Enostose múltipla em equino puro sangue de corrida / Enostosis-like lesion in thoroughbred horse

Background: Enostosis like lesions are characterized by areas of intramedullary sclerosis affecting the long bones andtheir presence in any cases may be not associated with lameness. It has a migratory characteristic and, therefore there isthe occurrence of lameness at different sites from the initial lesion. Its etiology is speculative and has been attributed tointraosseous increased pressure, of Havers’ canals compression, stimulation of unmyelinated fibers and circulating plateletaggregates. Diagnosis is made through nuclear scintigraphy and associated with radiographic examination. This paperaims to report a clinical case on the use of scintigraphy for the reference diagnosis of enostosis-type injury and treatmentthrough surgical bone decompression.Case: A 2-year-old thoroughbred mare, weighing 483 kg, with a history of acute lameness of the left pelvic limb associatedwith the no previous signs of trauma and no noteworthy changes in radiographic and ultrasound images, was referred to theHorse Center Veterinary Clinic. In the examination of the locomotor system, the animal presented a 2/5 degree lamenessin a straight line, with accentuated exacerbation of the same after flexion of the left femoro-tibio-patellar joint. In addition,presented a reduction in the caudal phase of the stride and croup asymmetry associated with mild myopenia. The findingsof the scintigraphic exam characterized by intense focal area of hyperconcentration of medullary radiopharmaceutical inthe proximal third of the right third metatarsal, and multiple areas of hyperconcentration in the aspect proximal to thedistal third of the left tibia. In the radiographic images, multifocal radiopaque regions that coincided with the areas ofradiopharmaceutical hyperconcentration were observed. The initial treatment was based on rest, use of non-steroidal antiinflammatory drugs and acetylsalicylic acid. In the 60 days...

Ventral slot in the clinical recovery of dogs with lateralized compression as a result of cervical intervertebral disc disease: 20 cases (2008-2018) / Fenda (slot) ventral na recuperação clínica de cães com compressões lateralizadas em decorrência da doença do disco intervertebral cervical: 20 casos (2008-2018)

The objective of this study was to verify the clinical recovery of dogs that underwent ventral slot surgical decompression with lateralized compressions of the cervical spinal cord caused by intervertebral disc disease (IVDD). Twenty patients were selected in different degrees of neurological dysfunction with definitive diagnosis of lateralized compression by cervical IVDD. Postoperative clinical recovery was assessed in patients who had undergone at least two months of the surgical procedure. There was a satisfactory recovery in 19 dogs (95%) and unsatisfactory recovery in another (5%), showing a significant clinical improvement (p 0.05) in the use of this technique in lateralized compression cases. The ventral slot promotes satisfactory clinical recovery of dogs with lateralized compression of the spinal cord caused by cervical IVDD and may be indicated as a surgical alternative.(AU)

O objetivo desse estudo foi verificar a recuperação clínica de cães submetidos a descompressão cirúrgica por fenda ventral em compressões lateralizadas da medula espinhal cervical ocasionada pela doença do disco intervertebral (DDIV). Foram selecionados 20 pacientes em diferentes graus de disfunção neurológica com diagnóstico definitivo de compressões lateralizadas por DDIV cervical. A recuperação clínica pós-operatória foi avaliada nos pacientes decorridos, no mínimo, dois meses do procedimento cirúrgico. Houve recuperação satisfatória em 19 cães (95%) e um insatisfatório (5%), demonstrando melhora clínica significativa (p 0,05) no emprego desta técnica em casos de compressões lateralizadas. A fenda ventral promove recuperação clínica satisfatória de cães com compressões lateralizadas da medula espinhal, ocasionadas pela DDIV cervical, e pode ser indicada como alternativa cirúrgica.(AU)

Acute cecal tympany during chemical restraint in free-ranging capybara (Hydrochoerus hydrochaeris) - iatrogenic cause and treatment

The occurrence of acute tympany, probable cause and treatment are being discussed for the first time in Hydrochoerus hydrochaeris, commonly known as the capybara. As part of a capybara population control study, adult male and female (n=18), prior to intervention, were physically confined and subsequently chemically immobilized with a ketamine dexmedetomidine (KD) association. Procedures included health exams, biomaterial collection, and ID markings. For surgical events, the animals were maintained under volatile anesthesia with Isoflurane. One animal, during anesthetic recovery, developed tachycardia and tachypnea, with cyanotic mucosa, and a low SPO2. During auscultation and percussion/palpation a taut abdominal wall was recognized. Shortly thereafter, the animal suffered a cardiorespiratory arrest and failed resuscitation. Immediately performed necropsy suggested death by acute respiratory and circulatory failure due to exerted pressure against the diaphragm and compression of major blood vessels, leading to hypoxia and hypovolemic shock, secondary to cecal dilation. Three animals under general anesthesia demonstrated moderate bloating and were treated by trans-abdominal catheterization for cecal decompression, successfully preventing any potential development of severe tympany. Conclusion: During chemical restraint all animals demonstrated bloat of varies degrees, suggesting iatrogenic cause brought about by adverse effects of anesthetic agents. Acute cecal tympany in sedated capybaras must be anticipated and closely monitored to prevent fatal outcome. Trans-abdominal catheterization into the cecum proved effective in treating bloat.

Acute cecal tympany during chemical restraint in free-ranging capybara (Hydrochoerus hydrochaeris) - iatrogenic cause and treatment

The occurrence of acute tympany, probable cause and treatment are being discussed for the first time in Hydrochoerus hydrochaeris, commonly known as the capybara. As part of a capybara population control study, adult male and female (n=18), prior to intervention, were physically confined and subsequently chemically immobilized with a ketamine dexmedetomidine (KD) association. Procedures included health exams, biomaterial collection, and ID markings. For surgical events, the animals were maintained under volatile anesthesia with Isoflurane. One animal, during anesthetic recovery, developed tachycardia and tachypnea, with cyanotic mucosa, and a low SPO2. During auscultation and percussion/palpation a taut abdominal wall was recognized. Shortly thereafter, the animal suffered a cardiorespiratory arrest and failed resuscitation. Immediately performed necropsy suggested death by acute respiratory and circulatory failure due to exerted pressure against the diaphragm and compression of major blood vessels, leading to hypoxia and hypovolemic shock, secondary to cecal dilation. Three animals under general anesthesia demonstrated moderate bloating and were treated by trans-abdominal catheterization for cecal decompression, successfully preventing any potential development of severe tympany. Conclusion: During chemical restraint all animals demonstrated bloat of varies degrees, suggesting iatrogenic cause brought about by adverse effects of anesthetic agents. Acute cecal tympany in sedated capybaras must be anticipated and closely monitored to prevent fatal outcome. Trans-abdominal catheterization into the cecum proved effective in treating bloat.(AU)

Avaliação clínica de cães com doença do disco intervertebral (Hansen tipo I) submetidos à descompressão cirúrgica: 110 casos / Clinical evaluation of dogs with intervertebral disc disease (Hansen type I) submitted to surgical decompression: 110 cases

O objetivo deste estudo foi identificar cães com doença do disco intervertebral toracolombar (Hansen tipo I) submetidos ao tratamento cirúrgico em um serviço de rotina em neurologia de um hospital veterinário universitário no período de 2006 a 2014, e obter informações a respeito da idade, do sexo, da raça, local da extrusão, interpretação da mielografia, avaliação dos graus de disfunção neurológica, recuperação funcional desses cães e observar a ocorrência de recidiva dos sinais clínicos da doença. A raça mais frequente foi Dachshund (69%), seguida dos cães sem raça definida (14,5%). Os locais mais afetados foram entre T12-T13 (31,9%) e L1-L2 (19,1%). Dos 110 cães, 74 (67,3%) tiveram melhora dos sinais clínicos após o procedimento cirúrgico, sendo 54 (49,1%) considerados satisfatórios e 20 (18,2%), parcialmente satisfatórios. Destes cães, seis (8,1%) cães estavam em grau II, 19 (25,7%) em grau III, 35 (47,3%) em grau IV e 14 (18,9%) em grau V. Pode-se concluir que o tratamento cirúrgico promove recuperação funcional satisfatória na maioria dos cães com extrusão de disco toracolombar. O prognóstico para recuperação funcional após o tratamento cirúrgico é tanto melhor quanto menor for o grau de disfunção neurológica e o percentual de recidiva é baixo em animais submetidos a este tipo de terapia.(AU)

The aim of this study was to identify dogs with thoracolumbar intervertebral disc disease (Hansen type I) submitted for surgical treatment on a routine service in neurology in a university veterinary hospital in 2006-2014, and to get information about age, sex, breed, site of extrusion, interpretation of myelography, evaluation of the degree of neurological dysfunction, functional recovery of these dogs, and to verify the recurrence of clinical signs of disease. The most common breed was Dachshund (69%), followed by mixed breed (14.5%). The most affected sites were between T12-T13 (31.9%) and L1-L2 (19.1%). Of the 110 dogs, 74 (67.3%) improved clinical signs after surgery, 54 (49.1%) satisfactory and 20 (18.2%), in part satisfactory. From these dogs, six (8.1%) dogs were in grade II, 19 (25.7%) in grade III, 35 (47.3%) in grade IV, and 14 (18.9%) in grade V. It can be concluded that satisfactory surgical treatment promotes functional recovery in most dogs with thoracolumbar disk extrusion. The prognosis for functional recovery after surgical treatment is better the lower the degree of neurological dysfunction and the recurrence percentage is lower in dogs subjected to this type of therapy.(AU)

Avaliação clínica de cães com doença do disco intervertebral (Hansen tipo I) submetidos à descompressão cirúrgica: 110 casos / Clinical evaluation of dogs with intervertebral disc disease (Hansen type I) submitted to surgical decompression: 110 cases

O objetivo deste estudo foi identificar cães com doença do disco intervertebral toracolombar (Hansen tipo I) submetidos ao tratamento cirúrgico em um serviço de rotina em neurologia de um hospital veterinário universitário no período de 2006 a 2014, e obter informações a respeito da idade, do sexo, da raça, local da extrusão, interpretação da mielografia, avaliação dos graus de disfunção neurológica, recuperação funcional desses cães e observar a ocorrência de recidiva dos sinais clínicos da doença. A raça mais frequente foi Dachshund (69%), seguida dos cães sem raça definida (14,5%). Os locais mais afetados foram entre T12-T13 (31,9%) e L1-L2 (19,1%). Dos 110 cães, 74 (67,3%) tiveram melhora dos sinais clínicos após o procedimento cirúrgico, sendo 54 (49,1%) considerados satisfatórios e 20 (18,2%), parcialmente satisfatórios. Destes cães, seis (8,1%) cães estavam em grau II, 19 (25,7%) em grau III, 35 (47,3%) em grau IV e 14 (18,9%) em grau V. Pode-se concluir que o tratamento cirúrgico promove recuperação funcional satisfatória na maioria dos cães com extrusão de disco toracolombar. O prognóstico para recuperação funcional após o tratamento cirúrgico é tanto melhor quanto menor for o grau de disfunção neurológica e o percentual de recidiva é baixo em animais submetidos a este tipo de terapia.(AU)

The aim of this study was to identify dogs with thoracolumbar intervertebral disc disease (Hansen type I) submitted for surgical treatment on a routine service in neurology in a university veterinary hospital in 2006-2014, and to get information about age, sex, breed, site of extrusion, interpretation of myelography, evaluation of the degree of neurological dysfunction, functional recovery of these dogs, and to verify the recurrence of clinical signs of disease. The most common breed was Dachshund (69%), followed by mixed breed (14.5%). The most affected sites were between T12-T13 (31.9%) and L1-L2 (19.1%). Of the 110 dogs, 74 (67.3%) improved clinical signs after surgery, 54 (49.1%) satisfactory and 20 (18.2%), in part satisfactory. From these dogs, six (8.1%) dogs were in grade II, 19 (25.7%) in grade III, 35 (47.3%) in grade IV, and 14 (18.9%) in grade V. It can be concluded that satisfactory surgical treatment promotes functional recovery in most dogs with thoracolumbar disk extrusion. The prognosis for functional recovery after surgical treatment is better the lower the degree of neurological dysfunction and the recurrence percentage is lower in dogs subjected to this type of therapy.(AU)

Consequences of intraoperative spinal cord manipulation in dogs with thoracolumbar intervertebral disc extrusion / Consequências da manipulação medular intraoperatória em cães com extrusão intervertebral de disco toracolombar

The objective of the present study was to evaluate if extradural contact during hemilaminectomy would cause neurological deterioration in the early and/or late postoperative period in dogs with intervertebral disc extrusion. Nineteen dogs with thoracolumbar intervertebral disc extrusion underwent hemilaminectomy for spinal cord decompression and removal of extruded disc material. Meningeal contacts during surgery were quantified. Paraplegia (with nociception) and paraparesis were observed in 11/19 and 8/19 of dogs, respectively, before surgery. At the end of our study, only two (2/19) had paraplegia and one (1/19), paraparesis. There were more extradural contacts when extruded intervertebral disc material was at a ventrolateral position. Extradural contacts during surgery had no influence on neurological progression nor on time to recovery of motor function. Immediately (24 and 48 hours) after surgery, 13/19 dogs had the same neurological stage before surgery. At 7 and 90 days, 13/19 and 17/19 dogs, respectively, showed neurological improvement, compared with their preoperative stage. There was no influence of the number of extradural contacts on neurological recovery. These findings indicate that a careful inspection of the vertebral canal for removal of as much extruded disc material as possible does not cause neurologic deterioration.(AU)

O presente trabalho teve como objetivo avaliar se contatos extradurais durante hemilaminectomia em cães com extrusão de disco intervertebral causariam piora neurológica no pós-operatório imadiato e/ou tardio. Dezenove cães com extrusão toracolombar de disco intervertebral foram submetidos à hemilaminectomia para descompressão medular e remoção do material extruso. Durante o procedimento cirúrgico, os contatos meningomedulares foram quantificados. Antes da cirurgia, 11/19 cães apresentavam paraplegia (com nocicepção) e 8/19 cães, paraparesia. Ao fim do estudo, apenas dois cães (2/19) mostravam paraplegia com dor profunda e um (1/19), paraparesia. Observou-se maior quantidade de contatos extradurais quando o material discal extruso encontrava-se em posição ventrolateral. Os contatos extradurais não mostraram influência estatística na evolução neurológica dos animais, bem como no tempo de recuperação das funções motora. Vinte e quatro e 48 horas após a cirurgia, 13/19 cães apresentavam o mesmo grau neurológico de antes da cirurgia. Após sete e 90 dias de pós-operatório, 13/19 e 17/19 demonstraram melhora neurológica em comparação com o pré-operatório, respectivamente. A quantidade de contatos extradurais não influenciou na recuperação neurológica dos cães. Esses achados indicam que uma inspeção minuciosa do canal vertebral pode ser recomendada, a fim de remover o máximo de material discal extruso, evitando-se piora neurológica por compressão medular.(AU)

Consequences of intraoperative spinal cord manipulation in dogs with thoracolumbar intervertebral disc extrusion / Consequências da manipulação medular intraoperatória em cães com extrusão intervertebral de disco toracolombar

The objective of the present study was to evaluate if extradural contact during hemilaminectomy would cause neurological deterioration in the early and/or late postoperative period in dogs with intervertebral disc extrusion. Nineteen dogs with thoracolumbar intervertebral disc extrusion underwent hemilaminectomy for spinal cord decompression and removal of extruded disc material. Meningeal contacts during surgery were quantified. Paraplegia (with nociception) and paraparesis were observed in 11/19 and 8/19 of dogs, respectively, before surgery. At the end of our study, only two (2/19) had paraplegia and one (1/19), paraparesis. There were more extradural contacts when extruded intervertebral disc material was at a ventrolateral position. Extradural contacts during surgery had no influence on neurological progression nor on time to recovery of motor function. Immediately (24 and 48 hours) after surgery, 13/19 dogs had the same neurological stage before surgery. At 7 and 90 days, 13/19 and 17/19 dogs, respectively, showed neurological improvement, compared with their preoperative stage. There was no influence of the number of extradural contacts on neurological recovery. These findings indicate that a careful inspection of the vertebral canal for removal of as much extruded disc material as possible does not cause neurologic deterioration.(AU)

O presente trabalho teve como objetivo avaliar se contatos extradurais durante hemilaminectomia em cães com extrusão de disco intervertebral causariam piora neurológica no pós-operatório imadiato e/ou tardio. Dezenove cães com extrusão toracolombar de disco intervertebral foram submetidos à hemilaminectomia para descompressão medular e remoção do material extruso. Durante o procedimento cirúrgico, os contatos meningomedulares foram quantificados. Antes da cirurgia, 11/19 cães apresentavam paraplegia (com nocicepção) e 8/19 cães, paraparesia. Ao fim do estudo, apenas dois cães (2/19) mostravam paraplegia com dor profunda e um (1/19), paraparesia. Observou-se maior quantidade de contatos extradurais quando o material discal extruso encontrava-se em posição ventrolateral. Os contatos extradurais não mostraram influência estatística na evolução neurológica dos animais, bem como no tempo de recuperação das funções motora. Vinte e quatro e 48 horas após a cirurgia, 13/19 cães apresentavam o mesmo grau neurológico de antes da cirurgia. Após sete e 90 dias de pós-operatório, 13/19 e 17/19 demonstraram melhora neurológica em comparação com o pré-operatório, respectivamente. A quantidade de contatos extradurais não influenciou na recuperação neurológica dos cães. Esses achados indicam que uma inspeção minuciosa do canal vertebral pode ser recomendada, a fim de remover o máximo de material discal extruso, evitando-se piora neurológica por compressão medular.(AU)

Cervical laminectomy for the treatment of chronic caudal cervical spondylomyelopathy in a dog

Background: Cervical spondylomyelopathy (CSM) is a common disease of the cervical spine, and causes neurogenic disorders commonly diagnosed in large and giant breeds dogs. There are many surgical procedures proposed for the treatment of CSM. Although many authors report a high success rate (between 70% and 90%) after surgical procedures, the high number of techniques described reflects the difficulty in treating this disorder. The objective of this paper is to report a case of CSM with chronic ventral compression (intervertebral disc extrusion) that was treated with dorsal decompression, and to demonstrate the effectiveness of the decompressive technique through pre- and post-operative myelograms. Case: A 9-year-old Doberman Pinscher dog weighing 41.8 kg presented due to a history of tetraparesis. Neurological examination did not reveal any alteration in mental status. There was absence of conscious proprioception on the four limbs; the pelvic limbs were more severely affected. Bilateral patellar hyperreflexia and normal flexor withdrawal reflex were observed on the hind limbs. There was decreased flexor withdrawal reflex and increased extensor tone on the forelimbs. The patient exhibited pain during caudal cervical palpation, and no alterations were seen on the cutaneous trunci reflex. Superficial pain was absent in the hind limbs; forelimbs exhibited presence of motor [...](AU)

Cervical laminectomy for the treatment of chronic caudal cervical spondylomyelopathy in a dog

Background: Cervical spondylomyelopathy (CSM) is a common disease of the cervical spine, and causes neurogenic disorders commonly diagnosed in large and giant breeds dogs. There are many surgical procedures proposed for the treatment of CSM. Although many authors report a high success rate (between 70% and 90%) after surgical procedures, the high number of techniques described reflects the difficulty in treating this disorder. The objective of this paper is to report a case of CSM with chronic ventral compression (intervertebral disc extrusion) that was treated with dorsal decompression, and to demonstrate the effectiveness of the decompressive technique through pre- and post-operative myelograms. Case: A 9-year-old Doberman Pinscher dog weighing 41.8 kg presented due to a history of tetraparesis. Neurological examination did not reveal any alteration in mental status. There was absence of conscious proprioception on the four limbs; the pelvic limbs were more severely affected. Bilateral patellar hyperreflexia and normal flexor withdrawal reflex were observed on the hind limbs. There was decreased flexor withdrawal reflex and increased extensor tone on the forelimbs. The patient exhibited pain during caudal cervical palpation, and no alterations were seen on the cutaneous trunci reflex. Superficial pain was absent in the hind limbs; forelimbs exhibited presence of motor [...]

Extrusion intervertebral disc multifocal in a dog / Extrusão de disco intervertebral multifocal em cão

Background: The intervertebral disc disease (IVD) is one of the most common causes of neurological disorders in dogs and is caused by the degeneration of the intervertebral disc. The objectives of the surgical treatment of IVD are: decompression of the spinal cord, removal of material from the vertebral canal, reducing the edema, pain relief and the prevent future extrusion. The extrusion of the intervertebral disc usually occurs in isolation being uncommon involve two or more concomitant locations. Thus, the objective of this study was to report the functional recovery of a dog with multiple intervertebral disc disease submitted to surgical spinal decompression.Case: A canine dachshund female five years old, was seen with a history of total loss of movement of the pelvic limbs two days, in an acute manner and no history of trauma. On neurological examination, the patient was alert and found out paraplegia and deficiency in postural reactions, evaluated by tests of proprioception and hopping reaction, normal segmental spinal reflexes in the hind limbs and muscle tone, urinary retention, pain on epaxial palpation between L1-L2 and absence of deep feeling in the pelvic limbs. As complementary tests hematological exams were requested which were within the standard for the species and simple and contrast radiography (myelography) of the spine were requested. In simple radiographic...(AU)

A doença do disco intervertebral (DDIV) é uma das causas mais comuns de alterações neurológicas em cães [2], sendo provocada pela degeneração do disco intervertebral. Pode ocorrer extrusão (Hansen tipo I) ou protrusão (Hansen tipo II) do disco, as quais podem causar compressão da medula ou das raízes nervosas, e até concussão medular [7]. É observada com frequência em raças condrodistróficas, com idade entre três e sete anos [1,6].Os sinais clínicos são variáveis e dependem da localização da lesão, do volume de material no interior do canal vertebral e da velocidade com que esse material é ejetado, variando desde hiperestesia espinhal até paraplegia com perda da percepção à dor profunda. O tratamento de cães com DDIV toracolombar pode ser clínico ou cirúrgico, dependendo do grau de disfunção neurológica [2].As indicações para o tratamento cirúrgico da DDIV são a falta de resposta ao tratamento clínico, os sinais clínicos recidivantes ou progressivos, a paraparesia não-ambulatória, paraplegia com preservação da nocicepção (dor profunda) e paraplegia e ausência da nocicepção (grau V) com duração inferior a 48 horas [2,7]. Os objetivos do tratamento cirúrgico na DDIV são: a descompressão da medula espinhal, a remoção do material do interior do canal vertebral, a redução do edema, o alívio da dor e a prevenção de futuras extrusões [7]. A extrusão do disco intervertebral geralmente...(AU)

Intraoperative ultrasonography of the vertebral canal in dogs / Ultrassonografia intraoperatória do canal vertebral em cães

Intraoperative ultrasound (IOS) can provide details on various conditions of the spinal cord and vertebral canal. The aim of the present study was to evaluate the feasibility of using IOS in dogs undergoing spinal surgery and to describe the main findings. The vertebral canal of 21 dogs was examined with intraoperative ultrasonography: 13 underwent spinal surgery for removal of herniated intervertebral disc material, three for stabilization of vertebral fracture/luxation, two for removal of vertebral neoplasia, and three for cauda equina decompression. Particular attention was given to signs of cord compression. Intraoperative ultrasonography was feasible and useful in dogs undergoing surgery for spinal cord or cauda equina decompression and fracture stabilization. It was not paramount for locating the compression when this had been done via computed tomography (CT), but it showed alterations in spinal cord parenchyma not observed on CT and also confirmed adequate decompression of the spinal cord. The main advantages of intraoperative ultrasonography were estimation of vascularization and extent of spinal cord lesion. Most importantly, it allowed real time evaluation of the spinal cord and vertebral canal, which permits the modification of the surgical procedure(AU)

A ultrassonografia intraoperatória pode fornecer detalhes sobre diversas condições da medula espinal e canal vertebral. O objetivo deste trabalho foi avaliar a viabilidade da utilização da ultrassonografia intraoperatória em cães submetidos à cirurgia espinomedular e descrever os principais achados. O canal vertebral de 21 cães foi examinado com ultrassonografia intraoperatória - 13 foram submetidos à cirurgia para remoção de material de disco herniado, três para estabilização de fratura/luxação vertebral, dois para remoção de neoplasia vertebral e três para descompressão de cauda equina. Atenção especial foi dada a sinais de compressão medular. A ultrassonografia intraoperatória foi viável e útil em cães submetidos a cirurgia para descompressão da medula espinal ou cauda equina e estabilização de fratura. Apesar de não ser indispensável para localização da compressão quando isso havia sido feito através de tomografia computadorizada (TC), demonstrou alterações no parênquima que não haviam sido observadas pela TC e confirmou a adequada descompressão da medula espinhal. As principais vantagens da ultrassonografia intraoperatória foram: estimar a vascularização e a extensão da lesão medular. Principalmente, permitiu uma avaliação em tempo real da medula espinal e do canal vertebral, o que permite modificação do procedimento cirúrgico(AU)

Extrusion intervertebral disc multifocal in a dog / Extrusão de disco intervertebral multifocal em cão

Background: The intervertebral disc disease (IVD) is one of the most common causes of neurological disorders in dogs and is caused by the degeneration of the intervertebral disc. The objectives of the surgical treatment of IVD are: decompression of the spinal cord, removal of material from the vertebral canal, reducing the edema, pain relief and the prevent future extrusion. The extrusion of the intervertebral disc usually occurs in isolation being uncommon involve two or more concomitant locations. Thus, the objective of this study was to report the functional recovery of a dog with multiple intervertebral disc disease submitted to surgical spinal decompression.Case: A canine dachshund female five years old, was seen with a history of total loss of movement of the pelvic limbs two days, in an acute manner and no history of trauma. On neurological examination, the patient was alert and found out paraplegia and deficiency in postural reactions, evaluated by tests of proprioception and hopping reaction, normal segmental spinal reflexes in the hind limbs and muscle tone, urinary retention, pain on epaxial palpation between L1-L2 and absence of deep feeling in the pelvic limbs. As complementary tests hematological exams were requested which were within the standard for the species and simple and contrast radiography (myelography) of the spine were requested. In simple radiographic...

A doença do disco intervertebral (DDIV) é uma das causas mais comuns de alterações neurológicas em cães [2], sendo provocada pela degeneração do disco intervertebral. Pode ocorrer extrusão (Hansen tipo I) ou protrusão (Hansen tipo II) do disco, as quais podem causar compressão da medula ou das raízes nervosas, e até concussão medular [7]. É observada com frequência em raças condrodistróficas, com idade entre três e sete anos [1,6].Os sinais clínicos são variáveis e dependem da localização da lesão, do volume de material no interior do canal vertebral e da velocidade com que esse material é ejetado, variando desde hiperestesia espinhal até paraplegia com perda da percepção à dor profunda. O tratamento de cães com DDIV toracolombar pode ser clínico ou cirúrgico, dependendo do grau de disfunção neurológica [2].As indicações para o tratamento cirúrgico da DDIV são a falta de resposta ao tratamento clínico, os sinais clínicos recidivantes ou progressivos, a paraparesia não-ambulatória, paraplegia com preservação da nocicepção (dor profunda) e paraplegia e ausência da nocicepção (grau V) com duração inferior a 48 horas [2,7]. Os objetivos do tratamento cirúrgico na DDIV são: a descompressão da medula espinhal, a remoção do material do interior do canal vertebral, a redução do edema, o alívio da dor e a prevenção de futuras extrusões [7]. A extrusão do disco intervertebral geralmente...

Hansen type II disc disease in dogs: pathophysiology, clinicalsurgical approach and controversies / Doença do disco intervertebral Hansen tipo II em cães: fisiopatologia, abordagem clínico-cirúrgica e controvérsias

Protrusion of the intervertebral disc can cause chronic progressive compression of the spinal cord, and the neurological associated signs vary according to anatomical location, duration and dynamic force of compression. The type II disc disease is not fully understood, and there are many controversies about is clinical significance and best form of treatment. The most important aspect of conservative treatment is rest and physiotherapy associated with mild exercise, and use of corticosteroids to reduce vasogenic edema. The spinal decompression by surgery for removal of disc material from within the medullary canal is the surgical treatment of choice in type I disc disease, but has technical limitations in the type II disc disease. The purpose of this paper is to review the pathophysiology and treatment of chronic intervertebral disc disease and discuss the controversies in medical treatment and the use of some traditional and new surgical techniques.(AU)

A protrusão do disco intervertebral pode provocar compressão progressiva crônica da medula espinhal e os sinais neurológicos associados variam de acordo com a localização anatômica, duração e força dinâmica da compressão. A doença do disco tipo II não é totalmente compreendida, havendo muitas controvérsias sobre seu significado clínico e melhor forma de tratamento. O aspecto mais importante do tratamento conservador refere-se ao repouso associado à fisioterapia e exercícios leves, além de uso de corticoesteróides para diminuir o edema vasogênico. A descompressão medular por meio de cirurgia para remoção de material do disco do interior do canal medular é o tratamento cirúrgico de eleição na doença do disco tipo I, mas apresenta limitações quanto à técnica e ao resultado na doença do disco do tipo II. O objetivo deste trabalho é revisar a fisiopatologia e o tratamento da doença do disco intervertebral crônica e discutir as controvérsias existentes no tratamento médico bem como o uso de técnicas cirúrgicas tradicionais e novas técnicas.(AU)

Recuperação funcional de cães paraplégicos com doença do disco intervertebral toracolombar sem percepção à dor profunda submetidos ao tratamento cirúrgico: 15 casos (2006-2010) / Functional recovery in paraplegic dogs with thoracolumbar intervertebral disc disease without deep pain perception submitted to surgical treatment: 15 cases (2006-2010)

O objetivo deste estudo retrospectivo foi avaliar a recuperação funcional de cães paraplégicos sem percepção à dor profunda (PDP) com doença do disco intervertebral (DDIV) toracolombar submetidos à hemilaminectomia dorsolateral. Foram incluídos somente cães com DDIV entre os segmentos da medula espinhal T3 e L3, que estavam paraplégicos sem PDP submetidos à cirurgia descompressiva. Foi observada recuperação funcional satisfatória em 73,3% dos cães (n=11), sendo um, aos cinco dias, sete entre 15 e 30 dias e três acima de 30 dias do procedimento cirúrgico. A duração da perda da PDP antes da cirurgia em cinco cães recuperados foi entre 12 e 48 horas e, em seis cães, acima de 48 horas. Cães paraplégicos sem PDP em decorrência da DDIV toracolombar podem apresentar recuperação funcional satisfatória quando submetidos ao tratamento cirúrgico mesmo sem percepção a dor profunda com tempo superior a 48 horas. Futuras pesquisas serão necessárias para avaliar a eficiência do tratamento cirúrgico, principalmente para aqueles que perderam a PDP acima de 48 horas.(AU)

This retrospective study was to evaluate the functional recovery of paraplegic dogs without deep pain perception (DPP) with intervertebral disc disease (IVDD) submitted to dorsolateral hemilaminectomy. Only dogs with IVDD between spinal cord segments T3 and L3, which were paraplegic without DPP and were submitted to decompressive surgery were included in the study. Satisfactory functional recovery was observed in 73.3% of the dogs (n=11). Recovery time after surgery was one day (one dog), between 15 and 30 days (seven dogs) and over 30 days 30 days 3 dogs). The duration of the lack of DPP before surgery was 12-48 hours, in five recovered dogs and over 48 hours in six recovered dogs It can be concluded that paraplegic dogs with thoracolumbar IVD and lack of DPP may present satisfactory functional recovery when submitted to surgical treatment even when the absence of deep pain perception has settled for more than 48 hours. Further research is needed to better evaluate the effectiveness of surgical treatment, mainly for dogs with lack of DPP over 48 hours.(AU)

Successful transplant of mesenchymal stem cells in induced osteonecrosis of the ovine femoral head: preliminary results / Sucesso no transplante de células tronco mesenquimais em ovinos com osteonecrose induzida da cabeça do fêmur: resultados preliminares

PURPOSE: Evaluate the bone tissue recovery following transplantation of ovine mesenchymal stem cells (MSC) from bone marrow and human immature dental-pulp stem cells (hIDPSC) in ovine model of induced osteonecrosis of femoral head (ONFH). METHODS: Eight sheep were divided in three experimental groups. First group was composed by four animals with ONFH induced by ethanol through central decompression (CD), for control group without any treatment. The second and third group were compose by two animals, six weeks after ONFH induction received transplantation of heterologous ovine MSC (CD + oMSC), and hIDPSC (CD + hIDPSC), respectively. In both experiments the cells were transplanted without application of any type of immunosupression protocol. RESULTS: Our data indicate that both cell types used in experiments were able to proliferate within injured site providing bone tissue recovery. The histological results obtained from CD+hIDPSC suggested that the bone regeneration in such animals was better than that observed in CD animals. CONCLUSION: Mesenchymal stem cell transplant in induced ovine osteonecrosis of femoral head by central decompression technique is safe, and apparently favors bone regeneration of damaged tissues.(AU)

OBJETIVO: Verificar os efeitos das células-tronco mesenquimais da medula óssea de ovinos e da polpa dentária imatura humana em ovinos com osteonecrose induzida, da cabeça do fêmur. MÉTODOS: Oito ovelhas foram distribuídas em três grupos experimentais. O primeiro grupo foi composto por quatro animais com osteonecrose da cabeça do fêmur induzida por etanol através da descompressão central, que não receberam nenhum tratamento. O segundo e o terceiro grupo, cada um composto por dois animais, receberam transplante heterólogo de células tronco mesenquimais de ovinos e polpa dentária imatura humana seis semanas após a indução da osteonecrose da cabeça do fêmur, respectivamente. Em ambos os grupos experimentais as células foram transplantadas sem o uso de drogas imunossupressoras. RESULTADOS: Os achados demonstram que as células-tronco mesenquimais injetadas na cabeça do fêmur se encontravam viáveis após o transplante no novo sítio e proliferaram em pouco tempo. Os dados histológicos sugerem que a regeneração óssea nos animais transplantados com polpa dentária imatura humana foi mais rápida do que nos animais submetidos somente a descompressão central. CONCLUSÃO: O transplante de células tronco mesenquimais na osteonecrose da cabeça do fêmur induzida em ovinos através da técnica de descompressão central é um procedimento seguro, e aparentemente favorece a regeneração óssea de tecidos lesados.(AU)

Anestesia epidural na cirurgia descompressiva lombossacral de cães

Objetivou-se neste trabalho avaliar a viabilidade, eficácia, vantagens e desvantagens da anestesia epidural lombossacral junto à anestesia geral inalatória em cirurgias de descompressão da cauda equina, tendo em vista que essa cirurgia é um procedimento longo e doloroso. Para isso, foram utilizados 11 cães adultos do atendimento de rotina do Hospital Veterinário, sem distinção de sexo, que apresentaram sinais clínicos de síndrome da cauda equina, diagnosticada através de exames neurológicos e radiográficos. Os cães foram submetidos à anestesia geral inalatória e deixados no estágio anestésico mais superficial. Depois, realizou-se a anestesia epidural em seis dos 11 pacientes, por punção espinhal em L7 -S1 , com o anestésico bupivacaína a 0,5%. Para a certificação do bloqueio foi realizado teste dos reflexos patelar e flexor, tônus muscular e dermátomos cutâneos, com os animais em plano anestésico superficial. Posteriormente, realizou-se a abordagem cirúrgica à coluna pela equipe de neurocirurgia. Os parâmetros fisiológicos (cardíacos, vasculares, respiratórios, temperatura corporal e glicemia) foram aferidos antes da medicação pré-anestésica (MPA), 10 minutos após a MPA, 30 minutos depois da epidural, depois da laminectomia, assim como após 60 minutos e 90 minutos, tanto no grupo com epidural quanto no sem epidural. Também se verificaram a quantidade de isofluorano consumido e o tempo de extubação. Os animais que possuíam bloqueio epidural apresentaram redução significativa no consumo de anestésico inalatório e no tempo de extubação. Não apresentaram déficits neurológicos causados pela anestesia epidural, quando comparados com o grupo sem anestesia epidural. Conclui-se que a técnica de anestesia epidural é eficiente e vantajosa na realização de cirurgias descompressivas lombossacrais, levando ao um menor risco anestésico para o animal.

The objective of this study was to evaluate the feasibility, effectiveness, advantages and disadvantages of lumbosacral epidural anesthesia associated with inhalation anesthesia in surgical decompression of cauda equina, seeing as this is a lengthy procedure with a painful recovery from anesthesia. Eleven adult dogs were selected from the Veterinary Hospital, without distinction of sex, which showed clinical signs of cauda equina syndrome, diagnosed by neurological examination and radiographs. The dogs were submitted to general inhalation anesthesia and left at a superficial stage, after which epiduralanesthesiawithbupivacaine0.5% via spinal tapinL7-S1was performed in six of11patients. To confirm epidural block, the patellar and flexor reflexes were tested, along with evalluation of muscle tone and skin dermatomes, with the animals in a superficial anesthetic plane. The approach to spinal column was then performed by the neurosurgery team. Physiological parameters(heart, vascular, respiratory and body temperature) were measured before the preanesthetic medication, 10 minutes after, 30 minutes after epidural block, after opening the spine and 60 minutes, 90 minutes, both in the animals with and without an epidural. The amount of isoflurane used and time to extubation were also noted. Animals that had epidurals showed a significant reduction in the consumption of isoflurane and time until extubation. There were no neurological deficits caused by the epidural anesthesia when compared with the group without epidural anesthesia .It was concluded that epidural anesthesia is effective in lumbosacral decompression surgeries, leading to a lower anesthetic risk for the animals.

Anestesia epidural na cirurgia descompressiva lombossacral de cães

Objetivou-se neste trabalho avaliar a viabilidade, eficácia, vantagens e desvantagens da anestesia epidural lombossacral junto à anestesia geral inalatória em cirurgias de descompressão da cauda equina, tendo em vista que essa cirurgia é um procedimento longo e doloroso. Para isso, foram utilizados 11 cães adultos do atendimento de rotina do Hospital Veterinário, sem distinção de sexo, que apresentaram sinais clínicos de síndrome da cauda equina, diagnosticada através de exames neurológicos e radiográficos. Os cães foram submetidos à anestesia geral inalatória e deixados no estágio anestésico mais superficial. Depois, realizou-se a anestesia epidural em seis dos 11 pacientes, por punção espinhal em L7 -S1 , com o anestésico bupivacaína a 0,5%. Para a certificação do bloqueio foi realizado teste dos reflexos patelar e flexor, tônus muscular e dermátomos cutâneos, com os animais em plano anestésico superficial. Posteriormente, realizou-se a abordagem cirúrgica à coluna pela equipe de neurocirurgia. Os parâmetros fisiológicos (cardíacos, vasculares, respiratórios, temperatura corporal e glicemia) foram aferidos antes da medicação pré-anestésica (MPA), 10 minutos após a MPA, 30 minutos depois da epidural, depois da laminectomia, assim como após 60 minutos e 90 minutos, tanto no grupo com epidural quanto no sem epidural. Também se verificaram a quantidade de isofluorano consumido e o tempo de extubação. Os animais que possuíam bloqueio epidural apresentaram redução significativa no consumo de anestésico inalatório e no tempo de extubação. Não apresentaram déficits neurológicos causados pela anestesia epidural, quando comparados com o grupo sem anestesia epidural. Conclui-se que a técnica de anestesia epidural é eficiente e vantajosa na realização de cirurgias descompressivas lombossacrais, levando ao um menor risco anestésico para o animal.(AU)

The objective of this study was to evaluate the feasibility, effectiveness, advantages and disadvantages of lumbosacral epidural anesthesia associated with inhalation anesthesia in surgical decompression of cauda equina, seeing as this is a lengthy procedure with a painful recovery from anesthesia. Eleven adult dogs were selected from the Veterinary Hospital, without distinction of sex, which showed clinical signs of cauda equina syndrome, diagnosed by neurological examination and radiographs. The dogs were submitted to general inhalation anesthesia and left at a superficial stage, after which epiduralanesthesiawithbupivacaine0.5% via spinal tapinL7-S1was performed in six of11patients. To confirm epidural block, the patellar and flexor reflexes were tested, along with evalluation of muscle tone and skin dermatomes, with the animals in a superficial anesthetic plane. The approach to spinal column was then performed by the neurosurgery team. Physiological parameters(heart, vascular, respiratory and body temperature) were measured before the preanesthetic medication, 10 minutes after, 30 minutes after epidural block, after opening the spine and 60 minutes, 90 minutes, both in the animals with and without an epidural. The amount of isoflurane used and time to extubation were also noted. Animals that had epidurals showed a significant reduction in the consumption of isoflurane and time until extubation. There were no neurological deficits caused by the epidural anesthesia when compared with the group without epidural anesthesia .It was concluded that epidural anesthesia is effective in lumbosacral decompression surgeries, leading to a lower anesthetic risk for the animals.(AU)

Avaliação dos resultados clínicos após cirurgia descompressiva em cães com doença de disco intervertebral / Evaluation of clinical results of decompressive surgery in dogs with degenerative disk disease

Avaliaram-se os resultados clínicos após realização de cirurgia descompressiva em 45 cães com doença do disco intervertebral cervical ou toracolombar. Após a cirurgia, 35 cães (77,8 por cento) recuperaram-se totalmente, oito (17,8 por cento) parcialmente e dois (4,4 por cento) não apresentaram alteração do quadro inicial. Em oito cães com paraplegia e perda da sensibilidade dolorosa profunda houve completa melhora do quadro clínico, com recuperação total em 62,5 por cento dos casos. Em quatro cães com tetraparesia, a cirurgia foi eficaz. A cirurgia descompressiva (slot cervical e hemilaminectomia toracolombar), com a retirada do material do disco do interior do canal vertebral, foi uma forma efetiva de gerar melhora do quadro funcional(AU)

Clinical results after decompressive surgery were evaluated in 45 dogs with cervical or thoracolumbar intervertebral disk disease. After surgery, 35 dogs recovered totally, eight (17.8 percent) partially, and two (4.4 percent) did not present any change in clinical findings. Eight dogs with paraplegy and loss of deep pain perception showed improvement, with total recovering in 62.5 percent of cases. Surgery was effective in four dogs with tetraparesy. Decompressive surgery (cervical slot or hemilaminectomy), with removal of disk material from inside the vertebral canal, was an effective form to produce functional improvement in dogs with this disease(AU)

Hansen type II disc disease in dogs: pathophysiology, clinicalsurgical approach and controversies / Doença do disco intervertebral Hansen tipo II em cães: fisiopatologia, abordagem clínico-cirúrgica e controvérsias

Protrusion of the intervertebral disc can cause chronic progressive compression of the spinal cord, and the neurological associated signs vary according to anatomical location, duration and dynamic force of compression. The type II disc disease is not fully understood, and there are many controversies about is clinical significance and best form of treatment. The most important aspect of conservative treatment is rest and physiotherapy associated with mild exercise, and use of corticosteroids to reduce vasogenic edema. The spinal decompression by surgery for removal of disc material from within the medullary canal is the surgical treatment of choice in type I disc disease, but has technical limitations in the type II disc disease. The purpose of this paper is to review the pathophysiology and treatment of chronic intervertebral disc disease and discuss the controversies in medical treatment and the use of some traditional and new surgical techniques.

A protrusão do disco intervertebral pode provocar compressão progressiva crônica da medula espinhal e os sinais neurológicos associados variam de acordo com a localização anatômica, duração e força dinâmica da compressão. A doença do disco tipo II não é totalmente compreendida, havendo muitas controvérsias sobre seu significado clínico e melhor forma de tratamento. O aspecto mais importante do tratamento conservador refere-se ao repouso associado à fisioterapia e exercícios leves, além de uso de corticoesteróides para diminuir o edema vasogênico. A descompressão medular por meio de cirurgia para remoção de material do disco do interior do canal medular é o tratamento cirúrgico de eleição na doença do disco tipo I, mas apresenta limitações quanto à técnica e ao resultado na doença do disco do tipo II. O objetivo deste trabalho é revisar a fisiopatologia e o tratamento da doença do disco intervertebral crônica e discutir as controvérsias existentes no tratamento médico bem como o uso de técnicas cirúrgicas tradicionais e novas técnicas.