Resumo

Background: The disease dioctophymatosis caused by the parasite Dioctophyma renale is a matter of veterinary public health, mainly in the control of zoonoses, monitoring of environmental pollution related to animals, hygiene and protection of animals. The fishs and frogs are paratenic hosts after ingestion of parasitized annelids. Humans and animals are definitive hosts after ingestion of intermediate or paratenic hosts with infective larvae. The objective was to describe a case of Canis lupus familiaris from a rural region, infested by a free adult D. renale in the abdominal cavity, indicating an alert for this zoonosis. Case: A 2-year-old bitch mixed breed, weighing 15,700 kg, from the rural area of the city of Miguel Pereira, state of Rio de Janeiro, was submitted to elective hysterectomy surgery. Routine preoperative tests were requested (hemogram, Alt, Ast, urea, creatinine, EAS and echocardiogram), with all results unchanged, eight-hour fasting and four-hour water fasting. The animal was sent to the operating room and submitted to pre anesthesia, induction and maintenance of anesthesia. At laparotomy, a dark red cylindrical worm was seen immobile inside the abdominal cavity over the viscera, which was removed with the aid of anatomical tweezers, identified as a female Dioctophyma renale, 51 cm long. The abdominal cavity was visualized to check for further peritoneal and kidney damage. Based on the physical clinical examination and the results of the laboratory tests, it was decided to perform the initial elective surgical indication. The laparotomy suture was performed in the midline with 2-0 nylon thread, subcutaneous with 2-0 polyglactin thread, both with continuous sutures and the skin suture was with simple stitches separated with nylon. The postoperative protocol immediate consisted of analgesia and abdominal ultrasound was requested, which was not authorized by the tutor. Mediate postoperative analgesia, anti-inflammatory and antibiotic and healing ointment in the surgical wound. Healing was by primary intention and the skin stitches were removed 10 days after the surgical procedure. After 24 h of removal of the stitches, the bitch, when urinating, expelled a dark red cylindrical worm with a length measured at 25 cm when the person responsible for the animal again claimed the need for an ultrasound. After the arguments, he agreed and authorized the imaging exam. Discussion: The reported case drew attention to municipalities that have rural areas with freshwater springs and that receive visits from wild animals and stray dogs. It is important to carry out new studies involving Dioctophyma renale and epidemiological data to better understand and facilitate the prevention and control of zoonosis, especially with regard to the capture, commercialization and consumption of fish from these regions in order to avoid transmission of this nematode (giant kidney worm) to humans. The zoonosis dioctophymatosis needs to be investigated on the epidemiological aspects of each region, where domestic and wild animals cohabit, and that there are favorable conditions such as freshwater sources for infestations of this parasite to occur, in addition to strict control of hygiene and inspection of food and of products of animal origin.

Resumo

Background: Hyperbaric oxygen therapy (HBOT) is a therapeutic modality in which pure and pressurized oxygen is de-livered to the patient, causing tissue hyperoxygenation and consequent improvements in the inflammatory state, immune defense capacity, and healing. It is performed in pressurized chambers with oxygen, specific for the therapy. Dioctophyme renale, a nematode, is a parasite in mammals that causes severe, chronic, and progressive kidney damage. It is usually diagnosed through abdominal ultrasonography. Most cases are asymptomatic, and the treatment of choice is surgery. This report concerns 2 cases of conditioning with HBOT before laparoscopic right nephrectomy. Cases: Two adult bitches, both of mixed breed, parasitized naturally by Dioctophyme renale in the right kidney, and were treated at the Veterinary Hospital. The bitch in case 1 had no clinical signs of the disease, whereas the bitch in case 2 had hematuria for 3 years. Parasite eggs were not found in the urine of either dog. Both dogs underwent 2 presurgical HBOT sessions, 24 h apart, at a pressure of 2 absolute total atmospheres for 30 min. Immediately after the 2nd session, general anesthesia was induced, and the dogs underwent laparoscopic right nephrectomy in the left lateral decubitus position, and surgical access was through 3 portals in the right flank. Hemostasis was achieved with titanium clips in case 1 and with bipolar forceps with impedance control in case 2. The parasitized kidneys were placed in a tissue extractor bag and removed from de cavity, and the surgical wound was sutured in 3 layers. Three male parasites were removed from the kidney in case 1 and one male parasite from that in case 2. Neither patient had free parasites in the abdominal cavity. No intraoperative or postoperative complications occurred. Hematological examinations revealed improvement in the red blood cell count and a decrease in the serum fibrinogen level in case 1 and a decrease in the red series and an increase in the serum fibrinogen level in case 2. Both patients had decreased total numbers of leukocytes and platelets. Discussion: Studies have shown that presurgical hyperbaric conditioning improves renal and hepatic response to ischemia-reperfusion disorders, such as those that may occur during laparoscopies. Such disorders result from the creation of a pneumoperitoneum during the procedure, which increases intra-abdominal pressure. These tissues may receive cytoprotection mediated by the expression of heme-oxygenase 1, an anti-inflammatory substance induced by HBOT. Although the red series was reduced in case 2, it remained within the harmless reference range for the species. The increase in the red series in case 1 demonstrates the potential benefit of HBOT, inasmuch as many animals with D. renale have anemia. Because dioctophymosis leads to chronic kidney damage, a mild inflammatory response is expected. Thus, therapies that reduce systemic inflammation, such as HBOT, are beneficial to patients. Preoperative oxygenation is also recommended in animals undergoing long procedures. The results obtained in these 2 cases were different, but the benefits already proven by the consulted literature indicate that hyperbaric therapy can be advantageous in animals undergoing surgery. HBOT proved to be beneficial in the preoperative conditioning of 2 bitches with Dioctophyme renale, and both animals tolerated very well the therapy.

Resumo

Background: Dioctophymosis is caused by Dioctophyma renale, a parasite known as the giant kidney worm, that canparasitize the kidneys of domestic and wild animals. There are also reports of its occurrence in humans, thus revealing itszoonotic potential. In most cases, parasitized animals are asymptomatic. This parasite can cause atrophy or destroy therenal parenchyma, although ectopic locations may occur. The diagnosis is made through ultrasonography, based on thepresence of eggs in the urine, visualization of the parasite, or during necropsy. Therefore, the aim of this work was to reportthe case of a young dog infected with D. renale and subjected to nephrectomy in the state of Mato Grosso do Sul, Brazil.Case: A 6-month-old bitch with a clinical suspicion of hydronephrosis in the right kidney was referred to the VeterinaryHospital of Anhanguera-Uniderp University in the city of Campo Grande, MS. A physical examination of the patientrevealed an alteration in the urinary system. An abdominal ultrasound, urinalysis, complete blood count (CBC) tests andbiochemical profile were ordered. The erythrogram indicated erythrocytosis resulting from dehydration and loss of bodyfluids, while enzyme levels (creatinine, urea, alanine aminotransferase [ALT] and albumin) were within normal limits.The abdominal ultrasound showed the presence of a cylindrical and rounded structure characteristic of a nematode and inthe right kidney, and loss of renal parenchyma typical of D. renale infection. A urinalysis then revealed the presence ofhelminth eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affected rightkidney, which showed destruction of the renal parenchyma. One adult female and one adult male parasite were removedfrom inside the kidney, measuring approximately 50 cm and 35 cm in length. The patient was successfully treated, keptin hospital for observation, and returned two weeks later for reassessment of her...

Resumo

Dioctophymosis is the disease caused by Dioctophyma renale, a large nematode, popularly known as giant kidney worm, and whose definitive hosts are the domestic dog and many wild mammal species. There are some reports of maned wolf parasitism by D. renale, however, in most cases the reports are restricted to the finding of the parasite during necropsy, without clinical assessment. The present report aimed to describe the clinical-therapeutic, ultrasonographic and pathological aspects of D. renale parasitism in a free-ranging maned wolf, emphasizing the treatment with an association of doramectin, praziquantel, pyrantel pamoate, and febantel that resulted in complete elimination of the parasite.(AU)

A dioctofimose é a doença causada pelo Dioctophyma renale, um nemátodo grande, popularmente chamado de verme gigante do rim e que tem como hospedeiro definitivo o cão doméstico e inúmeras espécies de mamíferos silvestres. Existem alguns relatos do parasitismo do lobo-guará por D. renale, contudo, na maioria das vezes, os relatos se restringem apenas ao achado do parasita durante a necropsia, sem a correlação clínica. O presente relato objetiva descrever os aspectos clínico-terapêuticos, ultrassonográficos e patológicos do parasitismo por D. renale em um lobo-guará de vida livre, enfatizando o tratamento com uma associação de doramectina, praziquantel, pamoato de pirantel e febantel, o que resultou na eliminação completa do parasita.(AU)

Resumo

Abstract Dioctophymatosis is caused by the giant kidney worm Dioctophyme renale which occurs in dogs, cats, and wild mammals. In Brazil, the disease has been diagnosed in dogs from several states around the country. In the present study, the occurrence of D. renale larvae in snakes from southern of Brazil is reported. Three specimens of Philodryas patagoniensis (Serpentes: Dipsadidae) (common names in Brazil: "parelheira", "papa-pinto") roadkill in the county of Capão do Leão, State of Rio Grande do Sul, southern Brazil, were necropsied. Two third-stage larvae of D. renale were found in the coelomic cavity of P. patagoniensis. This study reveals a new host for D. renale larvae in the southern region of the State of Rio Grande do Sul, Brazil. This particular geographic area of the country has stood out as several cases of D. renale infection have been reported in a number of vertebrates from this region including domestic dogs and cats and wild animals such as carnivores, fish, and freshwater turtles.

Resumo Dioctophyme renale, verme gigante do rim, parasita cães, gatos e mamíferos silvestres, sendo que no Brasil, a dioctofimatose canina vem sendo diagnosticada em diversos estados brasileiros. O estudo tem por objetivo registrar larvas de D. renale parasitando serpente no extremo sul do Brasil. Nesse contexto, foram examinados três espécimes de Philodryas patagoniensis (Serpentes: Dipsadidae) encontradas mortas após atropelamento em uma estrada do município de Capão do Leão, Rio Grande do Sul (RS). Duas larvas de terceiro estágio de D. renale foram encontradas na cavidade celomática de P. patagoniensis, a qual representa um novo hospedeiro para larvas de D. renale na região sul do RS, a qual vem se destacando devido aos diversos registros do parasito em cães e gatos domésticos, bem como animais silvestres (carnívoros, peixes, quelônios).

Resumo

A infecção por Dioctophyme renale é denominada dioctofimatose, uma doença crônica e degenerativa que comumente cursa com a destruição irreversível do parênquima renal. Conhecido como verme gigante do rim, o nematódeo D. renale tem coloração avermelhada, atinge até 100 cm de comprimento e tem predileção natural pelo rim direito. É frequentemente diagnosticado em cães no sul do Brasil, por meio de técnicas de análise de urina e ultrassonografia abdominal. O procedimento cirúrgico é preconizado no tratamento da infecção, uma vez que a doença não responde às terapias antiparasitárias habituais. Frequentemente, pacientes afetados apresentam destruição total do parênquima renal, sendo submetidos à nefrectomia terapêutica. Embora haja diversos relatos de cirurgias para o tratamento da parasitose, não há, na literatura atual, estudos com grandes grupos de pacientes e consolidação nas recomendações terapêuticas para cães parasitados. A oxigenoterapia hiperbárica (HBOT) é uma modalidade terapêutica, baseada na oferta de oxigênio a 100% em ambiente hiperbárico, em crescente ascensão na Medicina Veterinária. Estudos sugerem a contribuição na redução do estresse inflamatório, no estímulo à cicatrização, na potencialização de antimicrobianos e também na proteção renal e hepática frente a eventos de isquemia e reperfusão. Assim, o objetivo deste estudo foi reunir casos cirúrgicos de cães naturalmente parasitados por D. renale e submetidos à terapia cirúrgica, pelas técnicas convencional e videocirúrgica. Também, analisar a ação da oxigenoterapia hiperbárica em dois cães parasitados, submetidos a duas sessões de 2 ATA durante 30 minutos, como pré-condicionamento cirúrgico. O Artigo 1 reuniu 52 cães com D. renale em rim direito submetidos à nefrectomia convencional, sendo 61,5% dos animais assintomáticos. O intervalo entre o diagnóstico e a cirurgia foi de 27,4±23 dias e não houve nenhuma emergência cirúrgica. O acesso abdominal paracostal direito foi mais frequente e as complicações transoperatórias ocorreram em 9,6% dos procedimentos. A média de sobrevivência pós-operatória foi de 835.5±428 dias. O Artigo 2 relatou o caso de dois cães submetidos a duas sessões de HBOT previamente à nefrectomia terapêutica. Os pacientes apresentaram resultados variados, com melhora da série vermelha e declínio do fibrinogênio em um paciente e declínio da série vermelha e aumento do fibrinogênio no outro paciente. Já a série branca e a contagem de plaquetas diminuíram em ambos os casos. O Artigo 3 descreve a aplicação de nefrectomia laparoscópica em 15 cães realizadas em sete instituições brasileiras. Foram descritas três técnicas de acesso à cavidade abdominal, sendo mais frequente o uso de portais de disposição triangular no flanco direito. A forma de hemostasia mais utilizada foi a aplicação de clipes de titânio no hilo renal. Os procedimentos foram eficazes em todos os pacientes e permitiram a remoção do rim e dos parasitos, sendo uma técnica altamente recomendada pelos autores. Conclui-se que a terapia videocirúrgica da dioctofimatose é segura e aplicável e que a doença não se caracteriza como uma emergência cirúrgica. A HBOT se mostra potencialmente benéfica na estabilização de pacientes com dioctofimatose.

Infection by Dioctophyme renale is called dioctophymatosis, a chronic and degenerative disease that commonly leads to irreversible destruction of the renal parenchyma. Known as the giant kidney worm, the nematode D. renale is reddish in color and reaches up to 100 cm in length, with a natural predilection for the right kidney. It is often diagnosed in dogs in the south of the Brazil, through techniques of urinalysis and abdominal ultrasound. The surgical procedure is recommended in the treatment of infection, since the disease does not respond to usual antiparasitic therapies. Often, affected patients present with total destruction of the renal parenchyma, being submitted to therapeutic nephrectomy. Although there are several reports of surgeries for the treatment of parasitosis, there are no studies in the current literature with large groups of patients and consolidation of therapeutic recommendations for parasitized dogs. Hyperbaric oxygen therapy (HBOT) is a therapeutic modality based on the provision of 100% oxygen in a hyperbaric environment, which is on the rise in Veterinary Medicine. Studies suggest its participation in reducing inflammatory stress, stimulating healing, potentiating antimicrobials and also in renal and hepatic protection against ischemia and reperfusion events. Thus, the objective of this study was to gather surgical cases of dogs naturally parasitized by D. renale and submitted to surgical therapy, using conventional and video-surgical techniques. Also, to analyze the action of hyperbaric oxygen therapy in two parasitized dogs, submitted to two sessions of 2 ATA for 30 minutes, as surgical preconditioning. Article 1 gathered 52 dogs with D. renale in the right kidney submitted to conventional nephrectomy, 61.5% of which were asymptomatic. The interval between diagnosis and surgery was 27.4±23 days and there was no surgical emergency. The right paracostal abdominal approach was more frequent and intraoperative complications occurred in 9.6% of the procedures. The mean postoperative survival was 835.5±428 days. Article 2 reported the case of two dogs submitted to two sessions of HBOT before performing therapeutic nephrectomy. Patients presented varied results, with improvement in the red series and decline in fibrinogen in case 1 and decline in the red series and increase in fibrinogen in case 2. On the other hand, the white series and platelet counts decreased in both cases. Article 3 describes the application of laparoscopic nephrectomy in 15 dogs performed in seven Brazilian institutions. Three techniques for accessing the abdominal cavity were described, with the most frequent use of portals with a triangular arrangement on the right flank. The most used form of hemostasis was the application of titanium clips in the renal hilum. The procedures were effective in all patients and allowed the removal of the kidney and parasites, being a technique highly recommended by the authors. It is concluded that the surgical therapy of dioctophymatosis is safe and applicable and that the disease is not characterized as a surgical emergency. HBOT is potentially beneficial in stabilizing patients with dioctophymosis.

Resumo

Abstract Dioctophyme renale is a zoonotic nematode that parasites the kidneys of wild and domestic carnivores, and it has been reported frequently in Brazil. The aim here was to register the number of cases of dogs and cats diagnosed with dioctophymosis by necropsy (1981 to 2014) and ultrasound examination (2010 to 2015) in Pelotas-RS. In this context, a survey was conducted on dioctophymosis cases diagnosed at the Veterinary Pathology Laboratory (LPV) and Veterinary Clinical Hospital (HCV) of the Federal University of Pelotas (UFPel), and at a specialist veterinary imaging diagnostics clinic. In total, 95 cases were registered. The high series of the disease in dogs can be related to the presence of a large number of stray and semi-domestic dogs in the city, and also due to the ingestion of intermediate hosts of D. renale parasitized with the infective larvae. Thus, it can be concluded that Pelotas is a city with favorable conditions for the occurrence of dioctophymosis with high rate of disease in recent years.

Resumo Dioctophyme renale é um nematódeo zoonótico que parasita principalmente o rim de carnívoros silvestres e domésticos, e tem sido relatado com frequência no Brasil. Objetivou-se registrar o número de casos de cães e gatos diagnosticados com dioctofimatose por necropsia (1981 a 2014) e exame ultrassonográfico (2010 a 2015) em Pelotas-RS. Nesse contexto, foi realizado um inquérito de casos de dioctofimatose em animais de companhia no Laboratório de Patologia Veterinária (LPV) e no Hospital de Clínicas Veterinária (HCV) da Universidade Federal de Pelotas (UFPel), e em uma clínica veterinária especializada em diagnóstico por imagem, totalizando 95 casos registrados. A elevada casuística da doença em cães pode estar relacionada à presença de um grande número de cães errantes e semi-domiciliados na cidade, e também devido à ingestão dos hospedeiros intermediários de D. renale parasitados com a larva infectante. Assim, conclui-se que Pelotas é uma cidade propícia para a ocorrência de dioctofimatose, com elevada casuística da doença nos últimos anos.

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O lobo-guará (Chrysocyon brachyurus) é o maior canídeo da América do Sul, sendo classificado como quase ameaçado de extinção pela União Internacional para a Conservação da Natureza e dos Recursos Naturais e como uma espécie vulnerável pelo Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renováveis. A espécie possui área de vida extensa, ocorrendo inclusive em áreas onde conflitos entre animais silvestres e populações humanas podem acontecer. Sabe-se que o lobo-guará pode ser infectado por diversos parasitas. Neste estudo, é apresentado um novo registro do verme gigante renal (Dyoctophyma renale Goeze 1972) encontrado em lobo-guará, no estado de Goiás. Esse parasita já foi encontrado em outros estados brasileiros, sendo associado a taxas de mortalidade em populações de lobo-guará. A ocorrência desse parasita no estado de Goiás é uma informação crucial para avaliar tanto a distribuição geográfica quanto a influência potencial desse parasita na sobrevivência do lobo-guará no Brasil.

The maned wolf (Chrysocyon brachyurus) is the largest canid of South America and is classified as Near Threatened by International Union for Conservation of Nature. This species has a large home range and often occurs in areas where human-wildlife conflicts are likely to take place. The maned wolf has been previously shown to be infected by a diversity of parasite species. Here we present a new record of the giant kidney worm (Dyoctophyma renale Goeze 1972) in the maned wolf found in the State of Goiás, central Brazil. This parasite has been also found in other Brazilian states and has been shown to be linked to C. brachyurus mortality rates. The occurrence of this parasite in the State of Goiás is a crucial piece of information for evaluating the distribution as well as the potential influence of this parasite on the plight of the maned wolf in Brazil.