Alternative use of endocavitary probe to guide minimally invasive partial nephrectomy: is it reasonable?

Purpose: To describe the use of endocavitary ultrasound probe as an auxiliary tool when performing partial nephrectomy in cases of endophytic renal tumors, to standardize the method, and to report the preliminary results achieved with this technique. Methods: Fifteen patients diagnosed with completely endophytic underwent partial nephrectomy with the use of an endocavitary ultrasound probe. This article describes the technique involved in partial nephrectomy and details the preparation of the endocavitary ultrasound probe to ensure its safe use. Results: All the patients had a RENAL score between 8 and 11. The median time of warm ischemia was 26 and 18 minutes for laparoscopic or robot-assisted surgery, respectively. The median duration of surgery was 150 minutes, and the median console time was 145 minutes for the laparoscopic and robot-assisted surgery groups, respectively. The median estimate of blood loss was 200 mL. Only three patients in the laparoscopic group had focal positive surgical margins. There were no cases of infection at the site of probe entry. Conclusions: Intraoperative use of an endocavitary ultrasound probe for partial nephrectomy is possible and a safe alternative to the excision of endophytic tumors when neither robotic probes nor laparoscopic probes are available.

Hydronephrosis in a dog related to ovariosalpingohysterectomy

Background: Hydronephrosis is the dilation of the pelvis and renal calyxes due to post-renal obstruction. The obstruction is often associated with extraluminal masses, blood clots and ureter ligation in castration procedures. Ureter ligation is reported as a malpractice. The renal function is reestablished if ligation is rapidly undone, but not for obstructions longer than four weeks. Often, clinical signs are results from months to years after the castration, when nephrectomy is the best therapeutic option. This paper aims to report a case of asymptomatic unilateral hydronephrosis in a 10-year-old dog caused by chronic ureter occlusion with Nylon 3.0 suture during an elective procedure. Case: A 10-year-old female pinscher dog, spayed 3 years ago was admitted at the Surgery Department of the Veterinary Hospital of the Federal University of Jataí (HV-UFJ). The animal was taken for periodontal treatment. In the physical and laboratory examination (complete blood count, hepatic and renal biochemical tests) no significant and noteworthy alterations were found. Ultrasonographic examination showed no changes in the topography and echotexture of the left kidney, however the right kidney was not visualized, with an anechoic structure suggestive of advanced and severe hydronephrosis. Therefore, exploratory laparotomy was proposed to identify the observed structure, with the periodontal treatment considered for a later time. So, a retroumbilical incision was made, followed by linea alba and the removal of simple isolated suture remaining from previous surgical procedure. In the cavity, the viscera were isolated and the left kidney was identified, observing preserved anatomy. On the other hand, the right kidney had altered topography and morphology, being exposed after release of adhesions in adjacent structures. The right renal artery and vein were dissected and a double ligature was made. Then, the right ureter was dissected, observing marked dilatation in the proximal portion and the presence of local ligation with Nylon 3.0. Right ureterectomy and right nephrectomy were performed. After nephrectomy, the capsule was ruptured, observing dark fluid in it and absence of tissue compatible with renal parenchyma. The material was preserved in 10% formaldehyde and sent for histopathological examination. Histopathology revealed risk of rupture of the renal capsule due to the advance of renal degeneration and complete absence of parenchyma. However, contrary to the severity of the histopathological, surgical and ultrasonographic findings, the patient did not present clinical signs at the time of diagnosis. Discussion: In the intraoperative evaluation, the cause of the hydronephrosis was verified to be in fact the ligation of the ureter, which may have been accidental or due to the malpractice of the veterinarian surgeon. Other possible causes such as adhesions and granulomas were ruled out because the Nylon 3.0 suture was found in the proximal portion of the right ureter. It is believed that the patient may have presented clinical signs of hydronephrosis that may have been confused by the tutors as postoperative complications, changes that if identified and performed in time, could have avoided the occurrence or worsening of hydronephrosis and subsequent nephrectomy. Clinically, the bitch did not show clinical signs presented in the literature as consistent with hydronephrosis such as polyuria, polydipsia, abdominalgia, external fistula and anorexia. Therefore, it is believed that this case is one of the first reports of the occurrence of severe hydronephrosis without typical clinical manifestations of hydronephrosis. This fact raises a warning about the thorough monitoring in the postoperative period by owners and veterinarians, in addition to highlighting concerns regarding the occurrence of medical malpractice versus surgical accidents.

Pionefrose unilateral em cão - relato de caso / Unilateral pyonephrosis in a dog - case report / Pionefrosis unilateral en perro - relato de caso

A pionefrose consiste em uma hidronefrose contaminada, associada à destruição do parênquima renal. Tem como causas o bloqueio ureteral ou uretral por urólitos, inflamação crônica, neoplasia e ureter ectópico, seguidos de contaminação. O diagnóstico é realizado através de exames de imagem, principalmente a ultrassonografia e também através de urinálise e urocultura. Em casos avançados o tratamento preconizado é a nefrectomia. O presente trabalho tem como objetivo relatar um caso de um cão com suspeita inicial de hidronefrose. O paciente passou por nefrectomia, no pós-operatório observou-se melhora do seu quadro clínico, porém permanecendo a anemia. O diagnóstico definitivo, realizado por exame histopatológico, revelou pionefrose, entretanto sua causa não foi estabelecida.(AU)

Pyonephrosis consists of a contaminated hydronephrosis associated with the destruction of the renal parenchyma. Its causes include ureter or urethra blockage by uroliths, chronic inflammation, neoplasm, and ectopic ureter, followed by contamination. The diagnosis is made through image exams, mainly ultrasound, and also through urinalysis and uroculture. In advanced cases, nephrectomy is the recommended treatment. The objective of this study is to report a case of a dog with initial suspicion of hydronephrosis. The patient underwent nephrectomy, and during the postoperative period, an improvement in the clinical scenario was observed, despite the persistent anemia. The definitive diagnosis, carried out by histopathological examination, revealed pyonephrosis; however, its cause was not established.(AU)

La pionefrosis es una hidronefrosis contaminada, asociada con la destrucción del parénquima renal. Sus causas son el bloqueo ureteral o uretral por urolitos, inflamación crónica, neoplasia y uréter ectópico, seguido de contaminación. El diagnóstico se realiza mediante exámenes de imágenes, principalmente ultrasonografía y también mediante análisis de orina y urocultivo. En casos avanzados el tratamiento recomendado es la nefrectomía. Este artículo tiene como objetivo informar un caso de un perro con sospecha inicial de hidronefrosis. El paciente se sometió a nefrectomía; después de la operación, su estado clínico mejoró, pero la anemia permaneció. El diagnóstico definitivo realizado por el examen histopatológico reveló pionfrosis, sin embargo, su causa no se ha establecido.(AU)

Pionefrose unilateral em cão - relato de caso / Unilateral pyonephrosis in a dog - case report / Pionefrosis unilateral en perro - relato de caso

A pionefrose consiste em uma hidronefrose contaminada, associada à destruição do parênquima renal. Tem como causas o bloqueio ureteral ou uretral por urólitos, inflamação crônica, neoplasia e ureter ectópico, seguidos de contaminação. O diagnóstico é realizado através de exames de imagem, principalmente a ultrassonografia e também através de urinálise e urocultura. Em casos avançados o tratamento preconizado é a nefrectomia. O presente trabalho tem como objetivo relatar um caso de um cão com suspeita inicial de hidronefrose. O paciente passou por nefrectomia, no pós-operatório observou-se melhora do seu quadro clínico, porém permanecendo a anemia. O diagnóstico definitivo, realizado por exame histopatológico, revelou pionefrose, entretanto sua causa não foi estabelecida.(AU)

Pyonephrosis consists of a contaminated hydronephrosis associated with the destruction of the renal parenchyma. Its causes include ureter or urethra blockage by uroliths, chronic inflammation, neoplasm, and ectopic ureter, followed by contamination. The diagnosis is made through image exams, mainly ultrasound, and also through urinalysis and uroculture. In advanced cases, nephrectomy is the recommended treatment. The objective of this study is to report a case of a dog with initial suspicion of hydronephrosis. The patient underwent nephrectomy, and during the postoperative period, an improvement in the clinical scenario was observed, despite the persistent anemia. The definitive diagnosis, carried out by histopathological examination, revealed pyonephrosis; however, its cause was not established.(AU)

La pionefrosis es una hidronefrosis contaminada, asociada con la destrucción del parénquima renal. Sus causas son el bloqueo ureteral o uretral por urolitos, inflamación crónica, neoplasia y uréter ectópico, seguido de contaminación. El diagnóstico se realiza mediante exámenes de imágenes, principalmente ultrasonografía y también mediante análisis de orina y urocultivo. En casos avanzados el tratamiento recomendado es la nefrectomía. Este artículo tiene como objetivo informar un caso de un perro con sospecha inicial de hidronefrosis. El paciente se sometió a nefrectomía; después de la operación, su estado clínico mejoró, pero la anemia permaneció. El diagnóstico definitivo realizado por el examen histopatológico reveló pionfrosis, sin embargo, su causa no se ha establecido.(AU)

Parasitismo por Dioctophyma renale em cão: aspectos clínico-cirúrgico / Parasitism by Dioctophyma renale in a dog: clinical and surgical aspects

Background: Dioctophimosis is a parasitic disease caused by Dioctophyma renale, more commonly known as “giantKidney worm,” and can be found in other organs or free in the abdominal cavity, which is related to the patient’s eatinghabits. Most of the animals affected are asymptomatic. The diagnosis is made through ultrasonography, finding eggs ofthe parasite in the urine, or necropsy. The treatment of choice is nephrectomy of the affected kidney. We aimed to reportthe accidental diagnosis of parasitism by D. renale in an 8-year-old dog, which was surgically treated by nephrectomy ofthe right kidney after evident destruction of the renal parenchyma on ultrasonography.Case: An 8-year-old Boxer female dog underwent a physical examination and showed a mass in the region of the left caudal thoracic breast, bilateral alopecia on flanks, and purulent ocular secretions. Laboratory tests of complete blood count(CBC) and serum biochemical profile, X-ray examination, and ultrasonography were requested. Anemia was observedon the erythrogram, and enzymes (creatinine, urea, alanine aminotransferase [ALT], and albumin) were within normallimits. There were no abnormalities on X-ray examination, and abdominal ultrasonography showed slight splenomegaly,enlarged left kidney, reduced corticomedullary region, measuring approximately 7.63 cm longitudinally. In the rightkidney, loss of the renal parenchyma, measuring approximately 5.49 cm in diameter and the presence of a cylindrical androunded structure, typical of D. renale infection. After this, a urinalysis was suggested, which revealed the presence ofthe helminthic eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affectedkidney as treatment. The kidney showed destruction of the renal parenchyma. A single parasite was removed, measuringapproximately 46 cm in length. The patient was successfully treated and was hospitalized for...

Parasitismo por Dioctophyma renale em cão: aspectos clínico-cirúrgico / Parasitism by Dioctophyma renale in a dog: clinical and surgical aspects

Background: Dioctophimosis is a parasitic disease caused by Dioctophyma renale, more commonly known as “giantKidney worm,” and can be found in other organs or free in the abdominal cavity, which is related to the patients eatinghabits. Most of the animals affected are asymptomatic. The diagnosis is made through ultrasonography, finding eggs ofthe parasite in the urine, or necropsy. The treatment of choice is nephrectomy of the affected kidney. We aimed to reportthe accidental diagnosis of parasitism by D. renale in an 8-year-old dog, which was surgically treated by nephrectomy ofthe right kidney after evident destruction of the renal parenchyma on ultrasonography.Case: An 8-year-old Boxer female dog underwent a physical examination and showed a mass in the region of the left caudal thoracic breast, bilateral alopecia on flanks, and purulent ocular secretions. Laboratory tests of complete blood count(CBC) and serum biochemical profile, X-ray examination, and ultrasonography were requested. Anemia was observedon the erythrogram, and enzymes (creatinine, urea, alanine aminotransferase [ALT], and albumin) were within normallimits. There were no abnormalities on X-ray examination, and abdominal ultrasonography showed slight splenomegaly,enlarged left kidney, reduced corticomedullary region, measuring approximately 7.63 cm longitudinally. In the rightkidney, loss of the renal parenchyma, measuring approximately 5.49 cm in diameter and the presence of a cylindrical androunded structure, typical of D. renale infection. After this, a urinalysis was suggested, which revealed the presence ofthe helminthic eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affectedkidney as treatment. The kidney showed destruction of the renal parenchyma. A single parasite was removed, measuringapproximately 46 cm in length. The patient was successfully treated and was hospitalized for...(AU)

Unilateral idiopathic renal hematuria in a dog / Hematúria renal idiopática unilateral em um cão

Idiopathic renal hematuria is diagnosed in situations where the cause of hematuria is not clear, even after ruling out all possible differential diagnoses. A 14-year-old female Cocker Spaniel with continuous hematuria as the only clinical sign for two months. Concomitant changes were ruled out by blood tests, urinalysis, and abdominal ultrasonography. It was evidenced that hematuria originated from the left kidney through ureteral catheterization and the diagnosis of idiopathic renal hematuria was determined by excluding other possible causes of renal hematuria. Idiopathic renal hematuria is a rarely reported disease but has great importance as a differential diagnosis in cases where the main clinical sign is hematuria.

A hematúria renal idiopática é diagnosticada em situações onde a razão da hematúria não é esclarecida, descartando-se todos os possíveis diagnósticos diferenciais. Um cão, fêmea, Cocker Spaniel com 14 anos de idade manifestou hematúria contínua como único sinal clínico, por dois meses. Foram descartadas alterações concomitantes, por meio de exames de sangue, urinálise e ultrassonografia abdominal. A hematúria proveniente do rim esquerdo foi evidenciada através de cateterização ureteral e o diagnóstico de hematúria renal idiopática foi obtido por meio da exclusão de outras possíveis causas de hematúria renal. A hematúria renal idiopática é uma doença pouco relatada, no entanto apresenta grande importância como diagnóstico diferencial nos casos onde o principal sinal clínico é a hematúria.

Unilateral idiopathic renal hematuria in a dog / Hematúria renal idiopática unilateral em um cão

Idiopathic renal hematuria is diagnosed in situations where the cause of hematuria is not clear, even after ruling out all possible differential diagnoses. A 14-year-old female Cocker Spaniel with continuous hematuria as the only clinical sign for two months. Concomitant changes were ruled out by blood tests, urinalysis, and abdominal ultrasonography. It was evidenced that hematuria originated from the left kidney through ureteral catheterization and the diagnosis of idiopathic renal hematuria was determined by excluding other possible causes of renal hematuria. Idiopathic renal hematuria is a rarely reported disease but has great importance as a differential diagnosis in cases where the main clinical sign is hematuria.(AU)

A hematúria renal idiopática é diagnosticada em situações onde a razão da hematúria não é esclarecida, descartando-se todos os possíveis diagnósticos diferenciais. Um cão, fêmea, Cocker Spaniel com 14 anos de idade manifestou hematúria contínua como único sinal clínico, por dois meses. Foram descartadas alterações concomitantes, por meio de exames de sangue, urinálise e ultrassonografia abdominal. A hematúria proveniente do rim esquerdo foi evidenciada através de cateterização ureteral e o diagnóstico de hematúria renal idiopática foi obtido por meio da exclusão de outras possíveis causas de hematúria renal. A hematúria renal idiopática é uma doença pouco relatada, no entanto apresenta grande importância como diagnóstico diferencial nos casos onde o principal sinal clínico é a hematúria.(AU)

Type II retrocaval ureter causing hydronephrosis in a cat: case report / Ureter retrocava tipo II causando hidronefrose em um gato: relato de caso

Retrocaval ureter (RU) is an abnormal embryonic development of the caudal vena cava (CVC) that leads the ureter to be entrapped dorsal to the CVC. In most cases there is no clinical impact; however, it can cause hydronephrosis. We report a rare case of type II symptomatic retrocaval ureter in a feline treated with nephroureterectomy. A 4-year-old, intact male, mixed breed cat was submitted to abdominal ultrasound and severe right hydronephrosis was diagnosed, with no signs of obstruction. We performed an exploratory celiotomy, in which a displacement of the right ureter dorsal to the CVC was observed. The animal was treated with ureteronephrectomy and recovered well. No intraluminal cause was found, and a urethral catheter could be easily inserted across the ureter length. The real clinical relevance of the RU is unknown, since it is a common find in post-mortem examination without kidney impact and, when significant, is often associated to other causes of ureteral obstructions, such as calculi and strictures. Additionally, in humans, type II RU seldom develops obstruction and hydronephrosis. In our case, due to absence of other causes of obstruction, probably mechanical compression of the CVC against the psoas muscle caused the hydronephrosis.(AU)

O ureter retrocava (UR) é originado por uma falha na formação embriológica da veia cava caudal (VCC), que leva ao aprisionamento do ureter dorsal à VCC. Na maioria dos casos, não há impacto clínico; entretanto, essa anomalia pode causar hidronefrose. Relata-se um raro caso de UR tipo II sintomático em um felino, tratado com nefroureterectomia. O referido animal, sem raça definida, macho intacto de quatro anos de idade, foi submetido à ultrassonografia abdominal, que revelou acentuada hidronefrose direita, sem sinais de obstrução. Realizou-se celiotomia exploratória, na qual foi possível observar o ureter direito dorsal à VCC. O animal foi tratado com nefroureterectomia e se recuperou satisfatoriamente. Nenhuma causa intraluminal foi encontrada e um cateter uretral pôde ser facilmente inserido por todo o comprimento do ureter. A real relevância clínica do UR é desconhecida, visto que é um achado comum em exames post mortem, sem impacto aos rins e, quando significante, frequentemente está associado a outras causas de obstrução ureteral, como cálculos e estenoses. Adicionalmente, em humanos, o UR tipo II raramente desenvolve obstrução e hidronefrose. Neste caso, devido à ausência de outros motivos de obstrução, acredita-se que a compressão mecânica da VCC contra o músculo psoas foi a causa da hidronefrose.(AU)

Type II retrocaval ureter causing hydronephrosis in a cat: case report / Ureter retrocava tipo II causando hidronefrose em um gato: relato de caso

Retrocaval ureter (RU) is an abnormal embryonic development of the caudal vena cava (CVC) that leads the ureter to be entrapped dorsal to the CVC. In most cases there is no clinical impact; however, it can cause hydronephrosis. We report a rare case of type II symptomatic retrocaval ureter in a feline treated with nephroureterectomy. A 4-year-old, intact male, mixed breed cat was submitted to abdominal ultrasound and severe right hydronephrosis was diagnosed, with no signs of obstruction. We performed an exploratory celiotomy, in which a displacement of the right ureter dorsal to the CVC was observed. The animal was treated with ureteronephrectomy and recovered well. No intraluminal cause was found, and a urethral catheter could be easily inserted across the ureter length. The real clinical relevance of the RU is unknown, since it is a common find in post-mortem examination without kidney impact and, when significant, is often associated to other causes of ureteral obstructions, such as calculi and strictures. Additionally, in humans, type II RU seldom develops obstruction and hydronephrosis. In our case, due to absence of other causes of obstruction, probably mechanical compression of the CVC against the psoas muscle caused the hydronephrosis.(AU)

O ureter retrocava (UR) é originado por uma falha na formação embriológica da veia cava caudal (VCC), que leva ao aprisionamento do ureter dorsal à VCC. Na maioria dos casos, não há impacto clínico; entretanto, essa anomalia pode causar hidronefrose. Relata-se um raro caso de UR tipo II sintomático em um felino, tratado com nefroureterectomia. O referido animal, sem raça definida, macho intacto de quatro anos de idade, foi submetido à ultrassonografia abdominal, que revelou acentuada hidronefrose direita, sem sinais de obstrução. Realizou-se celiotomia exploratória, na qual foi possível observar o ureter direito dorsal à VCC. O animal foi tratado com nefroureterectomia e se recuperou satisfatoriamente. Nenhuma causa intraluminal foi encontrada e um cateter uretral pôde ser facilmente inserido por todo o comprimento do ureter. A real relevância clínica do UR é desconhecida, visto que é um achado comum em exames post mortem, sem impacto aos rins e, quando significante, frequentemente está associado a outras causas de obstrução ureteral, como cálculos e estenoses. Adicionalmente, em humanos, o UR tipo II raramente desenvolve obstrução e hidronefrose. Neste caso, devido à ausência de outros motivos de obstrução, acredita-se que a compressão mecânica da VCC contra o músculo psoas foi a causa da hidronefrose.(AU)

The relationship between renal warm ischemia time and glomerular loss. An experimental study in a pig model

Purpose: To investigate the glomerular number after different warm ischemia times. Methods: Thirty two pigs were assigned into four groups. Three groups (G10, G20, and G30) were treated with 10, 20, and 30 minutes of left renal warm ischemia. The sham group underwent the same surgery without renal ischemia. The animals were euthanized after 3 weeks, and the kidneys were collected. Right kidneys were used as controls. The kidney weight, volume, cortical-medullar ratio, glomerular volumetric density, volume-weighted mean glomerular volume, and the total number of glomeruli per kidney were obtained. Serum creatinine levels were assessed pre and postoperatively. Results: Serum creatinine levels did not differ among the groups. All parameters were similar for the sham, G10, and G20 groups upon comparison of the right and left organs. The G30 group pigs' left kidneys had lower weight, volume, and cortical-medullar ratio and 24.6% less glomeruli compared to the right kidney. A negative correlation was found between warm ischemia time and glomerular number. Conclusions: About one quarter of glomeruli was lost after 30 minutes of renal warm ischemia. No glomeruli loss was detected before 20 minutes of warm ischemia. However, progressive glomerular loss was associated with increasing warm ischemia time.(AU)

Nefrectomia total unilateral em cachorro-do-mato (Cerdocyon thous) / Total unilateral nephrectomy in a crab-eating fox (Cerdocyon thous)

Background: The loss of natural habitats associated with the development of humanity resulted in the need for longer trips and greater interaction with highways by some animal species. Vehicle collision with animals is one of the main factors of pressure over wild animal populations in Brazil; veterinary surgery can play an important role for the recovery of these patients. The lesions commonly seen in animals hit by vehicles may comprise skin lesions, central nervous system injuries, intrathoracic and intra-abdominal complications, among which renal lesions are included. The aim of this work is to report the use of a total nephrectomy technique in a crab-eating fox. Case: A female, adult, 5-kg crab-eating fox (Cerdocyon thous Linnaeus, 1766) was received for emergency care at the Veterinary Hospital of Universidade Federal do Paraná at Palotina. The patient had been struck by a vehicle at a local highway, was unconscious, and exhibited signs of blood loss such as hypothermia, hypotension, and pale mucous membranes. As the clinical evaluation was performed, the patient was stabilized with pain management, correction of hypovolemia and hypothermia, and oxygen therapy. Blood samples were taken in case of the need for preoperative tests. Subsequently, the animal was submitted to the diagnostic imaging section to investigate possible injuries. No chemical restraint was necessary for the procedures. Radiography examination revealed loss of intra-abdominal contrast, which was confirmed to be free fluid on ultrasound examination. Immediately after imaging examination, the animal was taken to the surgical room for exploratory laparotomy. The surgical incision, which was performed over the linea alba, extended from the xiphoid process to the pubis...

Nefrectomia total unilateral em cachorro-do-mato (Cerdocyon thous) / Total unilateral nephrectomy in a crab-eating fox (Cerdocyon thous)

Background: The loss of natural habitats associated with the development of humanity resulted in the need for longer trips and greater interaction with highways by some animal species. Vehicle collision with animals is one of the main factors of pressure over wild animal populations in Brazil; veterinary surgery can play an important role for the recovery of these patients. The lesions commonly seen in animals hit by vehicles may comprise skin lesions, central nervous system injuries, intrathoracic and intra-abdominal complications, among which renal lesions are included. The aim of this work is to report the use of a total nephrectomy technique in a crab-eating fox. Case: A female, adult, 5-kg crab-eating fox (Cerdocyon thous Linnaeus, 1766) was received for emergency care at the Veterinary Hospital of Universidade Federal do Paraná at Palotina. The patient had been struck by a vehicle at a local highway, was unconscious, and exhibited signs of blood loss such as hypothermia, hypotension, and pale mucous membranes. As the clinical evaluation was performed, the patient was stabilized with pain management, correction of hypovolemia and hypothermia, and oxygen therapy. Blood samples were taken in case of the need for preoperative tests. Subsequently, the animal was submitted to the diagnostic imaging section to investigate possible injuries. No chemical restraint was necessary for the procedures. Radiography examination revealed loss of intra-abdominal contrast, which was confirmed to be free fluid on ultrasound examination. Immediately after imaging examination, the animal was taken to the surgical room for exploratory laparotomy. The surgical incision, which was performed over the linea alba, extended from the xiphoid process to the pubis...(AU)

Dioctophyme renale parasitism in domestic cat in Rio Grande do Sul, Brazil - first reported case / Dioctophyme renale em gato doméstico: primeiro relato de caso no Rio Grande do Sul, Brasil

Dioctophyme renale is a worldwide known nematode of dogs and other domestic and wild species, being uncommon in cats. Some findings of D. renale parasitism in dogs and other wild species are reported in Brazil; but only two cases were recorded in domestic cats. This study aimed to report renal parasitism of D. renale in domestic cat assisted at the Hospital of Veterinary Clinics from the Universidade Federal de Pelotas, in Pelotas city, Rio Grande do Sul State, Brazil; which were the first successfully diagnosed and treated case in this species. The patient had signs of urethral obstruction. D. renale eggs were detected through urinalysis, and parasite location was categorized as being in the entire medullary area of the right kidney by ultrasound exam. Right nephrectomy was established as therapy, once this organ was destroyed. A 20-cm long female and a 12-cm long male were removed with the right kidney, besides another 16-cm long male from left perirenal region. After 10 days of surgery, the patient was completely recovered from urinary dysfunction, being ready for hospital discharge.(AU)

Dioctophyme renale é um nematódeo conhecido mundialmente que parasita cães e outras espécies domésticas bem como espécies selvagens, sendo incomum em gatos. No Brasil, existem alguns relatos do parasitismo em cães e espécies domésticas, mas somente dois casos foram relatados em gatos domésticos. Este trabalho teve como objetivo o relato de um gato doméstico que foi acometido pelo parasitismo de D. renale, na cidade de Pelotas, Rio Grande do Sul, Brasil e foi o primeiro animal diagnosticado e tratado com sucesso nesta espécie. O paciente foi apresentado para atendimento após sinais clínicos de obstrução uretral. Ao exame comum de urina, foram detectados ovos de D. renale. Com o uso do exame de ultrassonografia, foi detectada a localização renal do parasito com destruição total do parênquima deste órgão. O tratamento efetivado foi a realização de uma nefrectomia total unilateral. Uma fêmea e um macho de 20 cm e 12 cm de comprimento, respectivamente, foram removidos do rim excisado e um macho de 16 cm removido da região perirenal esquerda. Após 10 dias do procedimento, o paciente estava completamente recuperado das alterações urinárias.(AU)

Influence of chlorpromazine on renal histology of rats submitted to ischemia and reperfusion injury

PURPOSE:To analyze the influence of chlorpromazine on renal histology of rats submitted to ischemia and reperfusion injury.METHODS:Sixteen Wistar rats - split in two groups - have been used: control group, receiving 3 mg/kg isotonic saline solution through caudal vein, and, the chlorpromazine group, receiving 3 mg/kg-IV of such medication. The nephrectomy of the left kidney lower third was carried out; immediately, the test-drug was administrated. After 15 minutes of test-drug administration, the renal pedicle was clamped; in 60 minutes of ischemia it was released. After 24 hours of the renal reperfusion, the rats were, once more, anesthetized and submitted to total left nephrectomy, and, afterwards, to euthanasia. Histological findings regarding ischemia have been evaluated and compared between the groups.RESULTS:There was no statistical difference related to inferior renal pole histological analysis. Regarding 60-minute renal ischemia, chlorpromazine has statistically reduced the accrual of leucocytes within the vasa recta renis (p=0.036) and the congestion of peritubular capillaries (p=0.041). When conducting joint analysis of histological patterns, the control group showed a median score of 11 and chlorpromazine group of 5.5 (p=0.036).CONCLUSION:Chlorpromazine significantly reduced the occurrence of secondary damage to ischemia and reperfusion process in the overall histological analysis.(AU)

Characterization of an experimental model of progressive renal disease in rats

PURPOSE:To characterize an experimental model of progressive renal disease induced by different degrees of nephrectomy in rats.METHODS:Eighty male Wistar rats were divided into four experimental groups (n=20/group): sham surgery (control group), progressive degrees of nephrectomy leading to mild uremia (group 1), moderate uremia (group 2) and severe uremia (group 3). Ten animals of each group were followed for two or four weeks. At the end, blood and 24-hour urine samples were collected to determine renal function parameters. Urine output and water and food intake were daily monitored.RESULTS:In rats of group 1, serum levels of creatinine and urea and microalbuminuria were increased, while reduced creatinine clearance (p<0.05, compared with control group), without changing blood pressure. Animals of group 2 had more accentuated alterations: increases in urinary output, blood pressure, serum concentrations of urea, creatinine, sodium, potassium, and in microalbuminuria, and reduction of creatinine clearance (p<0.05). Group 3 exhibited even more increased serum concentrations of urea, creatinine, sodium and potassium, blood pressure and microalbuminuria, and decreased creatinine clearance (p<0.05) in comparison with control group and unilateral nephrectomy.CONCLUSION:Progressive nephrectomy in rats seems to be useful to study the physiopathology of chronic kidney disease and its mechanisms of progression.(AU)

Glomerular loss after arteriovenous and arterial clamping for renal warm ischemia in a swine model

PURPOSE:To evaluate the glomerular loss after arteriovenous or arterial warm ischemia in a swine model.METHODS:Twenty four pigs were divided into Group Sham (submitted to all surgical steps except the renal ischemia), Group AV (submitted to 30 minutes of warm ischemia by arteriovenous clamping of left kidney vessels), and Group A (submitted to 30 minutes of ischemia by arterial clamping). Right kidneys were used as controls. Weigh, volume, cortical volume, glomerular volumetric density (Vv[Glom]), volume-weighted glomerular volume (VWGV), and the total number of glomeruli were measured for each organ.RESULTS:Group AV showed a 24.5% reduction in its left kidney Vv[Glom] and a 25.4% reduction in the VWGV, when compared to the right kidney. Reductions were also observed when compared to kidneys of sham group. There was a reduction of 19.2% in the total number of glomeruli in AV kidneys. No difference was observed in any parameters analyzed on the left kidneys from group A.CONCLUSIONS:Renal warm ischemia of 30 minutes by arterial clamping did not caused significant glomerular damage, but arteriovenous clamping caused significant glomerular loss in a swine model. Clamping only the renal artery should be considered to minimize renal injury after partial nephrectomies.(AU)

Nefrectomia videolaparoscópica em Graxaim-do-campo (Pseudalopex gymnocercus) com displasia renal / Laparoscopic nephrectomy in Pampas fox (Pseudalopex gymnocercus) with renal dysplasia

Graxains-do-campo habitam o centro-leste da América do Sul, desde o sudeste do Brasil e leste da Bolívia. A displasia renal compreende um espectro de anomalias e é frequentemente relatada em cães de diversas raças, sendo a maioria dos relatos achados de necropsia. A maior parte das doenças renais congênitas nos cães apresenta caráter progressivo, portanto o tratamento é limitado e direcionado a fim de retardar a progressão da doença renal estabelecida. No presente relato é descrita a realização de nefrectomia laparoscópica em graxaim-do-campo (Pseudalopex gymnocercus) com displasia renal. Suspeitou-se de doença no rim direito por meio de ultrassonografia e urografia excretora. Para o procedimento cirúrgico foram utilizados três portais (10, 10, 5mm), endoscópio rígido de 10mm/0(0) e clipes para hemostasia dos vasos renais. A técnica cirúrgica utilizada neste canídeo selvagem foi semelhante à usada em cão doméstico, devido à escassez de relatos em cirurgias em graxaim e a inexistência de descrições de nefrectomia videolaparoscópica em graxaim-do-campo. O animal foi acompanhado por um período de 30 dias pós-cirurgia sem a ocorrência de complicações. O presente relato demonstra que a técnica proposta foi adequada para a realização de nefrectomia videolaparoscópica em Graxaim-do-campo.(AU)

Pampas fox (Pseudalopex gymnocercus) inhabits east-central South America, from southern Brazil to eastern Bolivia. The renal dysplasia comprises a spectrum of abnormalities and is often reported in dogs of various breeds; but this disease reports involve mostly necropsy findings. Congenital renal diseases in dogs have a progressive character, so that treatment is limited and directed to retard the disease. This report describes a laparoscopic nephrectomy in pampas fox with renal dysplasia. Right kidney disease was suspected by ultrasound and intravenous urography. For the surgical procedure we used three portal accesses (10, 10, 5mm), rigid endoscope 10mm/0(0) and clips for hemostasis of the renal vessels. Due the absence of reports of laparoscopic nephrectomy in pampas fox and scarcity of surgical techniques for this species, the operative technique used was similar to that used in the domestic dog. The pampas fox was monitored for 30 days after surgery without the occurrence of complications. This report demonstrates that the proposed technique is appropriate to perform laparoscopic nephrectomy in pampas fox.(AU)

Laparoscopic nephrectomy with single-portal access Gelpoint®in swines

PURPOSE: To analyze the viability of using Gelpoint® (single-port access) to make partial and total nephrectomy in pigs and to describe the technical difficulties found during these surgical procedures. METHODS: Ten pigs (Landrace specie) with 20kg in average were distributed in two groups. Group A: total right nephrectomy and Group B: partial left nephrectomy. The procedures were performed inside the Surgical Technique Room from Pontifícia Universidade Católica do Parana (PUCPR). RESULTS: In Group A, time to single-port insertion varied from one to two minutes and total time of the procedures were 20.4±8.2 minutes. Bleeding was under than 20 mL in 70% of animals. Time of instrument excision was 20.7±12 seconds and time of hilum dissection was 3.9±2.2 minutes. In Group B, after total contralateral nephrectomy two surgical procedures were not concluded due to bleeding. In this group, time of surgery was 6.8±4.2 minutes. With the exception of the second surgery, the highest blood volume loss was 50 mL. The mean excision time was 22.3 ± 22.3 seconds. CONCLUSION: Total and partial nephrectomy through umbilical single-access using GelPoint® was feasible and safe in pigs.(AU)

Laparoscopic nephrectomy with single-portal access Sitracc® in swines / Nefrectomia laparoscópica com portal único Sitracc® em suínos

PURPOSE: To analyze the viability of using SITRACC® (single-portal access) to make partial or total nephrectomy in pigs and also to describe the technical difficulties found during these surgical procedures. METHODS: Ten pigs (Landrace specie) with 20kg in average were distributed in two groups: Group A - total right nephrectomy - and Group B - partial left nephrectomy -. The anesthetic procedure was initially done with thiopental (10mg/kg) and maintained with halothane. The surgical procedures were performed inside the Surgical Technique Room from Pontifical Catholic University of Parana (PUCPR). RESULTS: It was analyzed the surgery duration, time to insert SITRACC®, the volemic loss and the size of the organ. In the first surgeries, the surgical time and blood volume loss were higher (between 15 to 43 minutes and 120 to 400 mL, respectively). The more the procedure was performed, the more the surgeons were used to the technique, so the bleeding and the time of surgery was significantly reduced to 15 minutes and 50 mL of blood loss, respectively. The difficulties found were associated with the nippers, however that was not relevant for the surgical technique. It was also found that the intra-body suture caused an expressive volemic loss. CONCLUSION: The total and partial nephrectomy through umbilical single-access by using SITRACC® was feasible and safe in pigs.(AU)

OBJETIVO: Analisar a viabilidade do uso do SITRACC® (portal único) para realização de nefrectomia total e parcial em suínos e descrever as dificuldades técnicas encontradas durante os atos cirúrgicos propostos. MÉTODOS: Foram operados 10 porcos da espécie Landrace, com peso médio de 20 Kg, distribuidos em dois grupos: Grupo A: nefrectomia total à direita e Grupo B: nefrectomia parcial à esquerda. A indução anestésica foi realizada com a administração de tiopental (10mg/Kg) e mantida com halotano. Os procedimentos cirúrgicos foram realizados na sala de Técnica Operatória da Pontifícia Universidade Católica do Paraná (PUCPR). RESULTADOS: Foram analisados tempo total de cirurgia, tempo de colocação do SITRACC®, perda volêmica e tamanho da peça. Nas primeiras cirurgias realizadas o tempo cirúrgico e o volume do sangramento foram maiores (entre 15 - 43 minutos e entre 120 - 400 ml, respectivamente); à medida que se adquiriu prática com a técnica, esses apresentaram reduções significativas para menos que 15 minutos e 50 ml, respectivamente. A dificuldade encontrada foi na articulação das pinças, porém, não afetou a técnica cirúrgica. Além disso, houve dificuldade na realização da sutura intracorpórea acarretando uma perda volêmica maior. CONCLUSÃO: A nefrectomia total e parcial por acesso umbilical único com uso do SITRACC® é plenamente viável e segura em suínos.(AU)