Chronic expanding hematoma secondary to excision of recurrent myxomas in a bitch

Background: Expanding chronic hematoma is a relatively common postoperative complication in humans, not in dogs, nevertheless, is important understand this condition because it may affect the animal's health. A hematoma could be formed within hours and usually stabilizes spontaneously with the reabsorption of its content. However, occasionally the hematoma slowly expands, becomes encapsulated and forms a mass, causing a chronic expanding hematoma. Possibly skin and adipose tissue are displaced secondary to trauma, causing the formation of blood-filled cysts surrounded by a fibrous capsule. The aim of this document is to present the first report of a postsurgical chronic expanding hematoma in dog. Case: A case of chronic expanding hematoma secondary to excision of recurrent myxoma in a bitch was described. Physical examination showed a hard, firm, non-mobile mass enclosed within the deep muscular layers. This mass was between the sternum and the cranial abdomen, similar to previous lesions excised by another veterinarian. Fine needle aspiration indicated the presence of blood. Radiology demonstrated that the bone-cartilage tissue was not involved. Due to the size of the mass, a skin stretching pre-suturing technique using self-adhesive tape was applied around the mass 48 h before surgery. The mass was removed with wide excision margins and portions of the affected muscles, but a large wound with great tension was created; consequently, a parallel to the wound incision and the thoraco-lumbar vertebrae was made. Six months after surgery, the animal presented recurrence of the same lesion, which was also removed. The bleeding times were within the normal range, but the animal was diagnosed with hyperadrenocorticism. After both surgeries histopathological exam revealed a hematoma, that had thrombosis and granulation tissue with fibrosis and severe panniculitis, in addition of multifocal, chronic, moderate lymphohistiocytic myositis; all these changes were compatible with a chronic expanding hematoma. Discussion: Chronic expanding hematoma is a mass that grows slowly secondary to hemorrhage and does not exhibit elements of malignancy. However, it can occasionally be confused for a soft-tissue neoplasm. It has been reported frequently in humans but not in small animals. The first case was reported in 2002: 5 puppies with a cervical hematoma classified as a chronic expanding hematoma was described. In addition, 3 cases were reported: 1 cat with perirenal chronic expanding hematoma; 1 bitch with intra-abdominal presentation, and 1 cat with this pathology on the right pelvic limb after an intramuscular injection. The etiology of chronic expansive hematoma is unidentified in dogs, nevertheless, it is stipulated that is not an inflammatory process as previously assumed, but rather a neoplastic process. As in other cases, it was difficult to determine the origin of the chronic expanding hematoma. The coagulation times and platelets count were within ranges. Similarly, it is very complicated to relate hyperadrenocorticism with chronic expanding hematoma because dogs with Cushing's disease generally present hypercoagulopathies. Myxomas are associated with endocrinopathies in humans and dogs, therefore, hyperadrenocorticism is possibly related with this neoplasia. Myxomas have an expansive growth pattern, contrasting with myxosarcomas, which are infiltrating; Although in the present case the skin mass appeared to be invasive, both macroscopical and histopathological appearance of it corresponded to a well-shaped capsule compatible with chronic expanding hematoma. In summary, to the best of our knowledge, this is the first report of a post-surgical chronic expanding hematoma in a dog.

Auto-hemoterapia em orquiectomia de cães / Autohemotherapy in dogs' orchiectomy

A orquiectomia consiste na remoção dos testículos e, em animais, pode ser realizada por motivo eletivo ou terapêutico. A cirurgia eletiva faz parte da guarda responsável de cães e gatos e é um dos procedimentos mais realizados na medicina veterinária, incluindo mutirões de castração onde a redução de custos é importante. A auto-hemoterapia (AHT) vem sendo aplicada em animais, inclusive em acupontos, com o intuito de produzir efeitos imunoestimulantes. Neste contexto, este estudo utilizou AHT, durante o período pós-operatório imediato, em acupontos de cães submetidos à orquiectomia eletiva sem a aplicação de antibióticos. Os resultados obtidos foram comparados com dados referentes a outro grupo de animais, os quais foram orquiectomizados e previamente tratados com antibiótico sistêmico. Todos os animais foram acompanhados clinicamente e foram feitos hemogramas nos períodos pré e pós-operatório, assim como o registro de infecções e outras intercorrências relacionadas ao procedimento cirúrgico. Considerando os 20 cães usados no estudo, não houve ocorrência de infecção ou processo inflamatório nos animais após o procedimento cirúrgico. Além disso, alterações hematológicas significativas não foram observadas entre os grupos e entre os períodos pré e pós-operatório de ambos os grupos. Desta forma, conclui-se que a auto-hemoterapia associada à acupuntura pode representar uma alternativa para um protocolo cirúrgico sem antibióticos em cirurgia eletiva de orquiectomia em animais hígidos.

The orchiectomy is the removal of the testicles and, in animals, can be performed due to by elective or therapeutic reasons. Elective surgery is part of the responsible ownership of dogs and cats and is one of the most performed procedures in veterinary medicine, including castration efforts where cost reduction is important. Autohemotherapy (AHT) has been applied in animals, including acupoints, to produce immunostimulatory effects. In this context, this study used AHT, during the immediate postoperative period, in acupoints of dogs submitted to elective orchiectomy without the use of antibiotics. The results obtained were compared to data from another group of animals, which were orchiectomized and previously treated with a systemic antibiotic. All animals were clinically monitored and hemograms were performed during the pre and post-operatory period, as well as the registration of infections and other complications related to the surgical procedure. Regarding the 20 dogs used in the study, there was no occurrence of infection or inflammation in the animals after the surgical procedure. In addition, significant hematologic alterations were not observed between groups and between pre- and post-operatory periods in both groups. Therefore, it is concluded that autohemotherapy associated with acupuncture may represent an alternative for a surgical protocol without antibiotics in elective orchiectomy surgery in healthy animals.

Incisional hernia in a dog

Background: The rupture of the suture in the abdominal wall, but with integrity of the cutaneous suture, results in a condition known as incisional hernia. It is characterized by the protrusion of the abdominal viscera through orifices or areas ofthe abdominal wall. In most of the cases these defects in the abdominal wall are iatrogenic. The incisional hernia occursin an intact wall that is weakened by surgical incisions. The available literature on the incidence of incisional herniasin animals is scarce. With the aim to contribute to the information about incisional hernia in animals, it was decided todescribe the case of incisional hernia in a female dog after performing ovariohysterectomy (OH).Case: An adult mongrel shelter bitch, of unknown age, weighing 9.5 kg was admitted for OH in a practical class of theveterinary surgical technical discipline. Once the anesthetic condition was established, a retro-umbilical cutaneous incisionwas made. After opening the abdominal cavity, the bitch was castrated routinely. The abdominal wall was sutured including peritoneum, muscle fascia, and rectus abdominis muscle with nylon thread and U-stitches. The subcutaneous tissuewas then sutured with the same thread using Cushing suture. Ten days after the surgery, when the stitches were removed,the bitch revealed an increase in volume at the region of the surgical scar. Incisional hernia was diagnosed after carefulpalpation. For correction of the hernia, the bitch was submitted to surgical procedure. After the skin opening, an intenseinflammatory reaction was observed in the subcutaneous tissue. The inflamed skin and subcutaneous tissue were removed.The abdominal cavity was closed with nylon thread by means of U-stitches. The subcutaneous and skin...

Incisional hernia in a dog

Background: The rupture of the suture in the abdominal wall, but with integrity of the cutaneous suture, results in a condition known as incisional hernia. It is characterized by the protrusion of the abdominal viscera through orifices or areas ofthe abdominal wall. In most of the cases these defects in the abdominal wall are iatrogenic. The incisional hernia occursin an intact wall that is weakened by surgical incisions. The available literature on the incidence of incisional herniasin animals is scarce. With the aim to contribute to the information about incisional hernia in animals, it was decided todescribe the case of incisional hernia in a female dog after performing ovariohysterectomy (OH).Case: An adult mongrel shelter bitch, of unknown age, weighing 9.5 kg was admitted for OH in a practical class of theveterinary surgical technical discipline. Once the anesthetic condition was established, a retro-umbilical cutaneous incisionwas made. After opening the abdominal cavity, the bitch was castrated routinely. The abdominal wall was sutured including peritoneum, muscle fascia, and rectus abdominis muscle with nylon thread and U-stitches. The subcutaneous tissuewas then sutured with the same thread using Cushing suture. Ten days after the surgery, when the stitches were removed,the bitch revealed an increase in volume at the region of the surgical scar. Incisional hernia was diagnosed after carefulpalpation. For correction of the hernia, the bitch was submitted to surgical procedure. After the skin opening, an intenseinflammatory reaction was observed in the subcutaneous tissue. The inflamed skin and subcutaneous tissue were removed.The abdominal cavity was closed with nylon thread by means of U-stitches. The subcutaneous and skin...(AU)

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion

ABSTRACT: The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.

RESUMO: O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion / A necessidade de opioide na analgesia pós-operatória de cães submetidos à hemilaminectomia devido à extrusão do disco intervertebral

The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.(AU)

O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.(AU)

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion / A necessidade de opioide na analgesia pós-operatória de cães submetidos à hemilaminectomia devido à extrusão do disco intervertebral

The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.(AU)

O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.(AU)

Antibiotic prophylaxis in breast cancer surgery: a randomized controlled trial

Purpose To assess the effect of antibiotic prophylaxis on surgical site infection (SSI) rates in women undergoing breast cancer surgery in two tertiary hospitals in Brazil. Methods This was a randomized, double-blind, placebo-controlled, parallel-group clinical trial. A total of 124 women without independent risk factors for SSI were randomly assigned to receive either cefazolin (antibiotic group, n = 62) or placebo (control group, n = 62) as preoperative prophylaxis. After surgery, all surgical wounds were examined once a week, for four weeks, according to the Centers for Disease Control and Prevention definitions and classifications for SSI. Results Baseline characteristics were homogeneous between the two groups. Only one patient in the antibiotic group developed SSI, which was classified as superficial incisional. The overall SSI rate was low, with no significant difference between groups. Conclusion Antibiotic prophylaxis had no significant effect on reducing SSI rates in women without independent risk factors for SSI undergoing breast cancer surgery.(AU)

Long-term clinical complications associated with the use of polymethyl methacrylate in spinal stabilization of dogs and cats: case series / Complicações clínicas de longo prazo relacionadas ao uso de pino ou parafuso/polimetilmetacrilato na estabilização espinhal de cães e gatos: série de casos

Vertebral and spinal cord trauma are common conditions in small animal practice and often result in vertebral fractures/luxation (VFL) with concomitant spinal cord laceration, concussion, compression, or ischemia. These lesions have several clinical presentations that may vary from moderate to severe pain and partial to total loss of motor, sensory, and visceral functions, which may result in death or euthanasia. Our purpose is to describe five cases (four dogs and one cat) of complications secondary to the use of bone cement for vertebral stabilization. The patients, between five months and four years of age and weighing between 1.4 and 12.2 kg, were referred to the Small Animal Orthopedics and Traumatology Service of the Veterinary Hospital of the College of Veterinary Medicine and Animal Science of the University of São Paulo. They had a history of post-operatory polymethyl methacrylate (PMMA) reactions (such as drainage or cement exposure due to infection or implant failure) in periods from 9 to 18 months after undergoing spinal osteosynthesis. Surgical implant removal occurred in 80% of the patients (4/5). Complete remission was not observed in the patient with residual implants. The association of pins/screws and PMMA is a versatile osteosynthesis technique and is applicable in all spinal regions. However, delayed complications can occur, which could require additional surgical procedures. Despite the small number of cases included in this study, one can infer that complications related to the use of bone cement in spinal surgery can occur in the long term and should be highlighted during the implant choosing process for vertebral osteosynthesis in small animals.

O trauma vertebromedular é uma afecção comum na rotina clínica de pequenos animais e resulta, muitas vezes, em fraturas e luxações vertebrais (FLV) associadas à laceração, concussão, compressão ou isquemia da medula espinhal. Essas lesões apresentam sinais clínicos que variam de dor moderada a grave, acompanhada por perda parcial ou total das funções motoras, sensoriais e viscerais, podendo resultar no óbito ou na indicação de eutanásia. O objetivo deste trabalho é descrever cinco casos de complicações inerentes o uso de cimento ósseo para estabilização vertebral em quatro cães e um gato. Os pacientes possuíam idades variando entre cinco meses a quatro anos, peso entre 1,4 e 12,2kg e foram atendidos no Serviço de Ortopedia e Traumatologia do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, com histórico de reações cutâneas ao polimetilmetacrilato (PMMA), como tratos drenantes ou exposição do cimento decorrente de infecção ou soltura precoce do implante, em períodos que variaram de nove à 18 meses após serem submetidos a osteossíntese da coluna vertebral. Foi realizada a remoção cirúrgica desses implantes em quatro pacientes e mantida a estabilização prévia em um caso. Houve resolução total do quadro de infecção nos pacientes em que se removeu o PMMA associada ao tratamento clínico, e remissão parcial no paciente em que o implante não pode ser removido. A utilização do cimento ósseo associado a parafusos ou pinos é uma técnica versátil e aplicável em todas as regiões da coluna vertebral, no entanto complicações tardias são possíveis, sendo necessário muitas vezes procedimentos cirúrgicos adicionais para a resolução do problema. Apesar da pequena quantidade de casos relatados, foi possível observar que complicações relacionadas ao uso do cimento ósseo na coluna vertebral podem ocorrer no médio ao longo prazo [...].

Long-term clinical complications associated with the use of polymethyl methacrylate in spinal stabilization of dogs and cats: case series / Complicações clínicas de longo prazo relacionadas ao uso de pino ou parafuso/polimetilmetacrilato na estabilização espinhal de cães e gatos: série de casos

Vertebral and spinal cord trauma are common conditions in small animal practice and often result in vertebral fractures/luxation (VFL) with concomitant spinal cord laceration, concussion, compression, or ischemia. These lesions have several clinical presentations that may vary from moderate to severe pain and partial to total loss of motor, sensory, and visceral functions, which may result in death or euthanasia. Our purpose is to describe five cases (four dogs and one cat) of complications secondary to the use of bone cement for vertebral stabilization. The patients, between five months and four years of age and weighing between 1.4 and 12.2 kg, were referred to the Small Animal Orthopedics and Traumatology Service of the Veterinary Hospital of the College of Veterinary Medicine and Animal Science of the University of São Paulo. They had a history of post-operatory polymethyl methacrylate (PMMA) reactions (such as drainage or cement exposure due to infection or implant failure) in periods from 9 to 18 months after undergoing spinal osteosynthesis. Surgical implant removal occurred in 80% of the patients (4/5). Complete remission was not observed in the patient with residual implants. The association of pins/screws and PMMA is a versatile osteosynthesis technique and is applicable in all spinal regions. However, delayed complications can occur, which could require additional surgical procedures. Despite the small number of cases included in this study, one can infer that complications related to the use of bone cement in spinal surgery can occur in the long term and should be highlighted during the implant choosing process for vertebral osteosynthesis in small animals.(AU)

O trauma vertebromedular é uma afecção comum na rotina clínica de pequenos animais e resulta, muitas vezes, em fraturas e luxações vertebrais (FLV) associadas à laceração, concussão, compressão ou isquemia da medula espinhal. Essas lesões apresentam sinais clínicos que variam de dor moderada a grave, acompanhada por perda parcial ou total das funções motoras, sensoriais e viscerais, podendo resultar no óbito ou na indicação de eutanásia. O objetivo deste trabalho é descrever cinco casos de complicações inerentes o uso de cimento ósseo para estabilização vertebral em quatro cães e um gato. Os pacientes possuíam idades variando entre cinco meses a quatro anos, peso entre 1,4 e 12,2kg e foram atendidos no Serviço de Ortopedia e Traumatologia do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, com histórico de reações cutâneas ao polimetilmetacrilato (PMMA), como tratos drenantes ou exposição do cimento decorrente de infecção ou soltura precoce do implante, em períodos que variaram de nove à 18 meses após serem submetidos a osteossíntese da coluna vertebral. Foi realizada a remoção cirúrgica desses implantes em quatro pacientes e mantida a estabilização prévia em um caso. Houve resolução total do quadro de infecção nos pacientes em que se removeu o PMMA associada ao tratamento clínico, e remissão parcial no paciente em que o implante não pode ser removido. A utilização do cimento ósseo associado a parafusos ou pinos é uma técnica versátil e aplicável em todas as regiões da coluna vertebral, no entanto complicações tardias são possíveis, sendo necessário muitas vezes procedimentos cirúrgicos adicionais para a resolução do problema. Apesar da pequena quantidade de casos relatados, foi possível observar que complicações relacionadas ao uso do cimento ósseo na coluna vertebral podem ocorrer no médio ao longo prazo [...].(AU)

Long-term clinical complications associated with the use of polymethyl methacrylate in spinal stabilization of dogs and cats: case series / Complicações clínicas de longo prazo relacionadas ao uso de pino ou parafuso/polimetilmetacrilato na estabilização espinhal de cães e gatos: série de casos

Vertebral and spinal cord trauma are common conditions in small animal practice and often result in vertebral fractures/luxation (VFL) with concomitant spinal cord laceration, concussion, compression, or ischemia. These lesions have several clinical presentations that may vary from moderate to severe pain and partial to total loss of motor, sensory, and visceral functions, which may result in death or euthanasia. Our purpose is to describe five cases (four dogs and one cat) of complications secondary to the use of bone cement for vertebral stabilization. The patients, between five months and four years of age and weighing between 1.4 and 12.2 kg, were referred to the Small Animal Orthopedics and Traumatology Service of the Veterinary Hospital of the College of Veterinary Medicine and Animal Science of the University of São Paulo. They had a history of post-operatory polymethyl methacrylate (PMMA) reactions (such as drainage or cement exposure due to infection or implant failure) in periods from 9 to 18 months after undergoing spinal osteosynthesis. Surgical implant removal occurred in 80% of the patients (4/5). Complete remission was not observed in the patient with residual implants. The association of pins/screws and PMMA is a versatile osteosynthesis technique and is applicable in all spinal regions. However, delayed complications can occur, which could require additional s

O trauma vertebromedular é uma afecção comum na rotina clínica de pequenos animais e resulta, muitas vezes, em fraturas e luxações vertebrais (FLV) associadas à laceração, concussão, compressão ou isquemia da medula espinhal. Essas lesões apresentam sinais clínicos que variam de dor moderada a grave, acompanhada por perda parcial ou total das funções motoras, sensoriais e viscerais, podendo resultar no óbito ou na indicação de eutanásia. O objetivo deste trabalho é descrever cinco casos de complicações inerentes o uso de cimento ósseo para estabilização vertebral em quatro cães e um gato. Os pacientes possuíam idades variando entre cinco meses a quatro anos, peso entre 1,4 e 12,2kg e foram atendidos no Serviço de Ortopedia e Traumatologia do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, com histórico de reações cutâneas ao polimetilmetacrilato (PMMA), como tratos drenantes ou exposição do cimento decorrente de infecção ou soltura precoce do implante, em períodos que variaram de nove à 18 meses após serem submetidos a osteossíntese da coluna vertebral. Foi realizada a remoção cirúrgica desses implantes em quatro pacientes e mantida a estabilização prévia em um caso. Houve resolução total do quadro de infecção nos pacientes em que se removeu o PMMA associada ao tratamento cl

Evaluation of intraperitoneal and incisional bupivacaine or levobupivacaine for postoperative analgesia in ovariohysterectomized dogs

Background: Ovariohysterectomy (OHE) is the most commonly performed elective surgical procedure in companionanimals. OHE offers benefits of control of population and decreased risk of potentially life-threatening diseases such asmammarian tumours and pyometra. Traditional OHE intervention causes inflammation and pain due to trauma duringorgan manipulation. The purpose of this study was to compare the effect of intraperitoneal and incisional administrationof bupivacaine (BP) or levobupivacaine (LP) on postoperative analgesia in dogs undergoing the OHE procedure.Materials, Methods & Results: A total of 24 mix-breed bitches aged between 1 - 3 years and weighed 19 - 20 kg wereused in this study. The animals were divided into three groups as control (n = 8), BP (n = 8) and LP group (n = 8). Theanimals were kept under surveillance at the hospitalisation unit of the animal hospital for one day before the elective OHE.The dogs were fasted for 12 h before the surgery, with adlib water consumption. Atropine sulphate 0.045 mg/kg was administered subcutaneously approximately 30 min before general anaesthesia. Midazolam (0.3 mg/kg) was intravenouslyinjected into all dogs for pre-anaesthetic medication. After sedation, anaesthesia was induced with propofol (4 mg/kg, IV)and then the dogs were orotracheally intubated using cuffed endotracheal tubes. General anaesthesia was maintained byadministration of 2% isoflurane. The ventral abdomen was prepared aseptically for OHE following the general anaesthesia.All animals were operated on by the same surgeon. During surgery, sprayed bupivacaine 0.5% (4.4 mg/kg) with an equalvolume of saline in BP group, levobupivacaine 0.5% (4.4 mg/kg) with an equal volume of saline in LP were then appliedover the ovaries, uterine broad ligaments and cervix uteri. After removal of the uterine body, either LP or BP was sprayedto left and right, or cranial and caudal parts of the abdominal cavity...

Evaluation of intraperitoneal and incisional bupivacaine or levobupivacaine for postoperative analgesia in ovariohysterectomized dogs

Background: Ovariohysterectomy (OHE) is the most commonly performed elective surgical procedure in companionanimals. OHE offers benefits of control of population and decreased risk of potentially life-threatening diseases such asmammarian tumours and pyometra. Traditional OHE intervention causes inflammation and pain due to trauma duringorgan manipulation. The purpose of this study was to compare the effect of intraperitoneal and incisional administrationof bupivacaine (BP) or levobupivacaine (LP) on postoperative analgesia in dogs undergoing the OHE procedure.Materials, Methods & Results: A total of 24 mix-breed bitches aged between 1 - 3 years and weighed 19 - 20 kg wereused in this study. The animals were divided into three groups as control (n = 8), BP (n = 8) and LP group (n = 8). Theanimals were kept under surveillance at the hospitalisation unit of the animal hospital for one day before the elective OHE.The dogs were fasted for 12 h before the surgery, with adlib water consumption. Atropine sulphate 0.045 mg/kg was administered subcutaneously approximately 30 min before general anaesthesia. Midazolam (0.3 mg/kg) was intravenouslyinjected into all dogs for pre-anaesthetic medication. After sedation, anaesthesia was induced with propofol (4 mg/kg, IV)and then the dogs were orotracheally intubated using cuffed endotracheal tubes. General anaesthesia was maintained byadministration of 2% isoflurane. The ventral abdomen was prepared aseptically for OHE following the general anaesthesia.All animals were operated on by the same surgeon. During surgery, sprayed bupivacaine 0.5% (4.4 mg/kg) with an equalvolume of saline in BP group, levobupivacaine 0.5% (4.4 mg/kg) with an equal volume of saline in LP were then appliedover the ovaries, uterine broad ligaments and cervix uteri. After removal of the uterine body, either LP or BP was sprayedto left and right, or cranial and caudal parts of the abdominal cavity...(AU)

Relationship between serum MMP-9 level and prognosis after radical resection for Hilar cholangiocarcinoma patients

Purpose: To analyze the preoperative serum matrix metalloproteinase-9 (MMP-9) levels and prognosis of patients with hilar cholangiocarcinoma (HC) undergoing radical resection. Methods: Preoperative serum MMP-9 levels in patients with HC undergoing radical resection were detected by enzyme-linked immunosorbent assay (ELISA). The ROC curve assay was used to analyze the preoperative serum MMP-9 level to determine the most valuable cut-off point. The relationship between MMP-9 and clinicopathological features of HC patients was analyzed. Kaplan-Meier method was used to analyze the prognostic factors, and COX regression model was used to analyze the independent risk factors affecting prognosis. Results: Preoperative serum MMP-9 levels were significantly elevated in the death patients compared with the survival patients. The most valuable cut-off point for preoperative serum MMP-9 for prognosis was 201.93 ng/mL. Preoperative serum MMP-9 was associated with Bismuth-Corlette classification) and lymph node metastasis. Kaplan-Meier analysis showed that MMP-9, Bismuth-Corlette classification, Lymph node metastasis, Portal vein invasion, Hepatic artery invasion, Liver invasion, Incised margin, and Preoperative biliary drainage were related to prognosis. Cox regression model confirmed that hepatic artery invasion, liver invasion, incised margin, and MMP-9 have the potential to independence predicate prognosis in HC patients. Conclusion: Preoperative serum MMP-9 has high predictive value for prognosis and is an independent influencing factor for the prognosis of patients with hilar cholangiocarcinoma.(AU)

Perfil de tutores de cadelas portadoras de tumor de mama / Profile of tutors of dogs with mammary tumor / Perfil de tutores de perras portadoras de tumor mama

É importante que se obtenha informações sobre tutores de cadelas portadoras de tumor de mama, pois o tutor precisa cuidar do animal principalmente no pós-operatório já que o tratamento é mastectomia. Foram entrevistados 11 tutores de cadelas submetidas à mastectomia. A maioria dos entrevistados tem ensino médio e superior, morando em casa própria com renda de um a cinco salários mínimos. Apenas uma pessoa disse que não sabia que cadelas podem ter câncer de mama. Entretanto, a maioria não sabe como prevenir o câncer de mama em cadelas, demonstrando que são necessárias campanhas educacionais sobre a doença para tutores de cadelas. A maneira mais frequente de aquisição do animal foi a adoção, o que demonstra o crescimento da posse responsável entre os tutores brasileiros. Três tutores afirmaram que aplicaram anticoncepcional nas suas cadelas várias vezes. Este fato é bastante preocupante porque tais fármacos possuem diversos efeitos colaterais adversos, inclusive tumor de mama. Oito tutores informaram que nunca haviam consultado um médico veterinário antes sobre o tumor, embora o mesmo fosse evidente. A maioria dos tutores só procurou ajuda para a cadela porque a participação no projeto era gratuita. Dificuldades financeiras é um dos principais motivos para que os tutores retardem as consultas. Entretanto, quando questionados por qual motivo as cadelas não tinham sido tratadas antes, nenhum tutor citou dificuldades financeiras. Concluiu-se que alguns tumores de mama foram causados por aplicação de anticoncepcional e que o desconhecimento sobre a doença ainda é grande entre os tutores entrevistados.(AU)

It is important to collect information about owners of dogs with mammary tumor, since the owner must take care of the animal after surgery, given that the treatment of choice is a mastectomy. This study interviewed eleven owners of female dogs submitted to mastectomy. Most respondents have high school and/or college education, live in their own homes with incomes between one to five minimum salaries. Only one person said they did not know that dogs could have mammary cancer. However, most do not know how to prevent mammary cancer in dogs, demonstrating the need for educational campaigns on the disease. The most frequent way of acquiring the animal was adoption, which demonstrates the growth of responsible ownership among Brazilian owners. Three owners stated that they used contraceptive drugs on their dogs several times. This fact is quite worrisome since such drugs have several adverse effects, including mammary tumor. Eight owners reported that they had never been to a veterinarian before about the tumor, although the tumor was evident. Most owners only sought help for the dog because participation in the project was free of charge. Financial difficulties are one of the main reasons for owners to delay consultations. However, when asked why the dogs had not been treated before, no owner mentioned financial difficulties. It can be concluded that some breast tumors were caused by the use of contraceptive drugs and that ignorance regarding the disease is still high among the interviewed tutorsd.(AU)

Es importante que se obtenga informaciones sobre los tutores de perras portadoras de tumor de mama, pues el tutor necesita cuidar del animal principalmente en el postoperatorio, ya que el tratamiento es la mastectomía. Se han entrevistado a once tutores de perras sometidas a la mastectomía. La mayoría de los encuestados tienen educación secundaria y universitaria, y viven en sus propios hogares con ingresos de uno a cinco sueldos mínimos. Solo una persona dijo que no sabía que las perras pueden tener cáncer de mama. Sin embargo, la mayoría no sabe cómo prevenir el cáncer de mama en perras, demostrando que son necesarias campañas educativas sobre la enfermedad para dueños de perras. La forma más frecuente de adquirir el animal es la adopción, lo que demuestra el crecimiento de la posesión responsable entre los tutores brasileños. Tres tutores declararon que aplicaron anticonceptivos a sus perras varias veces. Este hecho es bastante preocupante porque estos medicamentos tienen varios efectos secundarios adversos, incluso el tumor de mama. Ocho tutores informaron que nunca antes habían consultado a un médico veterinario sobre el tumor, aunque el mismo era evidente. La mayoría de los tutores solo buscaron ayuda para la perra porque la participación en el proyecto era gratuita. Las dificultades financieras es una de las principales razones por las cuales los tutores retrasan las consultas. Sin embargo, cuando cuestionados por cuál motivo las perras no habían sido tratadas antes, ningún tutor mencionó dificultades financieras. Se concluyó que algunos tumores de mama fueron causados por la aplicación de anticonceptivos y que el desconocimiento sobre la enfermedad aún es alta entre los tutores encuestados.(AU)

Perfil de tutores de cadelas portadoras de tumor de mama / Profile of tutors of dogs with mammary tumor / Perfil de tutores de perras portadoras de tumor mama

É importante que se obtenha informações sobre tutores de cadelas portadoras de tumor de mama, pois o tutor precisa cuidar do animal principalmente no pós-operatório já que o tratamento é mastectomia. Foram entrevistados 11 tutores de cadelas submetidas à mastectomia. A maioria dos entrevistados tem ensino médio e superior, morando em casa própria com renda de um a cinco salários mínimos. Apenas uma pessoa disse que não sabia que cadelas podem ter câncer de mama. Entretanto, a maioria não sabe como prevenir o câncer de mama em cadelas, demonstrando que são necessárias campanhas educacionais sobre a doença para tutores de cadelas. A maneira mais frequente de aquisição do animal foi a adoção, o que demonstra o crescimento da posse responsável entre os tutores brasileiros. Três tutores afirmaram que aplicaram anticoncepcional nas suas cadelas várias vezes. Este fato é bastante preocupante porque tais fármacos possuem diversos efeitos colaterais adversos, inclusive tumor de mama. Oito tutores informaram que nunca haviam consultado um médico veterinário antes sobre o tumor, embora o mesmo fosse evidente. A maioria dos tutores só procurou ajuda para a cadela porque a participação no projeto era gratuita. Dificuldades financeiras é um dos principais motivos para que os tutores retardem as consultas. Entretanto, quando questionados por qual motivo as cadelas não tinham sido tratadas antes, nenhum tutor citou dificuldades financeiras. Concluiu-se que alguns tumores de mama foram causados por aplicação de anticoncepcional e que o desconhecimento sobre a doença ainda é grande entre os tutores entrevistados.(AU)

It is important to collect information about owners of dogs with mammary tumor, since the owner must take care of the animal after surgery, given that the treatment of choice is a mastectomy. This study interviewed eleven owners of female dogs submitted to mastectomy. Most respondents have high school and/or college education, live in their own homes with incomes between one to five minimum salaries. Only one person said they did not know that dogs could have mammary cancer. However, most do not know how to prevent mammary cancer in dogs, demonstrating the need for educational campaigns on the disease. The most frequent way of acquiring the animal was adoption, which demonstrates the growth of responsible ownership among Brazilian owners. Three owners stated that they used contraceptive drugs on their dogs several times. This fact is quite worrisome since such drugs have several adverse effects, including mammary tumor. Eight owners reported that they had never been to a veterinarian before about the tumor, although the tumor was evident. Most owners only sought help for the dog because participation in the project was free of charge. Financial difficulties are one of the main reasons for owners to delay consultations. However, when asked why the dogs had not been treated before, no owner mentioned financial difficulties. It can be concluded that some breast tumors were caused by the use of contraceptive drugs and that ignorance regarding the disease is still high among the interviewed tutorsd.(AU)

Es importante que se obtenga informaciones sobre los tutores de perras portadoras de tumor de mama, pues el tutor necesita cuidar del animal principalmente en el postoperatorio, ya que el tratamiento es la mastectomía. Se han entrevistado a once tutores de perras sometidas a la mastectomía. La mayoría de los encuestados tienen educación secundaria y universitaria, y viven en sus propios hogares con ingresos de uno a cinco sueldos mínimos. Solo una persona dijo que no sabía que las perras pueden tener cáncer de mama. Sin embargo, la mayoría no sabe cómo prevenir el cáncer de mama en perras, demostrando que son necesarias campañas educativas sobre la enfermedad para dueños de perras. La forma más frecuente de adquirir el animal es la adopción, lo que demuestra el crecimiento de la posesión responsable entre los tutores brasileños. Tres tutores declararon que aplicaron anticonceptivos a sus perras varias veces. Este hecho es bastante preocupante porque estos medicamentos tienen varios efectos secundarios adversos, incluso el tumor de mama. Ocho tutores informaron que nunca antes habían consultado a un médico veterinario sobre el tumor, aunque el mismo era evidente. La mayoría de los tutores solo buscaron ayuda para la perra porque la participación en el proyecto era gratuita. Las dificultades financieras es una de las principales razones por las cuales los tutores retrasan las consultas. Sin embargo, cuando cuestionados por cuál motivo las perras no habían sido tratadas antes, ningún tutor mencionó dificultades financieras. Se concluyó que algunos tumores de mama fueron causados por la aplicación de anticonceptivos y que el desconocimiento sobre la enfermedad aún es alta entre los tutores encuestados.(AU)

Determination of the efficiencies of the prokinetics in ruminants with postoperative ileus using pro-inflammatory markers

Background: Recently, the role of inflammation triggered by handling of the intestine various gastrointestinal (GI) surgeries is generally accepted as the key event in postoperative ileus (POI). Because, prokinetics have been increased the smooth muscle contractions and may act by attenuating the inflammatory process in the GI tract, they have been used the treatment of POI in human and animals. There are many in vivo analysis techniques of GI motility. However, there have not yet been studied associated with the evaluation of the inflammatory response. Therefore, it was aimed to evaluate the efficiencies of 3 different prokinetics from inflammatory response during experimentally-induced POI.Materials, Methods & Results: Twenty healthy lambs (30-45 days old) were randomly assigned to four groups. In all groups, enterotomy was performed on the ileum. Erythromycin and metoclopramide were administered to the ERT and MET groups before the surgery, respectively, while lidocaine was administered to the LID group as bolus before and continuous rate infusion during the surgery. Physiological saline was administered to the lambs in control group as placebo before the surgery. Blood samples were collected before surgery (~30-45 min), at the end of surgery (0 h), and at the postoperative 1, 3, 5, 10, 48, 72 and 96 h. The concentrations of serum amyloid A (SAA), haptoglobin (HPT), fibrinogen (FIB) as acute phase proteins (APPs), thiobarbituric acide reactant substrate (TBARs), myeloperoxidase (MPO) as reactive oxygen species, and transforming growth factor-beta (TGF- β) as a cytokine were measured with ELISA reader. In terms of time points, it was found that FIB was statistically higher in ERT group at the 1st h, in MET and LID groups at the 10th h, and in LID group at the 48th and in MET group at the 72 h (P < 0.05).[...]

Determination of the efficiencies of the prokinetics in ruminants with postoperative ileus using pro-inflammatory markers

Background: Recently, the role of inflammation triggered by handling of the intestine various gastrointestinal (GI) surgeries is generally accepted as the key event in postoperative ileus (POI). Because, prokinetics have been increased the smooth muscle contractions and may act by attenuating the inflammatory process in the GI tract, they have been used the treatment of POI in human and animals. There are many in vivo analysis techniques of GI motility. However, there have not yet been studied associated with the evaluation of the inflammatory response. Therefore, it was aimed to evaluate the efficiencies of 3 different prokinetics from inflammatory response during experimentally-induced POI.Materials, Methods & Results: Twenty healthy lambs (30-45 days old) were randomly assigned to four groups. In all groups, enterotomy was performed on the ileum. Erythromycin and metoclopramide were administered to the ERT and MET groups before the surgery, respectively, while lidocaine was administered to the LID group as bolus before and continuous rate infusion during the surgery. Physiological saline was administered to the lambs in control group as placebo before the surgery. Blood samples were collected before surgery (~30-45 min), at the end of surgery (0 h), and at the postoperative 1, 3, 5, 10, 48, 72 and 96 h. The concentrations of serum amyloid A (SAA), haptoglobin (HPT), fibrinogen (FIB) as acute phase proteins (APPs), thiobarbituric acide reactant substrate (TBARs), myeloperoxidase (MPO) as reactive oxygen species, and transforming growth factor-beta (TGF- β) as a cytokine were measured with ELISA reader. In terms of time points, it was found that FIB was statistically higher in ERT group at the 1st h, in MET and LID groups at the 10th h, and in LID group at the 48th and in MET group at the 72 h (P < 0.05).[...](AU)

Efeitos adversos da morfina, metadona e tramadol no pós-operatório de cães submetidos à cirurgia da coluna vertebral: 180 casos (2011-2016) / Adverse effects of morphine, methadone and tramadol in the postoperative period of dogs undergone vertebral surgery: 180 cases (2011-2016)

A dor pós-operatória em cães que são submetidos a cirurgias da coluna vertebral é considerada severa e seu manejo inadequado pode influenciar no tempo de recuperação do paciente, na qualidade de vida e no resultado cirúrgico. Dentre os analgésicos indicados para uso no pós-operatório dessas cirurgias tem-se os opioides, que podem apresentar inúmeros efeitos adversos que requerem atenção. Devido à escassez de estudos clínicos acerca desse assunto em se tratando do pós-operatório de cães, objetivou-se com o presente estudo retrospectivo apresentar os efeitos adversos da morfina, metadona e tramadol utilizados no pós-operatório de cirurgias da coluna vertebral. Foram revisadas e avaliadas as fichas de 180 cães e anotadas as alterações observadas no pós-operatório e decorrentes do uso de opioides. Os principais efeitos adversos observados foram anorexia, hiporexia, vômito, salivação, vocalização, bradicardia, hipotermia, ofegação e sedação. Também foi observada persistência da dor em alguns cães mesmo com o uso de analgésicos. Houve diferença na ocorrência de anorexia nos cães tratados com morfina e nos tratados com metadona em relação aos tratados com tramadol. Ocorreu diferença também entre a observação de dor dos grupos morfina e tramadol. A associação de dipirona com morfina e com metadona não revelou diferença com relação à ocorrência de efeitos adversos, bem como a variação de doses. Conclui-se que a morfina, a metadona e o tramadol apresentam efeitos adversos quando empregados para tratamento da dor pós-operatória em cães submetidos à cirurgia da coluna vertebral; a anorexia, a hiporexia e o vômito foram os efeitos adversos frequentes com o uso de morfina e de metadona e, mesmo que o tramadol apresente menor ocorrência desses efeitos, seu uso, na dose estudada, pode não ser vantajoso quando se leva em consideração o grau de dor para cirurgias da coluna vertebral.(AU)

Postoperative pain in dogs undergone vertebral surgery is classified as severe and it's important an adequate approach to it, because it can influence recovery time, quality of life and surgery outcome. Opioids are indicated for postoperative pain treatment in these surgeries. Opioids may have adverse effects that may require attention. There are few clinical studies that present the adverse effects of these analgesics in canine postoperative period. The aim of this retrospective study was to present the adverse effects of morphine, methadone and tramadol in canine vertebral surgery postoperative period. There were revised the postoperative records of 180 dogs and the changes resulted from the opioids use were noted. The adverse effects observed were anorexia, hyporexia, vomiting, vocalization, bradycardia, hypothermia, panting, sedation. Pain was also observed in some dogs. A significant difference was found in anorexia between dogs treated with morphine and tramadol and methadone and tramadol. Significant difference was also found in pain between dogs treated with morphine and tramadol. The association of metamizole and morphine or metamizole and methadone was not different in relation to the adverse effects. There was also no difference with the dosage variation and the adverse effects. In conclusion, morphine, methadone and tramadol have adverse effects when used for pain control in the postoperative period of dogs submitted to vertebral surgery. Anorexia, hypophagia and emesis were frequent the adverse effects observed with morphine and methadone and, despite tramadol presented less adverse effects, its use may be not beneficial in the studied doses when we consider the degree of pain, however more controlled studies with clinical situation are needed to confirm this.(AU)

Description and post-operative evaluation of tie-in technique in tibial osteosynthesis in dogs / Descrição e avaliação pós-operatória de técnica de osteossíntese com tie-in em tíbia

The aim of this study was to describe and analyse the adaptability and functionality of tie-in configuration in tibial osteosynthesis in dogs. Twenty dogs with tibial fracture were included in this study. An orifice was made on the proximal tibial fragment, on the medial side, close to the tibial crest. The drill piece was angled at 45º and projected into the same orifice on the distal sense of the bone. Others orifices made with the aid of a low rotation drill and drill piece with diameter smaller than the chosen implant. After 10 days post-operative, the animals were evaluated. X-ray analysis was performed at the time of clinical examination; immediate post-operative period; and at 30, 60, 90, and 120 days post-surgery. A questionnaire was given to the owners to provide details on the post-operative period. There were no trans-operative complications or suture dehiscence up to the day of suture removal. Partial development of bone callus was observed in 20 dogs within a mean period of 76 days. Three animals showed bone consolidation within 35 days, nine by 60 days, three by 90 days, and 5 by 120 days post-operative. Dynamization was carried out in 9 animals. The surgical access to the tibial medullary canal through the orifice at the proximal medial face, by the tibial tuberosity, enables the insertion of IMP without risks to articular and peri-articular lesions in the knee in dogs.(AU)

O objetivo deste trabalho foi descrever e analisar a funcionalidade da configuração tie-in na ostessíntese de tíbia em cães. Foram usados 21 cães com fratura de tíbia da rotina clinica do hospital veterinário. Somente a primeira cortical (Sis) foi perfurada, em seguida a broca foi inclinada a 45o e projetada no mesmo orifício no sentido distal do osso. foram confeccionados outros orifícios com auxílio de furadeira de baixa rotação e broca cujo diâmetro era menor que o implante escolhido. Os procedimentos radiográficos foram realizados no momento do atendimento clínico, no período pós-operatório imediato e aos 30, 60, 90 e 120 dias pós-cirúrgico. Não houve nenhuma complicação transoperatória, tão pouco deiscência de sutura até o momento da retirada dos pontos de cútis. A formação parcial de calo ósseo foi evidenciada em 20 cães com tempo médio de 76 dias. Três cães obtiveram consolidação óssea em 35 dias, nove aos 60 dias, três aos 90 dias e cinco aos 120 dias de pós-operatório. Dinamizações foram realizadas em nove animais. Após a confirmação radiográfica de consolidação óssea, os implantes dos 20 animais foram totalmente removidos. Concluiu-se que o acesso cirúrgico ao canal medular da tíbia canina por meio de orifício na face medial proximal, junto à tuberosidade da tíbia, permite a inserção do PIM sem risco de lesões articulares e periarticulares no joelho.(AU)