Infusão contínua de fentanil e cetamina para controle de dor no transcirurgico: relato de caso / Continuous infusion of fentanyl and ketamine for trans-surgical pain control: case report

O paciente da espécie canina, sem raça definida, com 5 anos, deu entrada a clínica veterinária particular apresentando quadro de dor aguda e intensa em cavidade abdominal associada a prostração. Foram realizados exames de sangue, ultrassonografia e radiografia de abdômen, cuja suspeita foi torção parcial do estômago, com esplenomegalia, além de gastrite e enterite. O paciente foi submetido imediatamente ao procedimento cirúrgico para alívio, reposicionamento do órgão e gastropexia. O animal foi medicado previamente com metadona, tramadol e dipirona duas horas antes do ato cirúrgico, portanto não foram utilizadas medicações pré-anestésicas e optou-se pelo propofol e cetamina para a indução anestésica, além da infusão contínua com cetamina e fentanil para se obter a analgesia multimodal. Os parâmetros de dor foram avaliados por meio das frequências cardíaca e respiratória, traçado eletrocardiográfico, pressão arterial sistólica e média, aferição da temperatura retal e coloração de mucosas, a cada 5 minutos. Os mesmos indicaram boa estabilidade hemodinâmica, segurança e analgesia, sem necessidade de alterar as doses estabelecidas durante o procedimento. Pode ser observada também redução do requerimento de isoflurano para manutenção do plano cirúrgico. O paciente acordou sem sinais de dor no pós-operatório imediato evitando estresse sistêmico, o que conferiu o bom resultado do protocolo analgésico instituído.

The patient (Caramel) canine, mixed breed, approximately 5 years old, weighing 26kg was seen at the Ame Vet veterinary clinic, with severe abdominal pain, apathy, anorexia, prostration. Blood tests, abdominal ultrasound and abdominal x-ray were performed according to the tests a suspicion of partial torsion of the stomach and splenomegaly with right displacement, in addition to gastritis and enteritis. It was decided by the clinic and surgeon to perform laparotomy and prophylactic gastropexy. The animal was previously medicated by the clinic that treated the animal for analgesia with methadone, tramadol and dipyrone two hours before the beginning of the surgical procedure, therefore, pre-anesthetic medications, anesthetic induction with propofol, and ketamine were not used, aiming to perform analgesia. Multimodal with continuous infusion of ketamine and fentanyl, that is, more than one different mechanism of action, acting synergistically and reducing dose-dependent adverse effects and monitoring hemostasis and patient parameters, presenting its efficacy and safety in intraoperative pain control. The parameters addressed were heart rate (HR), respiratory rate (RR), electrocardiographic tracing, Spo2, systolic blood pressure (SBP), mean arterial pressure (MAP), temperature and mucosal color, evaluated every 5 minutes. The parameters evaluated indicated good hemodynamic stability, safety and analgesia, with no need to change the doses established during the procedure. A reduction in the requirement of isoflurane to maintain the surgical plan can also be observed. The patient woke up without signs of pain in the immediate postoperative period, thus avoiding systemic stress. which conferred the good result of the analgesic protocol instituted.

Clinical, surgical, and radiographic aspects in a white-eared opossum (Didelphis albiventris) with traumatic diaphragmatic hernia / Aspectos clínicos, cirúrgicos e radiográficos em um Gambá-de-orelha-branca (Didelphis albiventris) com hérnia diafragmática traumática

This is the case of a specimen of Didelphis albiventris with signs of respiratory difficulty after a dog attack. Thoracic radiographic examination revealed pneumothorax, pulmonary contusion, and rib fracture, but no alteration compatible with diaphragmatic hernia was observed. Pneumothorax was reduced and the other alterations were treated. However, clinical manifestations persisted, and thus a contrast-gastrointestinal radiographic study was performed, showing abdominal organs in the thoracic cavity and loss of diaphragmatic line. The surgical approach was instituted, with access to the diaphragm through median laparotomy. Through the diaphragmatic rupture, present in the left antimere, there were herniated liver and gastric portions, intestinal segments, and omentum. After inspection and repositioning of the abdominal organs, the diaphragm raffia was performed with single sutures interrupted with 3-0 Nylon thread. The patient’s complete recovery occurred 14 days after the surgical procedure, with remission of clinical manifestations and normality of thoracic images in radiographic studies.

Esse é o caso de um espécime de Didelphis albiventris com sinais de dificuldade respiratória após ataque por cão. O exame radiográfico torácico revelou pneumotórax, contusão pulmonar e fratura de costelas, porém nenhuma alteração com-patível com hérnia diafragmática foi observada. O pneumotórax foi reduzido e as demais alterações tratadas. Contudo; houve a persistência das manifestações clínicas, e dessa forma um estudo radiográfico gastrointestinal contrastado foi realizado, sendo evidenciados órgãos abdominais na cavidade torácica e perda da linha diafragmática. A abordagem cirúrgica foi instituída, com acesso ao diafragma por meio de laparotomia mediana. Através da ruptura diafragmática, presente no antímero esquerdo, estavam herniadas porções hepáticas e gástricas, segmentos intestinais e omento. Após inspeção e reposicionamento dos órgãos abdominais, a rafia do diafragma foi realizada com suturas simples interrompidas com fio Nylon 3-0. A recuperação completa do paciente ocorreu 14 dias após o procedimento cirúrgico, com remissão das manifestações clínicas e normalidade das ima-gens torácicas nos estudos radiográficos.

Hernioplastia com aplicação de tela por laparoscopia em equino com hérnia incisional / Hernioplasty with laparoscopy mesh application in equine with incisional hernia

Background: Incisional hernia in the midline can be a consequence of abdominal surgeries, which incidence is around5.7-18%. Surgical indication occurs in cases of large hernias, and the most common techniques used involve the closingof the musculature in a primary way, with sutures, and the implantation of a mesh on the abdominal wall. Laparoscopichernioplasty emerged as a less invasive option, showing superiority when compared with open surgical techniques in human medicine, however there are few reports describing this technique in equines. So, the aim of this paper is to report acase of hernioplasty, using laparoscopic mesh, in a horse with midline incisional hernia.Case: A 13-year-old castrated male Brasileiro de Hipismo horse, weighing 415 kg, practitioner of classic equestrian, presented an incisional hernia after 14 days from an exploratory laparotomy surgery realized to treat colic syndrome. After 6months, the patient was referred to a Veterinary Medicine Teaching Hospital for the correction of the defect in the abdominal wall. During palpation, the animal did not present local pain or other sign of inflammation, and the hernia measuredapproximately 20 cm in diameter. The animal was submitted to general anesthesia and placed in dorsal decubitus for thehernioplasty surgical procedure. An incision was made in cranial region of the midline, close to the xiphoid to introduce asingle port; the abdomen was inflated with CO2 gas (12 mmHg) and the operating table was tilted in order to displace theorgans cranially, facilitating the laparoscopic procedure. The abdomen was inspected and the presence of a single adherence could be observed, which was disrupted with endoscopic forceps. The mesh was introduced through the single port...

Clinical, surgical, and radiographic aspects in a white-eared opossum (Didelphis albiventris) with traumatic diaphragmatic hernia / Aspectos clínicos, cirúrgicos e radiográficos em um Gambá-de-orelha-branca (Didelphis albiventris) com hérnia diafragmática traumática

This is the case of a specimen of Didelphis albiventris with signs of respiratory difficulty after a dog attack. Thoracic radiographic examination revealed pneumothorax, pulmonary contusion, and rib fracture, but no alteration compatible with diaphragmatic hernia was observed. Pneumothorax was reduced and the other alterations were treated. However, clinical manifestations persisted, and thus a contrast-gastrointestinal radiographic study was performed, showing abdominal organs in the thoracic cavity and loss of diaphragmatic line. The surgical approach was instituted, with access to the diaphragm through median laparotomy. Through the diaphragmatic rupture, present in the left antimere, there were herniated liver and gastric portions, intestinal segments, and omentum. After inspection and repositioning of the abdominal organs, the diaphragm raffia was performed with single sutures interrupted with 3-0 Nylon thread. The patients complete recovery occurred 14 days after the surgical procedure, with remission of clinical manifestations and normality of thoracic images in radiographic studies.(AU)

Esse é o caso de um espécime de Didelphis albiventris com sinais de dificuldade respiratória após ataque por cão. O exame radiográfico torácico revelou pneumotórax, contusão pulmonar e fratura de costelas, porém nenhuma alteração com-patível com hérnia diafragmática foi observada. O pneumotórax foi reduzido e as demais alterações tratadas. Contudo; houve a persistência das manifestações clínicas, e dessa forma um estudo radiográfico gastrointestinal contrastado foi realizado, sendo evidenciados órgãos abdominais na cavidade torácica e perda da linha diafragmática. A abordagem cirúrgica foi instituída, com acesso ao diafragma por meio de laparotomia mediana. Através da ruptura diafragmática, presente no antímero esquerdo, estavam herniadas porções hepáticas e gástricas, segmentos intestinais e omento. Após inspeção e reposicionamento dos órgãos abdominais, a rafia do diafragma foi realizada com suturas simples interrompidas com fio Nylon 3-0. A recuperação completa do paciente ocorreu 14 dias após o procedimento cirúrgico, com remissão das manifestações clínicas e normalidade das ima-gens torácicas nos estudos radiográficos.(AU)

Hernioplastia com aplicação de tela por laparoscopia em equino com hérnia incisional / Hernioplasty with laparoscopy mesh application in equine with incisional hernia

Background: Incisional hernia in the midline can be a consequence of abdominal surgeries, which incidence is around5.7-18%. Surgical indication occurs in cases of large hernias, and the most common techniques used involve the closingof the musculature in a primary way, with sutures, and the implantation of a mesh on the abdominal wall. Laparoscopichernioplasty emerged as a less invasive option, showing superiority when compared with open surgical techniques in human medicine, however there are few reports describing this technique in equines. So, the aim of this paper is to report acase of hernioplasty, using laparoscopic mesh, in a horse with midline incisional hernia.Case: A 13-year-old castrated male Brasileiro de Hipismo horse, weighing 415 kg, practitioner of classic equestrian, presented an incisional hernia after 14 days from an exploratory laparotomy surgery realized to treat colic syndrome. After 6months, the patient was referred to a Veterinary Medicine Teaching Hospital for the correction of the defect in the abdominal wall. During palpation, the animal did not present local pain or other sign of inflammation, and the hernia measuredapproximately 20 cm in diameter. The animal was submitted to general anesthesia and placed in dorsal decubitus for thehernioplasty surgical procedure. An incision was made in cranial region of the midline, close to the xiphoid to introduce asingle port; the abdomen was inflated with CO2 gas (12 mmHg) and the operating table was tilted in order to displace theorgans cranially, facilitating the laparoscopic procedure. The abdomen was inspected and the presence of a single adherence could be observed, which was disrupted with endoscopic forceps. The mesh was introduced through the single port...(AU)

Doença inflamatória intestinal em cães: relato de casos / Inflammatory bowel disease in dogs: case reports

A doença inflamatória intestinal (DII) é uma enteropatia crônica idiopática que provoca distúrbios gastrointestinais em cães e gatos. Ocorre em animais com meia idade e as manifestações clínicas mais comuns incluem êmese e diarreia intermitente. A análise histológica permite classificar a DII de acordo com o infiltrado celular e pode ser obtida principalmente por laparotomia ou endoscopia. A terapia é baseada na dieta, oferta de fibras e medicações imunossupressoras. O objetivo do estudo é relatar três casos de DII, confirmada após biopsia. Neste relato os animais foram submetidos em procedimento de laparotomia e endoscopia digestiva alta para coleta de amostra histopatológica. Todos os animais foram diagnosticados com DII, contudo houve complicações pós-operatórias. O manejo dietético com proteínas de alta digestibilidade, suplementação de fibras e prednisona, azatioprina ou ciclosporina se demonstraram eficazes nestes pacientes.

Inflammatory Bowel Disease (IBD) is an idiopathic chronic enteropathy characterized by gastrointestinal diseases in dogs and cats. The middle-aged animals are more affected and the clinical signs include vomiting and intermittent diarrhea. The histopathological analysis shows IBD classification according to the form of cellular infiltration in the lamina propria, mainly obtained by laparotomy or endoscopy. The treatment is based on diet, fiber supply, and immunosuppressive drugs. The objective of this trial is to report three IBD cases confirmed through histopathologic evaluation. In the trial the animals were submitted to laparotomy and upper gastrointestinal endoscopy to take histopathological samples. All animals were diagnosed with IBD, although there were some postoperative complications. The diet management with high digestibility fiber, fiber supplementation, prednisone and azathioprine or cyclosporine demonstrated effective in these patients.

Doença inflamatória intestinal em cães: relato de casos / Inflammatory bowel disease in dogs: case reports

A doença inflamatória intestinal (DII) é uma enteropatia crônica idiopática que provoca distúrbios gastrointestinais em cães e gatos. Ocorre em animais com meia idade e as manifestações clínicas mais comuns incluem êmese e diarreia intermitente. A análise histológica permite classificar a DII de acordo com o infiltrado celular e pode ser obtida principalmente por laparotomia ou endoscopia. A terapia é baseada na dieta, oferta de fibras e medicações imunossupressoras. O objetivo do estudo é relatar três casos de DII, confirmada após biopsia. Neste relato os animais foram submetidos em procedimento de laparotomia e endoscopia digestiva alta para coleta de amostra histopatológica. Todos os animais foram diagnosticados com DII, contudo houve complicações pós-operatórias. O manejo dietético com proteínas de alta digestibilidade, suplementação de fibras e prednisona, azatioprina ou ciclosporina se demonstraram eficazes nestes pacientes.(AU)

Inflammatory Bowel Disease (IBD) is an idiopathic chronic enteropathy characterized by gastrointestinal diseases in dogs and cats. The middle-aged animals are more affected and the clinical signs include vomiting and intermittent diarrhea. The histopathological analysis shows IBD classification according to the form of cellular infiltration in the lamina propria, mainly obtained by laparotomy or endoscopy. The treatment is based on diet, fiber supply, and immunosuppressive drugs. The objective of this trial is to report three IBD cases confirmed through histopathologic evaluation. In the trial the animals were submitted to laparotomy and upper gastrointestinal endoscopy to take histopathological samples. All animals were diagnosed with IBD, although there were some postoperative complications. The diet management with high digestibility fiber, fiber supplementation, prednisone and azathioprine or cyclosporine demonstrated effective in these patients.(AU)

Deslocamento de abomaso à esquerda em bovino: relato de caso / Displacement of abomaso to the left in bovine: case of report

O trabalho objetivou relatar um caso um caso de deslocamento de abomaso à esquerda em bovino. O deslocamento de abomaso é uma patologia multifatorial, que afeta principalmente bovinos de alta produção leiteira, podendo ocorrer por uma dieta associada a um manejo errático ou até mesmo pelo desencadeamento do parto, ou seja, fatores que estão ligados ao acúmulo de gás e/ou hipomotilidade abomasal. Essa enfermidade pode gerar diversos prejuízos econômicos aos produtores, devido à queda na produção leite e gastos com o tratamento, diante disso, é importante revisar a importância do deslocamento de abomaso à esquerda e relatar o caso clínico de um bovino com essa patologia. Para se chegar a um diagnóstico conclusivo, deve-se conhecer a fundo os sinais clínicos, além dos métodos de diagnóstico para confirmação, tendo como técnica preconizada a auscultação com percussão do 9º ao 12º espaço intercostal, onde pode ser auscultado um tilintar metálico, quando ainda houver dúvidas, realiza-se a laparotomia exploratória, confirmando ou não a suspeita. Tendo o diagnóstico conclusivo desta patologia, é realizado o tratamento, que pode ser terapêutico, intervenção física por rolamento ou intervenção cirúrgica.

This study aimed to report a case of a case of left abomasum displacement in cattle. The displacement of abomasum is a multifactorial pathology which affects cattle of high milk production and may occur due to a diet associated with erratic management or even by the birthing mechanism, that is, factors that are linked directly to the accumulation of gas or abomasal hypomotility. This illness can generate different kinds of economic losses to the producers due to a fall in milk production and expenses with treatments. In that case, the objective with this job is to review the importance of the displacement of abomasum to the left and report the clinic case of a bovine with this pathology. To reach a conclusive diagnosis, the clinical signs should be thoroughly known, beyond the methods of diagnosis to confirmation, having as characteristic technique, the auscultation, with percussion from the ninth to the twelfth intercostal space where it can be auscultated a metallic tinkling. When there are still doubts, is performed an exploratory laparotomy, then having the confirmation. When having the conclusive diagnosis of this pathology is performed the treatment, being therapeutic, physical intervention by rolling or chirurgical intervention.

Deslocamento de abomaso à esquerda em bovino: relato de caso / Displacement of abomaso to the left in bovine: case of report

O trabalho objetivou relatar um caso um caso de deslocamento de abomaso à esquerda em bovino. O deslocamento de abomaso é uma patologia multifatorial, que afeta principalmente bovinos de alta produção leiteira, podendo ocorrer por uma dieta associada a um manejo errático ou até mesmo pelo desencadeamento do parto, ou seja, fatores que estão ligados ao acúmulo de gás e/ou hipomotilidade abomasal. Essa enfermidade pode gerar diversos prejuízos econômicos aos produtores, devido à queda na produção leite e gastos com o tratamento, diante disso, é importante revisar a importância do deslocamento de abomaso à esquerda e relatar o caso clínico de um bovino com essa patologia. Para se chegar a um diagnóstico conclusivo, deve-se conhecer a fundo os sinais clínicos, além dos métodos de diagnóstico para confirmação, tendo como técnica preconizada a auscultação com percussão do 9º ao 12º espaço intercostal, onde pode ser auscultado um tilintar metálico, quando ainda houver dúvidas, realiza-se a laparotomia exploratória, confirmando ou não a suspeita. Tendo o diagnóstico conclusivo desta patologia, é realizado o tratamento, que pode ser terapêutico, intervenção física por rolamento ou intervenção cirúrgica.(AU)

This study aimed to report a case of a case of left abomasum displacement in cattle. The displacement of abomasum is a multifactorial pathology which affects cattle of high milk production and may occur due to a diet associated with erratic management or even by the birthing mechanism, that is, factors that are linked directly to the accumulation of gas or abomasal hypomotility. This illness can generate different kinds of economic losses to the producers due to a fall in milk production and expenses with treatments. In that case, the objective with this job is to review the importance of the displacement of abomasum to the left and report the clinic case of a bovine with this pathology. To reach a conclusive diagnosis, the clinical signs should be thoroughly known, beyond the methods of diagnosis to confirmation, having as characteristic technique, the auscultation, with percussion from the ninth to the twelfth intercostal space where it can be auscultated a metallic tinkling. When there are still doubts, is performed an exploratory laparotomy, then having the confirmation. When having the conclusive diagnosis of this pathology is performed the treatment, being therapeutic, physical intervention by rolling or chirurgical intervention.(AU)

Biomechanical and adhesion comparison of linea alba prophylactic reinforcement with coated and uncoated three-dimensional T-shaped mesh in rabbits

Purpose: Incisional hernia (IH) is a frequent complication of median laparotomy. The use of prophylactic mesh to reduce IH incidence has gained increasing attention. We hypothesized that in an animal model, linea alba prophylactic reinforcement with a three-dimensional T-shaped polypropylene mesh results in greater abdominal wall resistance. Methods: Study was performed in 27 rabbits. After abdominal midline incision, animals were divided into three groups according to the laparotomy closure method used: (1)3D T-shaped coated mesh; (2)3D T-shaped uncoated mesh; and (3) closure without mesh. After 4 months, each animals abdominal wall was resected and tensiometric tests were applied. Results included IH occurrence, adhesions to the mesh, and wound complications. Results: There was no significant difference between the groups in maximum tensile strength (p=0.250) or abdominal wall elongation under maximum stress (p=0.839). One rabbit from the control group developed IH (p=1.00). Small intestine and colon adhesions occurred only in the uncoated mesh group (p 0.001) and the degree of adhesions was higher in this group compared to the coated mesh group (p 0.05). Conclusion: Use of the current 3D T-shaped prophylactic mesh model did not result in a significant difference in tensiometric measurements when compared with simple abdominal wall closure in rabbits.(AU)

Idiopathic urinary bladder rupture in two mares / Ruptura idiopática de bexiga urinária em duas éguas

Urinary bladder rupture is rarely reported in adult horses and is usually associated with parturition, history of traumaor urethral obstruction. This paper reports two cases in mares free of these predisposing factors, diagnosed throughclinical manifestations, abdominal ultrasound and abdominocentesis, corrected by cystorrhaphy through laparotomy.While recovery was satisfactory in one case, the other case had complications in celiorraphy such as development ofincisional hernia, small colon eventration and intestinal adherences, opting by the euthanasia of the animal. These reportsare important because of the rarity with which they occur in adult mares. The different prognoses may be related to theseverity of each case, according to the location and extension of the wound, which directly or indirectly influence thetechnique and recovery of the animals.

A ruptura de bexiga urinária é raramente relatada em equinos adultos, sendo normalmente associada ao parto, antecedentesde trauma ou obstrução de uretra. Este trabalho relata dois casos em éguas livres destes fatores predisponentes,diagnosticados através de manifestações clínicas, ultrassonografia abdominal e abdominocentese, corrigidos por cistorrafiaatravés de laparotomia. Em um dos casos a recuperação ocorreu satisfatoriamente, porém no outro houve complicaçõesna celiorrafia como desenvolvimento de hérnia incisional, eventração de cólon menor e posterior desenvolvimento deaderências intestinais, optando-se pela eutanásia do animal. Estes relatos são importantes pela raridade com que ocorremem éguas adultas. Os diferentes prognósticos podem estar relacionados à gravidade de cada caso, de acordo com o locale extensão da ferida, que direta ou indiretamente influenciam na técnica empregada e recuperação dos animais.

Hyperbaric oxygenation on adhesions prevention after laparotomy in rats

Purpose: To evaluate the effects of hyperbaric oxygenation on prevention of adhesions in the abdominal cavity after laparotomy. Methods: Fifty four rats underwent laparotomy; stitches were made in the four quadrant parietal peritoneum and abdominal cavity closure. Animals were divided into three groups: 1 - control; 2 - subjected to high pressures and oxygenation; 3 - subjected to 100% hyperbaric oxygenation. The animals in groups 2 and 3 were daily submitted to oxygenation hyperbaric chamber after surgery. On the seventh day another laparotomy, registration of procedure, assessment of adhesions and biopsies of the peritoneum were held. Professionals analyzed the videos and the biopsies. Results: Peritoneal cavity adhesions occurred in animals of three groups with no difference between them. In Group 3, the adhesions presented more fragile and vascular proliferation more pronounced, and there was no difference in comparison with the first and second groups. However, there was no significant difference in the evaluation of these parameters between the animals in groups 1 and 2. Conclusions: Postoperative hyperbaric oxygenation in rats submitted to laparotomy did not alter the frequency, but reduced the density of adhesions in the peritoneal cavity and promoted vascular proliferation. The change in atmospheric pressure alone had no influence on the results.(AU)

Thoracotomy compared to laparotomy in the traumatic diaphragmatic hernia. Systematic review and proportional methanalysis

Purpose: To evaluate the most used approach to treat traumatic diaphragmatic ruptures, and in which one the requirement to assess the second cavity is more frequent.Methods: Systematic review, observational studies. Outcomes: moment of approach, most commonly via addressed and the requirement to open the other cavity. Bases searched: Lilacs, Pubmed, Embase, Clinicaltrials.gov and Web of Science. Statistical analysis: StatsDirect 3.0.121 software. Results: Sixty eight studies (2023 participants) were included. Approach in acute phase was performed four times more than in chronic phase. Approach: abdominal 65% (IC 95% 63-67%), thoracic 23% (IC 95% 21-24%), abdominal in the acute phase 75% (IC 95% 71-78%), and chronic 24% (IC 95% 19-29%), thoracic in the acute phase 12% (IC 95% 10-14%) and chronic 69% (IC 95% 63-74%). Thorax opening in the abdominal approach: 10% (95% CI 8-14%). Abdomen opening in the thoracic approach: 15% (95% CI 7-24%). Conclusions: The most common approach was the abdominal. The approach in the acute phase was more common. In the acute phase the abdominal approach is more frequent than the thoracic approach. In the chronic phase the thoracic approach is more frequent than the abdominal one. The requirement to open the second cavity was similar in both approaches.(AU)

Complicações multissistêmicas decorrentes de hérnia inguino-escrotal em equino / Multisystemic complications due to inguinal hernia in a horse

O presente trabalho teve como objetivo descrever complicaçoes multissistêmicas associadas à hernia inguino-escrotal em equino. Um equino da raça Brasileiro de Hipismo, de 7 anos, foi encaminhado para atendimento veterinário apresentando dor abdominal moderada, desidrataçao severa e sinais de síndrome da resposta inflamatória sistêmica (SIRS). Indicou-se laparotomia e a hernia inguino-escrotal foi corrigida. Entretanto houve necessidade de uma segunda laparotomia realizada seis dias após a primeira intervenção cirúrgica devido aos sinais de dor e refluxo incessantes. No momento da admissão o animal já apresentava sinais de SIRS e no pós operatório apresentou íleo adinâmico, insuficiência renal aguda e duodeno-jejunite proximal, além de complicações respiratórias e disfagia. Ao final o animal se recuperou de todas essas complicações, porém desenvolveu laminite e acabou sendo eutanasiado devido à posição permanente de decúbito.

The aim of the present study was to describe multisystemic complications associated with inguinal hernia in a horse. A 7-year-old Brazilian-saddle horse was referred to veterinary care with moderate abdominal pain, severe dehydration and signs of systemic inflammatory response syndrome (SIRS). A laparotomy was indicated and the condition was treated. However, a second laparotomy was required six days after due to incessant pain and reflux. Upon admission the animal had signs of SIRS and showed adynamic ileus, acute renal failure and proximal duodenum-jejunitis during the postoperative period, in addition to respiratory complications and dysphagia. The horse recovered from all these complications but developed laminits and euthanasia was elected due to permanent decubitus.

Complicações multissistêmicas decorrentes de hérnia inguino-escrotal em equino / Multisystemic complications due to inguinal hernia in a horse

O presente trabalho teve como objetivo descrever complicaçoes multissistêmicas associadas à hernia inguino-escrotal em equino. Um equino da raça Brasileiro de Hipismo, de 7 anos, foi encaminhado para atendimento veterinário apresentando dor abdominal moderada, desidrataçao severa e sinais de síndrome da resposta inflamatória sistêmica (SIRS). Indicou-se laparotomia e a hernia inguino-escrotal foi corrigida. Entretanto houve necessidade de uma segunda laparotomia realizada seis dias após a primeira intervenção cirúrgica devido aos sinais de dor e refluxo incessantes. No momento da admissão o animal já apresentava sinais de SIRS e no pós operatório apresentou íleo adinâmico, insuficiência renal aguda e duodeno-jejunite proximal, além de complicações respiratórias e disfagia. Ao final o animal se recuperou de todas essas complicações, porém desenvolveu laminite e acabou sendo eutanasiado devido à posição permanente de decúbito.(AU)

The aim of the present study was to describe multisystemic complications associated with inguinal hernia in a horse. A 7-year-old Brazilian-saddle horse was referred to veterinary care with moderate abdominal pain, severe dehydration and signs of systemic inflammatory response syndrome (SIRS). A laparotomy was indicated and the condition was treated. However, a second laparotomy was required six days after due to incessant pain and reflux. Upon admission the animal had signs of SIRS and showed adynamic ileus, acute renal failure and proximal duodenum-jejunitis during the postoperative period, in addition to respiratory complications and dysphagia. The horse recovered from all these complications but developed laminits and euthanasia was elected due to permanent decubitus.(AU)

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal / Jugular thrombophlebitis in horses subjected to laparotomy for the treatment of gastrointestinal disease

Afecções do trato gastrointestinal de equinos podem causar distúrbios de coagulação devido à concentração elevada de mediadores inflamatórios que estimulam a hemostasia e inibem a fibrinólise, gerando um estado de hipercoagulação. Equinos submetidos à laparotomia no tratamento da síndrome cólica permanecem com cateter venoso durante vários dias para a administração de fluidos e fármacos no período pós-operatório e, a veia jugular é o principal local para a implantação de cateteres. Assim, o trauma vascular persistente causado pelo cateter, associado ao ambiente pró-trombótico induzido pela afecção gastrointestinal, aumenta o risco para o desenvolvimento de tromboflebite jugular. Objetivou-se avaliar as características físicas e ultrassonográficas da veia jugular canulada com cateter de poliuretano durante o período pós-operatório de equinos submetidos à laparotomia. O cateter foi inserido de forma asséptica à admissão e permaneceu por sete dias. A avaliação ultrassonográfica revelou o desenvolvimento de tromboflebite em um equino, 48 após o procedimento cirúrgico. Os demais equinos demonstraram espessamento da parede vascular no local de punção e pequenos trombos junto ao cateter. A monitoração ultrassonográfica demonstrou que a cateterização prolongada em equinos submetidos à laparotomia, seguindo o protocolo proposto, minimiza a lesão vascular e pode prevenir a tromboflebite jugular.(AU)

Coagulation abnormalities are usually associated with equine gastrointestinal disease due to the increased levels of inflammatory mediators, which promotes hemostasis and inhibit fibrinolysis, creating a hypercoagulable state. Horses underwent laparotomy to treat colic usually require a venous catheter for several days to administrate fluids and drugs during the postoperative period, and the jugular vein is the most frequent site for catheterization. Therefore, the persistent vascular trauma caused by an implanted catheter, associated with the prothrombotic environment induced by the gastrointestinal disorder, increases the risk for the development of jugular thrombophlebitis. The purpose of the present investigation was to evaluate physical and ultrassonographic features of the jugular vein cannulated with a polyurethane catheter during the postoperative period of horses underwent colic surgery. The catheter was inserted aseptically on admission and dwell time was seven days. Upon ultrasound examination, one horse developed thrombophlebitis 48 hours after surgery and the other horses showed thickened venous wall at puncture site and small clots associated to the catheter. Ultrasound monitoration showed that long-term catheterization in horses underwent colic surgery following the present protocol minimizes vascular trauma and could prevent jugular thrombophlebitis.(AU)

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal / Jugular thrombophlebitis in horses subjected to laparotomy for the treatment of gastrointestinal disease

Afecções do trato gastrointestinal de equinos podem causar distúrbios de coagulação devido à concentração elevada de mediadores inflamatórios que estimulam a hemostasia e inibem a fibrinólise, gerando um estado de hipercoagulação. Equinos submetidos à laparotomia no tratamento da síndrome cólica permanecem com cateter venoso durante vários dias para a administração de fluidos e fármacos no período pós-operatório e, a veia jugular é o principal local para a implantação de cateteres. Assim, o trauma vascular persistente causado pelo cateter, associado ao ambiente pró-trombótico induzido pela afecção gastrointestinal, aumenta o risco para o desenvolvimento de tromboflebite jugular. Objetivou-se avaliar as características físicas e ultrassonográficas da veia jugular canulada com cateter de poliuretano durante o período pós-operatório de equinos submetidos à laparotomia. O cateter foi inserido de forma asséptica à admissão e permaneceu por sete dias. A avaliação ultrassonográfica revelou o desenvolvimento de tromboflebite em um equino, 48 após o procedimento cirúrgico. Os demais equinos demonstraram espessamento da parede vascular no local de punção e pequenos trombos junto ao cateter. A monitoração ultrassonográfica demonstrou que a cateterização prolongada em equinos submetidos à laparotomia, seguindo o protocolo proposto, minimiza a lesão vascular e pode prevenir a tromboflebite jugular.(AU)

Coagulation abnormalities are usually associated with equine gastrointestinal disease due to the increased levels of inflammatory mediators, which promotes hemostasis and inhibit fibrinolysis, creating a hypercoagulable state. Horses underwent laparotomy to treat colic usually require a venous catheter for several days to administrate fluids and drugs during the postoperative period, and the jugular vein is the most frequent site for catheterization. Therefore, the persistent vascular trauma caused by an implanted catheter, associated with the prothrombotic environment induced by the gastrointestinal disorder, increases the risk for the development of jugular thrombophlebitis. The purpose of the present investigation was to evaluate physical and ultrassonographic features of the jugular vein cannulated with a polyurethane catheter during the postoperative period of horses underwent colic surgery. The catheter was inserted aseptically on admission and dwell time was seven days. Upon ultrasound examination, one horse developed thrombophlebitis 48 hours after surgery and the other horses showed thickened venous wall at puncture site and small clots associated to the catheter. Ultrasound monitoration showed that long-term catheterization in horses underwent colic surgery following the present protocol minimizes vascular trauma and could prevent jugular thrombophlebitis.(AU)

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal

ABSTRACT: Coagulation abnormalities are usually associated with equine gastrointestinal disease due to the increased levels of inflammatory mediators, which promotes hemostasis and inhibit fibrinolysis, creating a hypercoagulable state. Horses underwent laparotomy to treat colic usually require a venous catheter for several days to administrate fluids and drugs during the postoperative period, and the jugular vein is the most frequent site for catheterization. Therefore, the persistent vascular trauma caused by an implanted catheter, associated with the prothrombotic environment induced by the gastrointestinal disorder, increases the risk for the development of jugular thrombophlebitis. The purpose of the present investigation was to evaluate physical and ultrassonographic features of the jugular vein cannulated with a polyurethane catheter during the postoperative period of horses underwent colic surgery. The catheter was inserted aseptically on admission and dwell time was seven days. Upon ultrasound examination, one horse developed thrombophlebitis 48 hours after surgery and the other horses showed thickened venous wall at puncture site and small clots associated to the catheter. Ultrasound monitoration showed that long-term catheterization in horses underwent colic surgery following the present protocol minimizes vascular trauma and could prevent jugular thrombophlebitis.

RESUMO: Afecções do trato gastrointestinal de equinos podem causar distúrbios de coagulação devido à concentração elevada de mediadores inflamatórios que estimulam a hemostasia e inibem a fibrinólise, gerando um estado de hipercoagulação. Equinos submetidos à laparotomia no tratamento da síndrome cólica permanecem com cateter venoso durante vários dias para a administração de fluidos e fármacos no período pós-operatório e, a veia jugular é o principal local para a implantação de cateteres. Assim, o trauma vascular persistente causado pelo cateter, associado ao ambiente pró-trombótico induzido pela afecção gastrointestinal, aumenta o risco para o desenvolvimento de tromboflebite jugular. Objetivou-se avaliar as características físicas e ultrassonográficas da veia jugular canulada com cateter de poliuretano durante o período pós-operatório de equinos submetidos à laparotomia. O cateter foi inserido de forma asséptica à admissão e permaneceu por sete dias. A avaliação ultrassonográfica revelou o desenvolvimento de tromboflebite em um equino, 48 após o procedimento cirúrgico. Os demais equinos demonstraram espessamento da parede vascular no local de punção e pequenos trombos junto ao cateter. A monitoração ultrassonográfica demonstrou que a cateterização prolongada em equinos submetidos à laparotomia, seguindo o protocolo proposto, minimiza a lesão vascular e pode prevenir a tromboflebite jugular.

Eliminação de Dioctophyme renale pela urina em canino com dioctofimatose em rim esquerdo e cavidade abdominal - Primeiro relato no Rio Grande do Sul / Elimination of Dioctophyme renale to urine in canines with dioctophymosis in the left kidney and abdominal cavity - First report in Rio Grande do Sul

Dioctophyme renale é um parasito que afeta tanto animais como humanos e tem como órgão de eleição o rim direito. Relata-se o caso clínico-cirúrgico de um paciente canino com histórico de eliminação de três exemplares de D. renale pela urina e presença de parasitos no rim esquerdo e na cavidade abdominal. No Hospital de Clínicas Veterinárias da Universidade Federal de Pelotas, foram realizados exames pré-cirúrgicos, entre eles a ultrassonografia abdominal, que identificou a localização dos nematódeos, e o exame de Doppler pulsado dos vasos intrarrenais, que demonstrou aumento nos índices resistivos nas regiões avaliadas. O paciente foi conduzido para a realização de laparotomia exploratória, sendo removidos 23 parasitos da cavidade abdominal. A presença de D. renale causa graves lesões nos rins e nos demais órgãos da cavidade abdominal, sendo essencial o diagnóstico precoce e a remoção dos nematódeos para recuperação do paciente.(AU)

Dioctophyme renale is a parasite that attacks animals as well as humans and has the right kidney as a preferred target organ. This document reports the case of a clinical-chirurgical canine patient with a history of elimination of three D. renale samples through its urine and presence of parasites at its left kidney and abdominal cavity. Pre-cirurgical exams were performed at the Veterinary Hospital of the Federal University of Pelotas. Among these exams, abdominal ultrasonography identified the nematode's location and the Pulse-Doppler of the intrarenal vessels showed an increase in the resistive indices of the evaluated areas. An Exploratory Laparotomy was conducted with the patient who had 23 parasites removed from its abdominal cavity. The presence of D. renale causes severe lesions at kidneys and other organs of the abdominal cavity, for this reason early diagnosis and nematode´s removal are essential for the patient's recovery.(AU)

Eliminação de Dioctophyme renale pela urina em canino com dioctofimatose em rim esquerdo e cavidade abdominal - Primeiro relato no Rio Grande do Sul / Elimination of Dioctophyme renale to urine in canines with dioctophymosis in the left kidney and abdominal cavity - First report in Rio Grande do Sul

Dioctophyme renale é um parasito que afeta tanto animais como humanos e tem como órgão de eleição o rim direito. Relata-se o caso clínico-cirúrgico de um paciente canino com histórico de eliminação de três exemplares de D. renale pela urina e presença de parasitos no rim esquerdo e na cavidade abdominal. No Hospital de Clínicas Veterinárias da Universidade Federal de Pelotas, foram realizados exames pré-cirúrgicos, entre eles a ultrassonografia abdominal, que identificou a localização dos nematódeos, e o exame de Doppler pulsado dos vasos intrarrenais, que demonstrou aumento nos índices resistivos nas regiões avaliadas. O paciente foi conduzido para a realização de laparotomia exploratória, sendo removidos 23 parasitos da cavidade abdominal. A presença de D. renale causa graves lesões nos rins e nos demais órgãos da cavidade abdominal, sendo essencial o diagnóstico precoce e a remoção dos nematódeos para recuperação do paciente.(AU)

Dioctophyme renale is a parasite that attacks animals as well as humans and has the right kidney as a preferred target organ. This document reports the case of a clinical-chirurgical canine patient with a history of elimination of three D. renale samples through its urine and presence of parasites at its left kidney and abdominal cavity. Pre-cirurgical exams were performed at the Veterinary Hospital of the Federal University of Pelotas. Among these exams, abdominal ultrasonography identified the nematode's location and the Pulse-Doppler of the intrarenal vessels showed an increase in the resistive indices of the evaluated areas. An Exploratory Laparotomy was conducted with the patient who had 23 parasites removed from its abdominal cavity. The presence of D. renale causes severe lesions at kidneys and other organs of the abdominal cavity, for this reason early diagnosis and nematode´s removal are essential for the patient's recovery.(AU)