Resumo
Background: Ischemic neuromyopathy is the most common reason for amputation in cats. In veterinary medicine, the use of prosthetic limbs is not widespread; therefore, in most cases total limb amputation is indicated. However, hyperbaric oxygen therapy (HBOT) is an alternative with several benefits for the treatment of vascular disorders with reperfusion, ischemia, and infection. Therefore, this study aimed to report the positive effects of HBOT on the treatment of ischemic neuromyopathy secondary to arterial thromboembolism on the patient's clinical improvement, and on the preparation of the patient for insertion of an osseointegrated prosthesis. Case: A 6-month-old mixed-breed kitten returned for treatment after undergoing surgery seven days earlier for reduction of traumatic diaphragmatic hernia, during which it suffered a cardiorespiratory arrest. The patient presented with acute pelvic limb paralysis with 24-h evolution, absent femoral pulse, plantar cushions and dorsal part of the limbs cold and pale. After supportive therapy and diagnosis of aortic thromboembolism by arterial Doppler, the patient started adjunctive treatment with HBOT from the first day of hospitalization. Sessions took place in an exclusive hyperbaric chamber for animals and lasted 60 min at a pressure of 2.5 absolute atmospheres and 100% oxygen, initially every 12 h. However, during the first 5 days of hospitalization, the distal region of both pelvic limbs began to show tissue devitalization and edema, and hematologic parameters showed changes on the 7th day. The right pelvic limb (RPL) showed more involvement of superficial tissues, extending to the tarsometatarsal joint region. After 8 days of hospitalization, the devitalized tissue was debrided. The RPL had an extensive devitalized area with exposed bone in the phalanges and necrosis in the pads. The left pelvic limb (LPL) suffered minor complications, with involvement of the phalangeal region. After 12 days, with HBOT every 48 h, exuberant granulation tissue was observed. After 17 days, the patient was discharged, and HBOT sessions were performed weekly. Gangrene of the midfoot and lack of proprioception were observed in RPL, while LPL showed bone divulsion of the 1st, 3rd, and 4th phalanges. Because of the poor prognosis for limb viability, the RPL was partially amputated, and a self-threaded intraosseous prosthesis was inserted. Discussion: The cardiorespiratory arrest that occurred during the surgical procedure to reduce the diaphragmatic hernia without thromboprophylaxis may have contributed to the peripheral ischemia. HBOT was proposed for the adjuvant treatment of ischemic injury because it is especially indicated for cases of ischemia-reperfusion injury. The main hematological parameters were evaluated at an average interval of 7 days. While the platelet count and hematocrit increased, the leukocytosis decreased. This demonstrates the benefit of oxygen therapy in the reported patient. The use of HBOT in orthopedic injuries is known to result mainly in stimulation of osteoblasts, promoting osseointegration of the prosthesis. We conclude that the adjuvant treatment with HBOT helped to preserve a large segment of both pelvic limbs, prevent the progression of necrosis, and provide a healthy bed for fixation of an osseointegrated prosthesis in the RPL, resulting in clinical improvement of the patient.
Assuntos
Animais , Feminino , Gatos , Tromboembolia/terapia , Tromboembolia/veterinária , Prótese Ancorada no Osso/veterinária , Oxigenoterapia Hiperbárica/veterináriaResumo
Background: Thermography is a noninvasive, non-contact, painless, and non-ionizing imaging technique that records cutaneous thermal patterns generated by infrared emission of the surface. The surface heat is closely related to dermal microcirculation. Thromboembolism is responsible for important changes in the thermal pattern of the body surface due to physical obstruction of blood flow, being the main complication in immune-mediated hemolytic anemia. The aim of this paper is to report a dog with thrombus in his left forelimb secondary to idiopathic hemolytic anemia, whose diagnostic screening was performed through infrared thermography. Case: A 9-year-old mixed breed bitch was referred to a veterinary hospital with a history of emesis, diarrhea and dark-colored urine for 2 days. The complete blood count showed hypochromic macrocytic anemia (hematocrit [HTC] 28%, reference: 37 to 55%) with the presence of nucleated erythrocyte (14/100 leukocytes, reference: 0 to 5/100 leukocytes), polychromasia and spherocytes. Leukocytosis (28,300 mm³, reference: 6,000 to 17,000 mm³) by neutrophilia with left deviation and toxic granulations was also present, in addition to hemoglobinuria at urine exam. Therefore, treatment for immune-mediated hemolytic anemia (IMHA) was instituted. After 2 days, the animal returned with acute functional impairment of the left forelimb. Physical examination revealed that the limb was cold, without pulse, proprioception, reflexes, and deep pain. New blood analyses revealed decreased hematocrit (HTC 17%, reference: 37 to 55%), and increased total leukocyte number (57,000 mm3, reference: 6,000 to 17,000 mm³). Infrared thermography revealed an important temperature difference between the limbs, with the affected limb temperature considerably lower (31.3ºC) when compared to the contralateral limb (35.0ºC). Thermography showed the site of the thrombus in the medial portion of the limb (cephalic vein), where the catheter had been placed for fluid therapy. Due to the severity of the condition, the bitch was submitted to amputation surgery, which occurred without complications. The patient had a good response to treatment, with decreased signs of hemolysis and hypercoagulability. The medications were slowly withdrawn, and the clinical discharge occurred after 4 weeks. Discussion: In humans, thermography has been widely used in the assessment of thrombotic diseases, contributing to diagnosis, localization, and prognosis. In veterinary medicine, however, the use of this tool in the diagnosis of thromboembolism is still rare. The difference of 3.7°C between the affected and contralateral limb was objectively verified using thermography. A minimum difference of 2.4°C between limbs has high sensitivity and specificity for diagnosing thromboembolism and occurs due to the reduction in local blood flow. In the present case this tool was essential for the anatomical location of the thrombus, which was in the middle third of the forearm, and allowed an adequate surgical planning. It is known that the main complication of IMHA is thromboembolism. Its predisposing factors include venous stasis, endothelial damage, and hypercoagulability, being exacerbated by cage confinement, decubitus and presence of a peripheral venous catheter. The reported case corroborates at least one of these factors since it had a peripheral venous catheter in the left forelimb, which later showed absence of pulse, spinal reflexes, pain and proprioception. The thermography showed to be an objective, rapid and non-invasive tool to diagnose and precisely locate the thrombus, which allowed for adequate treatment and surgical planning for the case. To the best of our knowledge, this is the first report about use of thermography to diagnose thromboembolism secondary to immune-mediated hemolytic anemia in a dog.
Assuntos
Animais , Feminino , Cães , Tromboembolia/diagnóstico por imagem , Termografia/veterinária , Trombofilia/veterinária , Anemia Hemolítica/veterinária , Terapia de Imunossupressão/veterináriaResumo
Background: In cats, arterial thromboembolism is one of the most devastating diseases, with an acute presentation, andis often caused by undiagnosed cardiomyopathy. Defined as the obstruction of one or more arterial lumens by emboli,the arterial thromboembolism is responsible for hypoperfusion signs. As the temperature of the skin surface is directlyrelated to tissue perfusion, thermography can be promising for the early diagnosis of thromboembolism. Therefore, thisstudy reports the importance of thermography as a complementary examination for the diagnosis of thromboembolism inthe abdominal aorta of a domestic cat.Case: A 4-year-old mixed-breed cat weighing 2.95 kg was presented with a history of sudden onset paraplegia, apathy,and pain when handled, with greater intensity in the sacro-coccidian region. During physical exam, it was noted that thefemoral artery pulse was undetectable bilaterally during manual pulse measurement. Superficial and deep sensitivity inthe pelvic limbs and proprioception were also absent and the plantar cushions and nail beds of the posterior limbs werepale to cyanotic. Thermographic images revealed that the temperature of both hind limbs was lower than that of forelimbs,with difference of 3.2ºC and 2.9ºC between the left and right limbs, respectively. Doppler ultrasonography revealed theabsence of pulse and flow in the femoral arteries bilaterally. Electrocardiography revealed sinus tachycardia, with a heartrate of 250 bpm. Echocardiography revealed dilation of the left atrium and concentric cardiac hypertrophy. After 24 h, dueto the worsening of the clinical condition and unfavorable prognosis, the animal was euthanized and sent for necropsy.Necropsy revealed that the arterial lumen of the caudal abdominal aorta and bifurcation of the iliac arteries were obliterated...
Assuntos
Animais , Gatos , Artéria Femoral/patologia , Cardiomiopatia Hipertrófica/veterinária , Cianose/veterinária , Isquemia Miocárdica/veterinária , Tromboembolia/veterinária , Termografia/veterinária , Ultrassonografia Doppler de Pulso/veterináriaResumo
Background: In cats, arterial thromboembolism is one of the most devastating diseases, with an acute presentation, andis often caused by undiagnosed cardiomyopathy. Defined as the obstruction of one or more arterial lumens by emboli,the arterial thromboembolism is responsible for hypoperfusion signs. As the temperature of the skin surface is directlyrelated to tissue perfusion, thermography can be promising for the early diagnosis of thromboembolism. Therefore, thisstudy reports the importance of thermography as a complementary examination for the diagnosis of thromboembolism inthe abdominal aorta of a domestic cat.Case: A 4-year-old mixed-breed cat weighing 2.95 kg was presented with a history of sudden onset paraplegia, apathy,and pain when handled, with greater intensity in the sacro-coccidian region. During physical exam, it was noted that thefemoral artery pulse was undetectable bilaterally during manual pulse measurement. Superficial and deep sensitivity inthe pelvic limbs and proprioception were also absent and the plantar cushions and nail beds of the posterior limbs werepale to cyanotic. Thermographic images revealed that the temperature of both hind limbs was lower than that of forelimbs,with difference of 3.2ºC and 2.9ºC between the left and right limbs, respectively. Doppler ultrasonography revealed theabsence of pulse and flow in the femoral arteries bilaterally. Electrocardiography revealed sinus tachycardia, with a heartrate of 250 bpm. Echocardiography revealed dilation of the left atrium and concentric cardiac hypertrophy. After 24 h, dueto the worsening of the clinical condition and unfavorable prognosis, the animal was euthanized and sent for necropsy.Necropsy revealed that the arterial lumen of the caudal abdominal aorta and bifurcation of the iliac arteries were obliterated...(AU)
Assuntos
Animais , Gatos , Tromboembolia/veterinária , Artéria Femoral/patologia , Cianose/veterinária , Isquemia Miocárdica/veterinária , Cardiomiopatia Hipertrófica/veterinária , Ultrassonografia Doppler de Pulso/veterinária , Termografia/veterináriaResumo
Hemangiossarcoma é um câncer com alto poder de malignidade e metástase, tendo origem em células endoteliais de vasos sanguíneos, é frequentemente encontrado em baço, pele e raramente em cavidade nasal de cães. Foi atendido um cão, SRD, de 13 anos, com secreção nasal hemorrágica em narina esquerda e aumento de volume dorsal ao nariz que se estendia até seio frontal, com exoftalmia de globo ocular esquerdo, tendo se instalado de forma aguda. Pela radiografia de crânio nas projeções latero-lateral obliqua e dorso ventral, observou-se lise óssea dos seios nasal, frontal e orbital. Colhido material para Citopatologia, o diagnóstico presuntivo foi osteossarcoma. A fim de se planejar o ato cirúrgico, realizou se a tomografia computadorizada de crânio, que evidenciou formação na cavidade nasal esquerda, com expansão até o osso orbital, sem acometimento de linfonodos regionais. A fim de se avaliar a hemostasia e possibilidades de tromboembolismo no pós-cirúrgico, realizou-se o tromboelastograma e o paciente tinha possibilidades de realizar trombo. Ele foi operado com sucesso, removida a maior parte da massa tumoral e utilizada a eletroquimioterapia no leito cirúrgico. O diagnóstico histopatológico foi hemangiossarcoma pouco diferenciado grau 2. O paciente recebeu tratamento com anti-coagulante nos dias seguintes, teve uma recuperação satisfatória e iniciou-se a quimioterapia adjuvante com doxorubicina após 1 mês da cirurgia, entretanto, ele apresentou quadro de sangramento difuso compatível com CID e veio a óbito. Os hemangiossarcomas são raros na cavidade nasal de cães e parece adotar um pior comportamento nesta região, quando comparado ao baço e pele, inclusive com possibilidade de síndrome para-neoplásica. O trombolestograma tem se mostrado um exame importante para avaliação do equilíbrio hemostático no controle as doenças neoplásicas.
Hemangiosarcoma is a cancer with high power of malignancy and metastasis, originating in endothelial cells of blood vessels, it is often found in the spleen, skin and rarely in the nasal cavity of dogs. A dog, SRD, 13 years old, was treated with hemorrhagic nasal discharge in the left nostril and increase in volume dorsal to the nose that extended to the frontal sinus, with exophthalmos of the left eyeball, which had been installed acutely. On the skull X-ray in the lateral oblique and dorsal-ventral projections, bone lysis of the nasal, frontal and orbital sinuses was observed. After collecting material for cytopathology, the presumptive diagnosis was osteosarcoma. In order to plan the surgical act, a computed tomography scan of the skull was performed, which showed formation in the left nasal cavity, with expansion up to the orbital bone, without involvement of regional lymph nodes. In order to assess hemostasis and possibilities of thromboembolism in the postoperative period, a thromboelastogram was performed and the patient had possibilities of having a thrombus. He was successfully operated on, removing most of the tumor mass and using electrochemotherapy in the surgical bed. The histopathological diagnosis was grade 2 poorly differentiated hemangiosarcoma. The patient received treatment with anticoagulants in the following days, had a satisfactory recovery and adjuvant chemotherapy with doxorubicin was started 1 month after surgery, however, he presented compatible diffuse bleeding. with ICD and died. Hemangiosarcomas are rare in the nasal cavity of dogs and seem to have a worse behavior in this region when compared to the spleen and skin, including the possibility of paraneoplastic syndrome. The thrombolestogram has been shown to be an important test for evaluating the hemostatic balance in the control of neoplastic diseases.
Assuntos
Animais , Cães , Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/veterinária , Doxorrubicina/administração & dosagem , Coagulação Intravascular Disseminada/veterinária , Hemangiossarcoma/veterinária , Tromboelastografia/veterináriaResumo
This paper aimed to describe the main clinico-epidemiological, laboratory, and anatomopathological findings in 10 cattle affected with caudal vena cava thrombosis. The main clinical signs observed were decreased milk production, reduced appetite, apathy, impairment of ruminal motility, cardiorespiratory disorders (tachycardia and tachypnea), epistaxis, hemoptysis, and ascites. Intercurrent diseases such as mastitis, metritis, and phlebitis were verified. The hematological findings were mild anemia, leukocytosis due to neutrophilia with regenerative left shift, and hyperfibrinogenemia. The pathological exams revealed thrombi in the caudal vena cava, hepatomegaly, ascites, liver abscesses, pulmonary edema and emphysema, and abscesses in the lungs. The association of epidemiological information, clinical signs such as respiratory distress, epistaxis or hemoptysis, in addition to anemia and leukocytosis due to neutrophilia, as well as the occurrence of thrombus in the caudal vena cava as pathological findings, are indicative elements of the clinical picture of vena cava thrombosis in cattle. It is reiterated that this disease has an unfavorable prognosis and, when diagnosed, the animal must be culled.(AU)
Este trabalho teve por objetivo descrever os principais achados clínico-epidemiológicos, laboratoriais e anatomopatológicos de 10 bovinos diagnosticados com trombose da veia cava caudal. Os principais achados clínicos foram redução da produção leiteira, diminuição do apetite, apatia, comprometimento da dinâmica ruminal, alterações cardio-respiratórias (taquicardia e taquipnéia), epistaxe, hemoptise e ascite. Foi constatada a ocorrência de doenças intercorrentes como mastite, metrite e flebite. O hemograma revelou discreta anemia, leucocitose por neutrofilia com desvio para esquerda regenerativo e hiperfibrinogenemia. No exame anatomopatológico revelou trombos localizados na veia cava caudal, hepatomegalia, ascite e abscessos hepáticos; além de abscessos, enfisema e edema pulmonares. A associação de informações epidemiológicas, sinais clínicos como desconforto respiratório, epistaxe ou hemoptise, além de anemia e leucocitose por neutrofilia, bem como a ocorrência de trombo na veia cava caudal como achados patológicos são elementos indicativos do quadro clínico de trombose de veia cava em bovinos. Reitera-se que essa doença tem prognóstico desfavorável e, quando diagnosticada, o animal deve ser abatido.(AU)
Assuntos
Animais , Bovinos , Tromboembolia/patologia , Trombose/patologia , Doenças Vasculares/patologia , Bovinos , Técnicas de Laboratório Clínico/veterináriaResumo
This paper aimed to describe the main clinico-epidemiological, laboratory, and anatomopathological findings in 10 cattle affected with caudal vena cava thrombosis. The main clinical signs observed were decreased milk production, reduced appetite, apathy, impairment of ruminal motility, cardiorespiratory disorders (tachycardia and tachypnea), epistaxis, hemoptysis, and ascites. Intercurrent diseases such as mastitis, metritis, and phlebitis were verified. The hematological findings were mild anemia, leukocytosis due to neutrophilia with regenerative left shift, and hyperfibrinogenemia. The pathological exams revealed thrombi in the caudal vena cava, hepatomegaly, ascites, liver abscesses, pulmonary edema and emphysema, and abscesses in the lungs. The association of epidemiological information, clinical signs such as respiratory distress, epistaxis or hemoptysis, in addition to anemia and leukocytosis due to neutrophilia, as well as the occurrence of thrombus in the caudal vena cava as pathological findings, are indicative elements of the clinical picture of vena cava thrombosis in cattle. It is reiterated that this disease has an unfavorable prognosis and, when diagnosed, the animal must be culled.(AU)
Este trabalho teve por objetivo descrever os principais achados clínico-epidemiológicos, laboratoriais e anatomopatológicos de 10 bovinos diagnosticados com trombose da veia cava caudal. Os principais achados clínicos foram redução da produção leiteira, diminuição do apetite, apatia, comprometimento da dinâmica ruminal, alterações cardio-respiratórias (taquicardia e taquipnéia), epistaxe, hemoptise e ascite. Foi constatada a ocorrência de doenças intercorrentes como mastite, metrite e flebite. O hemograma revelou discreta anemia, leucocitose por neutrofilia com desvio para esquerda regenerativo e hiperfibrinogenemia. No exame anatomopatológico revelou trombos localizados na veia cava caudal, hepatomegalia, ascite e abscessos hepáticos; além de abscessos, enfisema e edema pulmonares. A associação de informações epidemiológicas, sinais clínicos como desconforto respiratório, epistaxe ou hemoptise, além de anemia e leucocitose por neutrofilia, bem como a ocorrência de trombo na veia cava caudal como achados patológicos são elementos indicativos do quadro clínico de trombose de veia cava em bovinos. Reitera-se que essa doença tem prognóstico desfavorável e, quando diagnosticada, o animal deve ser abatido.(AU)
Assuntos
Animais , Bovinos , Tromboembolia/patologia , Trombose/patologia , Doenças Vasculares/patologia , Bovinos , Técnicas de Laboratório Clínico/veterináriaResumo
Arterial thromboembolism (ATE) is an acute and severe clinical condition resulting from the formation of a thrombus and its accommodation in an artery, impairing the perfusion of tissues irrigated by it. In felines, it is often related to hypertrophic cardiomyopathy, but there are reports of its association with neoplasms. Ischemia and reperfusion syndrome may occur secondary to ATE and result in difficult to correct electrolyte and acid-base imbalances. The aim of the present study is to describe a case of ATE, including its clinical and laboratory findings and electrolyte and acid-base changes compatible with ischemia and reperfusion syndrome. A 14-year-old crossbreed female feline with sudden pelvic limb paralysis was treated at the Feline Medicine Service of the Federal University of Rio Grande do Sul. Clinical and laboratory alterations included hypothermia, hypotension, bradycardia, azotemia, metabolic acidosis, and hyperkalemia. The electrocardiogram indicated sinoventricular rhythm, and echocardiogram evaluation showed no alterations. Thorax radiographic evaluation revealed areas of higher radiopacity in the pulmonary fields. We opted for abdominal aorta arteriotomy as an emergency treatment for thrombus removal. The feline died in the postoperative period, and histopathological examination of lungs, mediastinal lymph nodes, and heart were performed, being compatible with pulmonary adenocarcinoma with lymph node metastasis. This study deals with a case of ATE of possible neoplastic origin, which is uncommon in cats. In this case, the patient had difficult-to-manage hemodynamic impairment, as well as electrolyte and acid-base balance disorders severe and refractory to therapy, culminating in death. The time to start treatment from the presentation of clinical signs may be determinant in therapeutic success, reducing the possible effects of reperfusion syndrome.(AU)
O tromboembolismo arterial (TEA) é uma condição clínica aguda e grave decorrente da formação de um trombo e seu alojamento em uma artéria, prejudicando a perfusão dos tecidos irrigados por ela. Em felinos, está frequentemente relacionado com a cardiomiopatia hipertrófica, porém existem relatos da sua associação com neoplasias. A síndrome de isquemia e reperfusão pode ocorrer secundária ao TEA e resultar em desequilíbrios eletrolíticos e ácido-base de difícil correção. O objetivo do presente trabalho é descrever um caso de TEA, incluindo seus achados clínico-laboratoriais e as alterações eletrolíticas e acidobásicas compatíveis com a síndrome de isquemia e reperfusão. Foi atendido no Serviço de Medicina de Felinos da Universidade Federal do Rio Grande do Sul um felino, sem raça definida (S.R.D.), fêmea, de 14 anos de idade, com paralisia súbita dos membros pélvicos. As alterações clínicas e laboratoriais incluíram hipotermia, hipotensão, bradicardia, azotemia, acidose metabólica e hipercalemia. O eletrocardiograma indicou ritmo sinoventricular e a avaliação do ecocardiograma não mostrou alterações. A avaliação radiográfica do tórax revelou áreas de maior radiopacidade nos campos pulmonares. Optou-se pela arteriotomia da aorta abdominal como tratamento emergencial para a retirada do trombo. O felino veio a óbito no pós-operatório e foi realizado exame histopatológico dos pulmões, linfonodos mediastinais e do coração, que foi compatível com adenocarcinoma pulmonar com metástase para o linfonodo. O presente trabalho trata de um caso de TEA de possível origem neoplásica, o que é pouco comum em gatos. Neste caso, o paciente apresentou comprometimento hemodinâmico de difícil manejo, além de desordens eletrolíticas e do equilíbrio ácido-base graves e refratárias a terapia, culminando em óbito. O tempo do início do tratamento a partir da apresentação dos sinais clínicos pode ser determinante no sucesso terapêutico, reduzindo os...(AU)
Assuntos
Animais , Gatos , Tromboembolia/veterinária , Tromboembolia/terapia , Isquemia/veterinária , Reperfusão/veterinária , Trombose/veterinária , Trombose/terapiaResumo
Background: Hypertrophic cardiomyopathy is the most common acquired cardiovascular disease in the feline species. A frequent complication of this cardiomyopathy is the development of cardiac congestive failure, left atrial enlargement and subsequent development of arterial thromboembolism. In a significant percentage of affected animals there is progression to congestive heart failure, resulting in cyanosis and dyspnea, often the first clinical signs reported by owners. This is a report of a 10-year-old Persian cat with hypertrophic cardiomyopathy and venous and arterial thromboembolism of non-cardiogenic origin. Case: The patient was referred for cardiac evaluation, arterial thromboembolism was the suspected cause of tetraparesis. On clinical examination, a metacarpal pulse was present in all limbs; there was no cyanosis or peripheral hypothermia thus, ruling out a thromboembolic event in the limbs. Changes consistent with feline asthma and pulmonary edema were seen on radiographs, therefore hypertrophic cardiomyopathy was suspected. Treatment with enalapril (0.25 mg/kg every 12 h) for the heart condition and prednisolone (1 mg/kg every 24 h) for asthma was started. Nine days later, the patient developed mixed dyspnea (inspiratory and expiratory) and was hospitalized with signs consistent with arterial thromboembolism: paralysis and cold extremities in the right and left pelvic limbs. The patient was euthanized due to the poor prognosis. Postmortem and histopathological findings revealed left ventricular concentric hypertrophy, with no valvular changes; disseminated intravascular coagulation, with thrombi in the arterial (iliac arteries, pancreatic and renal vessels) and venous (pulmonary and renal veins) beds; as well as multiple neoplastic lung masses, identified as scirrhous pulmonary adenocarcinoma, responsible for increased interstitial radiopacity. Metastasis was also identified at the tracheal bifurcation, causing radiographic changes similar to the alveolar pattern of pulmonary edema
Assuntos
Animais , Gatos , Cardiomiopatia Hipertrófica/veterinária , Heparina , Tromboembolia/veterinária , Trombofilia/veterinária , Adenocarcinoma de PulmãoResumo
Background: Hypertrophic cardiomyopathy is the most common acquired cardiovascular disease in the feline species. A frequent complication of this cardiomyopathy is the development of cardiac congestive failure, left atrial enlargement and subsequent development of arterial thromboembolism. In a significant percentage of affected animals there is progression to congestive heart failure, resulting in cyanosis and dyspnea, often the first clinical signs reported by owners. This is a report of a 10-year-old Persian cat with hypertrophic cardiomyopathy and venous and arterial thromboembolism of non-cardiogenic origin. Case: The patient was referred for cardiac evaluation, arterial thromboembolism was the suspected cause of tetraparesis. On clinical examination, a metacarpal pulse was present in all limbs; there was no cyanosis or peripheral hypothermia thus, ruling out a thromboembolic event in the limbs. Changes consistent with feline asthma and pulmonary edema were seen on radiographs, therefore hypertrophic cardiomyopathy was suspected. Treatment with enalapril (0.25 mg/kg every 12 h) for the heart condition and prednisolone (1 mg/kg every 24 h) for asthma was started. Nine days later, the patient developed mixed dyspnea (inspiratory and expiratory) and was hospitalized with signs consistent with arterial thromboembolism: paralysis and cold extremities in the right and left pelvic limbs. The patient was euthanized due to the poor prognosis. Postmortem and histopathological findings revealed left ventricular concentric hypertrophy, with no valvular changes; disseminated intravascular coagulation, with thrombi in the arterial (iliac arteries, pancreatic and renal vessels) and venous (pulmonary and renal veins) beds; as well as multiple neoplastic lung masses, identified as scirrhous pulmonary adenocarcinoma, responsible for increased interstitial radiopacity. Metastasis was also identified at the tracheal bifurcation, causing radiographic changes similar to the alveolar pattern of pulmonary edema (AU)
Assuntos
Animais , Gatos , Tromboembolia/veterinária , Cardiomiopatia Hipertrófica/veterinária , Heparina , Trombofilia/veterinária , Adenocarcinoma de PulmãoResumo
Cardiomyopathies are considered one of the most important causes of heart failure in cats and are subdivided into three main morphological types: hypertrophic (HCM), dilated (DCM), and restrictive (RCM). This study aimed to determine the frequency and types of cardiomyopathies in cats diagnosed in southern Brazil, with an emphasis on their epidemiological and pathological aspects. Necropsy reports filed in a veterinary pathology laboratory were reviewed, and cats diagnosed with cardiomyopathy were selected for the study. Animal identification data, history and clinical signs, and gross lesions, were reviewed and compiled. During the study period, 1.594 cat necropsies were performed, of which 72 (4.5%) comprised a diagnosis of cardiomyopathy. HCM was the most frequent followed by CMR and CMD, representing 77.8%, 12.5% and 9.7%, respectively. Age ranged from three months to 18 years, with a median age of seven years. In relation to sex, 62.5% were males and 37.5% females. In 76.4% of the cases, it affected cats without a breed defined. Restrictive mixed dyspnea and hydrothorax were the main signs or findings of the clinical examination. Sudden death and acute paresis of the pelvic limbs due to aortic thromboembolism have also been described. In HCM, myocardial thickening was observed, with a reduction in the ventricular chamber. Hypertrophy, disarray, and fibrosis of the myofibers were the main histological findings. In RCM, whitish and thickened endocardium was seen in most cases. DCM was characterized by dilated cardiac chambers, and microscopic examination revealed no significant findings. The main extra cardiac lesions revealed pulmonary edema and congestion, hydrothorax and chronic passive congestion of the liver. Cardiomyopathies are important causes of death in cats and should be included in the differential diagnosis of patients with cardio respiratory clinical signs and in cases related to sudden death and acute paresis of the pelvic limbs.(AU)
As cardiomiopatias são consideradas umas das mais importantes causas de insuficiência cardíaca em gatos e são subdivididas morfologicamente em três principais tipos: cardiomiopatia hipertrófica (CMH), dilatada (CMD) e restritiva (CMR). Este trabalho teve como objetivo determinar a frequência e os tipos de cardiomiopatias em gatos diagnosticados no Sul do Brasil, abordando seus aspectos epidemiológicos e patológicos. Foram revisados os laudos de necropsias de gatos e selecionados para o estudo de diagnóstico de cardiomiopatia. Os dados referentes à identificação do animal, o histórico/sinais clínicos e lesões macroscópicas foram revisados e compilados. No período estudado, foram realizadas 1.594 necropsias de gatos, destas, 72 (4,5%) compreenderam diagnóstico de cardiomiopatia. A CMH foi a mais frequente seguida pela CMR e CMD, representando 77,8%, 12,5% e 9,7%, respectivamente. A idade variou de três meses a 18 anos, com a idade mediana de sete anos. Em relação ao sexo, 62,5% eram machos e 37,5% fêmeas. Em 76,4% dos casos, afetou gatos sem raça definida. Dispneia mista restritiva e hidrotórax foram os principais sinais ou achados do exame clínico. Morte súbita e paresia aguda de membros pélvicos em razão do tromboembolismo aórtico também foram descritos. Na CMH, observou-se espessamento do miocárdio, com redução da câmara ventricular. Hipertrofia, desarranjo e fibrose das miofibras foram os principais achados histológicos. Na CMR, visualizou-se endocárdio esbranquiçado e espessado na maioria dos casos. A CMD caracterizou-se pela dilatação das câmaras cardíacas, e sem lesão histológica significante. As principais lesões extracardíacas encontradas foram edema e congestão pulmonares, hidrotórax e congestão passiva crônica do fígado. As cardiomiopatias são causas importantes de morte em gatos, devem ser incluídas no diagnóstico diferencial de pacientes com sinais clínicos cardiorrespiratórios e também em casos relacionados a morte súbita e paresia aguda dos membros pélvicos.(AU)
Assuntos
Animais , Gatos , Cardiomiopatia Hipertrófica/patologia , Cardiomiopatia Hipertrófica/veterinária , Cardiomiopatia Hipertrófica/epidemiologia , Cardiomiopatia Restritiva/patologia , Cardiomiopatia Restritiva/veterinária , Cardiomiopatia Restritiva/epidemiologia , Cardiomiopatia Dilatada/patologia , Cardiomiopatia Dilatada/veterinária , Cardiomiopatia Dilatada/epidemiologia , Doenças do GatoResumo
Cardiomyopathies are considered one of the most important causes of heart failure in cats and are subdivided into three main morphological types: hypertrophic (HCM), dilated (DCM), and restrictive (RCM). This study aimed to determine the frequency and types of cardiomyopathies in cats diagnosed in southern Brazil, with an emphasis on their epidemiological and pathological aspects. Necropsy reports filed in a veterinary pathology laboratory were reviewed, and cats diagnosed with cardiomyopathy were selected for the study. Animal identification data, history and clinical signs, and gross lesions, were reviewed and compiled. During the study period, 1.594 cat necropsies were performed, of which 72 (4.5%) comprised a diagnosis of cardiomyopathy. HCM was the most frequent followed by CMR and CMD, representing 77.8%, 12.5% and 9.7%, respectively. Age ranged from three months to 18 years, with a median age of seven years. In relation to sex, 62.5% were males and 37.5% females. In 76.4% of the cases, it affected cats without a breed defined. Restrictive mixed dyspnea and hydrothorax were the main signs or findings of the clinical examination. Sudden death and acute paresis of the pelvic limbs due to aortic thromboembolism have also been described. In HCM, myocardial thickening was observed, with a reduction in the ventricular chamber. Hypertrophy, disarray, and fibrosis of the myofibers were the main histological findings. In RCM, whitish and thickened endocardium was seen in most cases. DCM was characterized by dilated cardiac chambers, and microscopic examination revealed no significant findings. The main extra cardiac lesions revealed pulmonary edema and congestion, hydrothorax and chronic passive congestion of the liver. Cardiomyopathies are important causes of death in cats and should be included in the differential diagnosis of patients with cardio respiratory clinical signs and in cases related to sudden death and acute paresis of the pelvic limbs.(AU)
As cardiomiopatias são consideradas umas das mais importantes causas de insuficiência cardíaca em gatos e são subdivididas morfologicamente em três principais tipos: cardiomiopatia hipertrófica (CMH), dilatada (CMD) e restritiva (CMR). Este trabalho teve como objetivo determinar a frequência e os tipos de cardiomiopatias em gatos diagnosticados no Sul do Brasil, abordando seus aspectos epidemiológicos e patológicos. Foram revisados os laudos de necropsias de gatos e selecionados para o estudo de diagnóstico de cardiomiopatia. Os dados referentes à identificação do animal, o histórico/sinais clínicos e lesões macroscópicas foram revisados e compilados. No período estudado, foram realizadas 1.594 necropsias de gatos, destas, 72 (4,5%) compreenderam diagnóstico de cardiomiopatia. A CMH foi a mais frequente seguida pela CMR e CMD, representando 77,8%, 12,5% e 9,7%, respectivamente. A idade variou de três meses a 18 anos, com a idade mediana de sete anos. Em relação ao sexo, 62,5% eram machos e 37,5% fêmeas. Em 76,4% dos casos, afetou gatos sem raça definida. Dispneia mista restritiva e hidrotórax foram os principais sinais ou achados do exame clínico. Morte súbita e paresia aguda de membros pélvicos em razão do tromboembolismo aórtico também foram descritos. Na CMH, observou-se espessamento do miocárdio, com redução da câmara ventricular. Hipertrofia, desarranjo e fibrose das miofibras foram os principais achados histológicos. Na CMR, visualizou-se endocárdio esbranquiçado e espessado na maioria dos casos. A CMD caracterizou-se pela dilatação das câmaras cardíacas, e sem lesão histológica significante. As principais lesões extracardíacas encontradas foram edema e congestão pulmonares, hidrotórax e congestão passiva crônica do fígado. As cardiomiopatias são causas importantes de morte em gatos, devem ser incluídas no diagnóstico diferencial de pacientes com sinais clínicos cardiorrespiratórios e também em casos relacionados a morte súbita e paresia aguda dos membros pélvicos.(AU)
Assuntos
Animais , Gatos , Cardiomiopatia Hipertrófica/patologia , Cardiomiopatia Hipertrófica/veterinária , Cardiomiopatia Hipertrófica/epidemiologia , Cardiomiopatia Restritiva/patologia , Cardiomiopatia Restritiva/veterinária , Cardiomiopatia Restritiva/epidemiologia , Cardiomiopatia Dilatada/patologia , Cardiomiopatia Dilatada/veterinária , Cardiomiopatia Dilatada/epidemiologia , Doenças do GatoResumo
A anemia hemolítica imunomediada (AHIM) é o distúrbio imunológico de maior prevalência em cães. Caracteriza-se como uma hipersensibilidade do tipo II, que leva a destruição prematura de hemácias. Dentre as principais complicações, o estado de hipercoagulabilidade predispondo a coagulação intravascular disseminada e tromboembolismo pulmonar é a mais importante, sendo a causa de óbito em mais de 80% dos casos. O diagnóstico é realizado a partir da exclusão de outras causas para anemia e por meio da constatação de um ou mais desses sinais: anemia moderada a grave (hematócrito <25-35%), evidências de hemólise (hemoglobinemia, hemoglobinúria ou hiperbilirrubinemia) e presença de anticorpos na hemácia (caracterizado a partir da auto-aglutinação, esferocitose, teste de Coombs positivo ou citometria de fluxo). O tratamento é direcionado à supressão da resposta imune, sendo os corticosteroides e os imunossupressores, os fármacos de predileção.(AU)
Immune-mediated hemolytic anemia (IMHA) is the most prevalent immune disorder among dogs. It is characterized as type II hypersensitivity, leading to premature destruction of red blood cells. Among the main complications, hypercoagulability predisposing to disseminated intravascular coagulation and pulmonary thromboembolism is the most important, being the cause of death in more than 80% of the cases. The diagnosis is made by excluding other causes for anemia and the presence of one or more of these signs: moderate to severe anemia (hematocrit <25-35%), evidence of hemolysis (hemoglobinemia, hemoglobinuria or hyperbilirubinemia) and presence of antibodies in the erythrocyte (characterized by self-agglutination, spherocytosis, positive Coombs test, or flow cytometry). Treatment is directed to suppression of the immune response, with corticosteroids and immunosuppressants the drugs of predilection.(AU)
La anemia hemolítica inmunomediada (AHIM) es el disturbio inmunológico con mayor prevalencia en perros. Es definido como una hipersensibilidad tipo II, que lleva a destrucción prematura de hematíes. Dentro de las principales complicaciones, el estado de hipercoagulabilidad que predispone a coagulación intravascular diseminada y tromboembolismo pulmonar es el más importante, siendo la causa de muerte en más de 80% de los casos. El diagnóstico se realiza excluyendo otras causas de anemia y confirmando una o más de las siguientes alteraciones: anemia moderada a grave (hematocrito <25-35%), evidencias de hemolisis (hemoglobinemia, hemoglobinuria o hiperbilirrubinemia) y presencia de anticuerpos en hematíes (caracterizado a partir de autoaglutinación, esferocitosis, test de Coombs positivo o citometría de flujo). El tratamiento se basa en la supresión de la respuesta inmune, siendo los cortico esteroides y los inmunosupresores los fármacos de elección.(AU)
Assuntos
Animais , Cães , Cães/imunologia , Cães/sangue , Anemia Hemolítica Autoimune/classificação , Terapia de Imunossupressão/veterináriaResumo
A two-year-old, male, non-castrated cat was referred to the veterinary hospital with a three-month history of paresis of the pelvic limbs. Clinical examination revealed a discreet muffling of cardiac sounds and the presence of a degree III/VI holosystolic murmur. The animal was hospitalized and died of cardiorespiratory arrest. The heart had a thickened left ventricular endocardium characterized by the deposition of a fibrous white matter that was firmly adhered to the endocardium and also observed on the epicardium. Renal infarctions and thrombi in the atrium and bifurcation of the aorta were found. Microscopically, in the endocardium of the left ventricular chamber there was a diffuse and disorganized deposition of fibrous connective tissue filled with elastic fibers of varying thickness. In the left ventricular epicardium, the same lesion was observed, but with less extension. Clinical and anatomopathological findings were consistent with primary left ventricular endocardial and left ventricular epicardial fibroelastosis with secondary left ventricular congestive heart failure, thromboembolism and paresis.
Assuntos
Animais , Gatos , Fibroelastose Endocárdica/complicações , Fibroelastose Endocárdica/patologia , Fibroelastose Endocárdica/veterinária , Paresia/veterinária , Tromboembolia/veterinária , Insuficiência Cardíaca/veterinária , Parada Cardíaca/veterináriaResumo
A two-year-old, male, non-castrated cat was referred to the veterinary hospital with a three-month history of paresis of the pelvic limbs. Clinical examination revealed a discreet muffling of cardiac sounds and the presence of a degree III/VI holosystolic murmur. The animal was hospitalized and died of cardiorespiratory arrest. The heart had a thickened left ventricular endocardium characterized by the deposition of a fibrous white matter that was firmly adhered to the endocardium and also observed on the epicardium. Renal infarctions and thrombi in the atrium and bifurcation of the aorta were found. Microscopically, in the endocardium of the left ventricular chamber there was a diffuse and disorganized deposition of fibrous connective tissue filled with elastic fibers of varying thickness. In the left ventricular epicardium, the same lesion was observed, but with less extension. Clinical and anatomopathological findings were consistent with primary left ventricular endocardial and left ventricular epicardial fibroelastosis with secondary left ventricular congestive heart failure, thromboembolism and paresis.(AU)
Assuntos
Animais , Gatos , Paresia/veterinária , Fibroelastose Endocárdica/veterinária , Tromboembolia/veterinária , Fibroelastose Endocárdica/complicações , Fibroelastose Endocárdica/patologia , Parada Cardíaca/veterinária , Insuficiência Cardíaca/veterináriaResumo
As miocardiopatias hipertróficas observadas frequentemente, apresentam complexa fisiopatologia clínica e não são completamente elucidadas. Uma das causas conhecidas para a doença é a presença da mutação no gene MYPBC3, responsável pela contractilidade e relaxamento dos sarcômeros no miocárdio. Uma das consequências relacionadas ao desenvolvimento destas doenças é a presença e formação de trombos, por ocorrência de estase sanguínea e exposição de tromboplastina tecidual. A principal ferramenta diagnóstica para a prevenção ou tratamento da doença é o ecocardiograma. Esta revisão elucida aspectos sobre a fisiopatologia da doença e a sua relação com a presença ou ausência de tromboembolismo.
The hypertrophic cardiomyopathy is observed frequently in clinical practice, is a disease with a complex clinical pathophysiology and are not completely elucidated. A principal cause was reported for this disease is the presence of the mutation in the MYPBC3 gene, responsible for the capacity of contractility and relaxation of sarcomeres in the myocardio. One of the consequences related to the development of these diseases is the presence and formation of thromboses, due to the occurrence of blood stasis in the left atrium and exposure of tissue thromboplastin. The main diagnostic tool for the prevention or treatment of the disease is the echocardiogram. This review elucidates aspects about the pathophysiology of the disease and its relation to the presence or absence of thromboembolism.
Assuntos
Animais , Gatos , Cardiomiopatia Hipertrófica/fisiopatologia , Cardiomiopatia Hipertrófica/veterinária , Mutação , Tromboembolia/fisiopatologia , Tromboembolia/veterinária , Hemostasia , Trombose/veterináriaResumo
Thrombus is the term used to denote the blood clot formed inside the heart or inside blood vessels. These thrombi can detach and lodge in any artery, causing arterial thromboembolism, which is a frequent complication in feline patients with hypertrophic cardiomyopathy. Clinical signs vary depending on the stage of disease progression and thrombus location. For the treatment, it is necessary to use potent analgesics and antithrombotic drugs / anticoagulants, in order to prevent relapses. This paper aims to describe a case of aortic thromboembolism (TEA) in a feline with associated hypertrophic cardiomyopathy (HCM).
Assuntos
Masculino , Animais , Gatos , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico , Cardiomiopatia Hipertrófica/veterinária , Tromboembolia/complicações , Tromboembolia/diagnóstico , Tromboembolia/veterinária , Tromboembolia/tratamento farmacológicoResumo
Thrombus is the term used to denote the blood clot formed inside the heart or inside blood vessels. These thrombi can detach and lodge in any artery, causing arterial thromboembolism, which is a frequent complication in feline patients with hypertrophic cardiomyopathy. Clinical signs vary depending on the stage of disease progression and thrombus location. For the treatment, it is necessary to use potent analgesics and antithrombotic drugs / anticoagulants, in order to prevent relapses. This paper aims to describe a case of aortic thromboembolism (TEA) in a feline with associated hypertrophic cardiomyopathy (HCM).(AU)
Assuntos
Animais , Masculino , Gatos , Tromboembolia/complicações , Tromboembolia/diagnóstico , Tromboembolia/veterinária , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico , Cardiomiopatia Hipertrófica/veterinária , Tromboembolia/tratamento farmacológicoResumo
As miocardiopatias hipertróficas observadas frequentemente, apresentam complexa fisiopatologia clínica e não são completamente elucidadas. Uma das causas conhecidas para a doença é a presença da mutação no gene MYPBC3, responsável pela contractilidade e relaxamento dos sarcômeros no miocárdio. Uma das consequências relacionadas ao desenvolvimento destas doenças é a presença e formação de trombos, por ocorrência de estase sanguínea e exposição de tromboplastina tecidual. A principal ferramenta diagnóstica para a prevenção ou tratamento da doença é o ecocardiograma. Esta revisão elucida aspectos sobre a fisiopatologia da doença e a sua relação com a presença ou ausência de tromboembolismo.(AU)
The hypertrophic cardiomyopathy is observed frequently in clinical practice, is a disease with a complex clinical pathophysiology and are not completely elucidated. A principal cause was reported for this disease is the presence of the mutation in the MYPBC3 gene, responsible for the capacity of contractility and relaxation of sarcomeres in the myocardio. One of the consequences related to the development of these diseases is the presence and formation of thromboses, due to the occurrence of blood stasis in the left atrium and exposure of tissue thromboplastin. The main diagnostic tool for the prevention or treatment of the disease is the echocardiogram. This review elucidates aspects about the pathophysiology of the disease and its relation to the presence or absence of thromboembolism.(AU)
Assuntos
Animais , Gatos , Cardiomiopatia Hipertrófica/veterinária , Tromboembolia/fisiopatologia , Tromboembolia/veterinária , Cardiomiopatia Hipertrófica/fisiopatologia , Mutação , Hemostasia , Trombose/veterináriaResumo
A case of bacterial (Pseudomonas aeruginosa) valvular endocarditis in a red-billed curassow is described. A traumatic fracture in one limb of the bird was considered the port of entry for the bacterium, followed by septicemia and seeding of the heart valve. Brain embolism resulting from detached thrombus fragments followed.