Onfaloflebite em bezerra - tratamento com marsupialização da veia umbilical / Omphalophlebitis in a calf - treatment with umbilical vein marsupialization

Background: Omphalophlebitis is characterized as an omphalopathy that affects the umbilical vein. In these cases, ultrasonography can help identify the severity of abdominal lesions and guide the choice of treatment. Marsupialization of the umbilical vein is a surgical procedure indicated in cases where this vessel presents with purulent secretion up to the liver parenchyma. This report describes a case of omphalophlebitis in a calf treated by marsupialization of the umbilical vein. The preoperative and postoperative sonographic findings are also described. Case: A 4-day-old Holstein calf was attended at the Veterinary Hospital (HV) of the Universidade Federal de Goiás (UFG), Goiânia, Brazil. On physical examination, the animal was found to be apathetic, with tachycardia, tachypnea, hyperthermia, hyperemic mucous membranes, and moderate dehydration. An increase in volume was observed in the umbilical region, with local hyperthermia, firm consistency, and sensitivity to palpation. On deep palpation of the abdomen, a mass originating in the umbilical region and extending cranially was observed, leading to the suspicion of omphalophlebitis. Abdominal ultrasonography revealed external umbilical abscess and omphalophlebitis. Initially, conservative treatment with antibacterial and anti-inflammatory drugs was performed; however, there was no improvement in the clinical picture. Therefore, exploratory celiotomy was performed to remove the umbilical infectious focus. During the procedure, it was verified that the umbilical vein was dilated with a thickened wall until its insertion in the hepatic parenchyma, hence removal of the infected region through a ligature was not possible. Thus, marsupialization of the umbilical vein was performed to create a cutaneous opening for drainage of the purulent contents. In the postoperative period, antibacterial, anti-inflammatory, and analgesic drugs were administered. Dressing of the surgical wound and of the umbilical vein lumen was performed with topical polyvidone at 0.2%. Removal of the stitches was done 14 days postoperatively. Weekly ultrasonographic examinations were performed, which showed a gradual reduction in the diameter of the umbilical vein throughout the postoperative period. Thirty days after the surgical procedure, no further drainage of the purulent content was observed from the umbilical vein, and healing of the stump was demonstrated. After 7 months, a repeat ultrasonography was performed, revealing normal echogenicity and echotexture of the hepatic parenchyma and complete atrophy of the umbilical vein. Discussion: Umbilical vein marsupialization is a surgery rarely described in the literature, and no report has followed the evolution of a case by ultrasonography. The ultrasound examination of the umbilical structures was essential for the definitive diagnosis and choice of surgical treatment. Marsupialization of the umbilical vein was chosen due to the impossibility of ligature of this vessel, which presented with thickened walls and lumen filled with purulent content until its insertion into the liver. Postoperative monitoring via serial ultrasonography examinations allowed follow up of the evolution of the case and animal recovery. At the sonographic reevaluation after 7 months, the findings were unremarkable, indicating complete recovery of the patient. Umbilical marsupialization is a surgical technique that allows complete recovery of calves with severe omphalophlebitis. Ultrasonography is fundamental for the diagnosis of omphalophlebitis and in determining the best therapeutic protocol. Sonographic evaluation during the postoperative period allows follow-up of the progression of lesions in abdominal structures and helps in defining the prognosis.

Salmonella Typhimurium - associated meningoencephalomyelitis in a foal / Meningoencefalomielite por Salmonella Typhimurium em potro

A 10-day old foal presented with a history of acute recumbency and generalized weakness, that progressed to seizure episodes and death. Post mortem examination revealed necrotizing and purulent omphalophlebitis and fibrinopurulent meningoencephalomyelitis. Salmonella Typhimurium was isolated from the central nervous system and determined to be the cause of the meningoencephalomyelitis. Due to the lack of evidence of gastrointestinal disease, the umbilical cord was considered the most likely portal of entry of the bacteria. The isolated S. Typhimurium was resistant to ampicillin and cephalotin, and partially resistant to enrofloxacin. These drugs are commonly used in the treatment of salmonellosis. This is the first report of S. Typhimurium affecting the brain and spinal cord of a foal. Salmonellosis should be considered a differential diagnosis in foals with neurologic signs, even in the absence of enterocolitis.(AU)

Um potro de 10 dias de idade foi admitido com histórico de decúbito e fraqueza generalizada aguda, com progressão para episódios de convulsão e morte. A avaliação post mortem demonstrou onfalite necropurulenta e meningoencefalomielite fibrinopurulenta. Salmonella Typhimurium foi isolada do material purulento coletado do sistema nervoso central. A ausência de diarreia e lesões entéricas associadas à presença de onfalite sugerem que o umbigo foi possivelmente a porta de entrada do agente. O isolado de S. Typhimurium apresentou resistência a cefalotina e ampicilina e resistência intermediária a enrofloxacina, drogas utilizadas para o tratamento de salmonelose. Este é o primeiro relato de S. Typhimurium levando a alterações encefálicas e medulares em potro. A salmonelose deve ser considerada, portanto, como diagnóstico diferencial em potros neonatos com alterações neurológicas, mesmo na ausência de enterocolite.(AU)

Tratamento com imunoglobulina anti-toxina tetânica homóloga por via intratecal em tétano neonatal equino - relato de caso / Treatment with intrathecal administration of anti-tetanus toxoid immunoglobulin in neonatal foal tetanus - case report

Tetanus is a severe and highly fatal infectious disease caused by the toxin of Clostridium tetani, an anaerobic spore-forming Grampositive bacterium. The disease is characterized by muscle rigidity (tetany) and can lead to death by respiratory failure or seizures. The present study reports a case of tetanus in a 6-day-old Quarter Horse foal. The animal showed apathy, lateral recumbency, umbilical thickening, protrusion of the third eyelid, seizures and hyperesthesia. Was treated with 50,000 IU/kg of potassium penicillin; with anti-tetanus toxoid immunoglobulin in a dose of 25,000 IU, 20,000 IU and 20,000 IU intravenously, intramuscular and intrathecal, respectively; with acepromazine hydrochloride (0.05 mg / kg); fluid therapy of Ringer"s lactate solution and dressing for umbilical cord. After 48 hours of treatment, the animal demonstrated hyperacute symptoms and died, showing unsuccessful in treating. Possibly the infection has been caused by inadequate umbilical cord cleansing.

O tétano é uma doença infecciosa grave e altamente fatal, causada pela toxina Clostridium tetani, uma bactéria Gram-positiva formadora de esporos anaeróbicos. A doença é caracterizada por rigidez muscular (tetania) e pode levar à morte por parada respiratória ou convulsões. O presente trabalho relata um caso de tétano em um potro Quarto de Milha de 6 dias de idade. O animal apresentava apatia, decúbito lateral, espessamento umbilical, protrusão da terceira pálpebra e convulsões em resposta a estímulos externos, como som, luz e toque. Foi tratado com 110.000 IU / kg de penicilina potássica; com imunoglobulina anti-toxina tetânica homóloga, numa dose de 25000 UI, 20.000 UI e 20000 UI por via intravenosa, intramuscular e intratecal, respectivamente; com cloridrato de acepromazina (0,05 mg / kg); fluidoterapia à base de Ringer com lactato e curativo no cordão umbilical. Decorridas 48 horas de tratamento, o animal demonstrou sintomas hiperagudos e veio à óbito, mostrando insucesso no tratamento. Possivelmente, a infecção foi causada pela limpeza inadequada do cordão umbilical.

Tratamento com imunoglobulina anti-toxina tetânica homóloga por via intratecal em tétano neonatal equino - relato de caso / Treatment with intrathecal administration of anti-tetanus toxoid immunoglobulin in neonatal foal tetanus - case report

Tetanus is a severe and highly fatal infectious disease caused by the toxin of Clostridium tetani, an anaerobic spore-forming Grampositive bacterium. The disease is characterized by muscle rigidity (tetany) and can lead to death by respiratory failure or seizures. The present study reports a case of tetanus in a 6-day-old Quarter Horse foal. The animal showed apathy, lateral recumbency, umbilical thickening, protrusion of the third eyelid, seizures and hyperesthesia. Was treated with 50,000 IU/kg of potassium penicillin; with anti-tetanus toxoid immunoglobulin in a dose of 25,000 IU, 20,000 IU and 20,000 IU intravenously, intramuscular and intrathecal, respectively; with acepromazine hydrochloride (0.05 mg / kg); fluid therapy of Ringer"s lactate solution and dressing for umbilical cord. After 48 hours of treatment, the animal demonstrated hyperacute symptoms and died, showing unsuccessful in treating. Possibly the infection has been caused by inadequate umbilical cord cleansing.(AU)

O tétano é uma doença infecciosa grave e altamente fatal, causada pela toxina Clostridium tetani, uma bactéria Gram-positiva formadora de esporos anaeróbicos. A doença é caracterizada por rigidez muscular (tetania) e pode levar à morte por parada respiratória ou convulsões. O presente trabalho relata um caso de tétano em um potro Quarto de Milha de 6 dias de idade. O animal apresentava apatia, decúbito lateral, espessamento umbilical, protrusão da terceira pálpebra e convulsões em resposta a estímulos externos, como som, luz e toque. Foi tratado com 110.000 IU / kg de penicilina potássica; com imunoglobulina anti-toxina tetânica homóloga, numa dose de 25000 UI, 20.000 UI e 20000 UI por via intravenosa, intramuscular e intratecal, respectivamente; com cloridrato de acepromazina (0,05 mg / kg); fluidoterapia à base de Ringer com lactato e curativo no cordão umbilical. Decorridas 48 horas de tratamento, o animal demonstrou sintomas hiperagudos e veio à óbito, mostrando insucesso no tratamento. Possivelmente, a infecção foi causada pela limpeza inadequada do cordão umbilical.(AU)