Tridimensional models and radiographic study of dorsal laminectomy and thoracolumbar hemilaminectomy in dogs

Purpose: To create three-dimensional anatomical models of the thoracic and lumbar portions of the canine spine that reproduce the vertebral surgical approaches of dorsal laminectomy and hemilaminectomy, and to perform the respective radiographic evaluations of each approach. Methods: In a digital archive of the canine spine, digitally replicate the dorsal laminectomy and hemilaminectomy in the thoracic and lumbar portions and, then, make tridimensional prints of the vertebral models and obtain radiographs in three dorsoventral, ventrodorsal and laterolateral projections. Results: The anatomical models of the surgical spinal canal accesses of the thoracic and lumbar portions showed great fidelity to the natural bones. The created accesses have the proper shape, location and size, and their radiographic images showed similar radiodensities. Conclusions: The replicas of the dorsal laminectomy and hemilaminectomy developed in the anatomical models in the thoracic and lumbar portions are able to represent the technical recommendations of the specialized literature, as well as their respective radiographic images, which have certain radiological properties that allow to make a deep radiological study. Therefore, the models are useful for neurosurgical training.

Gurltia paralysans infection in a domestic cat in the São Paulo state, southeastern Brazil

Gurltia paralysans is a nematode first described in 1933 in Chile, causing a syndrome called feline crural parasitic paraplegia. Insects, mollusks, frogs, lizards, and rodents are paratenic hosts of this nematode, and cats probably become infected by ingesting them. This report aims to discuss the main anatomopathological findings of gurltiosis in a cat submitted to necropsy in a laboratory in Ribeirão Preto city, São Paulo state, southeastern Brazil, being the first case reported in this state. The main necroscopic findings were extramedullary reddened areas below the leptomeninges in the cervical and lumbar segments of the spinal cord. The histopathological examination showed marked thickening of the leptomeninges in the lumbar segment of the spinal cord, with marked neovascularization and fibrosis associated with eosinophilic and mononuclear inflammatory infiltration, as well as the presence of intravascular nematodes. The diagnosis of this lesion was chronic segmental meningomyelitis associated with intralesional parasites. Although uncommon, feline gurltiosis is a neglected parasitic disease that should be included as a differential diagnosis of paraparesis in domestic cats.(AU)

Biomechanical study of partial lateral corpectomy with or without an association with pediculectomy and hemilaminectomy in canine specimens / Estudo biomecânico de corpectomia lateral parcial com ou sem associação com pediculectomia e hemilaminectomia em espécimes caninos

The present objective was to increase the number of biomechanical cycles performed using non-chondrodystrophic dog specimens, based on the study by Araújo (2017), comparing partial lateral corpectomy (PLC) alone, corpectomy and pediculectomy, and PLC associated with pediculectomy and hemilaminectomy to determine if there are significant differences between them regarding deformation versus applied force. Groups were divided as: control (G1), corpectomy (G2), corpectomy +pediculectomy (G3), and corpectomy + pediculectomy + hemilaminectomy (G4). The level of displacement versus force was observed during axial compression, flexion, extension, right and left lateral bending, and right and left axial rotation. Significant differences were observed between groups for flexion, extension, right and left axial rotation, and left lateral bending, whereas there was no difference for axial compression and right lateral bending. PLC and PLC with pediculectomy had significant differences in flexion and in extension, similar to PLC associated with pediculectomy and with hemilaminectomy in right and left axial rotation, flexion, extension, and right lateral bending.

O presente objetivo foi, a partir de grupos de espécimes caninas não condrodistróficas, aumentar o número de ciclos biomecânicos realizados, com base no estudo de Araújo (2017), comparando-se corpectomia parcial lateral (CPL) isolada, corpectomia e pediculectomia, à CPL associada à pediculectomia e à hemilaminectomia, no intuito de determinar se há diferenças significativas entre eles quanto à deformação versus à força aplicada. Os grupos foram divididos em: controle (G1), corpectomia (G2), corpectomia + pediculectomia (G3) e corpectomia + pediculectomia + hemilaminectomia (G4). O nível de deslocamento versus a força foi observado durante a compressão axial, a flexão, a extensão, a flexão lateral direita e esquerda e a rotação axial direita e esquerda. Observaram-se diferenças significativas entre os grupos para flexão, extensão, rotação axial direita e esquerda e flexão lateral esquerda, ao passo que, na compressão axial e na flexão lateral direita, não houve diferença. CPL e CPL com pediculectomia tiveram diferenças significativas na flexão e na extensão, semelhantemente à CPL associada à pediculectomia e à hemilaminectomia nos movimentos de rotação axial direita e esquerda, flexão, extensão e flexão lateral direita.

Steroid-responsive myelitis in dogs - comparison with steroid-responsive meningitis-arteritis

Background: Myelitis is the inflammation of the spinal cord parenchyma alone, whereas meningitis is the inflammation of the meninges. Steroid-responsive meningitis-arteritis (SRMA) is a meningomyelitis in which the major lesions involve the meninges, not the spinal cord parenchyma, and respond well to glucocorticoid treatment. However, myelitis in dogs has rarely been reported, and myelitis with a good response to glucocorticoid treatment without relapse has not been reported. This report describes 5 cases of steroid-responsive myelitis (SRM) in dogs. Cases: Case 1. A 8-year-old intact female Cocker Spaniel presented with progressive nonambulatory paraplegia. Whole spinal parenchymal lesions were identified using magnetic resonance imaging (MRI) scan. Mononuclear pleocytosis with increased total protein levels was the only abnormal finding on cerebrospinal fluid (CSF) analysis. Prednisolone (PDS) was administered followed by dose tapering according to therapeutic response. Cyclosporine was administered until the termination of PDS. Since then, no recurrence of neurological symptoms has been observed. Follow-up MRI and CSF analysis revealed resolution of previously observed abnormal findings. Case 2. A 2-year-old intact female Maltese presented with non-progressive paraparesis. A spinal parenchymal lesion in the lumbosacral region was observed on MRI. PDS was administered and slowly tapered at approximately 3-week intervals. No recurrence of neurological symptoms was observed after the treatment. Case 3. A 6-year-old intact female Miniature Pinscher presented with neck pain, along with leukocytosis and neutrophilia. Cervical spinal parenchyma lesions were revealed through MRI. Increased total protein concentration with mixed cell pleocytosis was observed on CSF analysis. Immunomodulatory therapy, similar to that in case 2, was initiated. A second MRI and CSF analysis revealed an improvement in the previously observed abnormalities. Case 4. A 2-year-old, intact female Toy Poodle presented with acute paraplegia and back pain. Lesions were observed in the spinal parenchyma at the T12-L3 levels on MRI. The treatment was conducted as in case 2. During treatment, neurological symptoms, including paraplegia and back pain, were not observed. Follow-up MRI revealed improvement in the spinal lesion. Case 5. A 6-month-old, castrated male Standard Poodle presented with progressive paraparesis. On MRI, lesions were observed in the T11-T13 regions. Immunomodulation therapy, similar to that in case 2, was initiated. No recurrence of neurological symptoms was observed after treatment initiation Discussion: SRM is similar to SRMA in terms of good steroid-responsiveness and noninfectious inflammation etiology; however, it does not exactly satisfy the diagnostic criteria for SRMA, nor does it progress similarly. The characteristics of SRM that do not satisfy the diagnostic criteria of SRMA include the absence of fever, C-reactive protein elevation, hyperglobulinemia, and relapse, and the presence of spinal parenchymal lesions without parenchymal or meningeal enhancement on MRI. It is also a seemingly different from spinal cord-only meningoencephalomyelitis of unknown origin due to its better treatment response and prognosis. However, the dogs in the present report with SRM satisfied the diagnostic criteria for transverse myelitis in human patients. Therefore, SRM, including good steroid responsiveness and good prognosis without relapse, may represent a novel type of meningomyelitis.

Finite element analysis of a new intervertebral disc prosthesis developed for the canine cervical spine / Elementos finitos de uma nova prótese de disco intervertebral desenvolvida para a coluna cervical canina

Cervical spondylomyelopathy (CSM) is a disease that affects mostly large- and giant-breed dogs. It is characterized by abnormalities of the cervical spine that may cause damage to the spinal cord and nerve roots. Cervical disc arthroplasty has been proposed as a treatment option in veterinary medicine. The current study evaluated the main stresses in a novel canine vertebral disc prosthesis and vertebral bodies using finite element analysis. Two experimental groups were created based on the material used for the prosthesis: stainless steel group (SSG) and titanium alloy group (TAG). Vertebral and prosthetic average equivalents von-Mises stress (VMS) and minimum principal stress (MiPS) were assessed while compressive, tensile, and lateral bending shear loads were applied. The stainless steel group had greater VMS distribution on all the evaluated parameters while the titanium alloy group had greater MiPS. Stresses were more concentrated on the lateral and ventral surfaces of the vertebral bodies than on their endplates. The average prosthetic stresses were more concentrated on the bone/implant contact surface than on the prosthesis/screw interface. Maximum stresses were concentrated in the screws' cranial surface. The novel prosthesis allows even distribution along the vertebral body. Comparing prosthesis materials, titanium alloy was marginally superior regarding average stresses in all directions and should be less likely to suffer subsidence.

Espondilomielopatia cervical (EMC) é uma doença que geralmente afeta cães de raças grandes e gigantes. Ela é caracterizada por anormalidades da coluna cervical que podem causar danos à medula espinhal ou às raízes nervosas. Artroplastia cervical com prótese de disco tem sido proposta como opção de tratamento na medicina veterinária. O presente estudo teve como objetivo avaliar os principais estresses em uma nova prótese de disco intervertebral canina e corpos vertebrais por meio da análise de elementos finitos. Foram compostos dois grupos experimentais que representaram o material constituinte da nova prótese: grupos aço inoxidável (SSG) e o liga de titânio (TAG). Tensões equivalente de von-Mises (VMS) e tensão principal mínima (MiPS) média foram avaliadas sob forças de compressão, tração e torção para vértebras e prótese. O grupo SSG teve maior distribuição de VMS para todos parâmetros avaliados, enquanto o grupo TAG teve maior MiPS. Estresses estiveram mais concentrados nas superfícies lateral e ventral dos corpos vertebrais do que nas placas terminais. Os estresses médios da prótese foram mais concentrados na superfície de contato osso/implante do que na interface prótese/parafuso. Estresses máximos foram concentrados na superfície cranial do parafuso. A nova prótese permitiu distribuição uniforme do estresse ao longo do corpo vertebral. Comparando os materiais da prótese, a liga de titânio foi marginalmente superior quanto aos estresses médios em todas as direções, sendo menos provável que sofra afundamento da prótese.

Equine herpesvirus myeloencephalopathy

Clinical History: A euthanized, 14-year-old, Warmblood gelding that had participated in an equine show was presented for necropsy and diagnostic workup to the San Bernardino laboratory of the California Animal Health and Food Safety Laboratory System. The animal had a 4-day history of mildly swollen limbs and hyperthermia, and developed neurologic signs shortly before euthanasia. Necropsy Findings: The urinary bladder had multifocal to coalescing hemorrhages in the mucosa and approximately 5 ml of turbid urine with sandy sludge (Figure 1). The entire spinal cord was removed and cross-sectioned serially after fixation in 10% neutral-buffered formalin during 48h. Multifocally, in multiple sections of the cervical, thoracic, and lumbar segments, there were uni- or bilateral and asymmetrical, wedge-shaped areas of gray discoloration and hemorrhage (Figures 2-4). In addition, there were extensive hemorrhages around the nerve roots of the cauda equina. Follow-up questions: Five differential diagnoses for the gross lesions in the spinal cord (Fig. 1B-1D) Microscopic description for the lesions in the spinal cord (Fig. 2A-2D) Most likely cause based on clinical history and gross and microscopic findings.

Relation of fibrocartilaginous embolism and acute and non-compressive nucleus pulposus extrusion with imaging tests: case report / Relação de embolia fibrocartilaginosa e extrusão aguda e não-compressiva do núcleo pulposus com testes de imagem: relato de caso

Fibrocartilaginous embolism (FCEM) and acute, non-compressive nucleus pulposus extrusion (ANNPE) are non-compressive myelopathies that are difficult to differentiate. The definitive diagnosis is obtained only with histology, but the presumptive diagnosis is made through clinical signs and imaging tests. The aim of this study is to report the imaging tests performed for the diagnosis of a neurological clinical case and discuss the best diagnostic method. After attending the patient, complementary tests were requested. Radiography results showed no change. The computed tomography diagnostic impression indicated distal protrusion between C6-C7, T11-T12, T13-L1 followed by mild spinal cord compression defined by the presence of a ventral hyperattenuating region. Magnetic resonance (RMI), showed a slight T2W hypersignal, well delimited in the gray matter, lateralized to the right, over the cranial third of C7. Concluding that the magnetic resonance is the method that brought more information for the diagnosis, in which the others were not described medullary alterations pertinent to FCEM and ANNPE. With their fair prognosis, the absence of histological diagnosis of these diseases may be a limiting factor in this study and, in relation to the RMI alterations being very similar between FCEM and ANNPE it is not possible to diagnose fully accurately.

A embolia fibrocartilaginosa (EFC) e a extrusão aguda não compressiva do núcleo pulposo (EANCNP) são mielopatias não compressivas de difícil diferenciação. O diagnóstico definitivo é obtido apenas com a histologia, mas o diagnóstico presuntivo é feito por meio de sinais clínicos e exames de imagem. O objetivo deste trabalho é relatar os exames de imagem realizados para o diagnóstico de um caso clínico neurológico e discutir o melhor método diagnóstico. Após o atendimento do paciente, foram solicitados exames complementares. Os resultados da radiografia não mostraram nenhuma alteração. A impressão diagnóstica da tomografia computadorizada indicou protrusão distal entre C6-C7, T11-T12, T13-L1, seguida de leve compressão medular definida pela presença de região hiperatenuante ventral. À ressonância magnética (RM), apresentava discreto hipersinal em T2W, bem delimitado na substância cinzenta, lateralizado à direita, sobre o terço cranial de C7. Concluiu-se que a ressonância magnética é o método que mais trouxe informações para o diagnóstico, os demais métodos não foram descritos alterações medulares pertinentes à EFC e à EANCNP. Com seu prognóstico favorável, a ausência de diagnóstico histológico dessas doenças pode ser um fator limitante neste estudo. Em relação às alterações do RM serem muito semelhantes entre EFC e EANCNP, não é possível diagnosticar com total precisão.

Vacuolização neuronal e degeneração espinocerebelar em filhote de Rottweiler / Neuronal vacuolation and spinocerebellar degeneration in a Rottweiller puppy

Background: Spinocerebellar degenerations and neuronal vacuolations are alterations characterized by the formation of vacuoles in the nervous tissue, commonly called status spongiosus. This condition occurs in young Rottweiler dogs causing a disease called Neuronal Vacuolation and Spinocerebellar Degeneration. Clinically, it presents with ataxia of the pelvic limbs, which evolves to generalized ataxia, tetraparesis, and laryngeal paralysis. Histologically, spongiform and vacuolar alterations of the neuropil and neurons are highlighted. This reports a case of neuronal vacuolation and spinocerebellar degeneration in a Rottweiler puppy. Case: Necropsy was performed on the cadaver of a 5-month-old Rottweiler bitch that had been presenting with ataxia for approximately 1 month, in addition to dyspnea, pulmonary crepitations, and microphthalmia. Macroscopic evaluation revealed pale ocular and oral mucosae; marked gastric dilatation and abdominal distension; pulmonary hemorrhage and edema; hepatosplenomegaly; fatty degeneration of the liver; and congestion of meningeal blood vessels. Microscopically, histological evaluation of the spinal cord showed an increase in gray matter cellularity with marked presence of oligodendrocytes and microglia cells; moderate to severe multifocal intracytoplasmic micro- and macrovacuoles with displacement of the neurons' nuclei to the periphery of the cell; central chromatolysis of the neurons adjacent to neurons affected by vacuolation; and mild multifocal necrosis associated with mild multifocal neuronophagia. The white matter exhibited discrete digestion chambers, in addition to marked diffuse congestion of the leptomeninges. In the cerebellum, neurons in the nerve nuclei (emboliform, globose, and fastigial) showed moderate multifocal vacuoles in the cytoplasm, whereas adjacent neurons showed central chromatolysis, necrosis, and mild neuronophagia. Additional histological findings included lymphoid hyperplasia, fatty degeneration of the liver, pulmonary edema, and pulmonary hemorrhage. Discussion: Spongiform and degenerative encephalopathies are diseases recognized worldwide, mainly in cattle and sheep. However, the identification of these changes in new species has led to the need for further investigations. In dogs, the first reports occurred in 1995 and 1997 in Rottweiler animals. This disease affects young dogs, and although its pathogenesis is not completely known, it is believed to be associated with a genetic mutation in the RAB3GAP1 gene. Clinically, it is associated with clinical neurological manifestations, including progressive ataxia of the pelvic limbs, changes in spinal reflex, disordered proprioceptive reactions, laryngeal paralysis, as well as behavioral and gait alterations. In the clinical evaluation, leukoencephalomyelopathy and neuroaxonal dystrophy should be diseases considered as possible differential diagnoses, as they present with similar alterations. However, in histological evaluation, the exclusion of both is basically due to the absence of neuronal vacuolization. Unfortunately, the definitive diagnosis is only made post mortem, through a histopathological evaluation of the nervous tissue. Because it is a disease whose pathogenesis is little known and which shows signs of having a genetic character, histopathological examination for diagnostic purposes in young animals with neurological signs is of great importance.

Lafora's disease in a free-ranging toco toucan (Ramphastos toco) with neurologic disease

Lafora's disease is a genetic disease associated to mutations in genes that encodes laforin and malin, which results in intracellular polyglucan storage. The present report describes a case of Lafora's disease in a toco toucan with episodes of incoordination and myoclonus that resulted in traumatic lesions and fracture of the left hindlimb. The bird was euthanized and submitted to necropsy. Microscopically there were abundant PAS-positive and diastasis-resistant Lafora's inclusion bodies in neurons in the cerebellum, supporting the diagnosis of Lafora's disease.(AU)

Concomitant occurrence of multicentric hemangiosarcoma and histiocytic sarcoma in a dog

Histiocytic sarcoma (HS) is uncommon malignant neoplasia of round cells with marked predilection in Rottweiler and Bernese Mountain. The disseminated form, which mainly affects the spleen, lungs, lymph nodes, bone marrow, skin, and subcutis, presents a quick and aggressive clinical behavior. Hemangiosarcoma (HAS) is a malignant neoplasm of endothelial vessel cells commonly reported to affect the right atrium of dogs' hearts. A male Rottweiler, five years old, presented flaccid paraplegia and progressive muscular atrophy in the temporal, masseter, and limbs muscles; Due to the clinical stage of the animal, euthanasia was conducted. During the necroscopic examination, it was noticed that several masses presented different sizes; some were whitish, and others were reddish and spread in multiple organs (lungs, heart, spleen, stomach, kidneys, brain, medulla, skeletal muscle, and pre-scapular lymph node). Microscopically, in some organs such as the stomach, right ventricle, lungs, and medulla, it was noticed a proliferation of myeloid cells, highly cellular, with poor demarcation, no encapsulation, and with the infiltrative growth pattern of cells with high pleomorphism. Numerous tumoral emboli were observed in the spleen, brain, skeletal muscle, and lymph node. These cells were submitted for immunohistochemistry and were positive for CD18 (HS antibody). In the right atrium, liver, and kidney it was observed malignant and infiltrative endothelial proliferation (HSA) and emboli in the medulla. Therefore, we conclude that both neoplasms (HS and HSA) cause the animal's paraplegia due to their embolism and metastasis to the spinal cord and skeletal muscle.(AU)

Potential of marine compounds in the treatment of neurodegenerative diseases: a review / Potencial de compostos marinhos no tratamento de doenças neurodegenerativas: uma revisão

Neurodegenerative diseases (ND) are characterized, especially, by the progressive loss of neurons, resulting in neuropsychomotor dysfunctions. Even with a high prevalence, NDs are treated with drugs that alleviate the symptoms of patients, but which develop adverse events and still do not inhibit the progression of the disease. Thus, within a new pharmacological perspective, this review aimed to verify the therapeutic potential of natural compounds of marine origin against ND. For this, an integrative review was carried out, according to the PRISMA methodology, which included steps such as: search, pre-selection and inclusion of articles. The results described revealed species such as Acaudina malpodioides, Holothuria scabra and Xylaria sp., which presented important evidence in relation to Alzheimer's, reducing the generation of ROS, presenting neuroprotective effects and reducing the concentration of Aß peptide. Regarding Parkinson's disease (PD), another example of ND, the bioactive compounds from Holothuria scabra and Xylaria sp., showed to be able to reduce the degeneration of dopaminergic neurons, reduce the deposition of alpha synuclein and reduce the formation of Mutant Huntingtin protein (Mhtt). The other marine compounds and bioactive substances are also described in this review. In conclusion, the evaluated studies indicate that compounds of marine origin emerge as a promising source of bioactive compounds, revealing an important therapeutic potential for the treatment of ND.

As doenças neurodegenerativas (ND) são caracterizadas, especialmente, pela perda progressiva de neurônios, resultando em disfunções neuropsicomotoras. Mesmo apresentando uma alta prevalência, as DN são tratadas com medicamentos que aliviam os sintomas dos pacientes, mas que desenvolvem eventos adversos e ainda não inibem a progressão da doença. Assim, dentro de uma nova perspectiva farmacológica, esta revisão teve como objetivo verificar o potencial terapêutico de compostos naturais de origem marinha frente às DN. Para tal, foi realizada uma revisão integrativa, segundo a metodologia PRISMA que compreendeu etapas como: busca, pré-seleção e inclusão dos artigos. Os resultados descritos revelaram espécies como, Acaudina malpodioides, Holothuria scabra e Xylaria sp., que apresentaram importantes evidências em relação ao Alzheimer, reduzindo a geração de ROS, apresentando efeitos neuroprotetores e reduzindo a concentração de peptídeo Aß. Sobre a doença de Parkinson (PD), outro exemplo de ND, os compostos bioativos da Holothuria scabra e da Xylaria sp., mostraram ser capazes de diminuir a degeneração de neurônios dopaminérgicos, reduzir a deposição de alfa sinucleína e reduzir a formação de agregados da proteína Huntingtina mutante (Mhtt). Os outros compostos marinhos e substâncias bioativas também são descritos nesta revisão. Em conclusão, os estudos avaliados indicam que os compostos de origem marinha despontam como uma promissora fonte de compostos bioativos, revelando um importante potencial terapêutico para o tratamento das ND.

Physiological gait test: an effective method for analyzing balance, locomotion, and neuromuscular disorders in rats and a comparison to the elevated beam test / Teste de marcha fisiológica: um método eficaz para analisar distúrbios de equilíbrio, locomoção e neuromusculares em roedores

The evaluation of animal locomotor activity is a behavioral tool widely used to measure the mechanisms underlying a particular disease, disorder, or injury, as well as the effects of exposure to a xenobiotic. The elevated beam test is one of the most used tests in rodents to assess balance and motor coordination. Despite being inexpensive and utilizing a simple apparatus, the high beam test requires a long period of animal training and habituation. The development and characterization of an alternative test, namely the gait test, has the potential to circumvent the time and effort required for animal training, deeming it an effective, inexpensive, and fast method for the analysis of behaviors that are comparably assessed by the high beam test. Therefore, the present study focused on determining the effectiveness and feasibility of the gait test for assessing rodent locomotion and balance as a replacement for the elevated beam test. For this purpose, male rats were divided into three groups: one control group exposed to a saline solution (NaCl 0.9%) and two experimental groups exposed to a single dose of either 0.2 or 1.0 mg/kg of ivermectin intraperitoneally for induction of locomotor disturbance. The high beam and gait tests were performed 15 min and 24 h after drug administration. Results show that the experimental groups had difficulty performing the tasks of either test at both time points analyzed compared to the control groups. At the high beam, experimental animals had trouble maintaining balance and walking. At the gait test, experimental animals showed alterations in gait, which were quantitated by: (a) shortening of step length, (b) decrease of stride, (c) altered step symmetry, and (d) altered stride area. Such results are indicative of compensatory efforts and were comparable between both tests. Altogether, the data indicate that the gait test meets all requirements for assessing motor coordination in rodents. The gait test is therefore validated as a complement to the elevated beam test for the study and analysis of neurodegenerative impairment and other disorders involving neuromuscular disturbances.(AU)

A avaliação da atividade locomotora animal é uma ferramenta comportamental bastante utilizada para mensurar os mecanismos subjacentes a uma determinada doença, distúrbio ou lesão e efeitos da exposição a um xenobiótico. Um dos testes mais utilizados em roedores para avaliar o equilíbrio e coordenação motora é o teste da trave elevada que, apesar de ser um teste barato e que exige um aparato simples, é necessário um longo período de treino e habituação dos animais. O desenvolvimento e caracterização de um teste alternativo, chamado de teste da marcha, tem o potencial de contornar o tempo e o esforço necessários ao treino dos animais, considerando-o um método eficaz, barato e rápido para a análise de comportamentos avaliados comparativamente pelo alto teste de feixe. Portanto, o presente estudo concentrou-se em determinar a eficácia e viabilidade do teste de marcha para avaliação da locomoção e equilíbrio de roedores em substituição ao teste da trave elevada. Para isso, ratos machos foram divididos em 3 grupos, sendo 1 grupo controle exposto à solução salina (NaCl 0,9%) e 2 grupos experimentais expostos à dose única de 0,2 e 1,0 mg/kg de ivermectina por via intraperitoneal para indução da alteração locomotora. Os testes de trave elevada e marcha foram realizados 15 min e 24 h após a administração da droga. Os resultados mostram que os grupos experimentais tiveram dificuldade em realizar as tarefas de qualquer teste em ambos os momentos analisados em comparação com os grupos de controle. Na trave elevada, os animais experimentais tiveram dificuldade em manter o equilíbrio e andar. No teste de marcha, os animais experimentais apresentaram alterações na marcha, que foram quantificadas por: (a) encurtamento do comprimento da passada, (b) diminuição da passada, (c) alteração da simetria da passada e (d) alteração da área da passada. Tais resultados são indicativos de esforços compensatórios e foram comparáveis entre os dois testes. Em conjunto, os dados indicam que o teste de marcha atende a todos os requisitos para avaliação da coordenação motora em roedores. O teste de marcha é, portanto, validado como um complementar para o teste da trave elevada e para o estudo e análise de comprometimento neurodegenerativo e outros distúrbios envolvendo distúrbios neuromusculares.(AU)

Empiema epidural espinhal em gato com suspeita de linfoma em canal vertebral / Spinal epidural empyema in a cat with suspect of spinal canal lymphoma

Background: Spinal epidural empyema (SEE) is a rare disease in cats that has been described as a cause of severe compressive myelopathy. It is characterized by accumulation of purulent exudate in the form of an abscess in the epidural space. Neurological signs range from spinal hyperesthesia to rapidly progressive paraplegia and may be associated with systemic signs. Spinal lymphoma is the most common neoplasm affecting the central nervous system of cats and can mimic different neoplasms and non-neoplastic diseases, such as SEE. The aim of this study is to report a case of SEE in a cat and highlight the similarities in neurological, laboratory, and imaging findings between this disease and spinal lymphoma. Case: A 8-month-old male neutered mixed-breed cat was referred to the Veterinary Medical Teaching Hospital (HVU) of the UFSM with acute, non-progressive paraplegia. On neurological examination, the patient was paraplegic with no nociception, normal spinal reflexes, increased muscle tone in the pelvic limbs, absence of cutaneous trunci reflex, and spinal hyperesthesia between T13-L1, demonstrating injury in the T3-L3 spinal cord segment. The differential diagnoses included acute spinal cord trauma, neoplasm (lymphoma), and infectious diseases. Hemogram showed lymphocytosis (8062/µL); the biochemical examinations were unremarkable. Tests for antibodies against feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) antigens were negative. Simple radiography, abdominal ultrasonography, and cerebrospinal fluid findings were also normal. Myelography showed left dorsolateral extradural spinal cord compression from T12 to L1. Based on these findings, the presumptive diagnosis was spinal lymphoma and chemotherapy was initiated. After 2 days, the animal began to show hyporexia, adipsia, vomiting, and diarrhea, in addition to an increase in subcutaneous volume in the thoracolumbar region. Antibiotic therapy was initiated; however, the patient died. Necropsy revealed an abscess in the left dorsolateral extradural space at T12-T13 and T13-L1. Bacterial cultures revealed the presence of Neisseria spp. that was resistant to various antibiotics. On the basis of these findings, the animal was diagnosed with SEE. Discussion: This case report aims to inform veterinarians about the diagnosis of SEE. SEE is a rare condition in cats compared to spinal lymphoma; however, their presentation is similar. Even in imaging examinations, such as magnetic resonance imaging, it is not possible to differentiate between these 2 conditions. The evolution of clinical signs made the diagnosis of the present case difficult since it was acute and not progressive. All cases of SEE reported in the literature were progressive, acute, or chronic. Although testing for FeLV was negative, only 56% of cats with spinal lymphoma test positive for this virus. Clinical signs reported by the owner after the start of chemotherapy may be related to adverse effects, such as immunosuppression, which led to worsening of the condition, culminating in the appearance of a subcutaneous abscess. Subsequently, SEE was suspected; however, surgical decompression was not performed as the animal died soon after. The authors of this report reinforce the need for a definitive and non-presumptive diagnosis of spinal lymphoma to initiate chemotherapy because it mimics different neoplasms and non-neoplastic diseases, such as SEE. Surgical removal of the compressive mass in the spinal cord and histopathological analyses are necessary.

Physical therapy modalities in the rehabilitation of cats (Felis catus) with neurological and orthopedic conditions / Modalidades terapêuticas na reabilitação de gatos (Felis catus) com doenças neurológicas e ortopédicas

This retrospective study described the therapeutic modalities used for the rehabilitation of cats with neurological and orthopedic diseases and provided data regarding the number of sessions, frequency, and treatment duration; the study also evaluated the modality acceptance by this species. Twenty cats were selected, 11 with neurological diseases and nine with orthopedic conditions. Acute spinal cord trauma and femoral fracture were the most frequently observed neurological (72.7%) and orthopedic (44.4%) conditions, respectively. Manual therapies comprised of passive stretching (PS), passive range of motion (PROM), and bicycle movement (BM) exercises were included in all the protocols.Therapeutic modality acceptance was positive for physical agents, thermotherapy, and hydrotherapy (100%);in manual therapies, it was positive in 40% and partially positive in 60% of cats; in kinesiotherapy, it was positive for all the assisted active exercises and negative for the active exercises. The number of physical therapy sessions significantly influenced the positive acceptance of PS (P < 0.05). The PS, PROM, and BM exercises were the most commonly used modalities; the number of physiotherapy sessions and duration of treatment were higher in cats with neurological diseases, and acceptance was positive in most therapeutic modalities.

RESUMO: O objetivo deste estudo retrospectivo foi descrever as modalidades terapêuticas utilizadas na reabilitação de gatos com doenças neurológicas e ortopédicas em um centro de reabilitação, fornecer dados referentes ao número de sessões, a frequência, a duração do tratamento e avaliar a aceitação das modalidades pela espécie. Foram selecionados 20 gatos, sendo, 11 com doenças neurológicas e nove com afecções ortopédicas. O trauma agudo de medula espinhal e a fratura de fêmur foram as doenças neurológicas (72,7%) e ortopédicas (44,4%) mais observadas, respectivamente. As terapias manuais compostas pelos exercícios de alongamento passivo (AP), movimentação passiva articular (MPA) e movimento em bicicleta (MB) foram incluídas em 100% dos protocolos. A aceitação das modalidades terapêuticas foi positiva para os agentes físicos, termoterapia e hidroterapia (100%); nas terapias manuais, foi positiva em 40% e parcialmente positiva em 60% dos gatos e, na cinesioterapia, foi positiva para os exercícios ativos assistidos em 100% e negativa para os exercícios ativos. O número de sessões de fisioterapia influenciou significativamente na aceitação positiva do alongamento passivo (P < 0,05). O AP, a MPA, o MB foram as modalidades mais utilizadas; o número de sessões de fisioterapia e a duração do tratamento foram maiores nos gatos com doenças neurológicas e a aceitação foi positiva na maioria das modalidades terapêuticas.

Focal spinal hyperesthesia as a prognostic factor in paraplegic dogs without deep pain perception / Hiperestesia espinhal focal como fator prognóstico em cães paraplégicos sem percepção de dor profunda

Intervertebral disc extrusion (IVDE) is the most common cause of spinal cord compression in dogs, whose prognosis is variable and depends on several factors, with deep pain perception (DPP) being the main parameter used. Investigations of new prognostic factors are studied to assist in the estimation of functional recovery. Thus, this study aimed to evaluate whether spinal hyperesthesia (SH) at the compression site can be used as a prognostic factor for the functional recovery of dogs with acute IVDE (Hansen type I), without DPP being subjected to thoracolumbar hemilaminectomy. Decompression surgery was performed on the same day or the day after admission. The duration of the loss of DPP until surgery performance ranged from 1 to 60 days, with a median of 4.5 days for the group of dogs with SH and 5.5 days for those without SH. Among the 68 dogs included in this retrospective study, 73.5% (50/68) showed SH, and 26.5% (18/68) were not identified. Recovery was satisfactory in 60% (30/50) of dogs with SH and in 27.7% (5/18) of dogs without SH, demonstrating that paraplegic dogs without DPP but with SH were 3.9 times more likely to recover when compared to dogs in the same condition, but with no SH. No studies have evaluated SH by palpation of the spine as a prognostic factor, which reinforces the relevance of the present study. The results of this study imply that SH in paraplegic dogs affected by thoracolumbar IVDE, without the presence of DPP, can be used as a possible prognostic indicator of functional recovery.

A extrusão do disco intervertebral (EDIV) é a causa mais comum de lesão compressiva na medula espinhal de cães, cujo prognóstico é variável e depende de diversos fatores, sendo a percepção de dor profunda (PDP) o principal parâmetro utilizado. Pesquisas de novos fatores prognósticos são estudados com intuito de auxiliar na estimativa mais precisa de recuperação funcional. Com isso, o objetivo do estudo foi avaliar se a hiperestesia espinhal (HE) no local da compressão, pode ser utilizada como um fator prognóstico para recuperação funcional de cães com extrusão aguda do disco intervertebral (Hansen tipo I), sem a presença de PDP submetidos a hemilaminectomia toracolombar. A cirurgia descompressiva ocorreu no mesmo dia ou no dia seguinte ao atendimento. A duração da perda de dor profunda até a realização da cirurgia variou de 1 a 60 dias, com uma mediana de 4,5 dias para o grupo de cães com e 5,5 dias para aqueles sem hiperestesia espinhal. Dos 68 cães incluídos nesse estudo retrospectivo, 73,5% (50/68) apresentavam HE e, em 26,5% (18/68) a dor não foi identificada. A recuperação foi satisfatória nos cães com HE em 60% (30/50) e, sem HE, em 27,7% (5/18) dos casos, demonstrando que os cães paraplégicos sem PDP, mas com presença de hiperestesia espinhal tem 3,9 vezes mais chances de recuperação quando comparado com cães na mesma condição, mas sem HE. Não foram encontrados trabalhos que avaliaram a HE mediante a palpação da coluna vertebral como um fator prognóstico, o que reforça a relevância do presente estudo. Os resultados do presente trabalho sugerem que a HE em cães paraplégicos acometidos por EDIV toracolombar sem presença de PDP pode ser utilizada como um possível indicador prognóstico de recuperação funcional.

Prevalence and clinical features of neurological disorders in dogs attended at Federal Rural University of Rio de Janeiro (2017-2018) / Caracterização clínica dos distúrbios neurológicos observados em cães atendidos na Universidade Federal Rural do Rio de Janeiro (2017-2018)

Neurological disorders are frequent in small animal veterinary clinics and studies giving regional justification for such disorders are essential so that veterinarians can be better prepared. The objective of this retrospective study was to describe the clinical and epidemiological aspects of dogs with neurological disorders treated at the Veterinary Hospital of Federal Rural University of Rio de Janeiro, between August 2017 and April 2018. The study describes the location of the lesions and their etiology according to the acronym VITAMIN-D, as well as the distribution of cases according to sex, breed and age. One hundred and twenty-two (122) dogs were included, of which 58% (n=71) were males and 42% (n=51) females. The age distribution ranged from two months to 18 years old; 16% were less than two years old, 50% between two and seven years old and 34% were more than seven years old. The most affected breeds were Mixed Breed dogs (43%), Poodles (9%) and Dachshunds (7%). The diagnoses were confirmed in 54 animals (44%) and in 68 (56%) remained presumptive. The most common location was the spinal cord (61%), where the T3-L3 region was the most affected (35%), followed by multifocal (20%) and forebrain (10%). The most frequent categories were degenerative (24%), inflammatory/infectious (23%) and traumatic (20%) diseases. Intervertebral disc disease was the most observed, corresponding to 21.3% of all cases. The results showed that the neurological diseases in this Veterinary Hospital were more prevalent in young male adults with spinal cord diseases of degenerative nature.(AU)

Desordens neurológicas são frequentes na clínica de pequenos animais. Estudos caracterizando a casuística regio-nal são fundamentais para melhor instrução e preparo técnico do médico veterinário. O objetivo deste trabalho retrospectivo foi descrever os aspectos clínicos e epidemiológicos de cães com distúrbios neurológicos atendidos no Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro, entre agosto de 2017 e abril de 2018, caracterizando a localização da lesão e etiologia de acordo com o acrônimo VITAMINA-D, bem como a distribuição dos casos em relação ao sexo, raça e faixa etária. Foram incluídos 122 cães, com 58% (n=71) dos casos em machos e 42% (n=51) em fêmeas. A distribuição etária variou de dois meses a 18 anos, sendo 16% dos animais menores de dois anos, 50% entre dois e sete anos e 34% maiores de sete anos. As raças mais observadas foram SRD (43%), Poodle (9%) e Dachshund (7%). O diagnóstico etiológico foi confirmado em 54 animais (44%) e em 68 (56%) permaneceu como presuntivo. A localização mais comum foi na medula espinhal (61%), sendo a região entre T3-L3 a mais acometida (35%), seguida por multifocal (20%) e prosencéfalo (10%). As categorias mais frequentes foram de doenças degenerativas (24%), inflamatórias/infecciosas (23%) e traumáticas (20%). Dos cães com doenças degenerativas, a doença do disco intervertebral foi mais observada (21,3% do total dos casos). Com base nos resultados obti-dos, pode-se concluir que, na casuística regional deste Hospital, as doenças neurológicas foram mais prevalentes em machos, adultos jovens e com localização medular de origem degenerativa.(AU)

Clinical and pathological aspects of an outbreak of Streptococcus suis serotype 9 infection in pigs / Aspectos clínicos e patológicos de um surto de infecção por Streptococcus suis sorotipo 9 em suínos

Streptococcus suis is a Gram-positive pathogen that inhabits the upper respiratory tract and can cause severe systemic inflammatory disease in pigs, mainly during the nursery phase. Streptococcus suis is a reemergent pathogen, and outbreaks of its inducing disease represent significant economic losses for the pig industry worldwide. In this study, we described the clinical, pathological, and molecular aspects of an outbreak of S. suis infection with atypically high mortality. The outbreak occurred in nursery farms integrated into a cooperative in the state of Paraná, Brazil. Of the 30 nurseries, 10 were severely affected by the pathogen and had high economic losses. Clinical signs usually started approximately 10 days after weaning and were mainly characterized by acute nervous and locomotor disorders. The mortality of the affected batches usually ranged between 8% and 10%, but in some cases, it reached 18%. Nine piglets were submitted to post mortem examination. Macroscopically, the synovial joints were enlarged and contained fibrinous exudates. In the central nervous system, there was hyperemia of the leptomeningeal vessels associated with deposition of fibrin and purulent exudate in the leptomeninges. In three piglets, there was thickening of the choroid plexus associated with dilation of the lateral ventricles. Microscopic lesions were characterized mainly by fibrinosuppurative inflammation, which involved the synovial membranes, leptomeninges of the brain, and spinal cord. Furthermore, it also affects the choroid plexus, ependyma, nerve roots, and central canal of the spinal cord. S. suis was isolated from the cerebrospinal fluid, meningeal swabs, and/or synovial fluid of 8/9 piglets, and typified as serotype 9 by multiplex PCR.

Streptococcus suis é um patógeno Gram positivo que habita o trato respiratório superior e pode causar doença inflamatória sistêmica grave em suínos, principalmente durante a fase de creche. Streptococcus suis é um patógeno reemergente e surtos representam perdas econômicas significativas a suinocultura mundial. Neste estudo descrevemos os aspectos clínicos, patológicos e moleculares de um surto de infecção por S. suis com mortalidade atipicamente alta. O surto ocorreu em creches integradas a uma cooperativa do estado do Paraná, Brasil. Das 30 creches, 10 foram severamente afetadas pelo patógeno e apresentavam elevadas perdas econômicas. Os sinais clínicos iniciavam em torno de 10 dias após o desmame e eram caracterizados principalmente por sinais clínicos nervosos e locomotores agudos. A mortalidade dos lotes afetados variava entre 8% e 10%, mas em alguns casos ultrapassava 18%. Nove leitões foram submetidos ao exame post mortem. Macroscopicamente, as articulações sinoviais estavam aumentadas e continham exsudato fibrinoso. No sistema nervoso central havia hiperemia dos vasos leptomeníngeos associada a deposição de fibrina e exsudato purulento nas leptomeninges. Em três leitões havia espessamento do plexo coroide associado a dilatação dos ventrículos laterais. As lesões microscópicas eram caracterizadas principalmente por inflamação fibrinossupurativa que envolvia as membranas sinoviais, as leptomeninges do cérebro e medula espinhal. Além disso, também afetava o plexo coroide, epêndima, raízes nervosas e canal central da medula espinhal. S. suis foi isolado do líquido cefalorraquidiano, suabe de meninge e/ou líquido sinovial de 8/9 leitões e tipificado como sorotipo 9 por PCR multiplex.

Compressive lesions in the central nervous system of cattle: a retrospective study of 50 cases in the Amazon biome / Lesões compressivas no sistema nervoso central de bovinos: um estudo retrospectivo de 50 casos no bioma amazônico

The present study gathered epidemiological and clinical-pathological information about cattle with compressive lesions in the central nervous system (CNS). The retrospective study included observations made in 50 cattle from 1998 to 2021 by reviewing the clinical records of animals with compressive lesions in the CNS treated at the Veterinary Hospital of the Veterinary Medicine Institute of the Federal University of Pará. The animals had clinical signs and were subjected to general and specific clinical examination of the nervous system. Blood samples were collected from 13 animals for complete blood counts, and cerebrospinal fluid (CSF) samples were collected from four animals for physical evaluation. Twenty-nine cattle underwent necropsy. The most affected sites were the T3-L3 (46%, 23/50), C1-C5 (22%, 11/50), C6-T2 (14%, 7/50), sacrococcygeal vertebrae, (4%, 2/50), L4-S2 (2%, 1/50), brain (8%, 4/50) and cerebellum (4%, 2/50). The age of the affected cattle ranged from 20 days to 16 years, with a higher occurrence in animals younger than 12 months (56%, 28/50). More Females were affected (58%, 29/50) than males (42%, 21/50). The clinical signs varied according to the location of the lesion and were mainly represented by ataxia, paresis or paralysis of the limbs, inability to stand and walk, postural changes, hyperesthesia in the extremities, and loss of skin sensitivity at the location of the lesion. The necropsy findings revealed changes such as abscesses in the vertebral body; intervertebral space in the medullary canal, pituitary and cerebellum; granuloma in the arch of the vertebra; fractures of the body of the vertebrae; subarachnoid haematoma; congenital bone alteration causing spinal cord compression; and spondylitis. Detailed anamnesis and clinical examination of the CNS, associated with necropsy findings, were important to determine the cause of the disease, correlate with the clinical picture and locate the affected segments of the CNS in the cattle. It is important to include these diseases in the list of differential diagnoses in cattle with nervous symptoms.

O presente trabalho reúne informações epidemiológicas e clínicopatológicas de bovinos com lesões compressivas no sistema nervoso central (SNC). O estudo retrospectivo compreendeu as observações realizadas em 50 bovinos durante os anos de 1998 a 2021, por meio da revisão dos arquivos de fichas clínicas de animais com lesões compressivas no SNC atendidos pelo Hospital Veterinário do Instituto de Medicina Veterinária da Universidade Federal do Pará. Os animais atendidos com sinais clínicos foram submetidos a exame clínico geral e específico do sistema nervoso. Foram coletadas amostras de sangue de 13 animais para realização de hemograma e amostras de líquido cefalorraquidiano de quatro animais para avaliação física. Foram submetidos à necropsia 29 bovinos. Os locais mais acometidos foram as vértebras T3-L3 (46%, 23/50), C1-C5 (22%, 11/50), C6-T2 (14%, 7/50), sacrococcígea (4%, 2/50) e L4-S2 (2%, 1/50); cérebro (8%, 4/50) e cerebelo (4%, 2/50). A idade dos bovinos afetados variou de 20 dias a 16 anos, com maior ocorrência em animais com menos de 12 meses (56%, 28/50). As fêmeas foram mais acometidas (58%, 29/50) do que os machos (42%, 21/50). Os sinais clínicos variaram de acordo com a localização da lesão e foram representados principalmente por ataxia, paresia ou paralisia dos membros, incapacidade de se levantar e de ficar em estação, alterações posturais, hiperestesia nas extremidades, além de perda da sensibilidade cutânea relacionada com a localização da lesão. Os achados de necropsia revelaram alterações como abscessos no corpo vertebral, no espaço intervertebral, no canal medular, para-hipofisário e no cerebelo; granuloma no arco da vértebra, fraturas do corpo das vértebras; hematoma subaracnoide; alteração óssea congênita causando compressão medular e espondilite. Anamnese detalhada e exame clínico do SNC, associados aos achados de necropsia foram importantes para determinar a causa da doença, correlacionar com o quadro clínico e localizar os segmentos acometidos do SNC dos bovinos. Torna-se importante incluir estas enfermidades na lista de diagnósticos diferenciais em bovinos que apresentem sintomatologia nervosa.

Cystitis in a bitch with chronic kidney disease caused by multidrug-resistant Escherichia coli

Background: In dogs with bacterial cystitis that is resistant to multiple antibiotics, resulting from repeated infections andantimicrobial administration, especially if the dog has impaired renal function and the induction of systemic side effectsby intravenous or oral administration is a concern, intravesical instillation of antibiotics might represent an alternativetreatment option. In human and veterinary medicine, a number of studies showed intravesical instillation of antibiotics iseffective for the therapy multidrug-resistant bacterial urinary tract infection (UTI). This report firstly illustrates successfulintravesical meropenem treatment of a UTI caused by multidrug-resistant Escherichia coli with no systemic side effectsin dog with chronic kidney disease (CKD).Case: A 15-year-old spayed female Maltese was presented with recurrent bacterial cystitis. The risk factors for the recurrent UTI were spinal cord injury and CKD which had been managed for 1 year. Ultrasound-guided cystocentesis wasperformed to obtain a urine sample for urinalysis, bacteriologic culture, and antibiotic susceptibility testing. Bacterialcystitis caused by multidrug-resistant Escherichia coli was diagnosed on the basis of bacterial culture, and antimicrobialsusceptibility testing. Because the dog had CKD, reducing the clearance of meropenem, intravesical instillation of antibiotics was initiated. The intravesical instillation process consisted of the emptying of the urinary bladder, infusion of adiluted meropenem solution (8.5 mg/kg diluted in 20 mL of saline solution) into the bladder through a urethral catheter,and retention of the meropenem solution in the bladder for 1 h, and its removal. The procedure was repeated every 8 h. Onday 8 of the intravesical instillation therapy, bactereologic culture yielded a growth of E. coli (50,000 CFUs/mL), whichwas less than previously obtained. the concentration of the meropenem solution...

Cystitis in a bitch with chronic kidney disease caused by multidrug-resistant Escherichia coli

Background: In dogs with bacterial cystitis that is resistant to multiple antibiotics, resulting from repeated infections andantimicrobial administration, especially if the dog has impaired renal function and the induction of systemic side effectsby intravenous or oral administration is a concern, intravesical instillation of antibiotics might represent an alternativetreatment option. In human and veterinary medicine, a number of studies showed intravesical instillation of antibiotics iseffective for the therapy multidrug-resistant bacterial urinary tract infection (UTI). This report firstly illustrates successfulintravesical meropenem treatment of a UTI caused by multidrug-resistant Escherichia coli with no systemic side effectsin dog with chronic kidney disease (CKD).Case: A 15-year-old spayed female Maltese was presented with recurrent bacterial cystitis. The risk factors for the recurrent UTI were spinal cord injury and CKD which had been managed for 1 year. Ultrasound-guided cystocentesis wasperformed to obtain a urine sample for urinalysis, bacteriologic culture, and antibiotic susceptibility testing. Bacterialcystitis caused by multidrug-resistant Escherichia coli was diagnosed on the basis of bacterial culture, and antimicrobialsusceptibility testing. Because the dog had CKD, reducing the clearance of meropenem, intravesical instillation of antibiotics was initiated. The intravesical instillation process consisted of the emptying of the urinary bladder, infusion of adiluted meropenem solution (8.5 mg/kg diluted in 20 mL of saline solution) into the bladder through a urethral catheter,and retention of the meropenem solution in the bladder for 1 h, and its removal. The procedure was repeated every 8 h. Onday 8 of the intravesical instillation therapy, bactereologic culture yielded a growth of E. coli (50,000 CFUs/mL), whichwas less than previously obtained. the concentration of the meropenem solution...(AU)