney. The right kidney was apparently reduced and with less activity, especially in the medial portion. The relative renal uptake was 65% for the left kidney and 35% for right kidney, while the absolute renal uptake of the left kidney was 33% and that of the right kidney was 17%. The alteration described in the left kidney, in correlation with dynamic renal scintigraphy, suggested an aspect of lower activity in the caudal pole due to the presence of activity in the extrarenal pelvis. The left kidney was classified as presenting normal renal function and there was moderate to severe deficit of renal function on the right side. Discussion: Chronic kidney disease may be present before clinical signs and biochemical abnormalities are identified. In this report, the animal was referred for a routine evaluation and showed no clinical signs nor alterations on physical examination. However, as renal morphological alterations were seen on ultrasonography and the cat presented mild azotemia, it was decided to perform two renal scintigraphy exams. Despite the radiotracer elimination from the left kidney was seen only after the diuretic stimulus, dynamic renal scintigraphy did not show any obstructive process. This delay on elimination was probably a result of the anatomical variant called extrarenal pelvis. In the static renal scintigraphy, it was possible to evaluate morphological changes in the kidneys and suggest less activity in the caudal pole of the left kidney, due to the presence of activity in the extrarenal pelvis, apparently causing the mentioned defect. The correct diagnosis of morphological changes is essential and for this purpose the best combination of imaging tests is necessary. Renal scintigraphy was fundamental, in this case, for the diagnosis of extrarenal pelvis in one of the kidneys, an abnormality not reported in the feline species within the literature researched by the authors. In addition, renal scintigraphy helped to guide the clinical management of the patient described in this report.

Clinical and nutritional follow-up of cats with chronic kidney disease fed with a renal prescription diet

Background: The use of prescription diets for cats with chronic kidney disease (CKD) is one of the main managementapproach of this disease in cats, and is considered a renoprotective strategy that may promote increased survival and/orimprove quality of life, according to the stage of CKD. Besides that, nutritional assessment is important to monitor themaintenance of quality of life of the patients and their response to disease, especially those with chronic conditions. Theaim of this study was to follow the clinical and nutritional status of cats with chronic kidney disease (CKD) IRIS stagesII, III and IV fed with a renal prescription diet, followed for 12 months.Materials, Methods & Results: Patients were fed exclusively with a dry renal prescription diet and medications for themanagement of CKD were prescribed when needed. Exclusion criteria were cats that already received a renal prescriptiondiet or medications for the treatment of CKD. Cats were evaluated every 2 months, considering body weight (BW), bodycondition score (BCS), muscle mass score (MMS), clinical and laboratory parameters. In all assessments, a complete bloodcount and biochemistry were performed by conventional methods with the patient fasted for 12 h. In addition, urinalysis,urine protein:creatinine ratio (UPC) and urine culture were performed from a urine sample collected by cystocentesis.The quantitative variables were tested for their stability on consecutive assessments using the non-parametric Friedmantest, and did not present significant variation during follow-up, except for systolic blood pressure (SBP). Eight cats witha diagnosis of CKD were included in the study and 6 of them remained in the same CKD stage during follow-up. On catdied due to an unrelated CKD cause. Regarding nutritional assessment, 5 of 7 cats maintained BW during the 12 months...

Clinical and nutritional follow-up of cats with chronic kidney disease fed with a renal prescription diet

Background: The use of prescription diets for cats with chronic kidney disease (CKD) is one of the main managementapproach of this disease in cats, and is considered a renoprotective strategy that may promote increased survival and/orimprove quality of life, according to the stage of CKD. Besides that, nutritional assessment is important to monitor themaintenance of quality of life of the patients and their response to disease, especially those with chronic conditions. Theaim of this study was to follow the clinical and nutritional status of cats with chronic kidney disease (CKD) IRIS stagesII, III and IV fed with a renal prescription diet, followed for 12 months.Materials, Methods & Results: Patients were fed exclusively with a dry renal prescription diet and medications for themanagement of CKD were prescribed when needed. Exclusion criteria were cats that already received a renal prescriptiondiet or medications for the treatment of CKD. Cats were evaluated every 2 months, considering body weight (BW), bodycondition score (BCS), muscle mass score (MMS), clinical and laboratory parameters. In all assessments, a complete bloodcount and biochemistry were performed by conventional methods with the patient fasted for 12 h. In addition, urinalysis,urine protein:creatinine ratio (UPC) and urine culture were performed from a urine sample collected by cystocentesis.The quantitative variables were tested for their stability on consecutive assessments using the non-parametric Friedmantest, and did not present significant variation during follow-up, except for systolic blood pressure (SBP). Eight cats witha diagnosis of CKD were included in the study and 6 of them remained in the same CKD stage during follow-up. On catdied due to an unrelated CKD cause. Regarding nutritional assessment, 5 of 7 cats maintained BW during the 12 months...(AU)

Treatment of an atypical case of bilateral nephrolithiasis in a canine

Background: Less than 5% of canine uroliths are found in the kidney and ureter. The decision to remove a nephrolith iscontroversial and should be considered in cases of refractory infection, hematuria, presence of obstructive uropathy andcompression of the renal parenchyma. The aim of this report is to describe an unusual presentation of bilateral nephrolithiasis in a dog, occupying almost the entire renal parenchyma, its clinical and imaging findings, in addition to surgicaltreatment and its evolution.Case: A 10-year-old male Basset Hound was evaluated at the Veterinary Medical Teaching Hospital (HCV) of the FederalUniversity of Rio Grande do Sul (UFRGS), presenting prostration, anorexia, vomiting, diarrhea and severe hematuriafor three days. On physical examination the patient was dehydrated, with pale mucous membranes, uremic breath andabdominal pain. Blood tests showed mild anemia and azotemia. In both kidneys, abdominal ultrasonography exhibited alarge hyperechoic structure with deep acoustic shadowing. These same structures were observed in abdominal radiographicexamination as radiopaque structures, confirming the diagnosis of bilateral nephrolithiasis. Urine culture was positive forcoagulase-negative Staphylococcus sp. The patient was stabilized with fluid therapy, antiemetic, analgesics, antibiotics andwhole blood transfusion. Unilateral nephrotomy of the right kidney was performed to remove the urolith. After three months,nephrotomy of the left kidney was performed to remove the other urolith...

Arterial thromboembolism of non-cardiogenic origin in a domestic feline with ischemia and reperfusion syndrome / Tromboembolismo arterial de origem não cardiogênica em um felino doméstico com síndrome de isquemia e reperfusão

Arterial thromboembolism (ATE) is an acute and severe clinical condition resulting from the formation of a thrombus and its accommodation in an artery, impairing the perfusion of tissues irrigated by it. In felines, it is often related to hypertrophic cardiomyopathy, but there are reports of its association with neoplasms. Ischemia and reperfusion syndrome may occur secondary to ATE and result in difficult to correct electrolyte and acid-base imbalances. The aim of the present study is to describe a case of ATE, including its clinical and laboratory findings and electrolyte and acid-base changes compatible with ischemia and reperfusion syndrome. A 14-year-old crossbreed female feline with sudden pelvic limb paralysis was treated at the Feline Medicine Service of the Federal University of Rio Grande do Sul. Clinical and laboratory alterations included hypothermia, hypotension, bradycardia, azotemia, metabolic acidosis, and hyperkalemia. The electrocardiogram indicated sinoventricular rhythm, and echocardiogram evaluation showed no alterations. Thorax radiographic evaluation revealed areas of higher radiopacity in the pulmonary fields. We opted for abdominal aorta arteriotomy as an emergency treatment for thrombus removal. The feline died in the postoperative period, and histopathological examination of lungs, mediastinal lymph nodes, and heart were performed, being compatible with pulmonary adenocarcinoma with lymph node metastasis. This study deals with a case of ATE of possible neoplastic origin, which is uncommon in cats. In this case, the patient had difficult-to-manage hemodynamic impairment, as well as electrolyte and acid-base balance disorders severe and refractory to therapy, culminating in death. The time to start treatment from the presentation of clinical signs may be determinant in therapeutic success, reducing the possible effects of reperfusion syndrome.(AU)

O tromboembolismo arterial (TEA) é uma condição clínica aguda e grave decorrente da formação de um trombo e seu alojamento em uma artéria, prejudicando a perfusão dos tecidos irrigados por ela. Em felinos, está frequentemente relacionado com a cardiomiopatia hipertrófica, porém existem relatos da sua associação com neoplasias. A síndrome de isquemia e reperfusão pode ocorrer secundária ao TEA e resultar em desequilíbrios eletrolíticos e ácido-base de difícil correção. O objetivo do presente trabalho é descrever um caso de TEA, incluindo seus achados clínico-laboratoriais e as alterações eletrolíticas e acidobásicas compatíveis com a síndrome de isquemia e reperfusão. Foi atendido no Serviço de Medicina de Felinos da Universidade Federal do Rio Grande do Sul um felino, sem raça definida (S.R.D.), fêmea, de 14 anos de idade, com paralisia súbita dos membros pélvicos. As alterações clínicas e laboratoriais incluíram hipotermia, hipotensão, bradicardia, azotemia, acidose metabólica e hipercalemia. O eletrocardiograma indicou ritmo sinoventricular e a avaliação do ecocardiograma não mostrou alterações. A avaliação radiográfica do tórax revelou áreas de maior radiopacidade nos campos pulmonares. Optou-se pela arteriotomia da aorta abdominal como tratamento emergencial para a retirada do trombo. O felino veio a óbito no pós-operatório e foi realizado exame histopatológico dos pulmões, linfonodos mediastinais e do coração, que foi compatível com adenocarcinoma pulmonar com metástase para o linfonodo. O presente trabalho trata de um caso de TEA de possível origem neoplásica, o que é pouco comum em gatos. Neste caso, o paciente apresentou comprometimento hemodinâmico de difícil manejo, além de desordens eletrolíticas e do equilíbrio ácido-base graves e refratárias a terapia, culminando em óbito. O tempo do início do tratamento a partir da apresentação dos sinais clínicos pode ser determinante no sucesso terapêutico, reduzindo os...(AU)

Treatment of an atypical case of bilateral nephrolithiasis in a canine

Background: Less than 5% of canine uroliths are found in the kidney and ureter. The decision to remove a nephrolith iscontroversial and should be considered in cases of refractory infection, hematuria, presence of obstructive uropathy andcompression of the renal parenchyma. The aim of this report is to describe an unusual presentation of bilateral nephrolithiasis in a dog, occupying almost the entire renal parenchyma, its clinical and imaging findings, in addition to surgicaltreatment and its evolution.Case: A 10-year-old male Basset Hound was evaluated at the Veterinary Medical Teaching Hospital (HCV) of the FederalUniversity of Rio Grande do Sul (UFRGS), presenting prostration, anorexia, vomiting, diarrhea and severe hematuriafor three days. On physical examination the patient was dehydrated, with pale mucous membranes, uremic breath andabdominal pain. Blood tests showed mild anemia and azotemia. In both kidneys, abdominal ultrasonography exhibited alarge hyperechoic structure with deep acoustic shadowing. These same structures were observed in abdominal radiographicexamination as radiopaque structures, confirming the diagnosis of bilateral nephrolithiasis. Urine culture was positive forcoagulase-negative Staphylococcus sp. The patient was stabilized with fluid therapy, antiemetic, analgesics, antibiotics andwhole blood transfusion. Unilateral nephrotomy of the right kidney was performed to remove the urolith. After three months,nephrotomy of the left kidney was performed to remove the other urolith...(AU)

Perinephric pseudocyst in a two-month-old female cat

Background: Perinephric pseudocyst is defined as an accumulation of fluid in fibrous sacs surrounding one or both kidneys, and may be located in the subcapsular or extracapsular region. Histologically, it is characterized by the absence of an epithelial lining to the cyst wall and the term pseudocyst is used. This condition have been reported sporadically in cats, and is associated with chronic kidney disease, mainly in older animals. The diagnosis is based on imaging tests and the prognosis is related to the severity of renal dysfunction. The aim of this report is to describe an unusual presentation of perinephric pseudocyst in a very young female cat.Case: A mixed-breed 2-month-old female cat was evaluated for presenting abdominal distension and anatomical deformities of the limbs. Renomegaly on the left side was noted during abdominal palpation. On presentation, the serum creatinine was 134 µmol/L. Urinalysis showed mild proteinuria, presence of squamous and transitional cells, and rare bacteria. The urine specific gravity was 1.044 and urine protein to creatinine ratio was 0.23. Abdominal ultrasonography revealed a large anechoic subcapsular cyst on the left kidney, in adittion to dilatation of renal pelvis and calyces. The excretory urography showed left renomegaly, and the nephrogram and pyelogram were not clearly observed in this kidney, indicating unilateral deficiency in renal filtration. The cat was referred to unilateral left nephrectomy but died shortly before surgery. At necropsy, marked left kidney enlargment was observed (6.5 x 4.5 x 1.5 cm), with a cystic aspect, occupying almost the entire abdominal cavity. The cystic content was translucent and was compressing the renal parenchyma, resulting in hydronephrosis. The capsule forming the cyst wall was composed of connective tissue, characterizing the perinephric pseudocyst.Discussion: Reports show cases of perinephric pseudocyst affecting mostly older animals, above eight years old.[...]

Perinephric pseudocyst in a two-month-old female cat

Background: Perinephric pseudocyst is defined as an accumulation of fluid in fibrous sacs surrounding one or both kidneys, and may be located in the subcapsular or extracapsular region. Histologically, it is characterized by the absence of an epithelial lining to the cyst wall and the term pseudocyst is used. This condition have been reported sporadically in cats, and is associated with chronic kidney disease, mainly in older animals. The diagnosis is based on imaging tests and the prognosis is related to the severity of renal dysfunction. The aim of this report is to describe an unusual presentation of perinephric pseudocyst in a very young female cat.Case: A mixed-breed 2-month-old female cat was evaluated for presenting abdominal distension and anatomical deformities of the limbs. Renomegaly on the left side was noted during abdominal palpation. On presentation, the serum creatinine was 134 µmol/L. Urinalysis showed mild proteinuria, presence of squamous and transitional cells, and rare bacteria. The urine specific gravity was 1.044 and urine protein to creatinine ratio was 0.23. Abdominal ultrasonography revealed a large anechoic subcapsular cyst on the left kidney, in adittion to dilatation of renal pelvis and calyces. The excretory urography showed left renomegaly, and the nephrogram and pyelogram were not clearly observed in this kidney, indicating unilateral deficiency in renal filtration. The cat was referred to unilateral left nephrectomy but died shortly before surgery. At necropsy, marked left kidney enlargment was observed (6.5 x 4.5 x 1.5 cm), with a cystic aspect, occupying almost the entire abdominal cavity. The cystic content was translucent and was compressing the renal parenchyma, resulting in hydronephrosis. The capsule forming the cyst wall was composed of connective tissue, characterizing the perinephric pseudocyst.Discussion: Reports show cases of perinephric pseudocyst affecting mostly older animals, above eight years old.[...](AU)

Facial nerve ganglioneuroblastoma in a feline leukemia virus-positive cat / Ganglioneuroblastoma de nervo facial em um gato infectado pelo vírus da leucemia felina

Neuroblastic tumors can originate from the central neuraxis, olfactory epithelium, adrenal medullary region or autonomous system. Ganglioneuroblastoma are a type of neuroblastic tumor, with very few case descriptions in animals. Diagnosis of facial nerve ganglioneuroblastoma was made in a feline leukemia virus-positive 11-month-old cat. The cat had hyporexia, left head tilt, depressed mental state, horizontal nystagmus, inability to retract the pinched left lip, anisocoria, ptosis, and absence of the menace reflex. Gross necropsy showed a mass at the left facial nerve root region. Histological examination of this mass showed neoplastic proliferation of neuroblasts arranged in a cohesive pattern and mature ganglion cells. Ganglion cells were positive for neurofilament, neuron-specific enolase, S100, and glial fibrillary acidic protein by immunohistochemistry, while neuroblasts were positive for vimentin, S100, neuron-specific enolase and feline leukemia virus.

Tumores neuroblásticos podem se originar do neuraxis central, do epitélio olfativo, região medular da adrenal ou do sistema autônomo. O ganglioneuroblastoma é um tipo desses tumores, com raras descrições em animais. O diagnóstico de ganglioneuroblastoma de nervo facial foi feito em um gato de 11 meses de idade, sorologicamente positivo para o vírus da leucemia felina. O gato tinha hiporexia, inclinação de cabeça para o lado esquerdo, estado mental deprimido, nistagmo horizontal, incapacidade em retrair o lábio esquerdo quando pinçado, anisocoria, ptose e ausência do reflexo de ameaça. Na necropsia visualizou-se uma massa na região da raiz do nervo facial esquerdo. O exame histológico mostrou proliferação neoplásica de neuroblastos arranjados de maneira coesa, e células ganglionares maduras. As células ganglionares foram imunorreativas na imuno-histoquímica para neurofilamento, enolase neurônio específica, S-100 e proteína ácida glial fibrilar. Enquanto os neuroblastos foram positivos para vimentina, S-100, enolase neurônio específica e vírus da leucemia felina.

Facial nerve ganglioneuroblastoma in a feline leukemia virus-positive cat / Ganglioneuroblastoma de nervo facial em um gato infectado pelo vírus da leucemia felina

Neuroblastic tumors can originate from the central neuraxis, olfactory epithelium, adrenal medullary region or autonomous system. Ganglioneuroblastoma are a type of neuroblastic tumor, with very few case descriptions in animals. Diagnosis of facial nerve ganglioneuroblastoma was made in a feline leukemia virus-positive 11-month-old cat. The cat had hyporexia, left head tilt, depressed mental state, horizontal nystagmus, inability to retract the pinched left lip, anisocoria, ptosis, and absence of the menace reflex. Gross necropsy showed a mass at the left facial nerve root region. Histological examination of this mass showed neoplastic proliferation of neuroblasts arranged in a cohesive pattern and mature ganglion cells. Ganglion cells were positive for neurofilament, neuron-specific enolase, S100, and glial fibrillary acidic protein by immunohistochemistry, while neuroblasts were positive for vimentin, S100, neuron-specific enolase and feline leukemia virus.(AU)

Tumores neuroblásticos podem se originar do neuraxis central, do epitélio olfativo, região medular da adrenal ou do sistema autônomo. O ganglioneuroblastoma é um tipo desses tumores, com raras descrições em animais. O diagnóstico de ganglioneuroblastoma de nervo facial foi feito em um gato de 11 meses de idade, sorologicamente positivo para o vírus da leucemia felina. O gato tinha hiporexia, inclinação de cabeça para o lado esquerdo, estado mental deprimido, nistagmo horizontal, incapacidade em retrair o lábio esquerdo quando pinçado, anisocoria, ptose e ausência do reflexo de ameaça. Na necropsia visualizou-se uma massa na região da raiz do nervo facial esquerdo. O exame histológico mostrou proliferação neoplásica de neuroblastos arranjados de maneira coesa, e células ganglionares maduras. As células ganglionares foram imunorreativas na imuno-histoquímica para neurofilamento, enolase neurônio específica, S-100 e proteína ácida glial fibrilar. Enquanto os neuroblastos foram positivos para vimentina, S-100, enolase neurônio específica e vírus da leucemia felina.(AU)

Megaesophagus secondary to feline dysautonomia (Key-Gaskell Syndrome) in a cat / Megaesôfago secundário a disautonomia felina (Síndrome de Key-Gaskell) em um gato

Background: Feline dysautonomia is a rare autonomic neuropathy of unknown cause, that has already been reported in Europe, the United States and Brazil. Cats usually show nonspecific clinical signs that are associated with autonomic dysfunction of the nervous system. The diagnosis is based on the clinical signs and imaging tests, and confirmed by necropsy and histopathological findings. The prognosis is poor and there is no definitive treatment. The aim of this report is to describe a case of feline dysautonomia with emphasis in the clinical, diagnostic imaging and histopathological findings. Feline dysautonomia must always be considered as a differential diagnosis in cases of megaesophagus in cats.Case: A mixed-breed young male cat was evaluated for anorexia, regurgitation, bilateral nasal discharge and dyspnoea for 24 h. The animal was dehydrated and had pale mucous membranes, abdominal distension and keratoconjunctivitis sicca. The neurological examination was normal. Abdominal ultrasound showed a distended bladder and normal intestinal motility. Chest radiography and esophageal contrast study exhibited megaesophagus in the intrathoracic region. Blood work showed mild neutrophilic leukocytosis and the presence of toxic neutrophils. The cat remained hospitalized for supportive care, including fluidtherapy, broad spectrum antibiotics, antiemetic and mucosal protective drugs. [...]

Megaesophagus secondary to feline dysautonomia (Key-Gaskell Syndrome) in a cat / Megaesôfago secundário a disautonomia felina (Síndrome de Key-Gaskell) em um gato

Background: Feline dysautonomia is a rare autonomic neuropathy of unknown cause, that has already been reported in Europe, the United States and Brazil. Cats usually show nonspecific clinical signs that are associated with autonomic dysfunction of the nervous system. The diagnosis is based on the clinical signs and imaging tests, and confirmed by necropsy and histopathological findings. The prognosis is poor and there is no definitive treatment. The aim of this report is to describe a case of feline dysautonomia with emphasis in the clinical, diagnostic imaging and histopathological findings. Feline dysautonomia must always be considered as a differential diagnosis in cases of megaesophagus in cats.Case: A mixed-breed young male cat was evaluated for anorexia, regurgitation, bilateral nasal discharge and dyspnoea for 24 h. The animal was dehydrated and had pale mucous membranes, abdominal distension and keratoconjunctivitis sicca. The neurological examination was normal. Abdominal ultrasound showed a distended bladder and normal intestinal motility. Chest radiography and esophageal contrast study exhibited megaesophagus in the intrathoracic region. Blood work showed mild neutrophilic leukocytosis and the presence of toxic neutrophils. The cat remained hospitalized for supportive care, including fluidtherapy, broad spectrum antibiotics, antiemetic and mucosal protective drugs. [...](AU)

Arterial thromboembolism of non-cardiogenic origin in a domestic feline with ischemia and reperfusion syndrome / Tromboembolismo arterial de origem não cardiogênica em um felino doméstico com síndrome de isquemia e reperfusão

Arterial thromboembolism (ATE) is an acute and severe clinical condition resulting from the formation of a thrombus and its accommodation in an artery, impairing the perfusion of tissues irrigated by it. In felines, it is often related to hypertrophic cardiomyopathy, but there are reports of its association with neoplasms. Ischemia and reperfusion syndrome may occur secondary to ATE and result in difficult to correct electrolyte and acid-base imbalances. The aim of the present study is to describe a case of ATE, including its clinical and laboratory findings and electrolyte and acid-base changes compatible with ischemia and reperfusion syndrome. A 14-year-old crossbreed female feline with sudden pelvic limb paralysis was treated at the Feline Medicine Service of the Federal University of Rio Grande do Sul. Clinical and laboratory alterations included hypothermia, hypotension, bradycardia, azotemia, metabolic acidosis, and hyperkalemia. The electrocardiogram indicated sinoventricular rhythm, and echocardiogram evaluation showed no alterations. Thorax radiographic evaluation revealed areas of higher radiopacity in the pulmonary fields. We opted for abdominal aorta arteriotomy as an emergency treatment for thrombus removal. The feline died in the postoperative period, and histopathological examination of lungs, mediastinal lymph nodes, and heart were performed, being compatible with pulmonary adenocarcinoma with lymph node metastasis. This study deals with a case of ATE of possible neoplastic origin, which is uncommon in cats. In this case, the patient had difficult-to-manage hemodynamic impairment, as well as electrolyte and acid-base balance disorders severe and refractory to therapy, culminating in death. The time to start treatment from the presentation of clinical signs may be determinant in therapeutic success, reducing the possible effects of reperfusion syndrome.

O tromboembolismo arterial (TEA) é uma condição clínica aguda e grave decorrente da formação de um trombo e seu alojamento em uma artéria, prejudicando a perfusão dos tecidos irrigados por ela. Em felinos, está frequentemente relacionado com a cardiomiopatia hipertrófica, porém existem relatos da sua associação com neoplasias. A síndrome de isquemia e reperfusão pode ocorrer secundária ao TEA e resultar em desequilíbrios eletrolíticos e ácido-base de difícil correção. O objetivo do presente trabalho é descrever um caso de TEA, incluindo seus achados clínico-laboratoriais e as alterações eletrolíticas e acidobásicas compatíveis com a síndrome de isquemia e reperfusão. Foi atendido no Serviço de Medicina de Felinos da Universidade Federal do Rio Grande do Sul um felino, sem raça definida (S.R.D.), fêmea, de 14 anos de idade, com paralisia súbita dos membros pélvicos. As alterações clínicas e laboratoriais incluíram hipotermia, hipotensão, bradicardia, azotemia, acidose metabólica e hipercalemia. O eletrocardiograma indicou ritmo sinoventricular e a avaliação do ecocardiograma não mostrou alterações. A avaliação radiográfica do tórax revelou áreas de maior radiopacidade nos campos pulmonares. Optou-se pela arteriotomia da aorta abdominal como tratamento emergencial para a retirada do trombo. O felino veio a óbito no pós-operatório e foi realizado exame histopatológico dos pulmões, linfonodos mediastinais e do coração, que foi compatível com adenocarcinoma pulmonar com metástase para o linfonodo. O presente trabalho trata de um caso de TEA de possível origem neoplásica, o que é pouco comum em gatos. Neste caso, o paciente apresentou comprometimento hemodinâmico de difícil manejo, além de desordens eletrolíticas e do equilíbrio ácido-base graves e refratárias a terapia, culminando em óbito. O tempo do início do tratamento a partir da apresentação dos sinais clínicos pode ser determinante no sucesso terapêutico, reduzindo os...

Arterial thromboembolism of non-cardiogenic origin in a domestic feline with ischemia and reperfusion syndrome – a case report / Tromboembolismo arterial de origem não cardiogênica em um felino doméstico com síndrome de isquemia e reperfusão – Relato de caso

Arterial thromboembolism (ATE) is an acute and severe clinical condition resulting from the formation of a thrombus and its accommodation in an artery, impairing the perfusion of tissues irrigated by it. In felines, it is often related to hypertrophic cardiomyopathy, but there are reports of its association with neoplasms. Ischemia and reperfusion syndrome may occur secondary to ATE and result in difficult to correct electrolyte and acid-base imbalances. The aim of the present study is to describe a case of ATE, including its clinical and laboratory findings and electrolyte and acid-base changes compatible with ischemia and reperfusion syndrome. A 14-year-old crossbreed female feline with sudden pelvic limb paralysis was treated at the Feline Medicine Service of the Federal University of Rio Grande do Sul. Clinical and laboratory alterations included hypothermia, hypotension, bradycardia, azotemia, metabolic acidosis, and hyperkalemia. The electrocardiogram indicated sinoventricular rhythm, and echocardiogram evaluation showed no alterations. Thorax radiographic evaluation revealed areas of higher radiopacity in the pulmonary fields. We opted for abdominal aorta arteriotomy as an emergency treatment for thrombus removal. The feline died in the postoperative period, and histopathological examination of lungs, mediastinal lymph nodes, and heart were performed, being compatible wi

O tromboembolismo arterial (TEA) é uma condição clínica aguda e grave decorrente da formação de um trombo e seu alojamento em uma artéria, prejudicando a perfusão dos tecidos irrigados por ela. Em felinos, está frequentemente relacionado com a cardiomiopatia hipertrófica, porém existem relatos da sua associação com neoplasias. A síndrome de isquemia e reperfusão pode ocorrer secundária ao TEA e resultar em desequilíbrios eletrolíticos e ácido-base de difícil correção. O objetivo do presente trabalho é descrever um caso de TEA, incluindo seus achados clínico-laboratoriais e as alterações eletrolíticas e acidobásicas compatíveis com a síndrome de isquemia e reperfusão. Foi atendido no Serviço de Medicina de Felinos da Universidade Federal do Rio Grande do Sul um felino, sem raça definida (S.R.D.), fêmea, de 14 anos de idade, com paralisia súbita dos membros pélvicos. As alterações clínicas e laboratoriais incluíram hipotermia, hipotensão, bradicardia, azotemia, acidose metabólica e hipercalemia. O eletrocardiograma indicou ritmo sinoventricular e a avaliação do ecocardiograma não mostrou alterações. A avaliação radiográfica do tórax revelou áreas de maior radiopacidade nos campos pulmonares. Optou-se pela arteriotomia da aorta abdominal como tratamento emergencial para a retirada do trombo. O felino veio a óbito no pós-operatÃ

Arterial thromboembolism of non-cardiogenic origin in a domestic feline with ischemia and reperfusion syndrome – a case report / Tromboembolismo arterial de origem não cardiogênica em um felino doméstico com síndrome de isquemia e reperfusão – Relato de caso

Arterial thromboembolism (ATE) is an acute and severe clinical condition resulting from the formation of a thrombus and its accommodation in an artery, impairing the perfusion of tissues irrigated by it. In felines, it is often related to hypertrophic cardiomyopathy, but there are reports of its association with neoplasms. Ischemia and reperfusion syndrome may occur secondary to ATE and result in difficult to correct electrolyte and acid-base imbalances. The aim of the present study is to describe a case of ATE, including its clinical and laboratory findings and electrolyte and acid-base changes compatible with ischemia and reperfusion syndrome. A 14-year-old crossbreed female feline with sudden pelvic limb paralysis was treated at the Feline Medicine Service of the Federal University of Rio Grande do Sul. Clinical and laboratory alterations included hypothermia, hypotension, bradycardia, azotemia, metabolic acidosis, and hyperkalemia. The electrocardiogram indicated sinoventricular rhythm, and echocardiogram evaluation showed no alterations. Thorax radiographic evaluation revealed areas of higher radiopacity in the pulmonary fields. We opted for abdominal aorta arteriotomy as an emergency treatment for thrombus removal. The feline died in the postoperative period, and histopathological examination of lungs, mediastinal lymph nodes, and heart were performed, being compatible wi

O tromboembolismo arterial (TEA) é uma condição clínica aguda e grave decorrente da formação de um trombo e seu alojamento em uma artéria, prejudicando a perfusão dos tecidos irrigados por ela. Em felinos, está frequentemente relacionado com a cardiomiopatia hipertrófica, porém existem relatos da sua associação com neoplasias. A síndrome de isquemia e reperfusão pode ocorrer secundária ao TEA e resultar em desequilíbrios eletrolíticos e ácido-base de difícil correção. O objetivo do presente trabalho é descrever um caso de TEA, incluindo seus achados clínico-laboratoriais e as alterações eletrolíticas e acidobásicas compatíveis com a síndrome de isquemia e reperfusão. Foi atendido no Serviço de Medicina de Felinos da Universidade Federal do Rio Grande do Sul um felino, sem raça definida (S.R.D.), fêmea, de 14 anos de idade, com paralisia súbita dos membros pélvicos. As alterações clínicas e laboratoriais incluíram hipotermia, hipotensão, bradicardia, azotemia, acidose metabólica e hipercalemia. O eletrocardiograma indicou ritmo sinoventricular e a avaliação do ecocardiograma não mostrou alterações. A avaliação radiográfica do tórax revelou áreas de maior radiopacidade nos campos pulmonares. Optou-se pela arteriotomia da aorta abdominal como tratamento emergencial para a retirada do trombo. O felino veio a óbito no pós-operatÃ

Arterial thromboembolism of non-cardiogenic origin in a domestic feline with ischemia and reperfusion syndrome – a case report / Tromboembolismo arterial de origem não cardiogênica em um felino doméstico com síndrome de isquemia e reperfusão – Relato de caso

Arterial thromboembolism (ATE) is an acute and severe clinical condition resulting from the formation of a thrombus and its accommodation in an artery, impairing the perfusion of tissues irrigated by it. In felines, it is often related to hypertrophic cardiomyopathy, but there are reports of its association with neoplasms. Ischemia and reperfusion syndrome may occur secondary to ATE and result in difficult to correct electrolyte and acid-base imbalances. The aim of the present study is to describe a case of ATE, including its clinical and laboratory findings and electrolyte and acid-base changes compatible with ischemia and reperfusion syndrome. A 14-year-old crossbreed female feline with sudden pelvic limb paralysis was treated at the Feline Medicine Service of the Federal University of Rio Grande do Sul. Clinical and laboratory alterations included hypothermia, hypotension, bradycardia, azotemia, metabolic acidosis, and hyperkalemia. The electrocardiogram indicated sinoventricular rhythm, and echocardiogram evaluation showed no alterations. Thorax radiographic evaluation revealed areas of higher radiopacity in the pulmonary fields. We opted for abdominal aorta arteriotomy as an emergency treatment for thrombus removal. The feline died in the postoperative period, and histopathological examination of lungs, mediastinal lymph nodes, and heart were performed, being compatible wi

O tromboembolismo arterial (TEA) é uma condição clínica aguda e grave decorrente da formação de um trombo e seu alojamento em uma artéria, prejudicando a perfusão dos tecidos irrigados por ela. Em felinos, está frequentemente relacionado com a cardiomiopatia hipertrófica, porém existem relatos da sua associação com neoplasias. A síndrome de isquemia e reperfusão pode ocorrer secundária ao TEA e resultar em desequilíbrios eletrolíticos e ácido-base de difícil correção. O objetivo do presente trabalho é descrever um caso de TEA, incluindo seus achados clínico-laboratoriais e as alterações eletrolíticas e acidobásicas compatíveis com a síndrome de isquemia e reperfusão. Foi atendido no Serviço de Medicina de Felinos da Universidade Federal do Rio Grande do Sul um felino, sem raça definida (S.R.D.), fêmea, de 14 anos de idade, com paralisia súbita dos membros pélvicos. As alterações clínicas e laboratoriais incluíram hipotermia, hipotensão, bradicardia, azotemia, acidose metabólica e hipercalemia. O eletrocardiograma indicou ritmo sinoventricular e a avaliação do ecocardiograma não mostrou alterações. A avaliação radiográfica do tórax revelou áreas de maior radiopacidade nos campos pulmonares. Optou-se pela arteriotomia da aorta abdominal como tratamento emergencial para a retirada do trombo. O felino veio a óbito no pós-operatÃ