Effects of multimodal environmental modification in crystal-related feline lower urinary tract diseases / Efeitos da modificação ambiental multimodal em felinos com cristais doenças do trato urinário inferior relacionadas a cristais

This study aims to analyze the effects of multimodal environmental modification (MEMO) of cats with recurrence of lower urinary tract signs (LUTS). Treatment of FLUTD included pharmacological treatment, dietary management, and multimodal environmental modification approaches. Twenty client-owned indoor-housed cats with recurrence of lower urinary tract signs had been covered in this observation. Diagnosis of lower urinary tract was made primarily based on the cat's clinical signs, results of laboratory parameters, urinalysis and ultrasonographic examination. Cats were divided into two groups as cefovecin (8 mg/kg sc, single time use) + meloxicam (0.1mg/kg q24h, 3 days) + dry food including l-tryptophan and milk protein hydrolysate to dissolve struvite stones (Group 1) and cefovecin + meloxicam + dry food including l-tryptophan and milk protein hydrolysate to dissolve struvite stones + multimodal environmental modification (Group 2). Clinical and urinary parameters are scored as 0, 1, 2, 3 or 4 points on initial, third, seventh days. Scores of clinical parameters were significantly different between (p<0.05) group 2 and group 1 on the third and seventh days and scores of urinary parameters are significantly different between (p<0.05) group 2 than group 1 on the seventh day. Clients who were contacted after 1 year reported that they did not see any clinical signs of urinary tract diseases.

Este estudo tem como objetivo avaliar os efeitos da modificação ambiental multimodal (MEMO) em gatos com recorrência de sinais do trato urinário inferior (LUTS). O tratamento da FLUTD incluiu tratamento farmacológico, controle dietético e abordagens de modificação ambiental multimodal. Vinte gatos de propriedade de clientes, alojados em ambientes fechados, com recorrência de sinais do trato urinário inferior foram incluídos nessa observação. O diagnóstico do trato urinário inferior foi feito principalmente com base nos sinais clínicos do gato, nos resultados dos parâmetros laboratoriais, na urinálise e no exame ultrassonográfico. Os gatos foram divididos em dois grupos: cefovecina (8 mg/kg sc, uso único) + meloxicam (0,1mg/kg q24h, 3 dias) + ração seca incluindo l-triptofano e hidrolisado de proteína do leite para dissolver cálculos de estruvita (Grupo 1) e cefovecina + meloxicam + ração seca incluindo l-triptofano e hidrolisado de proteína do leite para dissolver cálculos de estruvita + modificação ambiental multimodal (Grupo 2). Os parâmetros clínicos e urinários foram pontuados como 0, 1, 2, 3 ou 4 pontos no primeiro, terceiro e sétimo dias. As pontuações dos parâmetros clínicos foram significativamente diferentes entre (p<0,05) o grupo 2 e o grupo 1 no terceiro e sétimo dias, e as pontuações dos parâmetros urinários foram significativamente diferentes entre (p<0,05) o grupo 2 e o grupo 1 no sétimo dia. Os clientes que foram contatados após um ano relataram que não observaram nenhum sinal clínico de doenças do trato urinário.

Megaureter gigante por ectopia ureteral intramural em cadela / Giant megaureter by intramural ureteral etopia in a bitch

Background: The urinary tract is composed by kidneys, urinary bladder and urethra. The kidneys produce urine that achieve urinary bladder by ureters. These have the origin in the renal pelvis, run through the retroperitoneum, end up at the dorsolateral superficies of the urinary bladder, and empty at the trigone. Ureters abnormalities are the rarest congenital defects in the canine urinary tract and ureteroceles are cystic dilatations of the distal segment of the ureter that could be associated to partial or complete urinary obstructions and could lead to megaureter and hydronephrosis. So, the aim of the present study was to describe a case of megaureter by intramural ureteral ectopia in a bitch. Case: A 1-year-old-and-8-month bitch Akita, weighing 18 kg, was referred to the Uniube Veterinary Hospital with vaginal secretion, prostration, hypodipsia, hyporexia and pyrexia related by the tutor. On physical examination, an increase in vulva volume and a vaginal discharge were observed. Nevertheless, others physical exams, blood count and biochemical tests were considered to be within normal parameters. Urinalysis showed cloudy aspect, proteinuria, occult blood, erythrocytes, pyuria, leucocytes, and discreet presence of bacteria. Abdominal ultrasonography revealed a megaureter with right uterocele and excretory urography showed absence of glomerular filtration by right kidney. The patient was submitted to surgery for right kidney and ureter exeresis. Histopathology evaluation showed intense dilation of the ureter and severe multifocal renal fibrosis. The surgery was well succeeded, and the patient recovered completely. Discussion: Once megaureter are associated with congenital abnormalities like ectopic ureter and ureterocele, it is usually diagnosed in young patients with medium age of 10 months, which is below the age of the patient in this case report. Additionally, in the patient here reported, the unilateral alteration could explain the absence of kidney fail symptoms. In more than 90% of the cases, the ureteral ectopia was associated with multiple anomalies in the urinary tract, as was observed in this patient, that presented besides ectopic ureter, ureterocele, megaureter and renal dystrophy. All these morphological alterations made impossible the complete urine elimination, which predispose to urinary tract infection, that was observed in this report. According to literature, urinary tract anomalies are associated with infection in 64 to 85% and 50% of the cases also present hydronephrosis and hydroureter. It was also described that ureteral ectopia is diagnosed by visualization of hydroureter in abdominal ultrasonography. The findings present in this report differs a little, once the right kidney was atrophic possibly by malformation or even so by a chronic renal lesion due to the difficulty in urine flow. The excretory urography showed no filtration in the right kidney, indicating non-functionality that was confirmed by histopathology, in which was observed small glomerulus and large amount of connective tissue deposition. In cases of unilateral megaureter with ipsilateral kidney commitment, there is indication of nephroureterectomy, that was performed in the patient of the present report. As far as we know, this is the first report of megaureter, ureterocele and ectopia ureteral together in the same patient. In conclusion, the procedure was secure, efficient and promote a better quality of life for the patient and prevent the recurrence of urinary tract infections.

Follicular cystitis in a dog: first case report described in Brazil / Cistite folicular em cão: primeiro relato de caso descrito no Brasil

A 2-year-old English bulldog presented history of recurrent lower urinary tract disease, refractory to treatment. The Complete Blood Count revealed lymphopenia, hyperproteinemia, and hyperglobulinemia, while urinalysis indicated leukocyturia and bacteriuria. On the abdominal ultrasound, the bladder had a focal wall thickening in its cranial portion, as well as irregular echogenicity and internal margins. A bladder surgical biopsy was performed, indicating the presence of follicular cystitis. Clinical signs disappeared after treatment with a combination of amoxicillin and clavulanic acid, NSAIDs, supplementation with cranberry extract associated with cat's claw (Uncaria tomentosa). Clinical follow-up 12 months after surgery showed remission at all clinical signs. Follicular cystitis in dogs was reported only once worldwide, this case report is the first in Brazil; thus, it may be considered in the differential diagnosis for patients with refractory and recurrent lower urinary tract disease.

Um Bulldog Inglês de 2 anos apresentou história clínica de doença recorrente do trato urinário inferior, refratária ao tratamento. O hemograma revelou uma discreta linfopenia, hiperproteinemia e hiperglobulinemia. Já a urinálise apontou leucocitúria e bacteriúria. Na ultrassonografia, a bexiga apresentava espessamento focal da parede da bexiga em porção cranial, ecogênica e margens internas irregulares. A biópsia cirúrgica da bexiga foi compatível com cistite folicular. Os sinais clínicos desapareceram após o tratamento com uma combinação de amoxicilina - ácido clavulânico, AINEs, suplementação alimentar de extrato de cranberry associado a unha de gato (fitoterápico da planta Uncaria tomentosa). O acompanhamento, 12 meses após a cirurgia, confirmou que o cão estava livre de sinais clínicos. A cistite folicular foi relatada apenas em 1 cão no mundo, sendo esse considerado o primeiro relato no Brasil. Essa enfermidade deve ser considerada um diferencial para pacientes com doença refratária do trato urinário inferior de longa data.

Cell therapy with adipose tissue-derived human stem cells in the urinary bladder improves detrusor contractility and reduces voiding residue / A terapia celular com células-tronco humanas derivadas do tecido adiposo na bexiga urinária melhora a contratilidade do detrusor e reduz o resíduo miccional

Detrusor hypocontractility (DH) is a disease without a gold standard treatment in traditional medicine. Therefore, there is a need to develop innovative therapies. The present report presents the case of a patient with DH who was transplanted with 2 x 106 adipose tissue-derived mesenchymal stem cells twice and achieved significant improvements in their quality of life. The results showed that cell therapy reduced the voiding residue from 1,800 mL to 800 mL, the maximum cystometric capacity from 800 to 550 mL, and bladder compliance from 77 to 36.6 mL/cmH2O. Cell therapy also increased the maximum flow from 3 to 11 mL/s, the detrusor pressure from 08 to 35 cmH2O, the urine volume from 267 to 524 mL and the bladder contractility index (BCI) value from 23 to 90. The International Continence on Incontinence Questionnaire - Short Form score decreased from 17 to 8. Given the above, it is inferred that the transplantation of adipose tissue-derived mesenchymal stem cells is an innovative and efficient therapeutic strategy for DH treatment and improves the quality of life of patients affected by this disease.

A Hipocontratilidade Detrusora (HD) é uma doença sem um tratamento padrão-ouro na medicina tradicional. Logo, há a necessidade de desenvolvimento de terapias inovadoras. O presente relato apresenta um caso de paciente com HD transplantado duas vezes com 2 x 106 células-tronco mesenquimais derivadas do tecido adiposo que obteve melhoras significativas em sua qualidade de vida. Os resultados demonstraram que a terapia celular reduziu o resíduo miccional de 1.800mL para 800mL; a Capacidade Cistométrica Máxima de 800 para 550mL; a complacência de 77 para 36,6mL/cmH2O. A terapia celular também aumentou o fluxo máximo de 3 para 11mL/s; a pressão detrusora de 08 para 35cmH2O; o volume urinado de 267 para 524mL e o índice de contratilidade vesical (BCI) de 23 para 90. O score do International Continence on Incontinence Questionare - Short Form passou de 17 para 8. Diante do exposto, infere-se que o transplante de células-tronco mesenquimais derivadas do tecido adiposo é uma estratégia terapêutica inovadora e eficiente para o tratamento da HD e para melhoria da qualidade de vida de pacientes acometidos por essa doença.

Urethral obstruction due to seminal vesiculitis in a sheep: case report / Obstrução uretral por vesiculite seminal em ovino: relato de caso

We report a case of urethral obstruction due to seminal vesiculitis in a Dorper sheep, with symptoms of anuria, rectal prolapse, orchitis/epididymitis, and uroperitoneum and biochemical tests indicating severe azotemia. The animal died due to advanced azotemia, and necropsy revealed kidneys with cortical and medullary necrosis, pyelonephritis of renal calyces, hydronephrosis, ruptured and necrotic bladder, and vesicular, bulbourethral, and ampoule accessory sex glands. There was prostate hyperplasia that revealed a large amount of pus in the cross section, which was also observed bilaterally in the epididymis and right testis. Morphotintorial and biochemical analyses of bacteria obtained from microbiological culture revealed Corynebacterium sp. and Escherichia coli. Infection, hyperplasia, and abscessation of accessory sex glands caused urethral compression, resulting in an obstructive condition, similar to urolithiasis, in addition to bacteremia. Hyperplastic seminal vesiculitis, although rare, must be included among the differential diagnoses of obstructive processes in the urinary tract of sheep.

Relata-se um caso de obstrução uretral decorrente de vesiculite seminal em carneiro da raça Dorper, com quadro de anúria, prolapso retal, orquite/epididimite e uroperitôneo, com exames bioquímicos indicativos de severa azotemia. Devido ao quadro avançado de azotemia, o animal faleceu e, na necropsia, foi observado:: rins com necrose de cortical e medular, pielonefrite dos cálices renais e hidronefrose, bexiga rompida e necrosada, assim como glândulas sexuais acessórias vesiculares, bulbouretrais e ampola. Havia hiperplasia de próstata que, ao corte transversal, revelou grande quantidade de pus, que também foi observado bilateralmente no epidídimo e no testículo direito. As análises morfotintoriais e bioquímicas das bactérias obtidas a partir do cultivo microbiológico foram compatíveis com Corynebacterium sp. e Escherichia coli. A infecção, a hiperplasia e a abscedação das glândulas sexuais acessória, causaram compressão uretral, levando a um quadro obstrutivo, semelhante à urolitíase, somado à bacteremia. A vesiculite seminal hiperplásica, apesar de rara, deve ser incluída entre os diagnósticos diferenciais dos processos obstrutivos do trato urinário de carneiros.

Hypospadias in two cats: case report / Hipospadia em dois gatos: relato de caso

Hypospadias is an uncommon sexual development disorder in cats, in which the urethral opening is not in its anatomical location on the penis. The purpose of this report is to describe two cases of hypospadias in the feline species. The first cat was asymptomatic, had a history of bacterial cystitis, and was diagnosed with perineal hypospadias at an appointment for preoperative evaluation of orchiectomy. The second cat had clinical signs of dysuria and pollakiuria for 30 days and had glandular hypospadias. Both cats showed abnormalities in the urinalysis which were suggestive of lower urinary tract disease. For both cases, clinical treatment with antibiotic therapy was performed. In the first patient, surgical treatment consisted of orchiectomy, while in the second animal a perineal urethrostomy and orchiectomy were performed. The cats had a satisfactory recovery after the treatments. Performing a thorough physical examination is essential to diagnose cases of hypospadias and choose the best treatment for each patient.

A hipospadia é uma desordem do desenvolvimento sexual pouco comum nos gatos, na qual a abertura uretral não está em sua localização anatômica do pênis. O objetivo do presente relato é descrever dois casos de hipospadia em felinos domésticos. O primeiro gato era assintomático, tinha histórico de cistite bacteriana prévio, e foi diagnosticado com hipospadia perineal em uma consulta para avaliação pré-cirúrgica de orquiectomia. O segundo gato apresentava sinais clínicos de disúria e polaquiúria há 30 dias e apresentava hipospadia glandular. A partir dos exames complementares, pôde-se observar que os animais, além do defeito anatômico, apresentavam alterações sugestivas de doença do trato urinário inferior. Para ambos os casos, foi realizado o tratamento clínico inicial com antibioticoterapia. No primeiro paciente, optou-se pelo procedimento de orquiectomia, enquanto no segundo animal foram realizadas as técnicas de uretrostomia perineal e orquiectomia. Os gatos mostraram recuperação satisfatória após os tratamentos instituídos. Dessa forma, pode-se observar a importância de se realizar um exame físico minucioso a fim de diagnosticar os casos de hipospadia e escolher o tratamento correto para cada paciente.

Urethral obstruction secondary to Staphylococcus felis chronic urethritis and hepatoid gland adenoma in a captive ocelot (Leopardus pardalis)

A male adult ocelot (Leopardus pardalis) kept under human care developed anuria, which progressed to death. Grossly, the urinary bladder was markedly dilated and filled with red discolored urine containing blood clots. In addition, the animal had a hepatoid cell adenoma adjacent to the urethra, which likely caused partial urethral occlusion. Microscopically, there was a predominantly neutrophilic, fibrinous and hemorrhagic urethritis, cystitis, and pyelonephritis with intralesional gram-positive cocci. Microbiologic culture followed by MALDI-TOF MS analysis resulted in the identification of isolates from the urine and urethra as Staphylococcus felis.(AU)

Extensive emphysematous pyelonephritis in a nondiabetic female cat - treatment with unilateral nephroureterectomy

Background: Emphysematous pyelonephritis (EPN) is an acute, severe necrotizing infection of the renal parenchyma and surrounding tissues that results in gas formation in the kidney, collecting system, or surroundings. EPN is a rare condition in veterinary medicine and occurs most frequently in dogs with diabetes mellitus. Although the prognosis of medical management in animals is poor, the standardized treatment protocol according to EPN severity is unclear. This report describes the first case of a nondiabetic female cat with extensive EPN and good prognosis following direct nephroureterectomy (NU). Case: A 10-year-old spayed female cat presented with the chief complaint of an acute loss of weight within 1 week, vomiting, and disorientation including stumbling, discoordination, circling, wobbling, head tilting, and difficulties in standing. At presentation, the patient had a body condition score of 1/9 and weighed 2.6 kg. Blood examination revealed leukocytosis, anemia, and hypoproteinemia. Abdominal radiography revealed severely decreased serosal details. A massive gas silhouette observed in the peritoneal and retroperitoneal cavities, was diagnosed as abdominal free gas. Abdominal ultrasound showed an accumulation of moderately anechoic fluid mixed with gas and cyst-like capsules around the left kidney. Left partial ureteral obstruction and dilation were also observed. Computed tomography (CT) was performed without sedatives or anesthetic drugs. The findings showed severe inflammatory changes in the peritoneum and a loss of the normal inner structure in the left kidney. A pyelogram of the left kidney was not observed after injection of the contrast material. Diffuse fat stranding and free gas observed in the mesentery of the entire abdominal cavity and around the left kidney were considered septic peritonitis. Urinalysis revealed proteinuria and hematuria. Numerous neutrophils with rod-type bacteria were observed in the ascites. Following diagnostic examinations, the patient was diagnosed with extensive left EPN, including inflammatory ascites and abdominal free gas. Therefore, emergency NU of the nonfunctional left kidney and ruptured ureter and thorough abdominal lavage were conducted. Diffuse inflammation and a nephrolith were observed in the section of the harvested kidney. The nephrolith was composed of 100% calcium oxalate monohydrate. The realtime polymerase chain reaction (RT-PCR) test for feline infectious peritonitis (FIP) was negative. Escherichia coli was detected in the ascites, and antibiotic therapy was administered following the antibiotic sensitivity test. The histological findings from the left kidney and ureter included marked chronic inflammation and fibrosis. The patient was discharged 4 days after surgery. During the 8-month follow-up period, the patient's condition improved. Discussion: This was a unique case of EPN in a nondiabetic cat and the first reported case of EPN with a ruptured ureter, including abdominal free gas, inflammatory ascites, and peritonitis. This patient had a bacterial urinary tract infection with E. coli, which is the most frequently isolated pathogen in humans. This gas-forming bacteria produced a massive amount of gas and inflammation that were considered to have ruptured the urinary tract, so that the gas was released into the abdomen. This case corresponded to class 3B, with two risk factors according to the human EPN classification system. Direct NU and abdominal lavage were performed as emergency surgeries. The patient stabilized gradually and showed a good prognosis. Immediate surgical intervention is recommended in animal patients showing the extensive EPN stage.

Congenital extrahepatic portosystemic deviation of gastric vein with azygos in a bitch

Background: Portosystemic shunt (PSS), an alteration commonly found in toy dogs, is caused by an anastomosis between the systemic and portal circulation, interfering with the metabolism of several toxins. It can be of congenital or acquired origin and is classified as intra- or extrahepatic. Clinical signs include the gastrointestinal tract, nervous system, and urinary system according to the fraction of the shunt. It is diagnosed by several imaging tests and exploratory laparotomy. Therapy involves drug therapy and/or surgical correction of the anomalous vessels. Thus, the aim is to present an unusual case of extrahepatic cPSS originating from the left gastric vein and insertion into the azygos vein. Case: A 2-year-old female toy poodle, spayed, weighing 2.7 kg was treated with a history of recurrent cystitis and neurological signs such as focal seizures, ataxia, tremors, blindness, lethargy, head pressing, and compulsive gait. Complementary tests revealed normochromic microcytic anemia, neutrophilia-induced leukocytosis, monocytosis, and lymphopenia. Biochemical analysis revealed hypoproteinemia due to hypoglobulinemia, an increase in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase, and a decrease in urea. In the urinalysis, ammonium biurate crystals were detected, and Doppler ultrasound revealed microhepathy and the presence of an anomalous gastrosplenic vein inserted into the azygos vein, a finding compatible with the congenital extrahepatic PSS. Abdominal tomography confirmed vascular deviation with a sinuous path originating from the left gastric and splenic veins, inserting into the azygos vein, measuring approximately 5.95 cm in length. Cranial tomography revealed changes consistent with hepatic encephalopathy. Drug therapy was performed with hydration, liver chow, lactulose, probiotics, metronidazole, S-adenosyl-L-methionine, and ursodeoxycholic acid, and after 15 days, surgery was performed to place a 3.5 mm ameroid constrictor ring for gradual occlusion of the anomalous vessel. The animal recovered well, and a control abdominal ultrasound was repeated 30 days after the procedure, noting that the constrictor had not yet fully occluded the deviation. Doppler imaging revealed a favorable evolution with an increase in the diameter of the portal vein in the hepatopetal direction. The patient was followed-up for a year and had a normal and healthy life. Discussion: Extrahepatic PSS is frequently diagnosed in purebred and toy dogs, commonly occurring between the portal vein and one of its tributaries, with a lower frequency of anomalous vessels between the azygos veins, as in the present report. The patient's age and clinical signs were compatible with the disease, in addition to ammonia biurate crystals and hematological and biochemical alterations. The neurological clinical signs observed were compatible with hepatic encephalopathy secondary to congenital PSS. The imaging examinations facilitated the identification of the extrahepatic vascular anomaly, with the tomography being more accurate and helping in proper surgical planning. Clinical treatment should be performed for presurgical stabilization, and occlusion can be performed by placing cellophane bands or an ameroid constrictor, which is the technique of choice for congenital PSS, as it allows for slow constriction to avoid acute portal hypertension, as in this case, emphasizing that anesthesia in animals with portosystemic shunts must be performed with care.

Canine cystitis - biofilm formation by bacterial isolates

Background: Biofilms have been reported as important virulent markers associated with drug resistance in urinary tractinfections (UTIs) in humans and dogs. However, in veterinary medicine, researches involving biofilm formation, treatments and preventions have been limited; yet, it is still possible to find few studies demonstrating biofilm-forming bacteriaassociated with different comorbidities such as otitis, wound infections, UTIs, and endometritis. These studies generallyselect dogs with chronic and recurrent infections, which could be an important factor in antibiotic resistance. We aimed toevaluate biofilms in sporadic cystitis regarding prevalence and drug resistance.Materials, Methods & Results: Urine samples were collected by cystocentesis from 36 client-owned dogs under clinicaland laboratory suspicion of non-recurrent urinary bladder infection (cystitis). Urine was aseptically plated onto bloodagar, MacConkey, and CLED, followed by incubation for 24 to 48 h. Definitive identification of a potential pathogen wasmade by subculture collected from an isolated colony to obtain a pure culture. The gram staining method and specificbiochemical tests (phenol red fermentation, lysine, phenylalanine, citrate, sulfide-indole-motility, and urease) were usedto distinguish and classify the bacteria. After identification, the bacteria were tested for antimicrobial susceptibility by astandard disk diffusion method, using the following antimicrobials: amoxicillin with clavulanic acid, ampicillin, ceftriaxone, ciprofloxacin, clindamycin, cefazolin, cephalothin, erythromycin, gentamicin, norfloxacin, and sulfamethoxazoletrimethoprim. The biofilm-forming ability was determined based on a culture...

Crystallurical profile in sheep after ammonium chloride supplementation / [Perfil cristalúrico em ovinos suplementados com cloreto de amônio]

Although urinary crystals are habitual components, urolithiasis formation is always preceded by these concretions. We aimed to identify the change in the crystalline profile in sheep supplemented with ammonium chloride. Twenty-five male sheep aged three months, feedlot and randomly distributed into three groups were used: Control Group (CG) n = 5 did not receive Ammonium Chloride; G200 Group (n=10) (200mg/kg) of Ammonium Chloride for 56 consecutive days; G500 Group (n=10) (500mg/kg) of Ammonium Chloride for 56 consecutive days, administered daily orally. Sampling times and clinical evaluation were performed at seven days, with M0 (immediately before Ammonium Chloride), M1 (seven days after) until M8, totaling 70 days of feedlot. Urine samples were performed to identify the presence, type, and quantity of crystals. There was an increase in crystalluria in all groups in relation to time due to dietary influence, mainly in the CG, which presented more crystals of amorphous calcium phosphate and calcium oxalate. In addition, the G500 Group presented a higher presence of urate/uric acid crystals after urinary acidification, which are closely related to urinary pH.

Apesar de cristais urinários serem componentes habituais, a formação de urolitíase é sempre precedida dessas concreções. O presente estudo objetivou identificar a mudança do perfil cristalúrico em ovinos suplementados com cloreto de amônio. Foram utilizados 25 ovinos, machos, com idade de três meses, confinados e distribuídos aleatoriamente em três grupos: grupo controle (GC) (n=5) não recebeu cloreto de amônio; grupo G200 (n=10) (200mg/kg) recebeu cloreto de amônio por 56 dias consecutivos; grupo G500 (n=10) (500mg/kg) recebeu cloreto de amônio por 56 dias consecutivos, administrados diariamente por via oral. Os momentos (M) de colheita de amostras e avaliação clínica foram realizados com intervalo de sete dias, sendo M0 (imediatamente antes da administração do cloreto de amônio), M1 (sete dias após) até M8, totalizando 70 dias de confinamento. As amostras de urina foram analisadas para se identificar a presença, o tipo e a quantidade de cristais. Houve aumento da cristalúria em todos os grupos em relação ao tempo por influência dietética, principalmente no GC, que apresentou mais cristais de fosfato de cálcio amorfo e oxalato de cálcio. Além disso, o grupo G500 apresentou maior presença de cristais de urato/ácido úrico após acidificação urinária, estando esses intimamente relacionados ao pH urinário.

Agents causing genital infections in routine cytological tests: frequency and characteristics of Papanicolaou smears / Agentes causadores de infecções genitais em exames citológicos de rotina: frequência e características dos esfregaços de papanicolaou

Urinary tract infections are responsible for most human infections, these are caused by bacteria, fungi, protozoa and associated microorganisms. The goal of this study was to determine the rate of vaginal infection-causing agents in routine cytological exams and also to evaluate the characteristics of positive tested Pap smears. A retrospective documental with descriptive aspect research was performed in a Clinical Pathology laboratory from Maceió-AL. The results of the Pap smears exams for Trichomonas vaginalis, Gardnerella vaginalis, Candida spp and HPV were arranged in a database as well as other data such as bacterial, protozoan, fungal and viral coinfections. The sample was composed by 18.645 women who have undergone Pap smear exams from 2013 to 2017. Of these analyzed exams, 27.4% in 2013, 10.9% in 2014, 10.6% in 2015, 15.2% in 2016 and 13.67% in 2017 were within normal range, however more than half of these exams presented some infections caused by unspecific or microbiological agents. By analyzing all the reports, 4.073 (21.84%) presented inflammations caused by some species of infectious agent with the following rate order: G. vaginalis and T. vaginalis. Furthermore, it was possible to confirm high rates of coinfection by and Candida spp. The rate of genital infections in this study highlights that there is a public health matter that must be controlled, which points a greater need for monitoring, guidance and actions towards greater awareness in order to prevent these problems.

Infecções do trato urinário são responsáveis pela maior parte das infecções humanas, sendo causadas por bactérias, fungos, protozoários, e por microrganismos associados. O objetivo deste trabalho foi determinar a frequência de agentes causadores de infecções vaginais nos exames citológicos de rotina, bem como avaliar as características dos esfregaços positivos. Foi realizada uma pesquisa do tipo documental retrospectiva de aspecto descritivo, com abordagem quantitativa, em um Laboratório de Patologia Clínica de Maceió-AL. Nesse sentido, os resultados dos exames colpocitológicos para Trichomonas vaginalis, Gardnerella vaginalis, Candida spp e HPV foram organizados em um banco de dados, contendo os resultados para estes agentes, bem como a coinfecção bacteriana, protozoária, fúngica e viral. A amostra foi composta por 18.645 mulheres que realizaram exame colpocitológico, no período de 2013 a 2017. Destes exames analisados 27,4% em 2013, 10,9% em 2014, 10,6% em 2015, 15,2% em 2016 e 13,67% em 2017, estavam dentro do limite da normalidade, porém mais que a metade desses exames analisados apresentou algumas infecções causadas por agentes inespecíficos ou microbiológicos. Do total de laudos analisados, 4.073 (21,84%), apresentaram inflamações causadas por algum tipo de agente infeccioso, com a seguinte ordem de frequência: G. vaginalis, e T. vaginalis. Além disto, foi possível confirmar a elevada frequência de coinfecção entre G. vaginalis e Candida spp. Os índices de infecções genitais nesse trabalho mostram que há um problema de saúde pública que deve ser controlado, apontando uma necessidade maior de acompanhamento, orientações e de ações para uma maior conscientização para prevenir esses problemas.

Retrospective study of bacterial agents found in urine culture of dogs: antimicrobial sensitivity and resistance profile / Estudo retrospectivo de agentes bacterianos observados na urocultura de cães: perfil de sensibilidade e resistência antimicrobiana

Urinary tract infections are commonly diagnosed in dogs, accounting for 2 to 3% of cases in the clinical routine, as cystitis being the most reported condition. Dogs of all ages and breeds can be affected, and early diagnosis is an important tool for therapeutic success. Urine culture and antibiogram are gold-standard tests for the diagnosis of bacterial cystitis, allowing correct therapy and better recovery of the patient, since currently there is great resistance to antimicrobials used in the veterinary clinics. Thus, the aim of this study was to determine the main etiological agents isolated in dog urine cultures, as well as the resistance and sensitivity profile of the isolated agents in relation to antibiotics, in order to assist the clinician ́s choice of the most appropriate antimicrobial, aiming at the patient's therapeutic success. For this study, a retrospective study was performed of 49 samples of urine cultures of male and female dogs, collected between 2012 and 2021, which were positive for bacterial growth. From this analysis, it was observed that Escherichia coli, Enterococcus spp. and Staphylococcus spp. were the most isolated agents, presenting higher antimicrobial resistance to cephalexin, sulfadiazine plus trimethoprim, ampicillin, enrofloxacin and ciprofloxacin, respectively.(AU)

s infecções do trato urinário são comumente diagnosticadas em cães, representando de 2 a 3% dos casos na rotina clínica, sendo a cistite a afecção mais relatada. Cães de todas as idades e raças podem ser acometidos, sendo o diagnóstico precoce uma ferramenta importante para o sucesso terapêutico. A urocultura e o antibiograma são exames padrão-ouro para o diagnóstico das cistites bacterianas, permitindo a terapêutica correta e melhor recuperação do paciente, já que atualmente há grande resistência aos antimicrobianos empregados na rotina clínica veterinária. Desta forma, o objetivo deste estudo foi determinar os principais agentes etiológicos isolados nas uroculturas de cães, bem como o perfil de resistência e sensibilidade dos agentes isolados frente aos antibióticos, de modo a auxiliar o médico veterinário na eleição do antimicrobiano mais adequado, visando sucesso terapêutico do paciente. Para realização deste estudo foi feita uma análise retrospectiva de 49 uroculturas de cães machos e fêmeas, coletadas entre os anos de 2012 e 2021, as quais apresentaram crescimento bacteriano positivo. A partir desta análise foi observado que Escherichia coli, Enterococcus spp. e Staphylococcus spp. foram os agentes mais isolados nas uroculturas, apresentando maior resis-tência aos antimicrobianos cefalexina, sulfazotrim ampicilina, enrofloxacina e ciprofloxacina, respectivamente.(AU)

Antimicrobial resistance profile of bacteria isolated from canine and feline samples at the Preventive Veterinary Laboratory of the Federal University of Rio Grande do Sul (UFRGS) - Brazil

Background: Antimicrobial resistance (AMR) is a major global health threat. In small animals such as dogs and cats, antimicrobials are most commonly prescribed for skin and genitourinary diseases; therefore, the AMR of bacteria involved in these infections should be monitored. In addition, the results of antimicrobial susceptibility testing (AST) may be interpreted as a local epidemiological history of AMR. The Preventive Veterinary Medicine Laboratory (PVML) received clinical samples from dogs and cats for bacterial isolation and AST. Thus, this study aimed to assess the AMR of bacteria isolated from the samples of dogs and cats received at the Preventive Veterinary Medicine Laboratory (PVML). Materials, Methods & Results: Data from bacteriological examinations performed at the PVML of the Universidade Federal do Rio Grande do Sul (UFRGS) during 5 years were analyzed. Skin and ear canal samples were inoculated in 5% sheep blood agar, and urine samples were streaked on CHROMagar™ orientation. After incubation at 36±1°C for up to 72 h, identification and AST were performed according to routine protocols. Of 1,534 samples submitted to the PVML, 1,086 (70.8%) were collected from dogs and 29.2% from feline patients. Otological swabs (n = 533, 49.1%) were the most frequent samples from dogs, while cat urine samples (n = 384, 84.8%) predominated by far. Considering the canine samples, no bacterial growth (NBG) was observed in 443 (40.8%) samples, while only one colony type was noted in 516 (47.5%) samples. Gram-positive bacteria (n = 298) were more frequent than gram-negative bacteria (n = 77) in the skin. In urine samples, gram-negative bacteria (n = 94) were isolated more frequently than gram-positive bacteria (n = 47). In feline samples, a high number of NBG (n = 308, 68%) was observed. Gram-positive (n = 22) was predominant in comparison to gram-negative bacteria (n = 9) in cultures from the ear and skin swabs. Enterococcus spp. and Escherichia coli were the most frequently identified bacteria in urine samples. Among the Staphylococcus sp. strains of any origin, AMR frequency varied from 4.22% (amikacin) to 50.70% (sulfa/trimethoprim). Enterococcus spp. showed AMR frequencies from 12.5% (amoxicillin/clavulanic acid) to 62.06% (enrofloxacin). Among the gram-negative genera, E. coli presented AMR frequencies from 10.20% (gentamicin) to 60.0% (neomycin). The frequency of AMR was stable over time, and a profile of much higher resistance to fluoroquinolones in comparison to beta-lactams was observed. Discussion: The recurrence of skin and urinary infections implies the need for frequent treatment with antibiotics, which exerts selection pressure for resistance and multidrug resistance. In this study, the frequency of multidrug resistance was low, and the resistance to the tested antimicrobials showed high variation. However, a trend of high resistance to the fluoroquinolone group was observed in contrast to the low resistance to beta-lactams. This trend was consistent among the isolated bacteria, regardless of the type of sample or origin. The overprescription of fluoroquinolones in small animal practices has been widely documented in several countries. However, this class of antimicrobials, is highly prioritized for the treatment of infections in humans. Therefore, the selection of resistant strains has gained special emphasis, especially when considering the possibility of the transmission of resistant bacteria between pets and humans. In summary, the results of bacteriological tests conducted at the PVML-Universidade Federal do Rio Grande do Sul confirmed that ubiquitous bacteria predominate in clinical samples of dogs and cats. The high frequency of resistance to the fluoroquinolone group, while a predominance of susceptible strains in the first-choice drugs such as amoxicillin/clavulanic acid, may indicate excessive and empirical use of the second-choice drugs in clinical practice.

Physicochemical techniques for determining the composition of canine and feline uroliths: a literature review / Técnicas físico-químicas para determinação da composição de urólitos em caninos e felinos: uma revisão de literatura

Urinary lithiasis has been reported as a problem that affects humankind since ancient times and has been described in several animal species. The condition is a consequence of other diseases that may be present in the urinary system or related to other body disorders. The stone composition needs to be analyzed to identify the possible causes that led to the formation and development of uroliths. For this, several techniques are currently available, some of which are promptly accessible, while others are not. Thus, this literature review aimed to perform a brief introduction on urolithiasis, present the most used techniques in the analysis of the composition of canine and feline uroliths and point out the advantages and disadvantages of each technique.

A litíase urinária foi reportada como um problema que atinge a humanidade desde a antiguidade e já foi descrita em diversas espécies de animais. A doença é considerada consequência de outras enfermidades que podem estar presentes no sistema urinário, ou relacionados com outros distúrbios do organismo. Para identificar as possíveis causas que levaram à formação e desenvolvimento de urólitos é importante analisar a composição dos cálculos. Para isso, existem várias técnicas disponíveis atualmente, algumas de mais fácil acesso e outras, nem tanto. Dessa forma, objetiva-se com a presente revisão realizar uma breve introdução sobre a urolitíase e apresentar as técnicas mais utilizadas na análise da composição de urólitos, em caninos e felinos, bem como apontar as vantagens e desvantagens de cada uma das técnicas.

Physicochemical techniques for determining the composition of canine and feline uroliths: a literature review / Técnicas físico-químicas para determinação da composição de urólitos em caninos e felinos: uma revisão de literatura

Urinary lithiasis has been reported as a problem that affects humankind since ancient times and has been described in several animal species. The condition is a consequence of other diseases that may be present in the urinary system or related to other body disorders. The stone composition needs to be analyzed to identify the possible causes that led to the formation and development of uroliths. For this, several techniques are currently available, some of which are promptly accessible, while others are not. Thus, this literature review aimed to perform a brief introduction on urolithiasis, present the most used techniques in the analysis of the composition of canine and feline uroliths and point out the advantages and disadvantages of each technique.(AU)

A litíase urinária foi reportada como um problema que atinge a humanidade desde a antiguidade e já foi descrita em diversas espécies de animais. A doença é considerada consequência de outras enfermidades que podem estar presentes no sistema urinário, ou relacionados com outros distúrbios do organismo. Para identificar as possíveis causas que levaram à formação e desenvolvimento de urólitos é importante analisar a composição dos cálculos. Para isso, existem várias técnicas disponíveis atualmente, algumas de mais fácil acesso e outras, nem tanto. Dessa forma, objetiva-se com a presente revisão realizar uma breve introdução sobre a urolitíase e apresentar as técnicas mais utilizadas na análise da composição de urólitos, em caninos e felinos, bem como apontar as vantagens e desvantagens de cada uma das técnicas.(AU)

Leptospira spp. of the urinary tract of female carrier goats in semi-arid conditions

Background: Leptospirosis is an important infectious disease in goat farming, with a worldwide distribution. It is usually transmitted by rodents and the genital route, may cause reproductive losses, negatively impacting goat farming. The diagnosis lies on serological, molecular and isolation techniques. Considering the importance of this disease for small ruminants, this work aimed to evaluate the serological, molecular findings and isolation of pathogenic leptospires in the urinary tract (kidney and bladder tissues) of goats. Materials, Methods & Results: Thirty-four adult goats were used for slaughter. Renal samples (n = 34), bladder (n = 34), were collected for isolation of the agent and molecular detection of Leptospira sp. and blood samples (n = 34) for serological testing. The polymerase chain reaction (PCR) was used as a molecular test and the microscopic serum agglutination test (MAT) was used as a serological test. Samples with DNA amplification were subjected to genetic sequencing. The presence of Leptospira DNA was found in the tissues of 8 (23.4%) goats, and of these, only 2 were positive in PCR and MAT. There was a slight agreement between the PCR and MAT techniques (k = 0.150; P = 0.436). In 6 (17.6%) samples of renal tissue and 2 (5.8%) bladder samples, Leptospira DNA was detected. The genes in a kidney tissue sample were sequenced and demonstrated 99% similarity to Leptospira interrogans. Anti-Leptospira sp. were detected in 6 (17.6%) of the animals tested. Discussion: Serology identified 3 predominant serogroups: Icterohaemorrhagiae, Tarassovi and Autumnalis, serogroups that are related to the presence of rodents that coexist in rural environments. Autumnalis has been reported in small ruminants, raising the hypothesis that goats are adapted, becoming chronic carriers and possible maintenance hosts. The frequency obtained (17.6%) may be the result of the mixed breed pattern and rustic characteristics inherent to the goat species. Given the characteristics of the semi-arid region, such as low rainfall and high solar incidence, it is essential to use an adapted methodology, with a lower cut-off point (1:50), as the serological titer is an established relationship between the animal species, the level of exposure throughout its evolution and the region studied. Molecular findings and bacterial isolation reveal the agent's ability to colonize the urinary tract of goats. These data show the importance that urine has in the epidemiological chain, being able to transmit the agent through direct contact with this product or through contamination of soil and water. There was no statistical agreement between the diagnostic techniques used in this study, in this case, an association between PCR and MAT is recommended to obtain data with high sensitivity and specificity. A bladder sample was sequenced and showed 99% similarity to Leptospira interrogans. In the semiarid region, the most common form of leptospirosis spread is through the sale of animals in business fairs for breeding, rearing or slaughter, as well as sharing the same property with several breeders. The introduction of chronic and asymptomatic carriers on the properties represents a serious risk for the spread of the disease. The results show the presence of Leptospira spp. in semi-arid goat herds, having as risk factors the presence of rodents and intercropping. The association of MAT and PCR is necessary for a better diagnosis of the disease.

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

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

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

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

Agents causing genital infections in routine cytological tests: frequency and characteristics of Papanicolaou smears

Abstract Urinary tract infections are responsible for most human infections, these are caused by bacteria, fungi, protozoa and associated microorganisms. The goal of this study was to determine the rate of vaginal infection-causing agents in routine cytological exams and also to evaluate the characteristics of positive tested Pap smears. A retrospective documental with descriptive aspect research was performed in a Clinical Pathology laboratory from Maceió-AL. The results of the Pap smears exams for Trichomonas vaginalis, Gardnerella vaginalis, Candida spp and HPV were arranged in a database as well as other data such as bacterial, protozoan, fungal and viral coinfections. The sample was composed by 18.645 women who have undergone Pap smear exams from 2013 to 2017. Of these analyzed exams, 27.4% in 2013, 10.9% in 2014, 10.6% in 2015, 15.2% in 2016 and 13.67% in 2017 were within normal range, however more than half of these exams presented some infections caused by unspecific or microbiological agents. By analyzing all the reports, 4.073 (21.84%) presented inflammations caused by some species of infectious agent with the following rate order: G. vaginalis and T. vaginalis. Furthermore, it was possible to confirm high rates of coinfection by and Candida spp. The rate of genital infections in this study highlights that there is a public health matter that must be controlled, which points a greater need for monitoring, guidance and actions towards greater awareness in order to prevent these problems.

Resumo Infecções do trato urinário são responsáveis pela maior parte das infecções humanas, sendo causadas por bactérias, fungos, protozoários, e por microrganismos associados. O objetivo deste trabalho foi determinar a frequência de agentes causadores de infecções vaginais nos exames citológicos de rotina, bem como avaliar as características dos esfregaços positivos. Foi realizada uma pesquisa do tipo documental retrospectiva de aspecto descritivo, com abordagem quantitativa, em um Laboratório de Patologia Clínica de Maceió-AL. Nesse sentido, os resultados dos exames colpocitológicos para Trichomonas vaginalis, Gardnerella vaginalis, Candida spp e HPV foram organizados em um banco de dados, contendo os resultados para estes agentes, bem como a coinfecção bacteriana, protozoária, fúngica e viral. A amostra foi composta por 18.645 mulheres que realizaram exame colpocitológico, no período de 2013 a 2017. Destes exames analisados 27,4% em 2013, 10,9% em 2014, 10,6% em 2015, 15,2% em 2016 e 13,67% em 2017, estavam dentro do limite da normalidade, porém mais que a metade desses exames analisados apresentou algumas infecções causadas por agentes inespecíficos ou microbiológicos. Do total de laudos analisados, 4.073 (21,84%), apresentaram inflamações causadas por algum tipo de agente infeccioso, com a seguinte ordem de frequência: G. vaginalis, e T. vaginalis. Além disto, foi possível confirmar a elevada frequência de coinfecção entre G. vaginalis e Candida spp. Os índices de infecções genitais nesse trabalho mostram que há um problema de saúde pública que deve ser controlado, apontando uma necessidade maior de acompanhamento, orientações e de ações para uma maior conscientização para prevenir esses problemas.