Aural hematomas in small ruminants - clinical features, surgical treatment and outcome

Background: Aural or auricular hematoma is an important and prevalent surgical condition in small animals practice, and commonly reported in companion pets. The condition is characterized by blood accumulation between the pinnae's dermal surface and the underlying perichondrium. In farm animals, most cases present surgical treatment with drainage of serosanguineous fluid from acute cases with clinical evolution ranging from 1 to 5 days. Therefore, the present work reports the clinical features, surgical treatment and outcome of aural hematomas in 3 small ruminants with a chronic evolution (7 to 20 days), detailing the post-surgical complications, such as wound infection and recurrence, and final cosmetic appearance of the pinnae. Cases: Upon physical examination, all animals were alert and presenting a good body condition score. Clinical alteration was restricted to a bilateral (Case 1) or unilateral (Cases 2 & 3) painless, and fluid-filled swelling, presenting doughy consistency masses within the fluid during pinna manipulation. The fluid-filled swellings were located on the concave (Case 1 - left ear & Case 2) and convex (Case 1 - right ear & Case 3) surface of the pinna. No primary pruritic disorders of the pinna were detected, and a diagnosis of traumatic aural hematoma was proposed. Due to the chronicity of the cases, surgical approach was advisable. The small ruminants underwent general anesthesia, and a linear incision over the skin overlying the hematoma was performed (Cases 1 & 2). After removal of blood and fibrin clots, the cavity was flushed and captonated size 0 nylon mattress sutures were performed on either side of the incision, in order to obliterate the dead space. Due to recurrence after 14 days, Case 2 was submitted to a modified surgical approach using a S-shaped incision combined to multiple drainage holes (MDH) using a disposable 6 mm biopsy punch. The same approach has performed in Case 3. Then, size 0 nylon mattress sutures followed by a tight protective pressure and absorbent bandage combined with an Elizabethan collar was applied. Postoperatively, Case 1 presented surgical site infection and the antibiotic was changed after bacterial culture and antibiogram results. Hospital discharge varied from 14 to 19 days' post-surgery. All animals presented some degree of ear retraction and a linear or S-shaped scar on the affected ear, but final cosmetic appearance was satisfactory to all owners. Discussion: Aural or auricular hematomas are a frequent disorder in dogs and cats clinical practice. In sheep, the few reported cases have been associated with pruritic disorders of the pinna, such as ticks infestation and sarcoptic mange. Whilst in goats, traumatic injuries, such as ear tagging and trauma from others goats, are considered the main cause, especially in breeds with pendulous ear. In our cases with chronic evolution (> 7 days), the most important clinical feature was the presence of doughy consistency masses within the fluid, suggesting matured blood and fibrin clots. A linear incision with captonated size 0 nylon mattress sutures was associated to post-surgical complications, such as wound infection and aural hematoma recurrence. Therefore, a S-shaped incision associated to creation of MDH, in order to achieve better drainage, was the chosen approach in the second surgery (Case 2) and on the subsequent patient (Case 3). To the best of our knowledge, this is the first report using the MDH approach in farm animals, that appears to be an effective treatment for chronic aural hematomas in small ruminants.

Utilização de curativo a vácuo de baixo custo para cicatrização de fratura de casco com ruptura de cavidade celomática em um Chelonia carbonaria / Use of cost-effective vacuum-assisted closure technique for shell fracture Repair and coelomic cavity rupture healing in a Chelonia carbonaria

Background: The vacuum-assisted closure (VAC) therapy system has been used as a noninvasive wound managementtechnique for shell damage in Chelonians. These animals are excellent candidates for VAC therapy because of their uniqueshell anatomy consists of dermal bones, which make bandage placement easier. Beyond that, they are suited for this technique behaviorally, because they are not inclined to remove the vacuum system intentionally. Considering the possibilityof Testudines shell repair with the use of less invasive techniques, that result no additional dermal bone lesions, the objective of the present study is to describe the adaptation of a vacuum dressing protocol using low-cost and easily accessiblematerials for post-traumatic shell healing of a specimen of Chelonoidis carbonaria.Case: A specimen of tortoise (Chelonoidis carbonaria), a male, weighing 630 g, approximately 3-year-old, was received atthe Veterinary Hospital - Wild Animals Sector in the Federal University of Pará (UFPA) after of being run over by a vehicle.On physical examination, fractures of the dermal plaques and underlying bone structures were found, with rupture of thecoelomic cavity. In addition, there was exposure and incarceration of an intestinal loop, with the presence of bleeding.According to the findings of the physical screening examination, the patient’s prognosis was defined as good, as describedin the literature that specifically focused on chelonian shell injuries. The animal was sent to the diagnostic imaging sector.Then, drug therapy was provided for pain control, vitamins were administered for nutritional support, and antibiotics andanti-inflammatory drugs were instituted. For the closure of the shell and coelomic cavity, a bandage was used with theVAC therapy system adapted as described for Chelonians in previous reports. After a complete osteosynthesis and closureof the coelomic cavity, repair of the integumentary component of the shell was...

Utilização de curativo a vácuo de baixo custo para cicatrização de fratura de casco com ruptura de cavidade celomática em um Chelonia carbonaria / Use of cost-effective vacuum-assisted closure technique for shell fracture Repair and coelomic cavity rupture healing in a Chelonia carbonaria

Background: The vacuum-assisted closure (VAC) therapy system has been used as a noninvasive wound managementtechnique for shell damage in Chelonians. These animals are excellent candidates for VAC therapy because of their uniqueshell anatomy consists of dermal bones, which make bandage placement easier. Beyond that, they are suited for this technique behaviorally, because they are not inclined to remove the vacuum system intentionally. Considering the possibilityof Testudines shell repair with the use of less invasive techniques, that result no additional dermal bone lesions, the objective of the present study is to describe the adaptation of a vacuum dressing protocol using low-cost and easily accessiblematerials for post-traumatic shell healing of a specimen of Chelonoidis carbonaria.Case: A specimen of tortoise (Chelonoidis carbonaria), a male, weighing 630 g, approximately 3-year-old, was received atthe Veterinary Hospital - Wild Animals Sector in the Federal University of Pará (UFPA) after of being run over by a vehicle.On physical examination, fractures of the dermal plaques and underlying bone structures were found, with rupture of thecoelomic cavity. In addition, there was exposure and incarceration of an intestinal loop, with the presence of bleeding.According to the findings of the physical screening examination, the patients prognosis was defined as good, as describedin the literature that specifically focused on chelonian shell injuries. The animal was sent to the diagnostic imaging sector.Then, drug therapy was provided for pain control, vitamins were administered for nutritional support, and antibiotics andanti-inflammatory drugs were instituted. For the closure of the shell and coelomic cavity, a bandage was used with theVAC therapy system adapted as described for Chelonians in previous reports. After a complete osteosynthesis and closureof the coelomic cavity, repair of the integumentary component of the shell was...(AU)