Laparoscopic adrenalectomy: comparison between pneumoperitoneum and the use of a laparoscopic lift device in dog cadavers / Adrenalectomia laparoscópica: comparação entre o pneumoperitônio e o uso de dispositivo paraliftlaparoscopy em cadáveres de cães

This study evaluated the feasibility of abdominal liftfor laparoscopic adrenalectomy and compared it with the conventional laparoscopic technique using pneumoperitoneum with medicinal CO2 in dog cadavers. The total surgical time (TST), adrenalectomy time (AT), and gland integrity after removal were evaluated. Thirty-eight adrenalectomies were performed in 19 cadavers. Regardless of the antimere, the TST was significantly lower in the CO2 procedures than in the lift laparoscopy procedures (P=0.001). When comparing the techniques between antimeres, the TST was significantly higher on the left side with lift laparoscopy than with CO2 (P=0.015) and similar between the techniques on the right side of the animals (P=0.086). In the comparison of AT, regardless of the execution side, no differences were observed between the techniques (P=0.05). The same was observed when AT was evaluated separately using antimeres (P=0.902). Of the 38 adrenals evaluated, 92.1% were removed in a single block, and 32.29% had a superficial lesion in the capsule. There was no difference between the groups in the removal capacity in a single block (P=0.340) and capsule integrity (P=0.287). Abdominal lift for laparoscopic adrenalectomy is a feasible technique in dog cadavers; however, it requires a longer surgical time than the conventional technique. The traction force used to elevate the abdominal wall must be evaluated.

O presente trabalho teve como objetivo avaliar a exequibilidade da adrenalectomia laparoscópica utilizando dispositivo de elevação da parede abdominal via liftlaparoscopy e comparar com a técnica laparoscópica convencional utilizando pneumoperitônio com CO2 medicinal em cadáveres de cães. Para isso, avaliou-se tempo cirúrgico total (TCT), tempo de adrenalectomia (TA) e integridade das glândulas após remoção. Foram realizadas 38 adrenalectomias em 19 cadáveres. Independentemente do antímero, o TCT foi significativamente menor nos procedimentos com CO2 do que com liftlaparoscopy (P=0,001). Na comparação das técnicas entre antímeros, o TCT foi significativamente maior no lado esquerdo com liftlaparoscopy do que com CO2 (P = 0,015) e semelhante entre as técnicas no lado direito dos animais (P=0,086). Já na comparação do TA, independente do lado de execução, não foram observadas diferenças entre os métodos (P=0,05). O mesmo foi observado quando o TA foi avaliado separadamente por antímero (P=0,902). Das 38 adrenais avaliadas, 92,1% foram removidas em um único bloco e destas, 32,29% apresentaram lesão superficial na cápsula. Não houve diferença entre grupos para capacidade de remoção em um único bloco (P=0,340) e da integridade da cápsula (P=0,287). A adrenalectomia laparoscópica por elevação da parede abdominal é factível de ser realizada em cadáveres de cães, entretanto, demanda maior tempo cirúrgico quando comparada à técnica convencional. Além disso, a força de tração empregada para elevar a parede abdominal necessita ser avaliada.

Pivalato de desoxicorticosterona no controle do hipoadrenocorticismo canino - relato de casos / Deoxycorticosterone pivalate in the control of canine hypoadrenocorticism reports - case / Pivalato de desoxicorticosterona en el control del hipoadrenocorticismo canino - reporte de casos

O hipoadrenocorticismo primário ou doença de Addison é uma endocrinopatia que envolve a deficiência de glicocorticoides, comumente associada a deficiência mineralocorticoide. O tratamento mais utilizado para reposição hormonal envolve a associação de fludrocortisona e prednisona. O pivalato de desoxicorticosterona (DOCP) tem sido demonstrado na literatura como superior no controle eletrolítico no paciente com hipoadrenocorticismo, e sempre deve ser associado a prednisona/prednisolona. Neste trabalho, relatamos o benefício do DOCP e o protocolo de ajuste de dose desse fármaco em duas etapas em dois casos distintos. Houve uma eficácia superior no controle eletrolítico e redução dos efeitos colaterais com o protocolo de DOCP e prednisolona em relação ao uso de fludrocortisona em ambos os pacientes.(AU)

Primary hypoadrenocorticism or Addison's disease is an endocrinopathy involving glucocorticoid deficiency, commonly associated with mineralocorticoid deficiency. The most commonly used treatment for hormone replacement involves the combination of fludrocortisone and prednisone. Deoxycorticosterone pivalate (DOCP) has been shown in the literature to be superior in electrolyte control in patients with hypoadrenocorticism, and should always be associated with prednisone/prednisolona. In this study, we report the benefit of DOCP and the two-stage dose adjustment protocol for this drug in 2 different cases. There was superior efficacy in electrolyte control and reduction of side effects with the DOCP and prednisolone protocol compared to the use of fludrocortisone in both patients.(AU)

El hipoadrenocorticismo primario o enfermedad de Addison es una endocrinopatía que cursa con deficiencia de glucocorticoides, comúnmente asociada con deficiencia de mineralocorticoides. El tratamiento más utilizado para el reemplazo hormonal consiste en la combinación de fludrocortisona y prednisona. El pivalato de desoxicorticosterona (DOCP) ha demostrado en la literatura ser superior en el control de electrolitos en pacientes con hipoadrenocorticismo, y siempre debe asociarse con prednisona/prednisolona. En este trabajo, reportamos el beneficio de DOCP y el protocolo de ajuste de dosis en dos etapas para este fármaco en 2 casos diferentes. Hubo una eficacia superior en el control de electrolitos y la reducción de los efectos secundarios con el protocolo DOCP y prednisolona en comparación con el uso de fludrocortisona en ambos pacientes.(AU)

Hyperadrenocorticism in a crab-eating fox (Cerdocyon thous) kept under human care / Hiperadrenocorticismo em cachorro-do-mato (Cerdocyon thous) mantido sob cuidados humanos

Hyperadrenocorticism is a relatively common endocrine disease affecting the adrenal glands of domestic dogs. However, there are few reports of this disease in wild canids. A crab-eating fox (Cerdocyon thous) kept under human care was diagnosed with the disease after detection of conformational abnormalities in the adrenal glands visualized by ultrasonography, a cortisol suppression test after low-dose dexamethasone, and the detection of proteinuria and bacteria in urinalysis. After the diagnosis, the patient was treated with trilostane with a satisfactory clinical response. This report aims to report the sonographic and laboratory findings of hyperadrenocorticism and its treatment in a specimen of the species.

O hiperadrenocorticismo é uma doença endócrina que acomete as glândulas adrenais relativamente comum em cães domésticos. Porém, em canídeos selvagens, poucos são os relatos descritos dessa enfermidade. Um exemplar de cachorro-do-mato (Cerdocyon thous), mantido sob cuidados humanos, foi diagnosticado com a doença após detecção de anormalidades conformacionais em glândulas adrenais visibilizadas via ultrassonografia, teste de supressão de cortisol após uso de baixa dose de dexametasona, além de detecção de proteinúria e bactérias em urinálise. Após o diagnóstico, instituiu-se tratamento medicamentoso a base de trilostano com resposta clínica satisfatória. Este relato objetiva reportar os achados ultrassonográficos e laboratoriais de hiperadrenocosticismo e seu tratamento em um exemplar da espécie.

Ultrasonographic findings in dogs diagnosed with hyperadrenocorticism ­ retrospective study (2013 to 2020) / Achados ultrassonográficos em cães diagnosticados com hiperadrenocorticismo ­ estudo retrospectivo (2013 a 2020)

Hyperadrenocorticism is a relatively common endocrinopathy in middle-aged and older dogs, which has become increasingly frequent in the clinical routine. The diagnosis is made by information obtained by history, physical exam findings and results of screening and specific endocrine tests. In addition to laboratory tests, imaging diagnosis, such as ultrasound, can aid on evaluation of possible changes in these cases; also, they may reveal the possible involvement of other organs and systems. The aim of this study was to present the main ultrasonographic changes observed in 18 dogs with hyperadrenocorticism, diagnosed from 2013 to 2020 by the low-dose dexamethasone suppression test, among which hepatomegaly, splenomegaly, gallbladder sludge, renal changes, cystitis and changes in adrenal size, such as bilateral and/or unilateral adrenomegaly, can be cited. Ultrasound examination, therefore, is an examination that can help the clinician in confirming the diagnosis of hyperadrenocorticism, in addition to allowing differentiation between pituitary-dependent hyperadrenocorticism (PDH) and adrenal tumors, and the evaluation of possible secondary changes to the disease.(AU)

iperadrenocorticismo é uma endocrinopatia relativamente comum em cães de meia idade e idosos, que tem se tornado cada vez mais frequente na rotina clínica O diagnóstico é confirmado por informações obtidas pelo histórico, achados de exame físico e resultados de exames de triagem e endócrinos específicos. Além dos exames laboratoriais, os exames de ima-gem, como a ultrassonografia, podem auxiliar na avaliação de possíveis alterações nesses casos; ademais, eles também podem revelar o possível envolvimento de outros órgãos e sistemas. O objetivo deste estudo foi apresentar as principais alterações ultrassonográficas observadas em 18 cães com hiperadrenocorticismo, diagnosticados de 2013 a 2020 pelo teste de supressão por dexametasona em baixa dose, dentre as quais podem ser citadas hepatomegalia, esplenomegalia, lama biliar, alterações renais, cistite e alterações no tamanho e formato das adrenais, como adrenomegalia bilateral e/u unilateral. A avaliação ultras-sonográfica, portanto, é um exame que pode ajudar o clínico a confirmar o diagnóstico de hiperadrenocorticismo, além de ajudar a diferenciar entre hiperadrenocorticismo hipófise-dependente (HHD) e tumores adrenais, e na avaliação de possíveis alterações secundárias à doença.(AU)

Adrenal glands of Chinchilla lanigera - study of anatomical features with computed tomography and magnetic resonance imaging

Background: Since chinchilla (Chinchilla lanigera) is frequently used as a laboratory animal, satisfactory data about the imaging anatomical appearance of its adrenal glands, such as their anatomical location and closeness with other abdominal soft tissue and vessels, are important. The aim of this study to determine anatomical features of the chinchilla adrenal gland's using computed tomography and magnetic resonance imaging. Materials, Methods & Results: We used 12 chinchillas (6 males and 6 females), aged 18 months. The animals were in supine recumbency when contrast-enhanced computed tomography (CT) was performed. Transverse, sagittal and dorsal images of the adrenal glands were obtained with iodinated contrast medium, and 3D reconstruction of the obtained images was applied. The craniocaudal (CrCc - length), dorsoventral (DV - height) and lateromedial (LM - width) diameters were measured using an electronic calliper. Magnetic resonance imaging was performed, and coronal T1-weighted images were obtained. The transverse CT anatomical image at the level of the 3rd lumbar vertebra demonstrated the location of the both adrenal glands in accordance with the grey-white scale's variation. The right adrenal gland was hypo-attenuated and elliptic compared to the right kidney and in close contact to it and to the caudal vena cava. The left adrenal gland was oval and at a distance to the abdominal aorta. The dorsal MRI anatomical study of the chinchilla's abdominal organs at a distance of 10 mm from the spine and in a T1-weighted sequence showed that both adrenal glands were retroperitoneal organs. Discussion: Post-contrasted CT defined the topography of both glands. The right adrenal gland has an oval shape and is cranially situated to the left gland, whose shape is cylindrical and elongated. The LM diameter of the right gland is higher than that measured in the left gland. Both DV and CrCc diameters of the right gland are lower compared to those of the left gland. The right adrenal gland is in close contact to the caudal vena cava, the right kidney and the liver, and the left adrenal gland is in a distance to the abdominal aorta. The right adrenal gland was close to the caudal vena cava and the right kidney and medially to the left kidney. The successful comparative analysis of the images in 3D reconstruction and post-contrast CT in 2D allowed us to conclude that 3D reconstruction is suitable to obtain detailed information in a summary form regarding the closeness of the glands and their shape, mainly because the results are in a real time and highly comprehensive. Our data are in in agreement with previous findings about the advantages of 3D reconstruction. The research algorithm applied was based on the dorsal visualization of the glands in T1-weighted sequence, achieving a comprehensive and high-quality MRI imaging of the examined organs in chinchillas. Both adrenal glands were retroperitoneal organs and with low signal. The dorsal MRI anatomical study of the chinchilla's abdominal organs at a distance of 10 mm from the spine and in a T1-weighted sequence showed the whole profile of the right and left glands and the cranial position of the right gland to the left one, the close contact between the right gland and the kidney and the distance between the left gland and the left kidney. The MRI results are detailed and comprehensive for interpretation. In conclusion, the results of the present study are comprehensive, detailed and with high resolution. We present data for the anatomical relationships of the studied organs, their shape and macrometric parameters, concluding that the above mentioned modalities are very important tools for studying the chinchilla's adrenal glands to create a morphological base, which is necessary to investigate specific diseases.

Use of hyaluronic acid associated with triamcinolone acetonide or ozone gas in the treatment of induced osteoarthritis in rabbits

Purpose: To evaluate the effects of the intra-articular application of hyaluronic acid associated with triamcinolone acetonide, and ozone gas in the treatment of induced osteoarthritis in rabbit’s stifles.Methods: Twenty-one Norfolk rabbits were submitted to cranial cruciate ligament transection of the left stifle. After six weeks of the surgery, the rabbits were randomized assigned into three groups: G1 (control) – saline solution (0.9%); G2 – hyaluronic acid associated with triamcinolone; G3 – ozone gas, submitted to three intra-articular applications every seven days. Results: Significant differences occurred: osteophytes at medial femoral condyle (G2 > G1, G2 > G3) on radiography exam; thickening of the medial condyle (G1 > G3, G2 > G3) on ultrasound exam; osteophytes at lateral tibial condyle (G2 > G1, G2 > G3), and medial femoral condyle (G1 > G2, G3 > G1) on computed tomography. Histologically, mean values of chondrocytes in the femur and tibia in G3 and G2 were statistically lower. Conclusions: The intra-articular injection of hyaluronic acid associated with triamcinolone accentuated degenerative joint disease by imaging and macroscopic evaluations, and by histological findings, this treatment and the ozone gas treatment showed similar effects and were inferior to the saline solution (0.9%).

Investigation of stress in primates maintained in zoo and its main implications on behavior and well-being

Brazil is considered the country which holds the largest number of known primate species. At captives without environmental enrichment program, especially in zoos, it is common for the animals to be easily discouraged from captive life, being bound to develop chronic stress condition. This review aimed to provide veterinary professionals and students with updated bibliography on stress in zoo captive primates, focusing on reactions resulting from these changes, as well as their implications for behavior and well-being. Integrative literature review using descriptors "Captivity", "Stress", "Primates", "Zoos" and "Wellbeing", on the main scientific research bases. The present work highlighted stress responses and its consequences on primate’s health and behavior captive in zoo through bibliographic survey, performing selected articles analysis, results interpretation, and discussion. It is concluded behavioral profile individual variations expose primates differently to stressful conditions. Public visitation, lack of structure, reduced enclosure, improper nutritional management, and unstimulated environment may be potential stress sources for some housed primates in zoo.

Investigation of stress in primates maintained in zoo and its main implications on behavior and well-being

Brazil is considered the country which holds the largest number of known primate species. At captives without environmental enrichment program, especially in zoos, it is common for the animals to be easily discouraged from captive life, being bound to develop chronic stress condition. This review aimed to provide veterinary professionals and students with updated bibliography on stress in zoo captive primates, focusing on reactions resulting from these changes, as well as their implications for behavior and well-being. Integrative literature review using descriptors "Captivity", "Stress", "Primates", "Zoos" and "Wellbeing", on the main scientific research bases. The present work highlighted stress responses and its consequences on primates health and behavior captive in zoo through bibliographic survey, performing selected articles analysis, results interpretation, and discussion. It is concluded behavioral profile individual variations expose primates differently to stressful conditions. Public visitation, lack of structure, reduced enclosure, improper nutritional management, and unstimulated environment may be potential stress sources for some housed primates in zoo.(AU)

Biometry of adrenal glands of mixed-breed dogs

Background: Differences of the size of the adrenal glands, in healthy dogs or in endocrinopathies, undermine correct diagnosis of endocrine disorders and evaluations of the adrenal cortex in relation to its size and possible correlation with endocrinopathies are rare. The aim of the present study was to perform measurements of the length, width, thickness and weight of the adrenal glands of young, adult and elderly mixed-breed dogs and correlate them with the age, sex and weight of animals. In addition, the areas occupied by the zona glomerulosa, zona fasciculata, and zona reticularis of the adrenal cortex were measured in order to establish a microscopic biometric pattern. Material, Methods & Results: The right and left adrenal glands of 12 young (six females and six males), 12 adults (six females and six males), and 12 elderly (six females and six males), all mongrels, derived from routine and necropsied in the Animal Pathology Sector of the Veterinary Hospital of the Federal University of Espírito Santo (HOVET-UFES) were weighed and the length, width, and thickness were measured. For the microscopic measurement of the adrenal cortex, 10 randomly selected samples were submitted to routine histological processing and the microscope slides were observed under a light microscope at 5× and 10× objectives, photodocumented and measurements were obtained from a random portion of the adrenal cortex and the zones composing the cortex were measured in triplicate with the aid of the computerized image analysis software. The left adrenal showed a greater average length than the right adrenal in young, adult, and elderly dogs. The size of the glands in the young and adult dogs is not influenced by the sex of the animals, but in older dogs the females had a greater mean...

Understanding the trade-off between the environment and fertility in cows and ewes

The environment contributes to production diseases that in turn badly affect cow performance, fertility and culling. Oestrus intensity is lower in lame cows, and in all cows 26% potential oestrus events are not expressed (to avoid getting pregnant). To understand these trade-offs, we need to know how animals react to their environment and how the environment influences hypothalamus-pituitary-adrenal axis (HPA) interactions with the hypothalamus-pituitary-ovarian axis (HPO). Neurotransmitters control secretion of GnRH into hypophyseal portal blood. GnRH/LH pulse amplitude and frequency drive oestradiol production, culminating in oestrus behaviour and a precisely-timed GnRH/LH surge, all of which are disrupted by poor environments. Responses to peripheral neuronal agents give clues about mechanisms, but do these drugs alter perception of stimuli, or suppress consequent responses? In vitro studies confirm some neuronal interactions between the HPA and HPO; and immuno-histochemistry clarifies the location and sequence of inter-neurone activity within the brain. In both species, exogenous corticoids, ACTH and/or CRH act at the pituitary (reduce LH release by GnRH), and hypothalamus (lower GnRH pulse frequency and delay surge release). This requires inter-neurones as GnRH cells do not have receptors for HPA compounds. There are two (simultaneous, therefore fail-safe?) pathways for CRH suppression of GnRH release via CRH-Receptors: one being the regulation of kisspeptin/dynorphin and other cell types in the hypothalamus, and the other being the direct contact between CRH and GnRH cell terminals in the median eminence. When we domesticate animals, we must provide the best possible environment otherwise animals trade-off with lower production, less intense oestrus behaviour, and impaired fertility. Avoiding life-time peri-parturient problems by managing persistent lactations in cows may be a worthy trade-off on both welfare and economic terms – better than the camouflage use of drugs/hormones/feed additives/intricate technologies? In the long term, getting animals and environment in a more harmonious balance is the ultimate strategy.

Understanding the trade-off between the environment and fertility in cows and ewes

The environment contributes to production diseases that in turn badly affect cow performance, fertility and culling. Oestrus intensity is lower in lame cows, and in all cows 26% potential oestrus events are not expressed (to avoid getting pregnant). To understand these trade-offs, we need to know how animals react to their environment and how the environment influences hypothalamus-pituitary-adrenal axis (HPA) interactions with the hypothalamus-pituitary-ovarian axis (HPO). Neurotransmitters control secretion of GnRH into hypophyseal portal blood. GnRH/LH pulse amplitude and frequency drive oestradiol production, culminating in oestrus behaviour and a precisely-timed GnRH/LH surge, all of which are disrupted by poor environments. Responses to peripheral neuronal agents give clues about mechanisms, but do these drugs alter perception of stimuli, or suppress consequent responses? In vitro studies confirm some neuronal interactions between the HPA and HPO; and immuno-histochemistry clarifies the location and sequence of inter-neurone activity within the brain. In both species, exogenous corticoids, ACTH and/or CRH act at the pituitary (reduce LH release by GnRH), and hypothalamus (lower GnRH pulse frequency and delay surge release). This requires inter-neurones as GnRH cells do not have receptors for HPA compounds. There are two (simultaneous, therefore fail-safe?) pathways for CRH suppression of GnRH release via CRH-Receptors: one being the regulation of kisspeptin/dynorphin and other cell types in the hypothalamus, and the other being the direct contact between CRH and GnRH cell terminals in the median eminence. When we domesticate animals, we must provide the best possible environment otherwise animals trade-off with lower production, less intense oestrus behaviour, and impaired fertility. Avoiding life-time peri-parturient problems by managing persistent lactations in cows may be a worthy trade-off on both welfare and economic terms better than the camouflage use of drugs/hormones/feed additives/intricate technologies? In the long term, getting animals and environment in a more harmonious balance is the ultimate strategy.(AU)

Infecção de trato urinário inferior por Citrobacter sp em cadela com hipoadrenocorticismo / Citrobacter sp lower urinary tract infection in a bitch with hypoadrenocorticism

Citrobacter sp. é um microrganismo frequentemente encontrado em vagina de cadelas, mas corresponde a menos de 3% do total de microrganismos isolados em urocultura. O hipoadrenocorticismo (HA) é uma doença endócrina incomum e que leva a poliúria e hipostenúria. O objetivo deste trabalho é relatar o caso de uma fêmea da espécie canina, da raça Teckel, 11 anos, atendida com queixa de urina de odor alterado há vários dias, além de vômito, diarreia e inapetência há três dias, e poliúria e polidipsia há 2 meses, com histórico de tratamento anterior com mitotano para hiperadrenocorticismo. O diagnóstico foi de ITU por Citrobactersp., além de HA iatrogênico. Como destaques nos exames, relação sódio:potássio de 22,6 foi observada, sugestiva de HA, que foi confirmado por teste de estimulação com ACTH, além de urina inicialmente hipostenúrica (densidade 1,006), o que pode ser atribuído ao washout medular renal devido à hiponatremia causada pelo hipoadrenocorticismo. O tratamento foi feito com amoxicilina associada a ácido clavulânico por 20 dias, além da terapia específica para HA com prednisona e fludrocortisona, que foi continuado. A paciente recuperou-se bem, a densidade urinária aumentou após início do tratamento para HA e não houve recidiva da ITU em período de acompanhamento de 8 meses. Acredita-se que a baixa densidade urinária causada pelo HA tenha sido fator essencial para a ocorrência da ITU por Citrobacter.

Citrobacter sp. is a normal constituent of bitches' vagina, but it is related to less than 3% of total isolated microorganism in uroculture. Hypoadrenocorticism (HA) is an endocrine disease uncommonly diagnosed that leads to polyuria and hypostenuria. The aim of this work is report the case of a Teckel bitch, 11 years old, attended with complaint of altered urinary smell for several days, besides vomiting, diarrhea and inappetence for three days, and polyuria and polydispsia for two months, with previous mitotane treatment for hyperadrenocorticism. The diagnosis was Citrobacter UTI, besides iatrogenic HA. The most important exam results include sodium:potassium ratio of 22.6, suggestive of HA, that was confirmed by ACTH stimulation test. Besides, hypostenuria (urinary specific gravity ­ USG - of 1.006) was noted, attributed to renal medular washout due to hyponatremia seen in HA. Therapy comprised amoxicillin associated with clavulanic acid for 20 days, in addition to specific therapy for AH with prednisone and fludrocortisone. The patient recovery well, USG increased after the beginning of the treatment for HA and there was no UTI reinfection for a 8 month period. It is believed that low USG due to HA was essential for the occurrence of Citrobacter UTI.

Uso de técnica adaptada para cavotomia em cão com feocromocitoma associado a trombo neoplásico / Adapted cavotomy technique for pheochromocytoma associated tumor thrombi in a dog

Background: In dogs pheochromocytoma usually compress and invade into the adjacent vessels and structures, whichmay lead to the occurrence of caudal vena caval tumor thrombi. The surgical approach in these cases requires adrenalectomy with caval thrombectomy. Conventionally, tourniquets and partial occlusion clamp are used to reduce intraoperativeblood loss, but in dogs with a large thrombus associated to a great local tumor invasion, the traditional technique may behindered. The aim of this study was to report the use of a purse-string suture during venotomy of the caudal vena cava forthrombectomy, as an alternative to tourniquet and partial occlusion clamp.Case: An 11-year-old male Daschound breed dog, was referred for evaluation because of the appearance of small blackenednodules in the ventral abdomen. During a search for metastatic lesions with abdominal ultrasound, the right adrenal wasidentified with significant volume increase, and presence of tumor-associate circular formation that appeared to invade thecaudal vena cava, suggestive of neoplastic invasion or thrombus. Abdominal computed tomography showed caudal venacava in its hepatic portion presenting considerable increase in diameter, with caudal dilation and presence of hypoattenuatingmaterial in its lumen. Right adrenal gland with rounded appearance and regular borders, heterogeneous parenchyma andjuxtaposed caudal vena cava suggesting invasion of this, confirming the sonographic findings. During exploratory celiotomy,adherence of the adrenal mass to the right renal vessels and invasion of the caudal vena cava were observed, leading to theneed of nephrectomy and venotomy for thrombectomy. To perform the venotomy, a Rumel tourniquet was placed looselyaround the vena cava only caudal to the invasion point of the tumor thrombus, cranially, tourniquet application was notpossible due to the presence of a large thrombus extending into the intrahepatic cava...

Infecção de trato urinário inferior por Citrobacter sp em cadela com hipoadrenocorticismo / Citrobacter sp lower urinary tract infection in a bitch with hypoadrenocorticism

Citrobacter sp. é um microrganismo frequentemente encontrado em vagina de cadelas, mas corresponde a menos de 3% do total de microrganismos isolados em urocultura. O hipoadrenocorticismo (HA) é uma doença endócrina incomum e que leva a poliúria e hipostenúria. O objetivo deste trabalho é relatar o caso de uma fêmea da espécie canina, da raça Teckel, 11 anos, atendida com queixa de urina de odor alterado há vários dias, além de vômito, diarreia e inapetência há três dias, e poliúria e polidipsia há 2 meses, com histórico de tratamento anterior com mitotano para hiperadrenocorticismo. O diagnóstico foi de ITU por Citrobacter sp., além de HA iatrogênico. Como destaques nos exames, relação sódio:potássio de 22,6 foi observada, sugestiva de HA, que foi confirmado por teste de estimulação com ACTH, além de urina inicialmente hipostenúrica (densidade 1,006), o que pode ser atribuído ao washout medular renal devido à hiponatremia causada pelo hipoadrenocorticismo. O tratamento foi feito com amoxicilina associada a ácido clavulânico por 20 dias, além da terapia específica para HA com prednisona e fludrocortisona, que foi continuado. A paciente recuperou-se bem, a densidade urinária aumentou após início do tratamento para HA e não houve recidiva da ITU em período de acompanhamento de 8 meses. Acredita-se que a baixa densidade urinária causada pelo HA tenha sido fator essencial para a oco

Citrobacter sp. is a normal constituent of bitches vagina, but it is related to less than 3% of total isolated microorganism in uroculture. Hypoadrenocorticism (HA) is an endocrine disease uncommonly diagnosed that leads to polyuria and hypostenuria. The aim of this work is report the case of a Teckel bitch, 11 years old, attended with complaint of altered urinary smell for several days, besides vomiting, diarrhea and inappetence for three days, and polyuria and polydispsia for two months, with previous mitotane treatment for hyperadrenocorticism. The diagnosis was Citrobacter UTI, besides iatrogenic HA. The most important exam results include sodium:potassium ratio of 22.6, suggestive of HA, that was confirmed by ACTH stimulation test. Besides, hypostenuria (urinary specific gravity USG - of 1.006) was noted, attributed to renal medular washout due to hyponatremia seen in HA. Therapy comprised amoxicillin associated with clavulanic acid for 20 days, in addition to specific therapy for AH with prednisone and fludrocortisone. The patient recovery well, USG increased after the beginning of the treatment for HA and there was no UTI reinfection for a 8 month period. It is believed that low USG due to HA was essential for the occurrence of Citrobacter UTI.(AU)

Polimiopatia hipocalêmica e hipertensão secundária a hiperaldosteronismo primário felino / Hypokalemic polymyopathy and secondary hypertension to feline primary hyperaldosteronism

O hiperaldosteronismo se define pela hipersecreção de aldosterona pelas suprarrenais, resultando em excesso de sódio e redução de potássio sanguíneo. Esta hipersecreção deve-se à síntese autônoma de aldosterona por células adrenais hiperplásicas ou neoplásicas, que agem independentemente da estimulação pelo sistema renina-angiotensina. A doença acomete felinos de adultos maduros a idosos. O excesso de aldosterona culmina em hipertensão sistêmica e/ou hipocalemia, que levam à fraqueza muscular e alterações oculares. O diagnóstico é baseado em exames laboratoriais e de imagem, e o tratamento pode ser clínico ou cirúrgico. O prognóstico é considerado favorável quando as medicações são capazes de melhorar as manifestações clínicas ou quando é possível realizar o procedimento cirúrgico. O presente trabalho visa relatar o caso de um felino macho de 13 anos, castrado, sem raça definida, com hipocalemia persistente secundária a um presuntivo tumor adrenal.(AU)

Hyperaldosteronism is defined by the hypersecretion of aldosterone by the adrenal glands resulting in excess sodium and reduced blood potassium. This hypersecretion is due to the autonomous synthesis of aldosterone by hyperplastic or neoplastic adrenal cells, which act independently of stimulation by the renin-angiotensin system. The disease affects felines in the age group from mature adults to the elderly. The excess of aldosterone culminates in systemic hypertension and/or hypokalemia, which leads to muscle weakness and ocular changes. The diagnosis is based on laboratory and imaging tests and treatment can be clinical or surgical. The prognosis is considered favorable when the medications are able to improve the clinical manifestations or when it is possible to perform the surgical procedure. The present paper aims to report the case of a 13-year-old male cat, castrated, crossbred, with persistent hypokalemia secondary to a presumptive adrenal tumor.(AU)

Aortic and iliac thrombosis in a dog with adrenal-dependent hypercortisolism due to bilateral adrenocortical adenoma / Trombose aórtica e ilíaca em um cão com hipercortisolismo adrenal-dependente devido a adenoma adrenocortical bilateral

Hypercortisolism is a common endocrinopathy in dogs; however, in a few cases, bilateral functional adrenocortical adenomas cause spontaneous disease, and thrombotic events are considered uncommon complications. The aim of this report was to describe a case of bilateral adrenocortical adenoma in a dog with hyperadrenocorticism associated with distal aortic and iliac thrombosis, with emphasis on clinical and pathological aspects. A 15-year-old spayed female Dachshund with a previous clinical history of hyperadrenocorticism presented with acute bilateral hindlimb paraparesis. A vertebral thoracolumbar radiography was performed and did not present any evidence of intervertebral disk disease or vertebral abnormalities; however, abdominal ultrasound and vascular Doppler evaluation revealed bilateral adrenal enlargement in addition to an aortic and external iliac artery thrombus. The animal was euthanized. At necropsy, both adrenal glands were enlarged by well-demarcated neoplastic nodules in the parenchyma, and a thrombus caudal to the abdominal aorta bifurcation within the external iliac arteries that extended to the left external iliac artery was noted. Histological evaluation revealed a well-differentiated neoplastic proliferation of cortical epithelial cells, consistent with bilateral adenoma, and muscular necrosis in the pelvic limbs was also observed. Bilateral functional adrenocortical adenoma; although, very rare, should be considered as a cause of hypercortisolism, and aortic thrombosis in dogs should be considered as a possible consequence.(AU)

Hipercortisolismo é uma endocrinopatia comum em cães, no entanto, apenas em poucos casos adenomas adrenocorticais funcionais bilaterais são a causa de doença espontânea, e eventos trombóticos são considerados complicações incomuns. O objetivo deste relato foi descrever um caso de adenoma adrenocortical bilateral em um cão com hiperadrenocorticismo associado a trombose aórtica distal e ilíaca, com ênfase nos aspectos clínicos e patológicos. Um cão, Dachshund, fêmea castrada, de 15 anos, com histórico clínico prévio de hiperadrenocorticismo, apresentou paraparesia aguda dos membros posteriores. Foi realizada radiografia toracolombar vertebral, a qual não mostrou nenhuma evidência de doença do disco intervertebral ou anormalidades vertebrais; no entanto, ultrassonografia abdominal e Doppler vascular revelaram um trombo na aorta e artéria ilíaca externa, e adrenomegalia bilateral. O animal foi submetido à eutanásia. Na necropsia, ambas as adrenais estavam distendidas por nódulos neoplásicos bem delimitados no parênquima e notou-se um trombo caudalmente à bifurcação da aorta abdominal às artérias ilíacas externas, estendendo-se à ilíaca externa esquerda. Na avaliação histológica observou-se proliferação neoplásica bem diferenciada de células epiteliais corticais, consistente com adenoma bilateral; também foi observada necrose muscular nos membros pélvicos. O adenoma adrenocortical funcional bilateral, embora muito raro, deve ser considerado uma causa de hipercortisolismo, e a trombose aórtica em cães deve ser considerada uma possível consequência.(AU)

Uso de técnica adaptada para cavotomia em cão com feocromocitoma associado a trombo neoplásico / Adapted cavotomy technique for pheochromocytoma associated tumor thrombi in a dog

Background: In dogs pheochromocytoma usually compress and invade into the adjacent vessels and structures, whichmay lead to the occurrence of caudal vena caval tumor thrombi. The surgical approach in these cases requires adrenalectomy with caval thrombectomy. Conventionally, tourniquets and partial occlusion clamp are used to reduce intraoperativeblood loss, but in dogs with a large thrombus associated to a great local tumor invasion, the traditional technique may behindered. The aim of this study was to report the use of a purse-string suture during venotomy of the caudal vena cava forthrombectomy, as an alternative to tourniquet and partial occlusion clamp.Case: An 11-year-old male Daschound breed dog, was referred for evaluation because of the appearance of small blackenednodules in the ventral abdomen. During a search for metastatic lesions with abdominal ultrasound, the right adrenal wasidentified with significant volume increase, and presence of tumor-associate circular formation that appeared to invade thecaudal vena cava, suggestive of neoplastic invasion or thrombus. Abdominal computed tomography showed caudal venacava in its hepatic portion presenting considerable increase in diameter, with caudal dilation and presence of hypoattenuatingmaterial in its lumen. Right adrenal gland with rounded appearance and regular borders, heterogeneous parenchyma andjuxtaposed caudal vena cava suggesting invasion of this, confirming the sonographic findings. During exploratory celiotomy,adherence of the adrenal mass to the right renal vessels and invasion of the caudal vena cava were observed, leading to theneed of nephrectomy and venotomy for thrombectomy. To perform the venotomy, a Rumel tourniquet was placed looselyaround the vena cava only caudal to the invasion point of the tumor thrombus, cranially, tourniquet application was notpossible due to the presence of a large thrombus extending into the intrahepatic cava...(AU)

Polimiopatia hipocalêmica e hipertensão secundária a hiperaldosteronismo primário felino / Hypokalemic polymyopathy and secondary hypertension to feline primary hyperaldosteronism

O hiperaldosteronismo se define pela hipersecreção de aldosterona pelas suprarrenais, resultando em excesso de sódio e redução de potássio sanguíneo. Esta hipersecreção deve-se à síntese autônoma de aldosterona por células adrenais hiperplásicas ou neoplásicas, que agem independentemente da estimulação pelo sistema renina-angiotensina. A doença acomete felinos de adultos maduros a idosos. O excesso de aldosterona culmina em hipertensão sistêmica e/ou hipocalemia, que levam à fraqueza muscular e alterações oculares. O diagnóstico é baseado em exames laboratoriais e de imagem, e o tratamento pode ser clínico ou cirúrgico. O prognóstico é considerado favorável quando as medicações são capazes de melhorar as manifestações clínicas ou quando é possível realizar o procedimento cirúrgico. O presente trabalho visa relatar o caso de um felino macho de 13 anos, castrado, sem raça definida, com hipocalemia persistente secundária a um presuntivo tumor adrenal.

Hyperaldosteronism is defined by the hypersecretion of aldosterone by the adrenal glands resulting in excess sodium and reduced blood potassium. This hypersecretion is due to the autonomous synthesis of aldosterone by hyperplastic or neoplastic adrenal cells, which act independently of stimulation by the renin-angiotensin system. The disease affects felines in the age group from mature adults to the elderly. The excess of aldosterone culminates in systemic hypertension and/or hypokalemia, which leads to muscle weakness and ocular changes. The diagnosis is based on laboratory and imaging tests and treatment can be clinical or surgical. The prognosis is considered favorable when the medications are able to improve the clinical manifestations or when it is possible to perform the surgical procedure. The present paper aims to report the case of a 13-year-old male cat, castrated, crossbred, with persistent hypokalemia secondary to a presumptive adrenal tumor.

Infecção de trato urinário inferior por Citrobacter sp em cadela com hipoadrenocorticismo / Citrobacter sp lower urinary tract infection in a bitch with hypoadrenocorticism

Citrobacter sp. é um microrganismo frequentemente encontrado em vagina de cadelas, mas corresponde a menos de 3% do total de microrganismos isolados em urocultura. O hipoadrenocorticismo (HA) é uma doença endócrina incomum e que leva a poliúria e hipostenúria. O objetivo deste trabalho é relatar o caso de uma fêmea da espécie canina, da raça Teckel, 11 anos, atendida com queixa de urina de odor alterado há vários dias, além de vômito, diarreia e inapetência há três dias, e poliúria e polidipsia há 2 meses, com histórico de tratamento anterior com mitotano para hiperadrenocorticismo. O diagnóstico foi de ITU por Citrobacter sp., além de HA iatrogênico. Como destaques nos exames, relação sódio:potássio de 22,6 foi observada, sugestiva de HA, que foi confirmado por teste de estimulação com ACTH, além de urina inicialmente hipostenúrica (densidade 1,006), o que pode ser atribuído ao washout medular renal devido à hiponatremia causada pelo hipoadrenocorticismo. O tratamento foi feito com amoxicilina associada a ácido clavulânico por 20 dias, além da terapia específica para HA com prednisona e fludrocortisona, que foi continuado. A paciente recuperou-se bem, a densidade urinária aumentou após início do tratamento para HA e não houve recidiva da ITU em período de acompanhamento de 8 meses. Acredita-se que a baixa densidade urinária causada pelo HA tenha sido fator essencial para a oco

Citrobacter sp. is a normal constituent of bitches’ vagina, but it is related to less than 3% of total isolated microorganism in uroculture. Hypoadrenocorticism (HA) is an endocrine disease uncommonly diagnosed that leads to polyuria and hypostenuria. The aim of this work is report the case of a Teckel bitch, 11 years old, attended with complaint of altered urinary smell for several days, besides vomiting, diarrhea and inappetence for three days, and polyuria and polydispsia for two months, with previous mitotane treatment for hyperadrenocorticism. The diagnosis was Citrobacter UTI, besides iatrogenic HA. The most important exam results include sodium:potassium ratio of 22.6, suggestive of HA, that was confirmed by ACTH stimulation test. Besides, hypostenuria (urinary specific gravity – USG - of 1.006) was noted, attributed to renal medular washout due to hyponatremia seen in HA. Therapy comprised amoxicillin associated with clavulanic acid for 20 days, in addition to specific therapy for AH with prednisone and fludrocortisone. The patient recovery well, USG increased after the beginning of the treatment for HA and there was no UTI reinfection for a 8 month period. It is believed that low USG due to HA was essential for the occurrence of Citrobacter UTI.

Polimiopatia hipocalêmica e hipertensão secundária a hiperaldosteronismo primário felino / Hypokalemic polymyopathy and secondary hypertension to feline primary hyperaldosteronism

O hiperaldosteronismo se define pela hipersecreção de aldosterona pelas suprarrenais, resultando em excesso de sódio e redução de potássio sanguíneo. Esta hipersecreção deve-se à síntese autônoma de aldosterona por células adrenais hiperplásicas ou neoplásicas, que agem independentemente da estimulação pelo sistema renina-angiotensina. A doença acomete felinos de adultos maduros a idosos. O excesso de aldosterona culmina em hipertensão sistêmica e/ou hipocalemia, que levam à fraqueza muscular e alterações oculares. O diagnóstico é baseado em exames laboratoriais e de imagem, e o tratamento pode ser clínico ou cirúrgico. O prognóstico é considerado favorável quando as medicações são capazes de melhorar as manifestações clínicas ou quando é possível realizar o procedimento cirúrgico. O presente trabalho visa relatar o caso de um felino macho de 13 anos, castrado, sem raça definida, com hipocalemia persistente secundária a um presuntivo tumor adrenal.

Hyperaldosteronism is defined by the hypersecretion of aldosterone by the adrenal glands resulting in excess sodium and reduced blood potassium. This hypersecretion is due to the autonomous synthesis of aldosterone by hyperplastic or neoplastic adrenal cells, which act independently of stimulation by the renin-angiotensin system. The disease affects felines in the age group from mature adults to the elderly. The excess of aldosterone culminates in systemic hypertension and/or hypokalemia, which leads to muscle weakness and ocular changes. The diagnosis is based on laboratory and imaging tests and treatment can be clinical or surgical. The prognosis is considered favorable when the medications are able to improve the clinical manifestations or when it is possible to perform the surgical procedure. The present paper aims to report the case of a 13-year-old male cat, castrated, crossbred, with persistent hypokalemia secondary to a presumptive adrenal tumor.