Non-invasive monitoring of intracranial pressure waveforms using Braincare® BCMM 2000 monitor in dogs with myelopathies undergoing myelography / Monitoramento não invasivo do formato das ondas de pressão intracraniana usando o monitor Braincare® BCMM 2000 em cães com mielopatias submetidos à mielografia

ABSTRACT: Intracranial pressure (ICP) monitoring is considered the gold standard for optimizing the treatment of humans in intensive care units. However, this procedure is not commonly performed in veterinary medicine because of the limitations and complications of the method. There are some new promising non-invasive techniques for monitoring ICP, but they have not been validated in veterinary medicine. This study aimed to correlate the non-invasive intracranial pressure (NI-ICP) waveforms obtained with the BCMM-2000 Brain4care monitor during myelography in dogs with myelopathies undergoing this exam for diagnostic purposes with the waveforms obtained through invasive monitoring of the subarachnoid pressure (SP). The NI-ICP waveform was monitored in six dogs with myelopathies before (M1), during (M2), and after (M3) contrast medium injection into the subarachnoid space. Cerebrospinal fluid (CSF) was collected before contrast injection. The SP waveform was simultaneously monitored in three of the six dogs. Correlations between the two methods were performed using Pearson's coefficient. The analysis of the morphology and amplitude of the waves at each moment was performed, and at M2, an increase in the P2:P1 ratio (p<0.05) was observed in both monitoring methods. In M3, the values were similar to those of M1, demonstrating the return of cerebral compliance. The comparison of the NI-ICP and SP had a positive correlation in those moments (Pearson's coefficient r=0.76; p=0.027). The speed of contrast administration, degree of spinal cord compression, and volume of CSF previously collected may affect P2:P1 and ICP dynamics. The BCMM-2000 Brain4care monitor was effective in detecting changes in ICP dynamics and abnormal pulse waveforms in dogs with meningoencephalitis of unknown origin, vertebral neoplasm and intervertebral disc disease with and without hemorrhagic myelomalacia, suggesting increased ICP induced by myelography.

RESUMO: A monitorização da pressão intracraniana (PIC) é considerada o padrão ouro para otimizar o tratamento de humanos em unidades de terapia intensiva, entretanto, esse procedimento não é comumente realizado na medicina veterinária devido às limitações e complicações do método. Existem algumas técnicas não invasivas promissoras de monitoramento da PIC, mas elas não foram validadas na medicina veterinária. Este estudo teve como objetivo correlacionar os formatos das ondas não invasivas da PIC (NI-PIC), obtidas com o monitor BCMM-2000 Brain4care, antes e após a injeção de meio de contraste no espaço subaracnóideo de cães com mielopatias submetidos à mielografia para fins diagnósticos, com as formas de onda obtidas por meio de monitoração invasiva da pressão subaracnóidea (PS). O formato das ondas NI-PIC foram monitoradas em seis cães com mielopatias antes (M1), durante (M2) e após (M3) injeção de meio de contraste no espaço subaracnóideo. O líquido cefalorraquidiano (LCR) foi coletado antes da injeção de contraste. A forma da onda da PS foi monitorada simultaneamente em três dos seis cães. As correlações entre os dois métodos foram feitas usando o coeficiente de Pearson. Foi realizada a análise da morfologia e amplitude das ondas em cada momento, e em M2 observou-se aumento da relação P2:P1 (p<0,05) em ambos os métodos de monitoramento. Em M3, os valores foram semelhantes aos de M1, demonstrando o retorno da complacência cerebral. A comparação do NI-PIC e PS apresentou correlação positiva nesses momentos (coeficiente de Pearson r=0,76; p=0,027). A velocidade de administração do contraste, o grau de compressão da medula espinhal e o volume de LCR coletado anteriormente podem afetar a dinâmica P2:P1 e PIC. O monitor BCMM-2000 Brain4care foi eficaz na detecção de alterações na dinâmica da PIC e dos formatos das ondas de pulso anormais em cães com meningoencefalite de origem desconhecida, neoplasia vertebral e doença do disco intervertebral com e sem mielomalácia hemorrágica, sugerindo aumento da PIC induzida pela mielografia.

Microsurgery versus embolization: different risk factors for short- and long- term outcomes of patients with ruptured aneurysms

Purpose: To evaluate the risk factors for poor outcomes after surgical and endovascular treatment of aneurysmal subarachnoid hemorrhage (aSAH). Methods: Patients with ≥ 18-years of age and aSAH were included, while patients who died within 12 h of admission or lost follow-up were excluded. All participants underwent standardized clinical and radiological assessment on admission and were reassessed at discharge and at 6-months follow-up using the Glasgow Outcome Scale (GOS). Results: Death at discharge was associated with female gender, anterior communication artery (ACoA) aneurysm location and presence of atherosclerotic plaque in the surgical group, and with age in the endovascular group. Both groups had clinical condition on follow-up associated with mFisher score on admission and hypertension. GOS on follow-up was also associated with presence of atherosclerotic plaque and multiple aneurysms in surgical group, and with age in endovascular group. Conclusions: Subjects treated surgically are prone to unfavorable outcomes if atherosclerotic plaques and multiple aneurysms are present. In patients with endovascular treatment, age was the main predictor of clinical outcome.

Assessing ultrasonographic optic nerve sheath diameter in animal model with anesthesia regimens

Purpose: To determine the normal optical nerve sheath (ONS) diameter ultrasonography (ONSUS) and evaluate the possible effects of drugs on ONS diameter during anesthetic induction in healthy pigs. Methods: Healthy piglets were divided into three groups: a control group, that received xylazine and ketamine (X/K); other that received xylazine, ketamine and propofol (X/K/P); and a third group that received xylazine, ketamine, and thiopental (X/K/T). The sheath diameter was assessed by ultrasonography calculating the average of three measurements of each eye from the left and right sides. Results: 118 animals were anesthetized (49 X/K 33 X/K/P and 39 X/K/T). Mean ONS sizes on both sides in each group were 0.394 ± 0.048 (X/K), 0.407 ± 0.029 (X/K/P) and 0.378 ± 0.042 cm (X/K/T) (medians of 0.400, 0.405 and 0.389, respectively). The ONS diameter varied from 0.287-0.512 cm (mean of 0.302 ± 0.039 cm). For group X/K, the mean diameter was 0.394 ± 0.048 cm. Significant differences in ONS sizes between the groups P and T (X/K/P > X/K/T, p = 0.003) were found. No statistically significant differences were detected when other groups were compared (X/K = X/K/P, p = 0.302; X/K = X/K/T, p = 0.294). Conclusions: Sedation with thiopental lead to significative ONS diameter reduction in comparison with propofol. ONSUS may be useful to evaluate responses to thiopental administration.

Ulinastatin alleviates early brain injury after intracerebral hemorrhage by inhibiting necroptosis and neuroinflammation via MAPK/NF-κB signaling pathway

Purpose: Spontaneous intracerebral hemorrhage (ICH) is a major public health problem with a huge economic burden worldwide. Ulinastatin (UTI), a serine protease inhibitor, has been reported to be anti-inflammatory, immune regulation, and organ protection by reducing reactive oxygen species production, and inflammation. Necroptosis is a programmed cell death mechanism that plays a vital role in neuronal cell death after ICH. However, the neuroprotection of UTI in ICH has not been confirmed, and the potential mechanism is unclear. The present study aimed to investigate the neuroprotection and potential molecular mechanisms of UTI in ICH-induced EBI in a C57BL/6 mouse model. Methods: The neurological score, brain water content, neuroinflammatory cytokine levels, and neuronal damage were evaluated. The anti-inflammation effectiveness of UTI in ICH patients also was evaluated. Results: UTI treatment markedly increased the neurological score, alleviate the brain edema, decreased the inflammatory cytokine TNF-α, interleukin­1ß (IL­1ß), IL­6, NF­κB levels, and RIP1/RIP3, which indicated that UTI-mediated inhibition of neuroinflammation, and necroptosis alleviated neuronal damage after ICH. UTI also can decrease the inflammatory cytokine of ICH patients. The neuroprotective capacity of UTI is partly dependent on the MAPK/NF-κB signaling pathway. Conclusions: UTI improves neurological outcomes in mice and reduces neuronal death by protecting against neural neuroinflammation, and necroptosis.

Complications after cerebrospinal fluid collection in dogs with brain neoplasm / Complicações após colheita do líquido cerebroespinhal em cães com neoplasma encefálico

Cerebrospinal fluid (CSF) collection in dogs with brain neoplasms (BN) may be associated with complications owing to increased intracranial pressure caused by expansive lesions. Although this procedure has been performed in dogs with BN, no data regarding complications after CSF tap in these animals is available. Thus, this retrospective study aimed to identify the rate and types of complications observed after CSF taps in dogs with BN. Thirty dogs with BN were included in the study. In 83% (25/30) of the cases, clinical recovery after CSF tap was considered normal, and in 17% (5/30) the recovery was abnormal. The main clinical and neurological signs observed in dogs with abnormal clinical recovery were apnea (5/5), absence of pupillary photomotor reflex (3/5), coma (2/5), and stupor (1/5). In 40% (2/5) of the dogs, herniation of the cerebellum through the foramen magnum was observed on necropsy. In conclusion, the rate of complications after CSF taps was 17%, and was characterized by apnea, absent pupillary photomotor reflex, altered level of consciousness, and encephalic herniation.

A colheita do líquido cerebroespinhal (LCE) em cães com neoplasmas encefálicos (NE) pode estar associada a complicações devido ao aumento da pressão intracraniana (PIC), causada pela lesão expansiva. Embora o procedimento seja realizado em cães com NE, não foram encontrados dados referentes às complicações após colheita de LCE nesses pacientes. Sendo assim, o objetivo do presente estudo retrospectivo foi identificar a taxa, bem como os tipos de complicações observadas após a colheita de LCE em cães com neoplasma encefálico. Dos 30 cães com NE incluídos no estudo, em 83% (25/30) dos casos a evolução clínica após a colheita do LCE foi considerada normal e, em 17% (5/30) anormal. Os principais sinais clínicos e neurológicos observados nos cães com evolução clínica anormal foram apneia (5/5), reflexo fotomotor pupilar ausente (3/5), coma (2/5) e estupor (1/5). Em 40% (2/5) foi observado herniação do cerebelo na necropsia. Com base nos resultados encontrados, conclui-se que a taxa de complicações após a colheita de LCE foi baixa (17%) e as alterações encontradas foram apneia, seguido de reflexo fotomotor pupilar ausente, alteração no nível de consciência e herniação encefálica.

Compressive lesions in the central nervous system of buffaloes / Lesões compressivas no sistema nervoso central de bubalinos

This study describes, through a retrospective study, the epidemiological and clinical-pathological findings of compression in the central nervous system (CNS) of buffaloes. The study includes observations made in 15 animals from 1998 to 2021 by reviewing the clinical records of animals with compressive injuries of the CNS treated at the Veterinary Hospital of the Veterinary Medicine Institute of the Federal University of Pará. The animals treated with clinical signs compatible with CNS compressive lesions were subjected to general and specific clinical examinations of the nervous system. Blood samples were collected from four animals for complete blood counts, and cerebrospinal fluid (CSF) samples were collected from three animals for physical evaluation. Thirteen animals were necropsied. The age range of the affected animals ranged from four months to 11 years of age, with a greater frequency over age 12 months (80%, 13/15). The most affected vertebral segment was between T3 and L3 (60%, 9/15), followed by brain injury (20%, 3/15), the L4-S2 segment (13.3%, 2/15) and the C1-C5 segment (6.7%, 1/15). The clinical findings varied according to the location of the lesion. The necropsy findings revealed paraypophyseal abscess in the brainstem and vertebral body, subarachnoid hematoma, lymphoma and vertebral fractures. The performance of a thorough clinical examination of the CNS combined with the necropsy findings was important to characterize the clinical picture and to locate the cause and the affected CNS segments in the buffaloes studied. It is important to include CNS compressive lesions among the neurological diseases of buffaloes.

Esse trabalho descreve, através de estudo retrospectivo, os achados epidemiológicos e clínico-patológicos de compressão no sistema nervoso central (SNC) de bubalinos. O estudo compreendeu as observações realizadas em 15 animais, 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 compatíveis com lesões compressivas no SNC foram submetidos a exames clínicos geral e específico do sistema nervoso. Foram coletadas amostras de sangue de quatro animais para realização de hemograma e amostras de líquido cefalorraquidiano (LCR) de três animais para avaliação física. Foram necropsiados 13 animais. A faixa etária dos animais acometidos variou de quatro meses a 11 anos de idade, com maior frequência na faixa acima de 12 meses (80%, 13/15). O segmento vertebral mais acometido foi entre T3-L3 (60%, 9/15), seguida por lesão no encéfalo (20%, 3/15), pelo segmento L4-S2 (13,3%, 2/15) e pelo segmento C1-C5 (6,7%, 1/15). Os achados clínicos variaram de acordo com a localização da lesão. Os achados de necropsia revelaram abscesso parahipofisário, no tronco encefálico e no corpo da vértebra, hematoma subaracnoidea, linfoma e fraturas vertebrais. A realização de um minucioso exame clínico do SNC associado aos achados de necropsia foram importantes para caracterizar o quadro clínico e localizar a causa e os seguimentos acometidos do SNC nos búfalos estudados. Torna-se importante incluir as lesões compressivas do SNC entre as enfermidades neurológicas dos bubalinos.

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.

Hydrogen-rich saline alleviates early brain injury through regulating of ER stress and autophagy after experimental subarachnoid hemorrhage

ABSTRACT Purpose: Subarachnoid hemorrhage (SAH) is a common complication of cerebral vascular disease. Hydrogen has been reported to alleviate early brain injury (EBI) through oxidative stress injury, reactive oxygen species (ROS), and autophagy. Autophagy is a programmed cell death mechanism that plays a vital role in neuronal cell death after SAH. However, the precise role of autophagy in hydrogen-mediated neuroprotection following SAH has not been confirmed. Methods: In the present study, the objective was to investigate the neuroprotective effects and potential molecular mechanisms of hydrogen-rich saline in SAH-induced EBI by regulating neural autophagy in the C57BL/6 mice model. Mortality, neurological score, brain water content, ROS, malondialdehyde (MDA), and neuronal death were evaluated. Results: The results show that hydrogen-rich saline treatment markedly increased the survival rate and neurological score, increased neuron survival, downregulated the autophagy protein expression of Beclin-1 and LC3, and endoplasmic reticulum (ER) stress. That indicates that hydrogen-rich saline-mediated inhibition of autophagy and ER stress ameliorate neuronal death after SAH. The neuroprotective capacity of hydrogen-rich saline is partly dependent on the ROS/Nrf2/heme oxygenase-1 (HO-1) signaling pathway. Conclusions: The results of this study demonstrate that hydrogen-rich saline improves neurological outcomes in mice and reduces neuronal death by protecting against neural autophagy and ER stress.

Effects of lumbar myelography on subarachnoid pressure and cardiorespiratory parameters in healthy sheep / Efeitos da mielografia lombar na pressão subaracnoidea e nos parâmetros cardiorrespiratórios em ovelhas saudáveis

The purpose of this study was to evaluate the effects of lumbar myelography on subarachnoid pressure, cardiorespiratory parameters and pressure-volume index in sheep. Eight sheep were evaluated. The animals were submitted to puncture of the cisterna magna for monitoring of subarachnoid pressure (SaP). Lumbar myelography was performed through applying Iohexol (0.4mL/kg). ToC, PAS, PAD, MAP, InspISO, FeISO, SaP and CPP were recorded immediately after anesthetic stabilization (M0), during lumbar puncture (M1), and two, four and six minutes after contrast application (M2, M3 and M4, respectively). Blood pressure initially increased, then decreased, returning to basal level, similarly observed for InspISo and FeISo. The SaP rose initially thereafter remaining stable. Despite of the effect on subarachnoid pressure, lumbar myelography can be considered safe in sheep.(AU)

O objetivo foi avaliar os efeitos da mielografia lombar na pressão subaracnóidea, parâmetros cardiorrespiratórios e índice pressão-volume em ovinos. Oito ovelhas foram avaliadas. Os animais foram submetidos à punção da cisterna magna para monitoramento da pressão subaracnoidea (SaP). A mielografia lombar foi realizada com a aplicação de Iohexol (0,4mL/kg). Os momentos estudados foram: imediatamente após a estabilização anestésica (M0), durante a punção lombar (M1), dois, quatro e seis minutos após a aplicação do contraste (M2, M3 e M4, respectivamente), para avaliar as seguintes variáveis: ToC, PAS, PAD, MAP, InspISO, FeISO, Sap e CPP. A pressão arterial aumentou inicialmente, depois diminuiu, retornando aos valores iniciais, padrão também observado para o InspISo e o FeISo. O SaP subiu inicialmente, posteriormente, permanecendo estável. A mielografia lombar, apesar de influenciar a pressão subaracnoidea, pode ser considerada segura em ovinos.(AU)

Effects of lumbar myelography on subarachnoid pressure and cardiorespiratory parameters in healthy sheep / Efeitos da mielografia lombar na pressão subaracnoidea e nos parâmetros cardiorrespiratórios em ovelhas saudáveis

The purpose of this study was to evaluate the effects of lumbar myelography on subarachnoid pressure, cardiorespiratory parameters and pressure-volume index in sheep. Eight sheep were evaluated. The animals were submitted to puncture of the cisterna magna for monitoring of subarachnoid pressure (SaP). Lumbar myelography was performed through applying Iohexol (0.4mL/kg). ToC, PAS, PAD, MAP, InspISO, FeISO, SaP and CPP were recorded immediately after anesthetic stabilization (M0), during lumbar puncture (M1), and two, four and six minutes after contrast application (M2, M3 and M4, respectively). Blood pressure initially increased, then decreased, returning to basal level, similarly observed for InspISo and FeISo. The SaP rose initially thereafter remaining stable. Despite of the effect on subarachnoid pressure, lumbar myelography can be considered safe in sheep.(AU)

O objetivo foi avaliar os efeitos da mielografia lombar na pressão subaracnóidea, parâmetros cardiorrespiratórios e índice pressão-volume em ovinos. Oito ovelhas foram avaliadas. Os animais foram submetidos à punção da cisterna magna para monitoramento da pressão subaracnoidea (SaP). A mielografia lombar foi realizada com a aplicação de Iohexol (0,4mL/kg). Os momentos estudados foram: imediatamente após a estabilização anestésica (M0), durante a punção lombar (M1), dois, quatro e seis minutos após a aplicação do contraste (M2, M3 e M4, respectivamente), para avaliar as seguintes variáveis: ToC, PAS, PAD, MAP, InspISO, FeISO, Sap e CPP. A pressão arterial aumentou inicialmente, depois diminuiu, retornando aos valores iniciais, padrão também observado para o InspISo e o FeISo. O SaP subiu inicialmente, posteriormente, permanecendo estável. A mielografia lombar, apesar de influenciar a pressão subaracnoidea, pode ser considerada segura em ovinos.(AU)

Effects of lumbar myelography on subarachnoid pressure and cardiorespiratory parameters in healthy sheep

ABSTRACT: The purpose of this study was to evaluate the effects of lumbar myelography on subarachnoid pressure, cardiorespiratory parameters and pressure-volume index in sheep. Eight sheep were evaluated. The animals were submitted to puncture of the cisterna magna for monitoring of subarachnoid pressure (SaP). Lumbar myelography was performed through applying Iohexol (0.4mL/kg). ToC, PAS, PAD, MAP, InspISO, FeISO, SaP and CPP were recorded immediately after anesthetic stabilization (M0), during lumbar puncture (M1), and two, four and six minutes after contrast application (M2, M3 and M4, respectively). Blood pressure initially increased, then decreased, returning to basal level, similarly observed for InspISo and FeISo. The SaP rose initially thereafter remaining stable. Despite of the effect on subarachnoid pressure, lumbar myelography can be considered safe in sheep.

RESUMO: O objetivo foi avaliar os efeitos da mielografia lombar na pressão subaracnóidea, parâmetros cardiorrespiratórios e índice pressão-volume em ovinos. Oito ovelhas foram avaliadas. Os animais foram submetidos à punção da cisterna magna para monitoramento da pressão subaracnoidea (SaP). A mielografia lombar foi realizada com a aplicação de Iohexol (0,4mL/kg). Os momentos estudados foram: imediatamente após a estabilização anestésica (M0), durante a punção lombar (M1), dois, quatro e seis minutos após a aplicação do contraste (M2, M3 e M4, respectivamente), para avaliar as seguintes variáveis: ToC, PAS, PAD, MAP, InspISO, FeISO, Sap e CPP. A pressão arterial aumentou inicialmente, depois diminuiu, retornando aos valores iniciais, padrão também observado para o InspISo e o FeISo. O SaP subiu inicialmente, posteriormente, permanecendo estável. A mielografia lombar, apesar de influenciar a pressão subaracnoidea, pode ser considerada segura em ovinos.

Management of urethral obstruction in a cat with epidural sacrococcygeal anesthesia guided by electrical neurostimulation

Background: The treatment for urethral obstruction in cats consists of catheterization, and for this, the cat must be sedated or anesthetized. Sacococcygeal epidural block has the advantage of being close to receptors related to nociception located in the spinal cord and it is safer because it represents lower risk of spinal cord injury or inadvertent application in the subarachnoid space, when compared to the lumbosacral epidural. Nerve stimulation through the neurolocator to identify the epidural space increases the accuracy of this technique. Thus, the objective is to report a case of epidural anesthesia with a sacrococcygeal approach guided by neurostimulation in a cat with urethral obstruction. Case: A 4-year-old male Siamese cat, weighing 4 kg, was referred to the veterinary care with a history of apathy and anorexia for 2 days. From the physical exam, the clinical diagnosis of urethral obstruction was made, and to desobstruction, we chose to perform sacrococcygeal epidural block. Initially, the patient was anesthetized with propofol (4 mg/kg) and midazolam (0.3 mg/kg). To perform the anesthetic block, the cat was placed in sternal decubitus with the hind limbs extended cranially to perform sacrococcygeal epidural block. The positive pole (cathode) was connected to the skin of the right inguinal region at the caudal aspect of the thigh and the neurostimulator was turned on and adjusted to 0.7 mA of stimulating current intensity, 0.1 ms duration and 1 Hz frequency. The needle for electrical neurolocation was introduced in the dorsal midline, perpendicular to the skin surface, between the spinous processes of S3-Cd1 in the skin. The exact injection point was obtained observed by the muscular response of the middle and distal third of the animal's tail with the neurostimulator adjusted to 0.3 mA of intensity, in the same duration and frequency as before. The total volume of 0.9 mL (0.22 mL/kg) of solution containing the combination of 0.6 mL of 0.75% levobupivacaine and 0.3 mL of 2% lidocaine was injected. The success of the block was confirmed by the loss of reflexes of the pelvic limbs and anal sphincter 10 min after the administration of the anesthetic solution. Discussion: In this case, the use of the neurolocator helped to perform an effective sacrococcygeal block, allowing urethral catheterization without the addition of other analgesic agents. This technique desensitizes and relaxes muscles in the regions of the perineum, anus, distal colon and penis, being useful for performing urethral catheterization. The use of smaller anaesthetic volumes to perform sacrococcygeal block makes it possible to achieve a more localized anesthesia, without affecting the motor function of the pelvic limbs. However, in our report, using a combination of levobupivacaine and lidocaine, the pelvic limb block was also verified despite the low volume applied. A hypothesis that could justify the different responses in relation to the pelvic limb block compared to other studies would be due to the different physicalchemical properties of the drugs used. Lidocaine is known to be less fat-soluble than bupivacaine, so it tends to spread more through the epidural space, in order to result in more extensive blocks. The use of a neurostimulator using a fixed electric current of 0.7 mA, pulse 0.1 ms and a frequency of 1 Hz allowed the correct identification of the needle position for the application of the anesthetic.

First occurrence of Arnold Chiari type II malformation and associated abnormalities in a Gir calf produced in vitro from Brazil - case report / [Primeira ocorrência de malformação de Arnold Chiari tipo II e anormalidades associadas em uma bezerra Gir de produção in vitro no Brasil - relato de caso]

This study characterized the clinical, radiological, ultrasound, and necroscopic findings of a case of Arnold-Chiari type II malformation in a Gir breed calf from Brazil. The animal was hospitalized at sixty days of age, in permanent sternal recumbency, cutaneous appendix at the 4th lumbar vertebra and kyphoscoliosis of the caudal and lumbosacral thoracic spine. Radiographic examination of the spine and skull revealed spina bifida and suspected occipital hypoplasia. Upon examination of myelography with an injection of lumbar and atlantooccipital contrast, it was possible to visualize the meningocele at the 4th lumbar vertebra region and findings at the rhombencephalon level of increased regional pressure with failure to fill the contrast in the posterior fossa, in the presence of clear demarcation of the circumvolutions of the cerebral cortex and the subarachnoid space of the cervical spinal cord. Ultrasonographic examination of the cerebellum showed an insinuation of the cerebellar worm through the foramen magnum. The animal did not show changes in complete blood count, biochemical series, and cerebrospinal fluid and was negative for Pestivirus. There was a worsening of the clinical conditions and the animal died. This malformation of unknown etiology must be studied as a differential diagnosis of the nervous system disorders.(AU)

Este estudo caracterizou os achados clínicos, radiológicos, ultrassonográficos e necroscópicos de um caso de malformação de Arnold-Chiari tipo II em uma bezerra Gir no Brasil. O animal foi hospilatizado aos 60 dias de idade, apresentando decúbito esternal permanente, apêndice cutâneo na altura da quarta vértebra lombar e cifoescoliose da coluna vertebral torácica caudal e lombossacra. Ao exame radiográfico da coluna e do crânio, foram observadas espinha bífida e suspeita de hipoplasia occipital. Ao exame de mielografia com injeção de contraste lombar e atlanto-occipital, foi possivel visualizar a meningocele na altura da quarta vértebra lombar e achados em nível rombencefálico de aumento da pressão regional com falha de preenchimento do contraste na fossa posterior, na presença de nítida demarcação das circunvoluções do córtex cerebral e do espaço subaracnoide da medula espinhal cervical. Ao exame ultrassonográfico do cerebelo, foi observada insinuação do verme cerebelar através do forame magno. O animal não apresentou alterações em hemograma completo, série bioquímica e fluido cérebro-espinhal e foi negativo para Pestivirus. Houve uma piora do quadro clínico e o animal morreu. Essa malformação de etiologia desconhecida deve ser estudada como um diagnóstico diferencial.(AU)

First case report of nematode parasitic myelopathy in a wild feline in Brazil / Primeiro relato de caso de mielopatia parasitária causada por nematódeo em um felídeo selvagem no Brasil

Parasitic myelopathy caused by Gurltia paralysans in domestic cats is a disease commonly reported in several South American countries. The adult parasite is lodged in the meningeal veins and spinal cord, often causing clinical manifestations of vascular proliferation, thrombophlebitis, and medullary compression. Wild felines are believed to be the definitive hosts of this parasite. The infection occurs through the ingestion of paratenic hosts, but the life cycle of G. paralysans is not yet clearly understood. In this paper, we discuss a case of parasitic myelopathy in a margay (Leopardus wiedii) that died during post-surgical care. Necropsy revealed focal hemorrhages in the thoracolumbar spinal cord. A microscopic examination revealed adult nematodes and eggs inside the veins of subarachnoid space in spinal cord, suggesting G. paralysans infection. This is first description of parasitic myelopathy in a margay in Brazil.(AU)

Mielopatia parasitária causada por Gurltia paralysans em gatos domésticos é uma doença comumente relatada em vários países da América do Sul. O parasita adulto aloja-se nas veias das meninges e da medula espinhal, muitas vezes causando proliferação vascular, tromboflebite e compressão medular, que se manifestam como sinais clínicos. Acredita-se que os felídeos selvagens sejam hospedeiros definitivos deste parasita e que a infecção ocorre por ingestão de hospedeiros paratênicos, entretanto seu ciclo de vida completo é desconhecido. Aqui, apresentamos um caso de um gato-maracajá (Leopardus wiedii) que morreu durante a assistência pós-cirúrgica. Na necropsia, foram observadas hemorragias focais na medula espinhal toracolombar. A microscopia revelou presença de nematódeos adultos e ovos, localizados dentro das veias do espaço subaracnoide da medula espinhal, o que sugeriu a infecção por G. paralysans. Esta é a primeira descrição de mielopatia parasitária em um gato-maracajá no Brasil.(AU)

Craniosquise with meningocelis in newborn calf

Background: Cranioschisis is a malformation that occurs during embryological development and results in incomplete closure of the skull, leaving an opening through which the intracranial tissue can project. Meningocele consists of herniation of the meninges containing cerebrospinal fluid through the cranial defect. In cattle, this association usually manifested by the appearance of a floating saccular protrusion of variable size and volume in the frontal or parietal region of the cranium. This manuscript aims to report a case of cranioschisis associated with meningocele and neurological deficit in a newborn calf in the northwestern region of the state of Paraná. Case: A 2-day-old crossbred female calf was diagnosed with cranioschisis associated with meningocele in the frontal region of the head. On initial clinical examination, an ovoid mass with floating appearance was observed, extending from the supraorbital curvature of the frontal bone to the end of the nasal bones following the midline. The patient had normal parameters for the species and age and a positive sucking reflex. Neurological examination showed permanent lateral decubitus position, spastic paresis of the thoracic limbs and opisthotonus. Complementary imaging studies, including xrays and ultrasonography, showed a failure in the frontal bone, approximately 5 cm in diameter. Despite the unfavorable prognosis, surgical reduction was chosen. After drainage of the cerebrospinal fluid, excision of the meningeal sac was continuously performed, exposing the subarachnoid space, showing circular failure in the frontal bone with a diameter of 4.5 cm, making it possible to observe part of the right frontal lobe. We opted for occlusion of the bone defect by covering it with the dura mater. Absorbable 0 catgut suture was applied in a simple...(AU)

Craniosquise with meningocelis in newborn calf

Background: Cranioschisis is a malformation that occurs during embryological development and results in incomplete closure of the skull, leaving an opening through which the intracranial tissue can project. Meningocele consists of herniation of the meninges containing cerebrospinal fluid through the cranial defect. In cattle, this association usually manifested by the appearance of a floating saccular protrusion of variable size and volume in the frontal or parietal region of the cranium. This manuscript aims to report a case of cranioschisis associated with meningocele and neurological deficit in a newborn calf in the northwestern region of the state of Paraná. Case: A 2-day-old crossbred female calf was diagnosed with cranioschisis associated with meningocele in the frontal region of the head. On initial clinical examination, an ovoid mass with floating appearance was observed, extending from the supraorbital curvature of the frontal bone to the end of the nasal bones following the midline. The patient had normal parameters for the species and age and a positive sucking reflex. Neurological examination showed permanent lateral decubitus position, spastic paresis of the thoracic limbs and opisthotonus. Complementary imaging studies, including xrays and ultrasonography, showed a failure in the frontal bone, approximately 5 cm in diameter. Despite the unfavorable prognosis, surgical reduction was chosen. After drainage of the cerebrospinal fluid, excision of the meningeal sac was continuously performed, exposing the subarachnoid space, showing circular failure in the frontal bone with a diameter of 4.5 cm, making it possible to observe part of the right frontal lobe. We opted for occlusion of the bone defect by covering it with the dura mater. Absorbable 0 catgut suture was applied in a simple...

New determinants for casual peripheral mechanism of neurogenic lung edema in subarachnoid hemorrhage due to ischemic degeneration of vagal nerve, kidney and lung circuitry. Experimental study

Purpose:To evaluate whether there is a relationship between renal artery vasospasm related low glomerular density or degeneration and neurogenic lung edema (NLE) following subarachnoid hemorrhage.Methods:This study was conducted on 26 rabbits. A control group was formed of five animals, a SHAM group of 5 to which saline and a study group (n=16) injected with homologous blood into the sylvian cisterna. Numbers of degenerated axons of renal branches of vagal nerves, atrophic glomerulus numbers and NLE scores were recorded.Results:Important vagal degeneration, severe renal artery vasospasm, intrarenal hemorrhage and glomerular atrophy observed in high score NLE detected animals. The mean degenerated axon density of vagal nerves (n/mm2), atrophic glomerulus density (n/mm3) and NLE scores of control, SHAM and study groups were estimated as 2.40±1.82, 2.20±1.30, 1.80±1.10, 8.00±2.24, 8.80±2.39, 4.40±1.14 and 154.38±13.61, 34.69±2.68 and 12.19±1.97 consecutively. Degenerated vagal axon, atrophic glomerulus and NLE scores are higher in study group than other groups and the differences are statistically meaningful (p<0.001).Conclusion:Vagal complex degeneration based glomerular atrophy have important roles on NLE following SAH which has not been extensively mentioned in the literature.(AU)

Medical therapy using omeprazole in 12 hydrocephalic dogs: clinical, diagnostic, and therapeutic findings / Terapia médica utilizando omeprazol em 12 cães hidrocefálicos: achados clínicos, diagnósticos e terapêuticos

According to experimental studies with healthy dogs, omeprazole might decrease the CSF production by about 26%; therefore, book texts have been suggested the usage of omeprazole in medical protocols for hydrocephalus treatment. However, to the best knowledge of the authors, the usage and medical response of the omeprazole with substantial group of illness dogs, such as hydrocephalic animals, was lacking. This report describes clinical, diagnostic, and therapeutic findings in 12 dogs with hydrocephalus in which omeprazole were used for medical treatment. The diagnosis of hydrocephalus was accomplished by transcranial sonography (TCS) and/or computed tomography. The ventricular measurement was assessed periodically by TCS during medical treatment. Six dogs were diagnosed with non-obstrutive hydrocephalus and in the other 6 cases hydrocephalus occurred with other concomitant anomalous encephalic disease often related with obstructive hysdrocephalus, such as quadrigeminal cist, arachnoid cyst, chiary-like malformation, and syringomyelia. All of them had medical improvement after the use of omeprazole and the most of the cases had ventricular size reduction. In 10 dogs, the omeprazole was used as single drug, and in 2 dogs medical treatment with steroids and/or diuretics was previously being performed, and omeprazole was added because conventional treatment was resulting in mild to unsatisfactory medical control of the neurological status. The results of this paper shown that omeprazole may be used to ameliorate the neurological status in symptomatic hydrocephalic dogs. This work may represent the first description about the use of omeprazole in order to treat a substantial group of affected dogs with suspected increased intracranial pressure by hydrocephalus, probably due to limitation of CSF production.(AU)

O omeprazol diminui a produção do fluido cerebrospinal (FCE) por cerca de 26% de acordo com estudos experimentais em cães saudáveis. Segundo o conhecimento dos autores, embora utilizado na prática clínica e recomendado em livros textos, não há até o momento estudos clínicos em um grupo substancial de animais avaliando a resposta terapêutica ao uso do omeprazol em pacientes enfermos, tais como cães hidrocefálicos sintomáticos. Este trabalho descreve os achados clínicos, diagnósticos e terapêuticos em 12 cães com hidrocefalia que foram submetidos ao tratamento com omeprazol para o manejo médico de hidrocefalia. O diagnóstico de hidrocefalia e doenças neurológicas concomitantes foi realizado por ultrassonografia transcraniana (USTC) e/ou tomografia computadorizada. A mensuração do tamanho ventricular foi realizada pela USTC durante o tratamento médico. Seis cães foram diagnosticados com hidrocefalia não obstrutiva e os outros 6 casos apresentaram hidrofalia concomitante com outras afecções encefálicas anômalas comumente associada à hidrocefalia obstrutiva, tal como cisto quadrigêmio, cisto aracnóide, síndrome de chiari-like e seringomegalia. Em 10 cães o omeprazol foi utilizado como droga única e em 2 cães a terapia inicial foi a convencional utilizando esteroides e diuréticos, e o omeprazol foi adicionado, pois a resposta clínica a terapia convencional foi insatisfatória. Todos os animais obtiveram melhora dos parâmetros neurológicos e a maioria teve uma redução do tamanho ventricular após o uso do omeprazol. Os resultados deste estudo demonstram que o omeprazol pode ser utilizado para melhorar o estado neurológico em cães com hidrocefalia. Este estudo representa a primeira descrição clínica usando o omeprazol para tratar uma série de cães com suspeita de aumento da pressão intracraniana devido à hidrocefalia, provavelmente pela capacidade do fármaco em limitar a produção do FCE.(AU)

Medical therapy using omeprazole in 12 hydrocephalic dogs: clinical, diagnostic, and therapeutic findings / Terapia médica utilizando omeprazol em 12 cães hidrocefálicos: achados clínicos, diagnósticos e terapêuticos

According to experimental studies with healthy dogs, omeprazole might decrease the CSF production by about 26%; therefore, book texts have been suggested the usage of omeprazole in medical protocols for hydrocephalus treatment. However, to the best knowledge of the authors, the usage and medical response of the omeprazole with substantial group of illness dogs, such as hydrocephalic animals, was lacking. This report describes clinical, diagnostic, and therapeutic findings in 12 dogs with hydrocephalus in which omeprazole were used for medical treatment. The diagnosis of hydrocephalus was accomplished by transcranial sonography (TCS) and/or computed tomography. The ventricular measurement was assessed periodically by TCS during medical treatment. Six dogs were diagnosed with non-obstrutive hydrocephalus and in the other 6 cases hydrocephalus occurred with other concomitant anomalous encephalic disease often related with obstructive hysdrocephalus, such as quadrigeminal cist, arachnoid cyst, chiary-like malformation, and syringomyelia. All of them had medical improvement after the use of omeprazole and the most of the cases had ventricular size reduction. In 10 dogs, the omeprazole was used as single drug, and in 2 dogs medical treatment with steroids and/or diuretics was previously being performed, and omeprazole was added because conventional treatment was resulting in mild to unsatisfactory medical control of the neurological status. The results of this paper shown that omeprazole may be used to ameliorate the neurological status in symptomatic hydrocephalic dogs. This work may represent the first description about the use of omeprazole in order to treat a substantial group of affected dogs with suspected increased intracranial pressure by hydrocephalus, probably due to limitation of CSF production.(AU)

O omeprazol diminui a produção do fluido cerebrospinal (FCE) por cerca de 26% de acordo com estudos experimentais em cães saudáveis. Segundo o conhecimento dos autores, embora utilizado na prática clínica e recomendado em livros textos, não há até o momento estudos clínicos em um grupo substancial de animais avaliando a resposta terapêutica ao uso do omeprazol em pacientes enfermos, tais como cães hidrocefálicos sintomáticos. Este trabalho descreve os achados clínicos, diagnósticos e terapêuticos em 12 cães com hidrocefalia que foram submetidos ao tratamento com omeprazol para o manejo médico de hidrocefalia. O diagnóstico de hidrocefalia e doenças neurológicas concomitantes foi realizado por ultrassonografia transcraniana (USTC) e/ou tomografia computadorizada. A mensuração do tamanho ventricular foi realizada pela USTC durante o tratamento médico. Seis cães foram diagnosticados com hidrocefalia não obstrutiva e os outros 6 casos apresentaram hidrofalia concomitante com outras afecções encefálicas anômalas comumente associada à hidrocefalia obstrutiva, tal como cisto quadrigêmio, cisto aracnóide, síndrome de chiari-like e seringomegalia. Em 10 cães o omeprazol foi utilizado como droga única e em 2 cães a terapia inicial foi a convencional utilizando esteroides e diuréticos, e o omeprazol foi adicionado, pois a resposta clínica a terapia convencional foi insatisfatória. Todos os animais obtiveram melhora dos parâmetros neurológicos e a maioria teve uma redução do tamanho ventricular após o uso do omeprazol. Os resultados deste estudo demonstram que o omeprazol pode ser utilizado para melhorar o estado neurológico em cães com hidrocefalia. Este estudo representa a primeira descrição clínica usando o omeprazol para tratar uma série de cães com suspeita de aumento da pressão intracraniana devido à hidrocefalia, provavelmente pela capacidade do fármaco em limitar a produção do FCE.(AU)

Sonographic evaluation of the lumbosacral region for neuroaxial anaesthesia in domestic felines / Avaliação ultrassonográfica da região lombossacra para anestesia neuroaxial em felinos domésticos

The objective of this study was to describe the lumbosacral region of domestic felines using ultrasonography. The limits and dimensions of the epidural and subarachnoid spaces were identified and their correlation with sex and body score condition (BSC) were evaluated. Fourteen mongrel cat cadavers, nine males and five females, weighing between 2.0 and 4.5 kg and with BCS ranging from 2 to 5 (1–5) were used. The cadavers were put in sternal recumbency and ultrasonographic images of the lumbosacral region were obtained in the sagittal and transverse planes. There was no statistical difference in the measurements between males and females. The BCS was positively correlated with the distance between the skin and dorsal epidural space, the distance between the skin and dural sac, and the distance between the skin and the ventral floor. No correlations were identified between the BCS and the distance between epidural space and dural sac, BCS and the sagittal dural sac height, or BCS and transverse dural sac height. The study showed that animals with a higher body condition score present larger distances between structures, regardless of their sex. In addition, the sonographic study verified the close proximity of the epidural and subarachnoid spaces, highlighting the risk of inadvertent spinal puncture in felines.

O presente estudo objetivou avaliar a região lombossacra de felinos domésticos por meio da ultrassonografia, identificando os limites e dimensionando os espaços peridural e subaracnoide, relacionando essas medidas com o sexo e o escore corporal dos animais. Foram utilizados 14 cadáveres de gatos, sem raça definida, nove machos e cinco fêmeas, pesando entre 2,0 e 4,5 kg e com escore corporal variando de 2 a 5 (1-5). Para a avaliação da região lombossacra, os animais foram posicionados em decúbito esternal e imagens ultrassonográficas desta região foram adquiridas nos planos sagital e transversal. Não houve diferença estatística entre machos e fêmeas com relação às medidas. Houve correlação positiva entre o escore corporal e a distância entre a pele e o espaço peridural dorsal; escore corporal e a distância entre a pele e o saco dural; e escore corporal e a distância entre a pele e o assoalho ventral. Não foram identificadas correlações entre o escore corporal e a distância entre o espaço peridural e saco dural; escore corporal e altura do saco dural sagital; e escore corporal e altura saco dural transversal. Conclui-se que animais com maior escore corporal apresentam distâncias maiores, e não há diferença nas mensurações com relação ao sexo. Além disso, o estudo ultrassonográfico constatou a proximidade do espaço peridural e raquidiano, implicando no risco de punção inadvertida em felinos.