Thromboembolism in a bitch - diagnosis by infrared thermography

Background: Thermography is a noninvasive, non-contact, painless, and non-ionizing imaging technique that records cutaneous thermal patterns generated by infrared emission of the surface. The surface heat is closely related to dermal microcirculation. Thromboembolism is responsible for important changes in the thermal pattern of the body surface due to physical obstruction of blood flow, being the main complication in immune-mediated hemolytic anemia. The aim of this paper is to report a dog with thrombus in his left forelimb secondary to idiopathic hemolytic anemia, whose diagnostic screening was performed through infrared thermography. Case: A 9-year-old mixed breed bitch was referred to a veterinary hospital with a history of emesis, diarrhea and dark-colored urine for 2 days. The complete blood count showed hypochromic macrocytic anemia (hematocrit [HTC] 28%, reference: 37 to 55%) with the presence of nucleated erythrocyte (14/100 leukocytes, reference: 0 to 5/100 leukocytes), polychromasia and spherocytes. Leukocytosis (28,300 mm³, reference: 6,000 to 17,000 mm³) by neutrophilia with left deviation and toxic granulations was also present, in addition to hemoglobinuria at urine exam. Therefore, treatment for immune-mediated hemolytic anemia (IMHA) was instituted. After 2 days, the animal returned with acute functional impairment of the left forelimb. Physical examination revealed that the limb was cold, without pulse, proprioception, reflexes, and deep pain. New blood analyses revealed decreased hematocrit (HTC 17%, reference: 37 to 55%), and increased total leukocyte number (57,000 mm3, reference: 6,000 to 17,000 mm³). Infrared thermography revealed an important temperature difference between the limbs, with the affected limb temperature considerably lower (31.3ºC) when compared to the contralateral limb (35.0ºC). Thermography showed the site of the thrombus in the medial portion of the limb (cephalic vein), where the catheter had been placed for fluid therapy. Due to the severity of the condition, the bitch was submitted to amputation surgery, which occurred without complications. The patient had a good response to treatment, with decreased signs of hemolysis and hypercoagulability. The medications were slowly withdrawn, and the clinical discharge occurred after 4 weeks. Discussion: In humans, thermography has been widely used in the assessment of thrombotic diseases, contributing to diagnosis, localization, and prognosis. In veterinary medicine, however, the use of this tool in the diagnosis of thromboembolism is still rare. The difference of 3.7°C between the affected and contralateral limb was objectively verified using thermography. A minimum difference of 2.4°C between limbs has high sensitivity and specificity for diagnosing thromboembolism and occurs due to the reduction in local blood flow. In the present case this tool was essential for the anatomical location of the thrombus, which was in the middle third of the forearm, and allowed an adequate surgical planning. It is known that the main complication of IMHA is thromboembolism. Its predisposing factors include venous stasis, endothelial damage, and hypercoagulability, being exacerbated by cage confinement, decubitus and presence of a peripheral venous catheter. The reported case corroborates at least one of these factors since it had a peripheral venous catheter in the left forelimb, which later showed absence of pulse, spinal reflexes, pain and proprioception. The thermography showed to be an objective, rapid and non-invasive tool to diagnose and precisely locate the thrombus, which allowed for adequate treatment and surgical planning for the case. To the best of our knowledge, this is the first report about use of thermography to diagnose thromboembolism secondary to immune-mediated hemolytic anemia in a dog.

Distúrbios hidroeletrolíticos no hipoadrenocorticismo primário agudo em cães: Uma revisão / Hydroelectrolytic disorders in acute primary hypoadrenocorticism in dogs: A review

O hipoadrenocorticismo canino é uma endocrinopatia caracterizada, na sua forma mais comum, pela deficiência de glicocorticoides e mineralocorticoides. Pacientes não tratados podem desenvolver a forma aguda da doença (crise addisoniana), apresentação grave com risco de óbito, caso não sejam realizadas as intervenções adequadas. Entre as alterações apresentadas estão: distúrbios eletrolíticos (como hiponatremia, hipercalemia, hiperfosfatemia e hipercalcemia), desequilíbrio hídrico (desidratação e choque hipovolêmico) e acidobásico. Fluidoterapia intravenosa adequada é a base do manejo inicial da crise addisoniana, que irá reestabelecer o volume intravascular e hidratação, reduzindo a concentração sérica de fósforo e potássio, a acidose lática, a azotemia pré-renal e a acidose metabólica. A reposição de glicocorticoides também contribui para a normalização dessas alterações. Entre as possíveis complicações do tratamento está a mielinólise pontina, decorrente de aumento rápido na concentração sérica de sódio. Diante disso, o conhecimento dos distúrbios associados à essa endocrinopatia auxilia na suspeição e manejo adequado da doença.(AU)

Canine hypoadrenocorticism is an endocrinopathy characterized, in its most common form, by glucocorticoid and mineralocorticoid deficiency, often resulting from immune-mediated destruction of the adrenal glands. Untreated patients may develop the acute form of the disease (Addisonian crisis), a severe presentation with a risk of death if appropriate interventions are not performed. Among the changes presented are: electrolyte disorders (such as hyponatremia, hyperkalemia, hyperphosphatemia and hypercalcemia), water imbalance (dehydration and hypovolemic shock) and acid-base disorder. Adequate intravenous fluid therapy is the basis for the initial management of Addisonian crisis, which will restore intravascular volume and hydration, reducing serum phosphorus and potassium concentrations, lactic acidosis, pre-renal azotemia and metabolic acidosis. Glucocorticoid replacement also contributes to the normalization of these changes. Among the possible complications of the treatment is pontine myelinolysis, resulting from a rapid increase in serum sodium concentration. In view of this, knowledge of the disorders associated with this endocrinopathy helps in the suspicion and adequate management of the disease.(AU)

Polineuropatia motora em cão adulto / Motor polyneuropathy in an adult dog

Background: Nonambulatory flaccid tetraparesis can be the result of diseases of the peripheral nervous system and it is characterized by generalized lower motor neuron (LMN) signs, as weakness, tetraparesis/tetraplegia, decreased muscle tone and reflexes. The term polyneuropathy is used for dysfunction of multiple peripheral nerves. In Brazil, there are several etiologies for polyneuropathy in dogs, such as acute idiopathic polyradiculoneuritis, botulism and myasthenia gravis. Toxoplasma gondii is an uncommon cause of LMN diseases in dogs. The aim of this report was to describe a case of flaccid tetraplegia toxoplasmosis in an adult dog with a Toxoplasma gondii serology with a markedly elevated IgG titer of 1:4096. Case: A 4-year-old intact mongrel male dog, weighing 19.6 kg, was referred to the Veterinary Medical Teaching Hospital of the Universidade Estadual de Londrina (UEL) with a 5-day history of weakness that progressed to tetraparesis. Physical examination revealed no significant changes other than the dull and unkempt coat. Neurologic examination revealed severe tetraparesis that was worse in the pelvic limbs, with decreased muscle tone in all four limbs. Postural reactions and the interdigital reflex were absent in all four limbs, as was the patellar reflex, but pain perception was present. There were no clinical signs of dysfunction on examination of the cranial nerves. Laboratory tests were performed, and creatine kinase was elevated (819 U/L). Blood was drawn to look for antibodies to Toxoplasma gondii and Neospora caninum class IgG using the indirect immunofluorescence technique. The antibody titer for Toxoplasma gondii (IgG) was 1:4096. A chest radiograph was performed to look for megaesophagus, and a pulmonary pattern suggestive of mild diffuse pneumonia was observed. Treatment was performed with sulfamethoxazole and trimethoprim, and the dog's condition improved slightly. Discussion: Based on lower motor neuron findings, the neurologic lesion was localized in the nerve roots, peripheral nerves, neuromuscular junctions, or muscles. The most important diseases in the list of differential diagnoses were immune-mediated or infectious polyradiculoneuritis (toxoplasmosis, neosporosis), myasthenia gravis, toxic polyneuropathy (botulism, chronic organophosphate poisoning), and paraneoplastic polyneuropathy. Among these differential diagnoses, polyradiculoneuritis is one of the most common. It is an idiopathic inflammatory disease. Exposure to raccoon saliva (in the U.S.), vaccination, or infection have been proposed as precipitating causes, but the triggers of this disease remain unknown. Serology for neosporosis was negative, while IgG titers for toxoplasmosis were 1:4096. In a previous study, dogs with acute polyradiculoneuritis were more likely to have T. gondii IgG serum antibody titers than dogs without neurologic signs. Infection with the protozoa T. gondii and N. caninum can cause intense polyradiculoneuritis in dogs accompanied by myositis, especially in puppies. One treatment trial was based on the administration of sulfonamide-trimethoprim with pyrimethamine, whose efficacy in the treatment of toxoplasmosis in dogs has also been reported in the literature. Neurologic deficits improved slightly, and there is a possibility that certain signs may not disappear completely because of the permanent damage caused by inflammation of the nervous system, as observed in the present case. The case had the limitation that it was not possible to perform other laboratory tests to demonstrate histopathologically the presence of Toxoplasma gondii organisms in muscles or nerves. Recovery of normal function is less likely in protozoan polyradiculoneuritis than in noninfectious polyradiculoneuritis. Thus, in the present case, the main suspicion was polyradiculoneuritis secondary to toxoplasmosis. Although it is a rare condition, it is important to consider toxoplasmosis in dogs with LMN-type tetraparesis or tetraplegia.

Canine atopic dermatitis: systemic immunomodulatory protocol based on clinical phenotype / Dermatite atópica canina: protocolos imunomodulatórios sistêmicos baseados no fenótipo clínico

Canine atopic dermatitis (cAD) is a multifactorial allergic disease associated with immune dysfunction and abnormal skin barrier. Several immunological mediators play a role in its pathogenesis. Such molecules are produced by the activation of T helper lymphocytes (Th) through polarization to Th1 and/or Th2, which contributes to different lesion patterns. Acute lesions are mediated by an activation of the Th2 cytokine axis, which clinically induces erythema and pruritus. Conversely, in chronic injuries a mixed immune response of Th1/Th2 cytokines occurs, leading to hyperpigmented and lichenified skin. The clinical understanding of these patterns and the mode of action of immunomodulators are crucial for the best clinical management of the atopic patient. In this context, this review discussed the role of the immune response and the immunomodulatory drugs in dogs with atopic dermatitis and suggested a therapeutic protocol based on clinical phenotype. Based on the evidences showed in this review, it is considered appropriate to use immunomodulatory drugs that target cytokine spectrum related with the clinical phenotype of cAD.

A dermatite atópica canina (DAC) é uma doença alérgica multifatorial associada à disfunção imune e barreira cutânea anormal. Vários mediadores imunológicos desempenham um papel na sua patogênese. Tais moléculas são produzidas pela ativação de linfócitos T auxiliares (Th) por meio da polarização para Th1 e/ou Th2, o que contribui para diferentes padrões de lesão. Lesões agudas são mediadas pela ativação do eixo de citocinas Th2, que clinicamente induz eritema e prurido. Por outro lado, nas lesões crônicas ocorre uma resposta imune mista de citocinas Th1/Th2, levando à pele hiperpigmentada e liquenificada. O entendimento clínico desses padrões e o modo de ação dos imunomoduladores são cruciais para o melhor manejo clínico do paciente atópico. Esta revisão visa discutir o papel da resposta imune e das drogas imunomoduladoras em cães com dermatite atópica e sugerir um protocolo terapêutico baseado no fenótipo clínico. Baseado nas evidências apresentadas nessa revisão, é considerado apropriado utilizar drogas imunomoduladoras que abrangem o espectro de citocinas relacionadas ao fenótipo clínico da DAC.

Episcleroceratite nodular granulomatosa em cães / Nodular episclerokeratitis in dogs

Background: Episcleral inflammation may be assumed to be primary immune-mediated, secondary to intra- or extraocular diseases, or systemic abnormalities. We aimed to report a confirmed and another suspect case of nodular episclerokeratites (NEK) due to its rarity in the clinical setting and the paucity of case reports in Brazilian literature. Cases: Case 1. Refers to a 7-year-old castrated male, Collie-mixed breed, presenting with epiphora and an irregular ocular surface shape in the left eye (LE). Ophthalmic evaluation of this eye revealed mucoid discharge, conjunctival hyperemia, episcleral injection, and a gelatinous mass in the temporal limbic region. Biomicroscopic evaluation of the anterior chamber, lens, and vitreous was impaired in the LE because of corneal vessels and a mild flare in the aqueous humor. Histopathology of a scleral biopsy revealed the presence of lymphocytes, histiocytes, and some plasma cells. Positive CD3-lymphocytes were observed by immunohistochemistry, confirming the diagnosis of NEK. Case 2. Refers to a 8-year-old, spayed female Border Collie with a history of exophthalmos, conjunctival hyperemia, and inability to close the eyelid of the LE. During ophthalmic examination, an irregular espicleral nodule of approximately 9 mm was also found in the temporal limbic region, along with enlargement of episcleral vessels and scleral thinning at the equatorial region. The cornea showed mild and diffuse edema, and white crystal-like deposits were distributed in a band-like fashion at the dorsal aspect. Ultrasonography revealed scleral thinning without evidence of a mass effect arising from the iris, ciliary body, or retrobulbar space. Based on these findings, NEK was suspected. In both cases, the clinical signs reduced significantly after seven days of topical treatment with corticosteroids and cyclosporine. Discussion: It is assumed that scleral disorders are primarily immune mediated. However, such conditions may develop secondary to ocular trauma (surgery and foreign bodies), Ehrlichia canis, and Onchocerca spp. Infections and situations were ruled out in both cases. In case 1, additional histological and immunohistochemical findings supported a primary and immune-mediated scleral disease. Although the definitive diagnosis was not confirmed by histology in case 2, one can assume that the episcleral inflammation may have arisen due to an immune-mediated disorder once the eye responded positively to corticosteroid therapy. Additionally, secondary glaucoma was excluded as a possible diagnosis in case 2, because the intraocular pressure of the affected eye was below the reference range for dogs, coupled with the irregular appearance of the episclera, which is not characteristic of canine glaucoma. Moreover, in case 2, because remission of the masses of neoplastic origin after corticotherapy was not expected, the tumor was discarded. NEK has a characteristic ploriferative behavior and resistance to topical immunosuppression; clinical recurrence was not observed in the LE of either patient who remained on treatment after 60 days of follow-up. Regarding prognosis, one study showed a correlation between cellular contingent and therapeutic responses. The percentage of positive CD79a cells (B-lymphocytes) was significantly higher in cases of epicleritis and NEK, in which a poor response was achieved after topical immunosuppressive treatment. As shown by the veterinary literature and the cases described here, the complete remission of NEK is more common in unilateral cases, as confirmed after a 12-month follow-up. The 2 reported cases are useful for clarifying the common findings, diagnosis, and long-term management of NEK. Scleral abnormalities, such as NEK, must be included in the list of differential diagnoses of glaucoma, neoplasia, and endophthalmitis during ophtalmic examination.

Use of automated central lamellar superficial keratectomy in the treatment of chronic pigmentary superficial keratitis in dogs / [Uso da ceratectomia superficial lamelar central automatizada no tratamento das ceratites superficiais pigmentares crônicas em cães]

Pigmentary superficial keratitis (PSK) is a chronic corneal disorder with different causes, which may include immune-mediated diseases and reactions to ultraviolet rays. This study aimed to evaluate the use of automated central lamellar superficial keratectomy (ACLSK) in the treatment of chronic pigmentary superficial keratitis (CPSK) in dogs. We enrolled 24 animals with CPSK and loss of visual function even after clinical treatment with preserved post-corneal transparent media, and the potential for recovery of visual function after surgical treatment. The microkeratome was positioned on the eye surface, and the central corneal lamellae were obtained after translation. With ACSLC, 21 animals (87.5%) recovered their visual function. In 3 animals (12.5%), the formation of granuloma and posterior central leukoma in the cornea compromised the transparency of the visual axis. This study concludes that ACLSK is a viable surgical alternative for the restoration of visual function in dogs with severe PSK, thus improving their quality of life. The short execution time of this procedure reduces the costs and anesthetic risks.

A ceratite pigmentar superficial (CPS) é uma doença crônica da córnea, com diferentes causas, que podem incluir doenças imunomediadas e reação aos raios ultravioleta. Este estudo teve como objetivo avaliar a utilização da ceratectomia superficial lamelar central automatizada (CSLCA) no tratamento da ceratite superficial pigmentar crônica (CSPC) em cães. Vinte e quatro animais incluídos apresentaram CSPC e perda da função visual mesmo após o tratamento clínico, porém mantiveram os meios transparentes pós-córnea preservados e o potencial de recuperação da função visual após o tratamento cirúrgico. O microcerátomo foi posicionado na superfície do olho e, após o término de sua translação, foram obtidas as lamelas centrais da córnea. Com a CSLCA, 21 animais (87,5%) recuperaram a função visual. Em três animais (12,5%), a formação de granuloma e leucoma central posterior na córnea comprometeu a transparência do eixo visual. Este estudo conclui que a CSLCA é uma alternativa cirúrgica viável para o restabelecimento da função visual em cães com CPS grave, melhorando, assim, sua qualidade de vida. Seu curto tempo de execução proporciona redução de custos e de riscos anestésicos.

Discoid lupus erythematosus in dog / Lúpus eritematoso discoide em cão

Lupus erythematosus complex is an immune-mediated dermatological disease, mainly represented by the generalized and discoid forms. The last form described is milder, as it is limited to the appearance of lesions, usually on the face and in mucocutaneous regions. Its pathophysiology is considered multifactorial, however, continuous exposure to ultraviolet radiation seems to be very relevant to trigger and/or worsen clinical manifestations. DeÞ nitive diagnosis is obtained by histopathological analysis, and treatment is mainly based on immunosuppression and protection against ultraviolet radiation. The objective of this study was to report the case and clinical evolution of a mixed breed bitch, diagnosed with discoid lupus erythematosus. The bitch presented moderate desquamation, crusts and depigmentation restricted to the nasal plane. No other clinical or laboratory Þ ndings were evidenced in the screening tests. Upon conÞ rmation by histopathology, the initial therapy was started with oral prednisolone. The owners were also instructed to avoid exposure to sunlight, as well as to use topical protectors against ultraviolet radiation. The patient presented good response to therapy, showing remission of signs. Other sporadic recurrences were observed later, however, they were controlled only with topical corticosteroids, but always reinforcing the other precautions of environmental management. This work also addressed the risks, beneÞ ts and need to institute ongoing care to control discoid lupus erythematosus. Therapeutic success can vary among patients, as the intensity of the disease can be manifested in varying degrees. Therefore, in those individuals in which the condition is mild, it may be advantageous to opt for more conservative therapies in order to avoid side effects.(AU)

O complexo lúpus eritematoso é uma enfermidade dermatológica imunomediada, sendo principalmente representado pela forma generalizada e discoide. A última descrita é mais branda, pois se limita ao aparecimento de lesões geralmente em face e em regiões muco-cutâneas. Sua Þ - siopatogenia é considerada multifatorial, entretanto, a exposição contínua à radiação ultravioleta parece ser muito relevante para desencadear e/ou agravar as manifestações clínicas. O diagnóstico deÞ nitivo é obtido pela análise histopatológica, e o tratamento se baseia principalmente na imunossupressão e proteção contra a radiação ultravioleta. O objetivo deste trabalho foi relatar o caso e evolução clínica de uma cadela sem raça deÞ nida, diagnosticada com lúpus eritematoso discoide. A mesma apresentou moderada descamação, crostas e despigmentação restritas ao plano nasal. Nenhum outro achado clínico ou laboratorial foi evidenciado nos demais exames de triagem. Após conÞ rmado pela histopatologia, a terapia inicial foi instituída a partir da prednisolona por via oral. Os tutores também foram orientados a evitar exposição a luz solar, bem como, fazer a utilização de protetores tópicos contra a radiação ultravioleta. A paciente teve boa resposta à terapia, apresentando remissão dos sinais. Após este episódio, outras recidivas esporádicas foram observadas, entretanto, controladas apenas com corticoides tópicos, mas sempre reforçando os demais cuidados com o manejo ambiental. Este trabalho também abordou os riscos, benefícios e necessidade de instituir o cuidado contínuo para controle do lúpus eritematoso discoide. O sucesso terapêutico pode variar entre os pacientes, uma vez que a intensidade da doença pode ser manifestada em vários graus. Portanto, naqueles indivíduos em que o quadro é brando, pode ser vantajoso optar por terapias mais conservadoras, a Þ m de evitar seus efeitos colaterais.(AU)

Potential histopathological and immunological effects of SARS-CoV-2 on the liver / Efeitos histopatológicos e imunológicos potenciais do SARS-CoV-2 no fígado

The coronavirus disease outbreak of 2019 (COVID-19) poses a serious threat to public health worldwide. Lung injury is the most common complication of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. However, other organs, including the liver, can also be affected. Currently, there is limited evidence that liver impairment is associated with severe SARS-CoV-2 infection. Clinicians will need to determine whether liver injury is caused by an underlying liver condition, COVID-19 therapy, the virus directly, or immune-mediated inflammation or represents a complicated disease course in the context of COVID-19. To address the scarcity of data on histopathological changes and immunological effects on the liver with COVID-19 positivity, we analyze and summarize recent findings. We searched PubMed, Medline, Google Scholar, Science Direct, Scopus, and Web of Science databases up to December 1, 2021, identifying published studies with the search terms "Histopathology in COVID-19," "COVID-19," "Pathological changes in liver in COVID-19," "Liver pathology in COVID-19," "immunological effects in liver in COVID-19," and "SARS-CoV-2." This concise review will aid clinicians and researchers in better understanding the tissue histopathology and immunological consequences of SARS-CoV-2 on the liver, enabling improved care planning and avoiding future dangers.

O surto de doença por coronavírus de 2019 (COVID-19) representa uma séria ameaça à saúde pública em todo o mundo. A lesão pulmonar é a complicação mais comum da infecção por Coronavírus 2 da Síndrome Respiratória Aguda Grave (SARS-CoV-2). No entanto, outros órgãos, incluindo o fígado, também podem ser afetados. Atualmente, há evidências limitadas de que a insuficiência hepática está associada à infecção grave por SARS-CoV-2. Os médicos precisarão determinar se a lesão hepática é causada por condição hepática subjacente, terapia COVID-19, vírus diretamente, inflamação imunomediada ou se representa um curso complicado da doença no contexto da COVID-19. Para abordar a escassez de dados sobre alterações histopatológicas e efeitos imunológicos no fígado com positividade para COVID-19, analisamos e resumimos os achados recentes. Pesquisamos os bancos de dados PubMed, Medline, Google Scholar, Science Direct, Scopus e Web of Science até 1º de dezembro de 2021, identificando estudos publicados com os termos de pesquisa "Histopatologia em COVID-19", "COVID-19", "Alterações patológicas no fígado em COVID-19", "Patologia hepática em COVID-19", "Efeitos imunológicos no fígado em COVID-19" e "SARS-CoV-2". Esta revisão concisa ajudará médicos e pesquisadores a entender melhor a histopatologia do tecido e as consequências imunológicas do SARS-CoV-2 no fígado, permitindo um melhor planejamento de cuidados e evitando perigos futuros.

Anemia hemolítica imunomediada medicamentosa em uma cadela / Immune-mediated hemolytic anemia in a bitch triggered by drugs

Background: Immune-mediated hemolytic anemia (IMHA) is characterized by an autoimmune response with production of auto-antibodies and destruction of erythrocytes resulting in anemia. Primary IMHA is referred to a condition when the cause is unknown (idiopathic), whereas secondary IMHA involves changes in red blood cells caused by the action of drugs, neoplasms, or infectious diseases. The diagnosis can be made through changes in the blood count, usually of a regenerative character, Coombs test, and autoagglutination test. The present study aimed to report a case of drug-induced hemolytic anemia, with emphasis on the clinical signs, diagnostic methods, and treatment, in a female dog. Case: A 9-year-old mixed-breed bitch weighing 29.6 kg was referred to the Veterinary Medical Teaching Hospital (HCVUFRGS) with a previous diagnosis of gallbladder mucocele that was unresponsive to clinical treatment. After laboratory tests, cholecystectomy was performed, and the procedure required conversion from laparoscopic to open cholecystectomy. Therapy included administration of amoxicillin, dipyrone, tramadol hydrochloride, and meloxicam. Three days after surgery, the dog presented with apathy, lethargy, hyporexia, and a pale and subicteric mucosa. The patient developed hypochromic macrocytic anemia with reticulocytosis, spherocytosis, anisocytosis, and leukocytosis with neutrophilia. The result of the autoagglutination test was positive, confirming the diagnosis. All medications were suspended, and immunosuppressive treatment with dexamethasone was included, with a subsequent switch to prednisolone. After 10 days of treatment, the patient experienced significant improvement, and therapy was discontinued. Discussion: Based on the patient's history, the cause of the IMHA was secondary to drug administration, and it is not possible to distinguish if it was due to one or a combination of drugs, as they were all started and stopped simultaneously. The patient had hypothyroidism, which may have contributed to the production of antibodies against TSH receptors, blocking the hormone's action, thereby causing tissue damage due to T cell-mediated cytotoxicity and the effect of cytokines. The pale and subicteric mucosa, apathy, weakness, lethargy, exercise intolerance, and dyspnea resulted from extravascular hemolysis and bilirubin released from erythrocyte rupture with a subsequent decrease in the number of red blood cells, leading to oxygen transport deficiency. The diagnosis is based on the blood count and results of autoagglutination supported by the response to immunosuppressive therapy. Anemia results in increased production and release of precursor cells from the bone marrow, accompanied by reticulocytosis and increased mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC). The treatment of IMHA consists of supportive care and immunosuppressive therapy with corticosteroids to ensure suppression of the immune system, preventing response against erythrocytes. Initially, tramadol hydrochloride, dipyrone, and amoxicillin with potassium clavulanate were suspended to interrupt the cause of IMHA, and administration of dexamethasone in an immunosuppressive dose was started. Therefore, it is important to include drug-induced IMHA in the differential diagnosis of patients who present with anemia after using medications. Early diagnosis, initiation of therapy, and adequate care were important factors for the recovery of the animal.

Anemia hemolítica imunomediada associada à micoplasmose em um cão / Associated immunomediated hemolytic anemia mycoplasmosis in a dog

A anemia hemolítica imunomediada (AHIM) é uma reação de hipersensibilidade tipo II onde ocorre o aumento da destruição das hemácias. Ela pode ser dividida em primaria, caracterizada por não ter uma causa subjacente, e em secundária, pode ser causada por agentes infecciosos, como a micoplasmose, neoplasias, medicamentos e transfusões. O objetivo desse trabalho foi realizar uma análise clínica e laboratorial de um cão com anemia hemolítica imunomediada decorrente da Mycoplasma spp. Uma cadela da raça Pit Bull, com 05 meses de idade, foi levada ao hospital apresentando vômitos, diarreia e anorexia. No exame físico, foi possível observar a presença de carrapatos e mucosas ictéricas. Nos exames hematológicos foi possível evidenciaras alterações morfológicas de hemácias que caracterizavam anemia hemolítica imunomediada e a presença do parasita Mycoplasma spp. Nas análises bioquímicas se observou níveis séricos aumentados de creatinina e ureia. Pode-se concluir que, a observação de Mycoplasma spp. em esfregaços sanguíneos associada às alterações morfológicas eritrocitárias são de relevante importância para o diagnóstico de AHIM, auxiliando assim na instituição da melhor conduta terapêutica, contribuindo para o prognóstico do paciente.

Immune-mediated hemolytic anemia (AHIM) is a type II hypersensitivity reaction, where red blood cell destruction occurs or increases. It can be divided into primary, characterized by not having an underlying cause, and secondary, which can be caused by infectious agents, such as mycoplasmosis, neoplasms, drugs and transfusions. The objective of this work was to perform a clinical and laboratory analysis of a dog with immune-mediated hemolytic anemia due to Mycoplasma spp. A five-months-old female Pit Bull dog was taken to the hospital presenting vomiting, diarrhea and anorexia. On physical examination, it was possible to observe the presence of ticks and icteric mucous membranes. In hematological exams, it was possible to show morphological changes in red blood cells that characterize immune-mediated hemolytic anemia and the presence of the parasite Mycoplasma spp. In the biochemical analyzes it was observed increased serum levels of creatinine and urea. It can be concluded that the observation of Mycoplasma spp. in blood vessels associated with erythrocyte morphological changes are of relevant importance for the diagnosis of AHIM, thus assisting in the practice of a better method of therapy, contributing to the patient's prognosis.

Anemia hemolítica imunomediada associada à micoplasmose em um cão / Associated immunomediated hemolytic anemia mycoplasmosis in a dog

A anemia hemolítica imunomediada (AHIM) é uma reação de hipersensibilidade tipo II onde ocorre o aumento da destruição das hemácias. Ela pode ser dividida em primaria, caracterizada por não ter uma causa subjacente, e em secundária, pode ser causada por agentes infecciosos, como a micoplasmose, neoplasias, medicamentos e transfusões. O objetivo desse trabalho foi realizar uma análise clínica e laboratorial de um cão com anemia hemolítica imunomediada decorrente da Mycoplasma spp. Uma cadela da raça Pit Bull, com 05 meses de idade, foi levada ao hospital apresentando vômitos, diarreia e anorexia. No exame físico, foi possível observar a presença de carrapatos e mucosas ictéricas. Nos exames hematológicos foi possível evidenciaras alterações morfológicas de hemácias que caracterizavam anemia hemolítica imunomediada e a presença do parasita Mycoplasma spp. Nas análises bioquímicas se observou níveis séricos aumentados de creatinina e ureia. Pode-se concluir que, a observação de Mycoplasma spp. em esfregaços sanguíneos associada às alterações morfológicas eritrocitárias são de relevante importância para o diagnóstico de AHIM, auxiliando assim na instituição da melhor conduta terapêutica, contribuindo para o prognóstico do paciente.(AU)

Immune-mediated hemolytic anemia (AHIM) is a type II hypersensitivity reaction, where red blood cell destruction occurs or increases. It can be divided into primary, characterized by not having an underlying cause, and secondary, which can be caused by infectious agents, such as mycoplasmosis, neoplasms, drugs and transfusions. The objective of this work was to perform a clinical and laboratory analysis of a dog with immune-mediated hemolytic anemia due to Mycoplasma spp. A five-months-old female Pit Bull dog was taken to the hospital presenting vomiting, diarrhea and anorexia. On physical examination, it was possible to observe the presence of ticks and icteric mucous membranes. In hematological exams, it was possible to show morphological changes in red blood cells that characterize immune-mediated hemolytic anemia and the presence of the parasite Mycoplasma spp. In the biochemical analyzes it was observed increased serum levels of creatinine and urea. It can be concluded that the observation of Mycoplasma spp. in blood vessels associated with erythrocyte morphological changes are of relevant importance for the diagnosis of AHIM, thus assisting in the practice of a better method of therapy, contributing to the patient's prognosis.(AU)

Eritema multiforme e suas características clínico-patológicas em um equino no Brasil / Erythema multiforme and its clinicopathological features in a horse in Brazil

Background: Erythema multiforme (EM) is an immune-mediated skin disease which may manifest as cutaneous or mucocutaneous lesions. It is uncommon in horses. EM lesions have a symmetrical bilateral distribution; they are usually urticarial, necrotizing, and, less commonly, ulcerative. In equines, the trigger is usually unknown, and cases are often classified as idiopathic. Diagnosis is based on a thorough history and physical and histopathological examination of lesions. According to the clinical presentation and histopathological characteristics of the cutaneous lesions, this case is the first report to describe diagnosis and treatment of a horse with EM in Brazil. Case: A Quarter Horse filly was followed clinically for 12 months after sudden onset of skin lesions at 18 months of age. The initial lesions were non-alopecic papules with a symmetrical bilateral distribution. Six months after onset, the skin lesions maintained the original distribution pattern; however, they had progressed to papules and plaques with varying annular, arciform, serpiginous, targetoid, or alopecic appearance. At 8 months, the same distribution pattern and appearance remained, but the lesions had become more severe and extensive, with involvement of the labial commissures and perineal region, without any erosions/ulcerations, scaling/crusting, pain, or pruritus. At 12 months, new nodular lesions were found on the medial and lateral surfaces of the hind limbs, neck, bilateral trunk, and root of the tail. The lesions were firm, non-pruritic, and non-tender on palpation. Swabs were obtained from the papular lesions. Skin specimens were also obtained with a 6-mm punch and via incisional biopsy and histological sections were made. Bacterial and fungal cultures were negative. Appropriate stains did not identify fungal structures, were negative for acid-fast bacilli, and did not reveal any metachromatic granules in the sampled cell population. The histopathological findings were characteristic of immune-mediated disease, with a vacuolar interface dermatitis affecting the hair follicles more than the epidermis, necrotic keratinocytes, lymphocyte satellitosis, leukocytoclastic mixed vasculitis of the mid-dermis and deep dermis, and variable granulation tissue, consistent with erythema multiforme and leukocytoclastic vasculitis. Immunosuppressive therapy with corticosteroids and oral supplementation with omega-3 and omega-6 fatty acids and vitamin E were prescribed. After institution of therapy, no new lesions developed, the existing lesions remained stable (though permanent), and hair regrew in the previously alopecic areas. All physiological parameters remained normal throughout the follow-up period. Discussion: Erythema multiforme is rarely reported in horses. According to our literature review, this is the first description of EM in horses in Brazil. EM should be included in the differential diagnosis of horses that present with plaques in a diverse, geographic distribution and a negative initial dermatological screening examination. Further clinical investigation is warranted, with special attention to potential antigenic triggers. A thorough drug and dietary history and close attention to comorbidities are essential, as the suppression of potential culprit factors has important prognostic value and contributes to the elucidation of EM triggers.(AU)

Atypical spleen hemophagocytic histiocytic sarcoma in a dog

Background: The histiocytic sarcoma (HS) complex is a set of malignant neoplasms originating from interstitial dendritic cells or macrophages. When it involves macrophages of the splenic red pulp and bone marrow, it is referred to as hemophagocytic histiocytic sarcoma (HHS). HHS behaves more aggressively than HS and is usually fatal. HHS can be diagnosed by cytological and histopathological examination of neoplastic tissue. HHS is confirmed by immunohistochemistry using an anti-CD11d antibody. This neoplasm is often confused with immune-mediated hemolytic anemia or Evans syndrome due to erythrophagocytosis and platelet consumption. The clinical presentation of the animals progresses with evident anemia and thrombocytopenia, leading to signs such as prostration, inappetence, and pale mucosa, making diagnosis challenging and often late. This study aimed to report the clinic-pathological aspects of a canine with atypical hemophagocytic splenic HS. Case: A 4-year-old male Shih-Tzu canine was referred to the Veterinary Hospital with a history of prostration and anorexia. Pale mucous membranes were observed on physical examination. Blood tests revealed non-regenerative anemia, leukopenia, and thrombocytopenia. Serum protein levels were below the reference values for the species in biochemical examinations. Hemoparasitosis was suspected; however, the result of the polymerase chain reaction was negative. Abdominal ultrasound revealed a splenomegaly with heterogeneous parenchyma and a slightly irregular surface, but no visible mass in the spleen. Due to the difficulty of stabilizing the patient, even after successive transfusions, the animal underwent exploratory laparotomy with medial access and posterior splenectomy. Subsequently, the spleen was surgically removed, fixed in 10% buffered formalin, and processed routinely. Macroscopically, it had an irregular reddish-brown capsular surface. Histopathological examination of the spleen revealed a densely cellular neoplasm composed of round to spindle cells (histiocytes) arranged haphazardly in variably sized sheets separating the pre-existing spleen stroma. These histopathological findings were consistent with a histiocytic malignant neoplasm. Immunohistochemical analysis was performed to better define the origin of the histiocytic neoplasm. Neoplastic cells showed positive immunostaining of more than 80% of tumor cells for the CD11d antibody and weak immunostaining for CD11c and lysozyme. The patient survived for less than 30 days after the first hospital visit. Discussion: The diagnosis of HHS was based on the histological characteristics and positive immunostaining of more than 80% of the tumor cells for the CD11d antibody. HHS is an extremely aggressive and rare tumor that affects elderly dogs of any breed. In this study, HHS had atypical histologic characteristics, in which erythrophagocytosis and hemosiderin were not observed within macrophages. HHSs arise from macrophages of the red pulp of the spleen or bone marrow and express the b2 integrin, CD11d, and have low expression of CD1 and CD11c, which are predominantly expressed by non-hemophagocytic HS. The hematological and biochemical changes observed in this case were similar to those described in other dogs with HHS. Treatment of HHS is only palliative. Erlichia ewingii, E. canis, Anaplasma phagocytophilum, A. platys, Borrelia burgdorferi, Dirofilaria immitis, Leishmania infantum and immune-mediated hemolytic anemia are the main differential diagnoses because they cause anemia and thrombocytopenia accompanied by splenomegaly.

Osmotic demyelination syndrome after primary hypoadrenocorticism crisis management

Background: Primary hypoadrenocorticism is a rare condition resulting from immune-mediated destruction of the adrenal cortices. It can also occur due to necrosis, neoplasms, infarctions, and granulomas. The clinical and laboratory changes are due to deficient secretion of glucocorticoids and mineralocorticoids, which leads to electrolyte disorders associated with hyponatremia and hyperkalemia. These disorders can cause hypotension, hypovolemia and shock, putting a patient's life at risk if inadequate hydroelectrolytic supplementation and hormone replacement is provided. Nevertheless, rapid sodium chloride supplementation is contraindicated due to the risk of central pontine myelinolysis induction. The present study aims to describe a thalamic osmotic demyelination syndrome after management of a primary hypoadrenocorticism crisis in a 2-year-old, female West White Highland Terrier. Case: The patient had a presumptive diagnosis of hypoadrenocorticism already receiving oral prednisolone and gastrointestinal protectants in the last 2 days. After prednisolone dose reduction the dog presented a severe primary hypoadrenocorticism crisis treated with intravenous sodium chloride 0.9% solution along with supportive therapy. Four days after being discharged from the hospital, the patient showed severe neurological impairment and went back to the clinic where a neurological examination revealed mental depression, drowsiness, ambulatory tetraparesis and proprioceptive deficit of the 4 limbs, postural deficits, and cranial nerves with decreased response. Due to these clinical signs, a magnetic resonance imaging was performed. It showed 2 intra-axial circular lesions, symmetrically distributed in both thalamus sides, with approximately 0.8 cm in diameter each without any other anatomical changes on magnetic resonance imaging. The images were compatible with metabolic lesions, suggesting demyelination. Furthermore, liquor analysis did not show relevant abnormalities, except for a slight increase in density and pH at the upper limit of the reference range. After treatment, the patient had a good neurological evolution secondary to standard primary hypoadrenocorticism treatment, without sequelae. Discussion: In the present case report, primary hypoadrenocorticism gastrointestinal signs seemed to be triggered by a food indiscretion episode, not responsive to the symptomatic therapies employed. The patient´s breed and age (young West White Highland Terrier bitch) is in accordance with the demographic profile of patients affected by the disease, where young females are frequently more affected. Regarding the probable thalamic osmotic demyelination syndrome documented in this case, is important to notice that myelinolysis or demyelination is an exceedingly rare noninflammatory neurological disorder, initially called central pontine myelinolysis, which can occur after rapid correction of hyponatremia. It has already been observed in dogs after correction of hyponatremia of different origins, including hypoadrenocorticism and parasitic gastrointestinal disorders. Currently, the terms "osmotic myelinolysis" or "osmotic demyelination syndrome" are considered more suitable when compared to the term "central pontine myelinolysis" since it has been demonstrated in dogs and humans the occurrence of demyelination secondary to the rapid correction of hyponatremia in distinct regions of the central nervous system including pons, basal nuclei, striatum, thalamus, cortex, hypoppocampus, and cerebelum. The present case report emphasizes the difficulties for hormonal confirmation of primary hypoadrenocorticism in a patient already on corticosteroid treatment, as well as proposes that the current term osmotic demyelination syndrome replace the term "central pontine myelinolysis" in veterinary literature related to the management of hypoadrenocorticism crisis.

Meningomielite eosinofílica provavelmente associada à toxoplasmose em um gato / Eosinophilic meningomyelitis probably associated with toxoplasmosis in a cat

Background: The cerebrospinal fluid (CSF) of healthy cats presents up to 5 cells/µL, with predominance of mononuclear cells and the presence of more than 1% eosinophils is rare and should always be considered an abnormal finding. There is no consensus on the term eosinophilic pleocytosis, as it is used to indicate the presence of more than 10 eosinophils/µL or more than 10% of the total leukocytes. The increase in eosinophils in the CSF may result from infectious, inflammatory, neoplastic and idiopathic diseases. The objective of this paper is to report a case of marked pleocytosis in CSF, with 84% eosinophils, probably due to toxoplasmosis, in a cat with paraparesis and diffuse spinal pain. Case: A mixed breed female cat, neutered, adult and domiciled in a rural area was presented due to gait abnormalities in the pelvic limbs that started one day before presentation. The general physical examination was unremarkable. On neurological examination it was observed asymmetric deficit of postural reactions in pelvic limbs, patellar reflex normal to increased and pain elicited on palpation of the thoracic and lumbar spine. Based on these findings, the neurological syndrome was classified as thoracolumbar, but with diffuse pain, and the main differential diagnoses were inflammatory/ infectious and neoplastic diseases. The leukogram showed eosinophilia and the serum biochemistry showed no significant changes. Serological assays for feline immunodeficiency virus and feline leukemia virus were negative. Analysis of cerebrospinal fluid (CSF) identified marked pleocytosis with 84% eosinophils and increase in protein concentration. Myelography showed no compressive or expansive changes. Fungal culture for CSF cryptococcosis was negative. Serum immunofluorescence antibody titer for Toxoplasma gondii (IgG) was 1:256. There was a marked improvement after treatment with sulfametoxazole/trimethoprim and pyrimethamine and after 3 weeks of treatment, there was almost complete recovery of neurological signs and after 9 months the cat was neurologically normal. Discussion: The most common causes of acute-onset thoracolumbar spinal cord syndrome in cats, with diffuse pain on spinal palpation, are meningomyelitis of inflammatory/infectious origin, such as feline infectious peritonitis (FIP) and neoplasms such as lymphoma. Other meningomyelitis of inflammatory origin, such as infectious and immune-mediated meningomyelitis of unknown origin are considered uncommon in cats. Although the clinical, systemic and neurological signs of FIP and toxoplasmosis may have similarities, in the present case FIP was not considered responsible for the observed signs, as the evolution of the case and the analysis of the CSF tend to be different. The peripheral eosinophilia, the cytological analysis of the CSF, characterized by marked eosinophilic pleocytosis, associated with a positive titer for toxoplasmosis, good response to treatment and improvement in the neurological condition, with survival for more than 9 months after treatment, rules out the possibility of FIP. Neurological signs observed in the absence of systemic signs are more common in cases of protozoan reactivation, which probably occurred in the present case. The possibility of toxoplasmosis in the patient in this report was reinforced by the fact that the animal came from a rural area. Eosinophilia of CSF is most commonly associated with parasitic infections, although it can be caused by a variety of infectious agents, but in the cat of the present report, the marked eosinophilic pleocytosis was likely due to toxoplasmosis, which is a rare occurrence in this specie. In conclusion, toxoplasmosis should be considered in the differential diagnosis of focal spinal cord lesions in cats. The identification of laboratory findings as well as the appropriate therapy favored the good evolution of the condition.

Feline plasm cell pododermatitis: case report / Pododermatite plasmocitária felina: relatode caso

Feline Plasmacytic Pododermatitis is an uncommon dermatological disorder that affects one or multiple paw pads and leads to swelling, ulceration, hemorrhage, scaling, erythema, and striation. Its etiopathogenesis is poorly understood, however, an immune-mediated basis is strongly suggested. A two-year-old neutered, mixed breed, male cat was referred to the Veterinary Clinic of the Federal University of Santa Catarina (UFSC), Curitibanos Campus, with a brief clinical history of progressive lesions on palmar and plantar pads for one month. On physical examination, the patient had enlarged popliteal and inguinal lymph nodes, and paw pads with thin, swollen, hyperemic, erythematous, and purple color skin with multiple white striations. Histopathological diagnosis confirmed plasmacytic pododermatitis, and glucocorticoid therapy with prednisolone was prescribed. In the present report, the patient's clinical follow-up was compromised, as the tutor did not perform the prescribed treatment and did not return with the animal for further evaluations.

A pododermatite plasmocitáriafelina é uma desordem dermatológica incomum que acomete os coxins plantares e/ou palmares, levando a edema, ulceração, hemorragia, descamação, eritema e estrias esbranquiçadas. Sua etiologia e patogenia são desconhecidas, mas acredita-se que tenha origem imunomediada. Foi atendido na Clínica Veterinária Escola da UFSC, CampusCuritibanos, um felino, macho, sem raça definida, 2 anos de idade, castrado, com histórico de lesões nos coxins palmares e plantares há um mês, com evolução progressiva. Ao exame físico apresentava-se com os linfonodos poplíteos e inguinais aumentados, além de coxins com pele fina, edemaciada, hiperêmica, com eritema, púrpura e estrias esbranquiçadas. O diagnóstico histopatológico confirmou pododermatite plasmocitária e foi prescrito tratamento à base de prednisolona. Não foi possível acompanhar a evolução clínica do paciente, pois o tutor não realizou o tratamento prescrito e não trouxe o animal para novas avaliações.

Feline plasm cell pododermatitis: case report / Pododermatite plasmocitária felina: relatode caso

Feline Plasmacytic Pododermatitis is an uncommon dermatological disorder that affects one or multiple paw pads and leads to swelling, ulceration, hemorrhage, scaling, erythema, and striation. Its etiopathogenesis is poorly understood, however, an immune-mediated basis is strongly suggested. A two-year-old neutered, mixed breed, male cat was referred to the Veterinary Clinic of the Federal University of Santa Catarina (UFSC), Curitibanos Campus, with a brief clinical history of progressive lesions on palmar and plantar pads for one month. On physical examination, the patient had enlarged popliteal and inguinal lymph nodes, and paw pads with thin, swollen, hyperemic, erythematous, and purple color skin with multiple white striations. Histopathological diagnosis confirmed plasmacytic pododermatitis, and glucocorticoid therapy with prednisolone was prescribed. In the present report, the patient's clinical follow-up was compromised, as the tutor did not perform the prescribed treatment and did not return with the animal for further evaluations.(AU)

A pododermatite plasmocitáriafelina é uma desordem dermatológica incomum que acomete os coxins plantares e/ou palmares, levando a edema, ulceração, hemorragia, descamação, eritema e estrias esbranquiçadas. Sua etiologia e patogenia são desconhecidas, mas acredita-se que tenha origem imunomediada. Foi atendido na Clínica Veterinária Escola da UFSC, CampusCuritibanos, um felino, macho, sem raça definida, 2 anos de idade, castrado, com histórico de lesões nos coxins palmares e plantares há um mês, com evolução progressiva. Ao exame físico apresentava-se com os linfonodos poplíteos e inguinais aumentados, além de coxins com pele fina, edemaciada, hiperêmica, com eritema, púrpura e estrias esbranquiçadas. O diagnóstico histopatológico confirmou pododermatite plasmocitária e foi prescrito tratamento à base de prednisolona. Não foi possível acompanhar a evolução clínica do paciente, pois o tutor não realizou o tratamento prescrito e não trouxe o animal para novas avaliações.(AU)

Celulite juvenil canina: relato de caso / Canine juvenile cellulitis: case report

A celulite juvenil, também descrita como dermatite e linfadenite granulomatosa estéril, é um distúrbio pouco frequente que acomete cães entre três semanas a quatro meses. Sua etiologia é incerta, entretanto, a hipótese mais recente sugere uma provável falha no sistema imune associada à administração de vacinas. Os sinais clínicos incluem eritema, edema, pápulas e pústulas especialmente em pálpebras, lábios e focinhos, podendo também acometer outros locais, além de linfonodomegalia e otite bilateral. O diagnóstico requer exame citológico e histopatológico das lesões e a terapia deve ser precoce e agressiva, visando a imunossupresão através do uso de altas doses de glicocorticóides. Foi atendido no Centro Médico Veterinário da São Judas Campus Unimonte, um filhote de Golden Retriver, apresentando sinais clínicos acima descritos. Foram realizados exames diagnósticos e imposto o tratamento preconizado. Diante à resposta positiva ao uso de glicocorticoide, a reação de hipersensibilidade imunomediada após a administração da vacina é uma hipótese para o desenvolvimento da celulite juvenil neste caso. O objetivo deste trabalho é relatar um caso de celulite juvenil em um cão, visando a importância do conhecimento dos aspectos clínicos, diagnósticos e terapêuticos afim de um bom prognóstico.

Juvenile cellulitis, also described as dermatitis and sterile granulomatous lymphadenitis, is an uncommon disorder that affects dogs between three weeks to four months. Its etiology is uncertain, however, the most recent hypothesis suggests a probable immunesystem failure associated with vaccine administration. Clinical signs include erythema, edema, papules and pustules, especially on the eyelids, lips and snouts, and may also affect other areas, in addition to lymph node enlargement and bilateral otitis. The diagnosis requires, apart from history and clinical signs, additional exams such as the cytological and histopathological method of the lesions and the therapy must be early and aggressive, aiming at immunosuppression through the use of high doses of glucocorticoids. A Golden Retriver puppy was seen at the Veterinary Medical Center of São Judas Campus Unimonte, showing the clinical signs described above. Diagnostic exams were carried out and the recommended treatment was followed. Due to the positive response to the use of glucocorticoids, the immune-mediated hypersensitivity reaction after administration of the vaccine is a hypothesis for the development of juvenile cellulitis in this case. The objective of this work is to report a case of juvenile cellulites in a dog, aiming at the importance of knowledge of clinical, diagnostic and therapeutic aspects in order to have a good prognosis.

Celulite juvenil canina: relato de caso / Canine juvenile cellulitis: case report

A celulite juvenil, também descrita como dermatite e linfadenite granulomatosa estéril, é um distúrbio pouco frequente que acomete cães entre três semanas a quatro meses. Sua etiologia é incerta, entretanto, a hipótese mais recente sugere uma provável falha no sistema imune associada à administração de vacinas. Os sinais clínicos incluem eritema, edema, pápulas e pústulas especialmente em pálpebras, lábios e focinhos, podendo também acometer outros locais, além de linfonodomegalia e otite bilateral. O diagnóstico requer exame citológico e histopatológico das lesões e a terapia deve ser precoce e agressiva, visando a imunossupresão através do uso de altas doses de glicocorticóides. Foi atendido no Centro Médico Veterinário da São Judas Campus Unimonte, um filhote de Golden Retriver, apresentando sinais clínicos acima descritos. Foram realizados exames diagnósticos e imposto o tratamento preconizado. Diante à resposta positiva ao uso de glicocorticoide, a reação de hipersensibilidade imunomediada após a administração da vacina é uma hipótese para o desenvolvimento da celulite juvenil neste caso. O objetivo deste trabalho é relatar um caso de celulite juvenil em um cão, visando a importância do conhecimento dos aspectos clínicos, diagnósticos e terapêuticos afim de um bom prognóstico.(AU)

Juvenile cellulitis, also described as dermatitis and sterile granulomatous lymphadenitis, is an uncommon disorder that affects dogs between three weeks to four months. Its etiology is uncertain, however, the most recent hypothesis suggests a probable immunesystem failure associated with vaccine administration. Clinical signs include erythema, edema, papules and pustules, especially on the eyelids, lips and snouts, and may also affect other areas, in addition to lymph node enlargement and bilateral otitis. The diagnosis requires, apart from history and clinical signs, additional exams such as the cytological and histopathological method of the lesions and the therapy must be early and aggressive, aiming at immunosuppression through the use of high doses of glucocorticoids. A Golden Retriver puppy was seen at the Veterinary Medical Center of São Judas Campus Unimonte, showing the clinical signs described above. Diagnostic exams were carried out and the recommended treatment was followed. Due to the positive response to the use of glucocorticoids, the immune-mediated hypersensitivity reaction after administration of the vaccine is a hypothesis for the development of juvenile cellulitis in this case. The objective of this work is to report a case of juvenile cellulites in a dog, aiming at the importance of knowledge of clinical, diagnostic and therapeutic aspects in order to have a good prognosis.(AU)

Feline Hyperesthesia Syndrome - Case Report / Síndrome da Hiperestesia Felina Relato de Caso

Feline Hyperesthesia Syndrome (FHS) is a clinical condition, characterized by involuntary muscle contractions and changes in behavior. It is a rare syndrome, often of unknown origin, and the most common associated causes are skin related disorders, such as bacterial, fungal dermatitis, allergics and immune-mediated diseases. Causes related to the central nervous system and behavioral disorders are also reported. The clinical signs are varied, the diagnosis is often complex and the treatment varies according to the underlying cause. The purpose of this case report is to describe a case of FHS of possible dermatological etiology. A three-year-old Siamese male feline was treated for feline lower urinary tract disease throughout the duration of nine days. Associated, the animal also presented erythematous areas and hypotrichosis all over the face, especially around the eyes, nose and auricular pavilions, along with painful hypersensitivity to the touch and skin fasciculations in the lumbar and coccygeal region and pelvic limbs. An histopathological exam of the skin lesions was performed, where a chronic, superficial perivascular dermatitis was seen to be proliferative. Based on physical examination findings and additional tests, the animal was diagnosed with feline hyperesthesia syndrome secondary to dermatopathy.

A Síndrome da Hiperestesia Felina (FHS) é uma condição clínica, caracterizada por contrações musculares involuntárias e mudanças de comportamento. É uma síndrome rara, muitas vezes de origem desconhecida, sendo que as causas mais comuns associadas são doenças relacionadas à pele, tais como dermatites bacterianas, fúngicas, alérgicas e doenças imunomediadas. Causas relacionadas ao sistema nervoso central e distúrbios comportamentais também são relatadas. Os sinais clínicos são variados, o diagnóstico muitas vezes é complexo e o tratamento varia de acordo com a causa de base.  O objetivo deste relato de caso é descrever um caso de FHS de possível origem dermatológica. Um felino, macho, de três anos, da raça Siamês, foi atendido apresentando doença do trato urinário inferior felino há nove dias. Associado, o animal possuía áreas eritematosas e de hipotricose por toda a face, principalmente ao redor dos olhos, nariz e pavilhões auriculares, juntamente com hipersensibilidade dolorosa ao toque e fasciculações cutâneas na região lombar, coccígea e membros pélvicos. Foi realizado exame histopatológico das lesões de pele, onde foi visualizada dermatite superficial perivascular crônica proliferativa. Com base nos achados de exame físico e nos exames complementares, o animal foi diagnosticado com síndrome da hiperestesia felina secundária à dermatopatia.