Icterícia: da manifestação ao manejo clínico-terapêutico / Icterus: from manifestation to clinical-therapeutic management / Ictericia: de la manifestación al manejo clínico-terapéutico

A icterícia é considerada como a pigmentação amarelada de regiões corpóreas como esclera, pele e mucosas. É uma manifestação presente em variadas doenças e pode ser classificada em icterícia pré-hepática, hepática ou pós-hepática. A categorização dos tipos de icterícia e suas identificações são fundamentais para que haja um maior conhecimento acerca do seu local de ocorrência, da sua gravidade e progressão. A condição pode ser observada em cães e gatos, e cada tipo pode estar associado a doenças distintas como processos hemolíticos, doenças hepatocelulares, obstruções de fluxo biliar, dentre outros. O diagnóstico da manifestação pode ser determinado por meio dos dados coletados na anamnese, exame clínico e/ou complementar, este último mediante necessidade. O tratamento varia e depende da causa base que esteja associada como terapias medicamentosas a intervenções cirúrgicas.

Jaundice is considered the yellowish pigmentation of body regions such as the sclera, skin and mucous membranes. It is a manifestation present in several diseases and can be classified as pre-hepatic, hepatic or post-hepatic jaundice. The categorization of types of jaundice and their identification are essential for greater knowledge about its place of occurrence, its severity and progression. The condition can be observed in dogs and cats, and each type can be associated with different diseases such as hemolytic processes, hepatocellular diseases, bile flow obstructions, among others. The diagnosis of the manifestation can be determined through data collected through anamnesis, clinical and/or complementary examination, the latter as needed. Treatment varies and depends on the underlying cause that is associated with drug therapies and surgical interventions.

La ictericia se considera la pigmentación amarillenta de regiones del cuerpo como la esclerótica, la piel y las membranas mucosas. Es una manifestación presente en varias enfermedades y puede clasificarse en ictericia prehepática, hepática o poshepática. La categorización de los tipos de ictericia y su identificación son fundamentales para un mayor conocimiento sobre su lugar de aparición, su gravedad y progresión. La afección se puede observar en perros y gatos, y cada tipo puede asociarse con diferentes enfermedades como procesos hemolíticos, enfermedades hepatocelulares, obstrucciones del flujo biliar, entre otras. El diagnóstico de la manifestación se puede determinar mediante la recogida de datos mediante anamnesis, exploración clínica y / o complementaria, esta última según sea necesario. El tratamiento varía y depende de la causa subyacente asociada con las terapias farmacológicas y las intervenciones quirúrgicas.

Hematúria macroscópica em equinos associada à infecção por Leptospira interrogans / Macroscopic haematuria in horses associated with Leptospira interrogans infection

Hematúria é uma grave manifestação clínica de doença do sistema urinário, ocorrendo sob as formas micro ou macroscópica. Neste artigo relatam-se dois casos de hematúria macroscópica associada à infecção por Leptospira interrogans sorogrupo Canicola. O exame clínico inicial revelou hematúria macroscópica, taquicardia, taquipneia, febre, elevação do tempo de perfusão capilar, hipomotilidade intestinal, além de icterícia da mucosa oral. Leucocitose, proteinúria, glicosúria, piúria e azotemia foram achados comuns aos dois casos. Teste de Soroaglutinação Microscópica foi realizado para titulação de anticorpos contra Leptospira interrogans. Tratamento incluiu medidas terapêuticas de suporte (fluidoterapia), controle da hematúria e antibioticoterapia. Sete dias após manifestação dos sinais clínicos iniciais, ambos animais receberam alta hospitalar após remissão dos sinais clínicos.

Haematuria is a serious clinical manifestation of urinary system disease, occurring in micro or macroscopic forms. In this article two cases of macroscopic haematuria associated with Leptospira interrogans serogroup Canicolainfection are related. The initial clinical examination revealed macroscopic haematuria, tachycardia, tachypnea, fever, increased capillary perfusion time, intestinal hypomotility, in addition to jaundice of the oral mucosa. Leukocytosis, proteinuria, glycosuria, pyuria and azotemia were common findings in both cases. Microscopic serum agglutination test was performed for titration of antibodies against Leptospira interrogans. Treatment included supportive therapeutic measures (fluid therapy), hematuria control and antibiotic therapy. Seven days after the manifestation of the initial clinical signs, both animals were discharged from the hospital without complications.

Hematúria macroscópica em equinos associada à infecção por Leptospira interrogans / Macroscopic haematuria in horses associated with Leptospira interrogans infection

Hematúria é uma grave manifestação clínica de doença do sistema urinário, ocorrendo sob as formas micro ou macroscópica. Neste artigo relatam-se dois casos de hematúria macroscópica associada à infecção por Leptospira interrogans sorogrupo Canicola. O exame clínico inicial revelou hematúria macroscópica, taquicardia, taquipneia, febre, elevação do tempo de perfusão capilar, hipomotilidade intestinal, além de icterícia da mucosa oral. Leucocitose, proteinúria, glicosúria, piúria e azotemia foram achados comuns aos dois casos. Teste de Soroaglutinação Microscópica foi realizado para titulação de anticorpos contra Leptospira interrogans. Tratamento incluiu medidas terapêuticas de suporte (fluidoterapia), controle da hematúria e antibioticoterapia. Sete dias após manifestação dos sinais clínicos iniciais, ambos animais receberam alta hospitalar após remissão dos sinais clínicos.(AU)

Haematuria is a serious clinical manifestation of urinary system disease, occurring in micro or macroscopic forms. In this article two cases of macroscopic haematuria associated with Leptospira interrogans serogroup Canicolainfection are related. The initial clinical examination revealed macroscopic haematuria, tachycardia, tachypnea, fever, increased capillary perfusion time, intestinal hypomotility, in addition to jaundice of the oral mucosa. Leukocytosis, proteinuria, glycosuria, pyuria and azotemia were common findings in both cases. Microscopic serum agglutination test was performed for titration of antibodies against Leptospira interrogans. Treatment included supportive therapeutic measures (fluid therapy), hematuria control and antibiotic therapy. Seven days after the manifestation of the initial clinical signs, both animals were discharged from the hospital without complications.(AU)

Hematúria macroscópica em equinos associada à infecção por Leptospira interrogans / Macroscopic haematuria in horses associated with Leptospira interrogans infection

Hematúria é uma grave manifestação clínica de doença do sistema urinário, ocorrendo sob as formas micro ou macroscópica. Neste artigo relatam-se dois casos de hematúria macroscópica associada à infecção por Leptospira interrogans sorogrupo Canicola. O exame clínico inicial revelou hematúria macroscópica, taquicardia, taquipneia, febre, elevação do tempo de perfusão capilar, hipomotilidade intestinal, além de icterícia da mucosa oral. Leucocitose, proteinúria, glicosúria, piúria e azotemia foram achados comuns aos dois casos. Teste de Soroaglutinação Microscópica foi realizado para titulação de anticorpos contra Leptospira interrogans. Tratamento incluiu medidas terapêuticas de suporte (fluidoterapia), controle da hematúria e antibioticoterapia. Sete dias após manifestação dos sinais clínicos iniciais, ambos animais receberam alta hospitalar após remissão dos sinais clínicos.

Haematuria is a serious clinical manifestation of urinary system disease, occurring in micro or macroscopic forms. In this article two cases of macroscopic haematuria associated with Leptospira interrogans serogroup Canicolainfection are related. The initial clinical examination revealed macroscopic haematuria, tachycardia, tachypnea, fever, increased capillary perfusion time, intestinal hypomotility, in addition to jaundice of the oral mucosa. Leukocytosis, proteinuria, glycosuria, pyuria and azotemia were common findings in both cases. Microscopic serum agglutination test was performed for titration of antibodies against Leptospira interrogans. Treatment included supportive therapeutic measures (fluid therapy), hematuria control and antibiotic therapy. Seven days after the manifestation of the initial clinical signs, both animals were discharged from the hospital without complications.

Babesiose encefálica em cães: aspectos clínicos, epidemiológicos e patológicos / Encephalic babesiosis in dogs: clinical, epidemiological and pathological aspects

Background: Babesiosis is a hemolytic disease caused by protozoa of the genus Babesia spp. responsible for causinganemia, fever and splenomegaly in several animal species. The cerebral involvement of babesiosis in dogs manifests itselfin a hyperacute manner with neurological disorders such as motor incoordination, nystagmus, anisocoria and convulsions.In Brazil there still are no studies which describe the pathological aspects of cerebral babesiosis in dogs together withinformation relating to its clinical aspects and epidemiology. Therefore, this work had as an objective to describe sevencases of canine cerebral babesiosis, emphasizing its epidemiological, clinical and pathological aspects.Materials, Methods & Results: All the records of the necropsies performed in dogs at Animal Pathology Laboratory (LPA/HV) of the Federal University of Campina Grande (UFCG), Patos Campus, Paraíba, Northeast of Brazil were identified. In Theperiod from January 2003 to December 2017. Later, were selected all the cases of cerebral babesiosis. Were included in thestudy the cases in which was possible to detect structures that were morphologically compatible with Babesia spp. trophozoites,intra-erythrocyte in vessels, associated to the presence of lesions in the CNS. For the microscopical description all the histological slides of the cases were revised, in addition to new slides were made with the fragments stored in parafin blocks or withthe material fixed in a 10% formalin solution. The clinical course of the animals studied was hyperacute. In 4 cases, there wassudden death within 24 h, from the appearance of the first symptoms and case 7 presented an evolution of approximately 12 h.The main clinical symptoms described were vocalization, anorexia/hyporexia, jaundice and decubitus. Additionally, the mostconsistente macroscopical findings observed...

Babesiose encefálica em cães: aspectos clínicos, epidemiológicos e patológicos / Encephalic babesiosis in dogs: clinical, epidemiological and pathological aspects

Background: Babesiosis is a hemolytic disease caused by protozoa of the genus Babesia spp. responsible for causinganemia, fever and splenomegaly in several animal species. The cerebral involvement of babesiosis in dogs manifests itselfin a hyperacute manner with neurological disorders such as motor incoordination, nystagmus, anisocoria and convulsions.In Brazil there still are no studies which describe the pathological aspects of cerebral babesiosis in dogs together withinformation relating to its clinical aspects and epidemiology. Therefore, this work had as an objective to describe sevencases of canine cerebral babesiosis, emphasizing its epidemiological, clinical and pathological aspects.Materials, Methods & Results: All the records of the necropsies performed in dogs at Animal Pathology Laboratory (LPA/HV) of the Federal University of Campina Grande (UFCG), Patos Campus, Paraíba, Northeast of Brazil were identified. In Theperiod from January 2003 to December 2017. Later, were selected all the cases of cerebral babesiosis. Were included in thestudy the cases in which was possible to detect structures that were morphologically compatible with Babesia spp. trophozoites,intra-erythrocyte in vessels, associated to the presence of lesions in the CNS. For the microscopical description all the histological slides of the cases were revised, in addition to new slides were made with the fragments stored in parafin blocks or withthe material fixed in a 10% formalin solution. The clinical course of the animals studied was hyperacute. In 4 cases, there wassudden death within 24 h, from the appearance of the first symptoms and case 7 presented an evolution of approximately 12 h.The main clinical symptoms described were vocalization, anorexia/hyporexia, jaundice and decubitus. Additionally, the mostconsistente macroscopical findings observed...(AU)

Differential diagnoses in 83 dogs with icterus / Diagnósticos diferenciais em 83 cães com icterícia

Icterus (jaundice) is a yellowish pigmentation resulting from the depositing of bilirubin in tissues due to its high plasmatic concentration. The pathogenesis of icterus includes metabolic changes or obstructed bilirubin excretion and it is classified as pre-hepatic, hepatic and post-hepatic. This study aimed to evaluate and classify different causes of icterus in dogs during post mortem examination. These dogs were examined from 2014 to 2017, using macroscopic and histologic exams as well as ancillary tests. Eighty-three dogs were examined macroscopically and microscopically. They were separated into groups of icterus types: 24 (28.9%) dogs had pre-hepatic icterus, 45 (54.2%) had hepatic, 13 (15.7%) pre-hepatic and hepatic and one (1.2%) had post-hepatic icterus. Many factors were identified as a cause of icterus, including infectious agents (51/83), neoplasms (13/83), hepatic degeneration (11/83), chronic hepatic diseases (6/83), and obstructive causes (1/87). Among the infectious causes, leptospirosis, ehrlichiosis and disorders suggestive of septicemia were diagnosed. Neoplasms associated with icterus were cholangiocarcinoma, hemangiosarcoma and lymphoma. Other causes of icterus included degenerative diseases, such as lipidosis and glycogen degeneration. Hepatic fibrosis (cirrhosis) as a chronic disease and cholelithiasis also produced icterus. PCR was performed to confirm leptospirosis and ehrlichiosis. Samples of total DNA were used to amplify a fragment of a gene from Leptospira interrogans and Ehrlichia canis. In some dogs, co-infection of these agents was detected. The classification and identification of icterus etiologies in dogs is very important due to the number of diseases with this alteration, where ante mortem diagnosis is not always easily performed when some of these conditions are present.(AU)

Icterícia é a pigmentação amarelada decorrente da deposição de bilirrubina em tecidos devido à elevada concentração plasmática. A patogênese da icterícia inclui alterações no metabolismo ou na excreção de bilirrubina, sendo classificada em pré-hepática, hepática ou pós-hepática. O objetivo desse estudo foi identificar, avaliar e classificar as causas de icterícia em cães necropsiados de 2014 a 2017, associando as lesões macroscópicas, histológicas e exames complementares. Foram avaliados macro- e microscopicamente 83 cães com diferentes intensidades de icterícia. Os cães foram separados em grupos de acordo com o tipo de icterícia: 24 (28,9%) cães com icterícia pré-hepática, 45 (54,2%) cães com icterícia hepática, 13 (15,7%) com icterícia pré-hepática e hepática e um (1,2%) com icterícia pós-hepática. Foram identificadas várias etiologias associadas à icterícia, dentre elas pode-se destacar, agentes infecciosos (51/83), neoplasmas (13/83), processos degenerativos (11/83), crônicos (6/83) e obstrutivos (1/83). Dentre as causas infecciosas, destacam-se a leptospirose, a erliquiose e as lesões sugestivas de septicemia. Entre os neoplasmas associados com icterícia destacaram-se o colangiocarcinoma, hemangiossarcoma e linfoma. Outras causas de icterícia incluiriam os processos degenerativos como as degenerações gordurosa e glicogênica. Fibrose hepática (cirrose) e colelitíase foram também diagnosticados como causa de icterícia. A PCR foi utilizada para o diagnóstico confirmatório de leptospirose e erliquiose. Amostras de DNA total foram utilizadas para amplificar um fragmento dos genes de Leptospira interrogans e de Ehrlichia canis. Em alguns cães foi detectada co-infecção por estes agentes. A classificação e a identificação das causas de icterícia em cães são relevantes devido ao grande número de doenças que apresentam essa alteração, muitas vezes sem diagnóstico ante mortem.(AU)

Differential diagnoses in 83 dogs with icterus / Diagnósticos diferenciais em 83 cães com icterícia

Icterus (jaundice) is a yellowish pigmentation resulting from the depositing of bilirubin in tissues due to its high plasmatic concentration. The pathogenesis of icterus includes metabolic changes or obstructed bilirubin excretion and it is classified as pre-hepatic, hepatic and post-hepatic. This study aimed to evaluate and classify different causes of icterus in dogs during post mortem examination. These dogs were examined from 2014 to 2017, using macroscopic and histologic exams as well as ancillary tests. Eighty-three dogs were examined macroscopically and microscopically. They were separated into groups of icterus types: 24 (28.9%) dogs had pre-hepatic icterus, 45 (54.2%) had hepatic, 13 (15.7%) pre-hepatic and hepatic and one (1.2%) had post-hepatic icterus. Many factors were identified as a cause of icterus, including infectious agents (51/83), neoplasms (13/83), hepatic degeneration (11/83), chronic hepatic diseases (6/83), and obstructive causes (1/87). Among the infectious causes, leptospirosis, ehrlichiosis and disorders suggestive of septicemia were diagnosed. Neoplasms associated with icterus were cholangiocarcinoma, hemangiosarcoma and lymphoma. Other causes of icterus included degenerative diseases, such as lipidosis and glycogen degeneration. Hepatic fibrosis (cirrhosis) as a chronic disease and cholelithiasis also produced icterus. PCR was performed to confirm leptospirosis and ehrlichiosis. Samples of total DNA were used to amplify a fragment of a gene from Leptospira interrogans and Ehrlichia canis. In some dogs, co-infection of these agents was detected. The classification and identification of icterus etiologies in dogs is very important due to the number of diseases with this alteration, where ante mortem diagnosis is not always easily performed when some of these conditions are present.(AU)

Icterícia é a pigmentação amarelada decorrente da deposição de bilirrubina em tecidos devido à elevada concentração plasmática. A patogênese da icterícia inclui alterações no metabolismo ou na excreção de bilirrubina, sendo classificada em pré-hepática, hepática ou pós-hepática. O objetivo desse estudo foi identificar, avaliar e classificar as causas de icterícia em cães necropsiados de 2014 a 2017, associando as lesões macroscópicas, histológicas e exames complementares. Foram avaliados macro- e microscopicamente 83 cães com diferentes intensidades de icterícia. Os cães foram separados em grupos de acordo com o tipo de icterícia: 24 (28,9%) cães com icterícia pré-hepática, 45 (54,2%) cães com icterícia hepática, 13 (15,7%) com icterícia pré-hepática e hepática e um (1,2%) com icterícia pós-hepática. Foram identificadas várias etiologias associadas à icterícia, dentre elas pode-se destacar, agentes infecciosos (51/83), neoplasmas (13/83), processos degenerativos (11/83), crônicos (6/83) e obstrutivos (1/83). Dentre as causas infecciosas, destacam-se a leptospirose, a erliquiose e as lesões sugestivas de septicemia. Entre os neoplasmas associados com icterícia destacaram-se o colangiocarcinoma, hemangiossarcoma e linfoma. Outras causas de icterícia incluiriam os processos degenerativos como as degenerações gordurosa e glicogênica. Fibrose hepática (cirrose) e colelitíase foram também diagnosticados como causa de icterícia. A PCR foi utilizada para o diagnóstico confirmatório de leptospirose e erliquiose. Amostras de DNA total foram utilizadas para amplificar um fragmento dos genes de Leptospira interrogans e de Ehrlichia canis. Em alguns cães foi detectada co-infecção por estes agentes. A classificação e a identificação das causas de icterícia em cães são relevantes devido ao grande número de doenças que apresentam essa alteração, muitas vezes sem diagnóstico ante mortem.(AU)

Chronic copper poisoning in beef cattle in the state of Mato Grosso, Brazil / Intoxicação crônica por cobre em bovinos de corte no Estado de Mato Grosso, Brasil

Copper is an essential micromineral in animal feed; however, when consumed in excess, it can cause liver necrosis, hemolytic crisis, hemoglobinuric nephrosis and death in cattle. Although uncommon in this species, copper poisoning occurs as a result of exacerbated supplementation, deficiency of antagonist microminerals, or previous liver lesions. An outbreak of chronic copper poisoning is reported in semi-confined cattle after supplementation with 50 mg/Kg of dry matter copper. The cattle showed clinical signs characterized by anorexia, motor incoordination, loss of balance, jaundice, brownish or black urine, diarrhea and death, or were found dead, 10 to 302 days after consumption. Of the 35 cattle that died, 20 underwent necropsy, whose frequent findings were jaundice, enlarged liver with evident lobular pattern, black kidneys, and urinary bladder with brownish to blackish content. Microscopically, the liver showed vacuolar degeneration and/or zonal hepatocellular centrilobular or paracentral coagulative necrosis, in addition to cholestasis, mild periacinal fibrosis, apoptotic bodies, and mild to moderate mononuclear inflammation. Degeneration and necrosis of the tubular epithelium and intratubular hemoglobin cylinders were observed in the kidneys. Copper levels in the liver and kidneys ranged from 5,901.24 to 28,373.14 µmol/kg and from 303.72 to 14,021 µmol/kg, respectively. In conclusion, copper poisoning due to excessive nutritional supplementation is an important cause of jaundice, hemoglobinuria, and death in semi-confined cattle.(AU)

Cobre é um micromineral essencial, que quando em excesso induz necrose hepática, crise hemolítica, nefrose hemoglobínurica e morte em bovinos. As intoxicações, apesar de incomuns nessa espécie, ocorrem devido a suplementação exacerbada de cobre, pela deficiência de microminerais antagonistas ou secundária a lesão hepática prévia. Relata-se um surto de intoxicação crônica por cobre em bovinos semiconfinados após suplementação com 50mg/kg de cobre em matéria seca. Os bovinos manifestaram sinais clínicos caracterizados por anorexia, incoordenação motora, perda de equilíbrio, icterícia, urina acastanhada ou negra, diarreia e morte ou foram encontrados mortos, após 10 a 302 dias do início de consumo. De 35 bovinos que morreram 20 foram submetidos à necropsia sendo achada frequente icterícia, fígado aumentado e com padrão lobular evidente, rins pretos e bexiga urinária repleta de conteúdo acastanhado a enegrecida. Microscopicamente, no fígado havia degeneração vacuolar e ou necrose coagulativa hepatocelular zonal, centrolobular ou paracentral, além de degeneração vacuolar com corpúsculos de Councilman, colestase, fibrose periascinar leve, e inflamação de discreta a moderada. Nos rins havia degeneração e necrose do epitélio tubular assim como cilindros de hemoglobina intratubulares. Os níveis de cobre no fígado e rim foram de 5.901,24 a 28.373,14µmol/kg e 303,72 a 14.021µmol/kg respectivamente. A suplementação nutricional excessiva com cobre pode causar doença hemolítica com icterícia, hemoglobinúria e morte de bovinos mantidos em sistema de semiconfinamento.(AU)

Chronic copper poisoning in beef cattle in the state of Mato Grosso, Brazil / Intoxicação crônica por cobre em bovinos de corte no Estado de Mato Grosso, Brasil

Copper is an essential micromineral in animal feed; however, when consumed in excess, it can cause liver necrosis, hemolytic crisis, hemoglobinuric nephrosis and death in cattle. Although uncommon in this species, copper poisoning occurs as a result of exacerbated supplementation, deficiency of antagonist microminerals, or previous liver lesions. An outbreak of chronic copper poisoning is reported in semi-confined cattle after supplementation with 50 mg/Kg of dry matter copper. The cattle showed clinical signs characterized by anorexia, motor incoordination, loss of balance, jaundice, brownish or black urine, diarrhea and death, or were found dead, 10 to 302 days after consumption. Of the 35 cattle that died, 20 underwent necropsy, whose frequent findings were jaundice, enlarged liver with evident lobular pattern, black kidneys, and urinary bladder with brownish to blackish content. Microscopically, the liver showed vacuolar degeneration and/or zonal hepatocellular centrilobular or paracentral coagulative necrosis, in addition to cholestasis, mild periacinal fibrosis, apoptotic bodies, and mild to moderate mononuclear inflammation. Degeneration and necrosis of the tubular epithelium and intratubular hemoglobin cylinders were observed in the kidneys. Copper levels in the liver and kidneys ranged from 5,901.24 to 28,373.14 µmol/kg and from 303.72 to 14,021 µmol/kg, respectively. In conclusion, copper poisoning due to excessive nutritional supplementation is an important cause of jaundice, hemoglobinuria, and death in semi-confined cattle.(AU)

Cobre é um micromineral essencial, que quando em excesso induz necrose hepática, crise hemolítica, nefrose hemoglobínurica e morte em bovinos. As intoxicações, apesar de incomuns nessa espécie, ocorrem devido a suplementação exacerbada de cobre, pela deficiência de microminerais antagonistas ou secundária a lesão hepática prévia. Relata-se um surto de intoxicação crônica por cobre em bovinos semiconfinados após suplementação com 50mg/kg de cobre em matéria seca. Os bovinos manifestaram sinais clínicos caracterizados por anorexia, incoordenação motora, perda de equilíbrio, icterícia, urina acastanhada ou negra, diarreia e morte ou foram encontrados mortos, após 10 a 302 dias do início de consumo. De 35 bovinos que morreram 20 foram submetidos à necropsia sendo achada frequente icterícia, fígado aumentado e com padrão lobular evidente, rins pretos e bexiga urinária repleta de conteúdo acastanhado a enegrecida. Microscopicamente, no fígado havia degeneração vacuolar e ou necrose coagulativa hepatocelular zonal, centrolobular ou paracentral, além de degeneração vacuolar com corpúsculos de Councilman, colestase, fibrose periascinar leve, e inflamação de discreta a moderada. Nos rins havia degeneração e necrose do epitélio tubular assim como cilindros de hemoglobina intratubulares. Os níveis de cobre no fígado e rim foram de 5.901,24 a 28.373,14µmol/kg e 303,72 a 14.021µmol/kg respectivamente. A suplementação nutricional excessiva com cobre pode causar doença hemolítica com icterícia, hemoglobinúria e morte de bovinos mantidos em sistema de semiconfinamento.(AU)

Accumulative copper poisoning in sheep in Northeastern Brazil / Intoxicação cúprica acumulativa em ovinos no Nordeste brasileiro

Background: Despite the proven copper deficiency in several parts of Brazil, reports of acute and accumulative copper poisoning are increasing in ruminants. Sheep are known to be far more sensible to copper toxicity than cattle, but the sensibility of goats is not quite known. The present paper aimed to describe the epidemiological, clinical, laboratorial and pathological findings of two outbreaks of accumulative copper poisoning in sheep fed poultry litter in Ceará and Rio Grande do Norte, Northeastern Brazil, and to compare these findings with national outbreaks. Cases: Two outbreaks of copper poisoning occurred in the municipalities of Mossoró, Rio Grande do Norte [outbreak 1], and Icapuí, Ceará [outbreak 2], Brazil. A total of 35 sheep [outbreak 1] and 190 small ruminants (175 sheep and 15 goats) [outbreak 2] were fed poultry litter. First clinical signs of poisoning started after two months of litter consumption. Main clinical signs were apathy, jaundice, hepatomegaly, abdominal pain, diarrhea, and dark urine. Clinical evolution varied between one and eight days. Laboratorial findings in ill animals consisted of anemia, highly increased serum AST and GGT activities and urea and creatinine levels; whilst in the non symptomatic sheep and one goat revealed high and light GGT increase, respectively. Poultry litter analysis revealed levels of 449, 2610, 414 and 333 mg/kg of [...]

Accumulative copper poisoning in sheep in Northeastern Brazil / Intoxicação cúprica acumulativa em ovinos no Nordeste brasileiro

Background: Despite the proven copper deficiency in several parts of Brazil, reports of acute and accumulative copper poisoning are increasing in ruminants. Sheep are known to be far more sensible to copper toxicity than cattle, but the sensibility of goats is not quite known. The present paper aimed to describe the epidemiological, clinical, laboratorial and pathological findings of two outbreaks of accumulative copper poisoning in sheep fed poultry litter in Ceará and Rio Grande do Norte, Northeastern Brazil, and to compare these findings with national outbreaks. Cases: Two outbreaks of copper poisoning occurred in the municipalities of Mossoró, Rio Grande do Norte [outbreak 1], and Icapuí, Ceará [outbreak 2], Brazil. A total of 35 sheep [outbreak 1] and 190 small ruminants (175 sheep and 15 goats) [outbreak 2] were fed poultry litter. First clinical signs of poisoning started after two months of litter consumption. Main clinical signs were apathy, jaundice, hepatomegaly, abdominal pain, diarrhea, and dark urine. Clinical evolution varied between one and eight days. Laboratorial findings in ill animals consisted of anemia, highly increased serum AST and GGT activities and urea and creatinine levels; whilst in the non symptomatic sheep and one goat revealed high and light GGT increase, respectively. Poultry litter analysis revealed levels of 449, 2610, 414 and 333 mg/kg of [...](AU)

Babesiose equina por Theileria equi relato de caso

A babesiose trata-se de uma enfermidade transmitida por carrapatos, causada pela infecção de hemácias por parasitas protozoários, seja Babesia caballi ou Theileria equi. A doença caracteri­za-se em sua forma aguda, pelo surgimento de febre, às vezes de natureza intermitente, anemia, icterícia, hepato e esplenomegalia, bem como bilirrubinúria e hemoglobinúria podem estar presentes na fase nal da doença. Apesar da gravidade da infecção aguda, a maioria dos animais desenvolve a forma crônica, podendo apresentar reagudizações em situações que determinem a diminuição da taxa de anticorpos, como stress.

Cholangiocellular carcinoma in a cat / Carcinoma colangiocelular em gato

Background: Primary hepatobiliary tumors are rare in dogs and cats. Studies suggest a prevalence of 0.6% in dogs and 2.9% in cats from all occurring tumors. Neoplasia in these tissues can have hepatocellular and bile ducts origin or even be sarcomas or neuroendocrine tumors. Its clinical signs are nonspecific and the diagnosis is most often tardy or even done during necropsy. A case of cholangiocellular carcinoma and glomerulonephritis in a cat is reported, addressing its clinical aspects and emphasizing the importance of an early diagnosis. Case: A mixed breed, 12-year-old neutered cat was admitted in the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul treated previously without obvious improvement. Jaundice, severe dehydration, excessive salivation, low body condition (score three out of nine), abdominal discomfort, and lethargy were evident on physical examination. Blood tests showed neutrophilic leukocytosis, lymphopenia, and increased serum levels of both alanine aminotransferase and alkaline phosphatase enzymes. Abdominal ultrasound examination revealed a large single mass of three centimeters of diameter, approximately, compressing the bile ducts. Because of the severity of the patients condition, it was hospitalized to receive supportive care. During hospitalization, the animal received feeding through an esophageal tube, intravenous fluid...(AU)

Cholangiocellular carcinoma in a cat / Carcinoma colangiocelular em gato

Background: Primary hepatobiliary tumors are rare in dogs and cats. Studies suggest a prevalence of 0.6% in dogs and 2.9% in cats from all occurring tumors. Neoplasia in these tissues can have hepatocellular and bile ducts origin or even be sarcomas or neuroendocrine tumors. Its clinical signs are nonspecific and the diagnosis is most often tardy or even done during necropsy. A case of cholangiocellular carcinoma and glomerulonephritis in a cat is reported, addressing its clinical aspects and emphasizing the importance of an early diagnosis. Case: A mixed breed, 12-year-old neutered cat was admitted in the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul treated previously without obvious improvement. Jaundice, severe dehydration, excessive salivation, low body condition (score three out of nine), abdominal discomfort, and lethargy were evident on physical examination. Blood tests showed neutrophilic leukocytosis, lymphopenia, and increased serum levels of both alanine aminotransferase and alkaline phosphatase enzymes. Abdominal ultrasound examination revealed a large single mass of three centimeters of diameter, approximately, compressing the bile ducts. Because of the severity of the patients condition, it was hospitalized to receive supportive care. During hospitalization, the animal received feeding through an esophageal tube, intravenous fluid...

Etiologias da icterícia e diagnóstico diferencial prospectivo em 84 cães

A icterícia é a coloração amarelada decorrente da deposição de bilirrubina em tecidos ricos em elastina, devido à elevada concentração plasmática. A icterícia ocorre por alterações no metabolismo ou na excreção de bilirrubina, sendo classificadas em pré-hepática, hepática ou pós-hepática. A icterícia pré-hepática ocorre quando há hemólise intra- ou extravascular de causa infecciosa ou imunomediada. A icterícia hepática decorre de lesão hepática extensa. A icterícia pós-hepática pode ser secundária à obstrução parcial ou completa do ducto colédoco por colelitíases ou neoplasias. O objetivo desse estudo foi identificar, avaliar e classificar as causas de icterícia em cães necropsiados entre 2014 e 2017 associando as lesões macroscópicas, histológicas e exames complementares. Foram avaliados macro- e microscopicamente 84 cães com diferentes graus de icterícia, sendo classificados 22 (26,2%) cães com icterícia pré-hepática, 48 (57,1%) cães com icterícia hepática, 13 (15,5%) com icterícia pré-hepática e hepática e um (1,2%) com icterícia pós-hepática. Nos exames hematológicos, a alteração mais frequente foi anemia moderada a acentuada com leucocitose e trombocitopenia. Na bioquímica sanguínea, a maioria dos cães estava com azotemia e alteração nos níveis séricos das enzimas hepáticas, como fosfatase alcalina (FA), aspartato aminotransferase (AST) e alanina aminotransferase (ALT). Foram identificadas várias etiologias associadas à icterícia, dentre elas pode-se destacar, agentes infecciosos (47/84), neoplasias (13/84), processos degenerativos (12/84), crônicos (6/84), processos septicêmicos (5/84) e obstrutivos (1/84). Dentre as causas infecciosas, as mais frequentes foram leptospirose (40/84) e erliquiose (7/84). Das neoplásicas, foram colangiocarcinoma (5/84), hemangiossarcoma (4/84) e (2/84) linfoma. Dos processos degenerativos, os mais frequentes foram degenerações gordurosa (9/84) e glicogênica (3/84). Dos processos crônicos os mais frequentes foram fibrose hepática (cirrose) (6/84) e dos obstrutivos foi diagnosticado somente um caso de colelitíase (1/84). A PCR foi utilizada para o diagnóstico confirmatório da infecção por Leptopira interrogans e Ehrlichia canis. O DNA de Leptospira interrogans foi amplificado em 37 cães, e destes, quatro estavam co-infectados com Ehrlichia canis. A classificação e a identificação das causas de icterícia em cães são de relevância devido a frequência de doenças que apresentam essa alteração, muitas vezes sem diagnóstico ante-mortem.

Icterus is a yellowish discoloration developed from the bilirubin deposition, in tissues abundant in elastin, due to its high plasmatic concentration. It occurs in metabolism changes or bilirubin excretion and it is classified in pre-hepatic, hepatic and post-hepatic. Pre-hepatic icterus is a result of intra- or extravascular hemolysis by infectious or immune-mediated forms. The hepatic jaundice is a consequence of extensive liver damage. Post-hepatic form is usually secondary to partial or complete bile duct obstruction in cholelithiasis or neoplasms. The aim of this study was to evaluate and classify different icterus causes in dogs necropsied between 2014 and 2017, associating macroscopic and histologic changes as well as ancillary tests. Eighty four dogs were analyzed macro- and microscopically and separated in groups of icterus causes; 22 (26,2 %) dogs had pre-hepatic icterus, 48 (57,1%) hepatic, 13 (15.5%) pre-hepatic and hepatic and one (1.2%) with post-hepatic icterus. The hematological exam detected moderate anemia with severe leukocytosis and thrombocytopenia. The biochemical exam detected azotemia in most of the dogs with high increase in the sera levels of the hepatic enzymes, as alkaline phosphatase (AP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Many factors were identified as the cause of icterus and the main factors were infectious agents (47/84), neoplasms (13/84), degenerative changes (12/84), chronic changes (6/84) and obstructive cause (1/84). The most frequent infectious causes were leptospirosis (40/84) and ehrlichiosis (7/84). Neoplastic causes include cholangiocarcinoma (5/84), hemangiosarcoma (4/84) and lymphoma (2/84). Degenerative changes were lipidosis (9/84) and glycogen (3/84) degeneration. Hepatic fibrosis (cirrhosis) (6/84) was the most frequent chronic changes and cholelithiasis (1/84) was diagnosed once as obstructive cause. PCR was performed to confirm Leptopira interrogans e Ehrlichia canis infections. DNA of Leptospira interrogans was amplified in 37 dogs, which four had coinfection with Ehrlichia canis. The classification and identification of icterus causes in dogs are very important due to the number of diseases with this alteration, frequently without ante-mortem diagnosis.

Choque toxêmico por ruptura de vesícula biliar em canino

Introdução: Várias são as causas para que ocorra a ruptura da vesícula biliar em caninos. Uma das causas é a colecistite necrótica, que ocorre geralmente pela obstrução das vias biliares quando ocorre a formação de tecido fibroso mucoide. A vesícula biliar nestes casos se torna incapaz de armazenar bile e ocorre sua ruptura. Algumas raças caninas são mais propensas como o pastor de Shetland, o Schnauzer miniatura e o Cocker Spaniel. Os casos podem ser sintomáticos ou não. Nos episódios sintomáticos que em geral são mais graves, o animal apresenta dor abdominal, anorexia, poliúria, polidipsia, letargia, vômito e colapso vascular por choque toxêmico.Caso: Um canino macho SR D, de 12 anos de idade e massa corporal de 27 kg, foi apresentado com histórico de letargia, vomito e anorexia. O animal apresentava-se totalmente ictérico, prostrado, hipotérmico (temperatura retal 37C), com frequência cardíaca de 170 bpm, depressão respiratório com 12 mrpm, desidratação estimada em 9 ou 10%. Imediatamente o paciente recebeu um cateter venoso central e um cateter urinário. Iniciou-se a administração de solução cristaloide (NaCl 0.9%) na taxa de 20 mL/kg/hora e juntamente a um dose de 4 mL/kg de solução coloide (hetastarch®). Amostras de sangue venoso foram colhidas para exames laboratoriais que demonstraram azotemia pré renal com ureia 90 mg/dL e creatinina 6,2 mg/dL, alcalose metabólica com

Pancreatite aguda necrótica em bugio-ruivo (Alouatta guariba clamitans) macho adulto / Necrotic acute pancreatitis in male adult Southern Brown Howler Monkey (Alouatta guariba clamitans)

This paper reports the development of necrotic acute pancreatitis in a captive male adult Southern Brown Howler Monkey (Alouatta guariba clamitans, Cabrera, 1940) presenting acute apathy and anorexia. Blood samples were collected and supportive treatment was made although death could not be avoided. Necropsy was performed. First erythrogram results showed polycythaemia due to dehydration; second exam revealed anemia after fluid administration. Leukopenia with neutropenia suggested poor prognosis. Creatinine was in the reference range although BUN (blood urea nitrogen) was increased. Increased alanine aminotransferase, aspartate aminotransferase and creatin kinase serum activities were observed. Amylase and lipase serum activities were incredibly high. Necropsy revealed intense icterus in subcutaneous tissue and internal structures, including misshapen pancreas with rare glandular tissue. Acute pancreatitis diagnosis was made by clinical signs, laboratory findings, and necropsy.(AU)

Icterícia de íris após rabdomiólise por esforço em um equino

One case of icterus iris diagnosed in an American Paint Horse is described. Stiffness, painful muscle, reluctance to move, elevated respiratory and heart rates, and icterus iris were observed in the clinical examination. Creatine kinase, aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase, and bilirubin levels were markedly elevated. Exertional rhabdomyolysis syndrome was diagnosed. Analgesic therapy, fluid therapy, and limited exercise were prescribed. After six days there was a remission of clinical signs and return the original color of the iris.

Neste trabalho, é descrito um caso de icterícia de íris em equino da raça Paint. Ao exame clínico, foram observados tremores, dor muscular, relutância em andar, taquicardia, taquipnéia e icterícia de íris. As concentrações séricas de creatina cinase, aspartato aminotransferase, lactato desidrogenase e bilirrubina indireta estavam marcadamente elevadas. Com base na anamnese, sintomatologia clínica e bioquimica sérica, diagnosticou-se síndrome da rabdomiólise por esforço. Foram instituídos os seguintes tratamentos: terapia analgésica, fluidoterapia e restrição de exercício. Após seis dias, houve a remissão dos sinais clínicos e o retorno da coloração original da íris.

Icterícia de íris após rabdomiólise por esforço em um equino

One case of icterus iris diagnosed in an American Paint Horse is described. Stiffness, painful muscle, reluctance to move, elevated respiratory and heart rates, and icterus iris were observed in the clinical examination. Creatine kinase, aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase, and bilirubin levels were markedly elevated. Exertional rhabdomyolysis syndrome was diagnosed. Analgesic therapy, fluid therapy, and limited exercise were prescribed. After six days there was a remission of clinical signs and return the original color of the iris.

Neste trabalho, é descrito um caso de icterícia de íris em equino da raça Paint. Ao exame clínico, foram observados tremores, dor muscular, relutância em andar, taquicardia, taquipnéia e icterícia de íris. As concentrações séricas de creatina cinase, aspartato aminotransferase, lactato desidrogenase e bilirrubina indireta estavam marcadamente elevadas. Com base na anamnese, sintomatologia clínica e bioquimica sérica, diagnosticou-se síndrome da rabdomiólise por esforço. Foram instituídos os seguintes tratamentos: terapia analgésica, fluidoterapia e restrição de exercício. Após seis dias, houve a remissão dos sinais clínicos e o retorno da coloração original da íris.