Clinical and pathological aspects of progressive hyperphosphatasemia associated with vacuolar hepatopathy and hepatocellular carcinoma in a Scottish Terrier bitch / Aspectos clínicos e patológicos da hiperfosfatasemia progressiva associada à hepatopatia vacuolar e carcinoma hepatocelular em uma cadela da raça Scottish Terrier

ABSTRACT: Hyperphosphatasemia refers to an increase in alkaline phosphatase serum activity, and Scottish Terriers (STs) are predisposed to develop this condition of uncertain pathogenesis. This study describes a case of progressive hyperphosphatasemia with vacuolar hepatopathy and hepatocellular carcinoma (HCC) in a ST bitch. This dog had a five-year clinical follow-up with progressive hyperphosphatasemia (up to 5503 U/L) and with ultrasound findings and histologic diagnosis of vacuolar hepatopathy, in addition to posterior onset of HCC. A steroidogenic adrenal panel revealed an increase of adrenocortical hormones, especially progesterone and androstenedione, consistent with a subdiagnosed hypercortisolism. Euthanasia was elected and at necropsy, multinodular, yellow to red masses were observed in the liver, which were histologically and immunohistochemically defined as HCC. The association of the clinical, imaging, biochemical, adrenal panel and pathologic findings allowed to characterize and confirm a progressive disorder in this ST bitch associated with elevated adrenocortical hormones.

RESUMO: Hiperfosfatasemia é o aumento sérico de fosfatase alcalina, sendo que Scorrish Terriers estão predispostos a desenvolverem essa condição de patogênese desconhecida. Este trabalho descreve um caso de hiperfosfatasemia progressiva com hepatopatia vacuolar e carcinoma hepatocelular em um canino da raça Scottish Terrier. Uma cadela Scottish Terrier foi acompanhada clinicamente por cinco anos devido à hiperfosfatasemia persistente (até 5503 U/L), com achados ultrassonográficos e histológicos compatíveis com hepatopatia vacuolar, além de posterior desenvolvimento de carcinoma hepatocelular. O painel esteroidogênico realizado indicou aumento dos hormônios adrenocorticais, principalmente progesterona e androstenediona, consistente com diagnóstico de hipercortisolismo subdiagnosticado "atípico". Devido ao prognóstico desfavorável, a eutanásia foi realizada e na necropsia, massas amarelas a vermelhas e multinodulares foram observadas no fígado, com diagnóstico de carcinoma hepatocelular pela análise histológica e imuno-histoquímica. A associação dos achados clínicos, de imagem, bioquímicos, do painel androgênico e patológicos permitiram caracterizar e confirmar um distúrbio progressivo no canino da raça Scottish Terrier associado ao aumento dos hormônios adrenocorticais.

Clinical and pathological aspects of progressive hyperphosphatasemia associated with vacuolar hepatopathy and hepatocellular carcinoma in a Scottish Terrier bitch / Aspectos clínicos e patológicos da hiperfosfatasemia progressiva associada à hepatopatia vacuolar e carcinoma hepatocelular em uma cadela da raça Scottish Terrier

Hyperphosphatasemia refers to an increase in alkaline phosphatase serum activity, and Scottish Terriers (STs) are predisposed to develop this condition of uncertain pathogenesis. This study describes a case of progressive hyperphosphatasemia with vacuolar hepatopathy and hepatocellular carcinoma (HCC) in a ST bitch. This dog had a five-year clinical follow-up with progressive hyperphosphatasemia (up to 5503 U/L) and with ultrasound findings and histologic diagnosis of vacuolar hepatopathy, in addition to posterior onset of HCC. A steroidogenic adrenal panel revealed an increase of adrenocortical hormones, especially progesterone and androstenedione, consistent with a subdiagnosed hypercortisolism. Euthanasia was elected and at necropsy, multinodular, yellow to red masses were observed in the liver, which were histologically and immunohistochemically defined as HCC. The association of the clinical, imaging, biochemical, adrenal panel and pathologic findings allowed to characterize and confirm a progressive disorder in this ST bitch associated with elevated adrenocortical hormones.

Hiperfosfatasemia é o aumento sérico de fosfatase alcalina, sendo que Scorrish Terriers estão predispostos a desenvolverem essa condição de patogênese desconhecida. Este trabalho descreve um caso de hiperfosfatasemia progressiva com hepatopatia vacuolar e carcinoma hepatocelular em um canino da raça Scottish Terrier. Uma cadela Scottish Terrier foi acompanhada clinicamente por cinco anos devido à hiperfosfatasemia persistente (até 5503 U/L), com achados ultrassonográficos e histológicos compatíveis com hepatopatia vacuolar, além de posterior desenvolvimento de carcinoma hepatocelular. O painel esteroidogênico realizado indicou aumento dos hormônios adrenocorticais, principalmente progesterona e androstenediona, consistente com diagnóstico de hipercortisolismo subdiagnosticado "atípico". Devido ao prognóstico desfavorável, a eutanásia foi realizada e na necropsia, massas amarelas a vermelhas e multinodulares foram observadas no fígado, com diagnóstico de carcinoma hepatocelular pela análise histológica e imuno-histoquímica. A associação dos achados clínicos, de imagem, bioquímicos, do painel androgênico e patológicos permitiram caracterizar e confirmar um distúrbio progressivo no canino da raça Scottish Terrier associado ao aumento dos hormônios adrenocorticais.

Primary pulmonary chondrosarcoma in a bitch

Background: Primary lung neoplasms are uncommon in veterinary medicine, and when they develop, they are more frequently observed to be of epithelial origin. Although chondrosarcomas are the second most diagnosed type of neoplasm in dogs at skeletal sites, their development in extraskeletal tissues, including the spleen, aorta, heart, tongue, peritoneum, and lungs, corresponds to approximately only 1% of cases. Therefore, the occurrence of primary pulmonary chondrosarcoma is considered very rare in domestic animals. Considering the rare occurrence and scarcity of data regarding its development, the present report describes the clinical and pathological aspects of a case of primary pulmonary chondrosarcoma in a bitch. Case: A 8-year-old mixed-breed bitch, weighing 14.2 kg, was examined at one private veterinary clinic with the principal complaint of prolonged respiratory distress and resistance to exercise. Clinical evaluation revealed tachypnea with expiratory dyspnea due to intense pleural effusion, tachycardia, and diffusely pale mucous membranes. Thoracocentesis was performed with drainage of 1000 mL of modified transudate, and fluid cytology, blood count, and chest radiography were performed. Cytological analysis of the thoracic fluid did not identify neoplastic cells, the blood count showed intense regenerative anemia, and the radiograph showed an extensive area of consolidation in the left caudal lung lobe, compatible with neoplasia. The results of the tests performed, in addition to the evolution of the clinical picture and the impossibility of performing the indicated surgical intervention, culminated in the patient's unfavorable prognosis, followed by euthanasia, necropsy, and histopathological evaluation of the collected material. Necropsy revealed a white neoplastic formation with reddish areas and firm consistency that diffused into the parenchyma of the left caudal lung lobe with invasion of the rib cage, fracture of the fifth and sixth left ribs, diaphragmatic metastasis, intense hydrothorax, and moderate hydroperitoneum. Microscopically, in the histological sections of the lung and diaphragm, poorly differentiated mesenchymal cells with moderate anisocytosis and anisokaryosis and interspersed with them, moderately differentiated chondrocytes surrounded by chondroid matrix, moderate anisocytosis and anisokaryosis, and a low mitotic index culminated in the diagnosis of primary pulmonary mesenchymal chondrosarcoma. Discussion: Malignant epithelial neoplasms were suspected; however, the histopathological features observed were compatible with primary pulmonary chondrosarcoma. The characteristics of the fluid collected through thoracentesis led to its classification as a modified transudate, which is often associated with neoplastic and hemorrhagic processes; both alterations were present in this case. The diagnosis of primary pulmonary chondrosarcoma was established based on the histopathological findings since the cell type and distribution observed in the present case were compatible with the typical pattern observed in extraskeletal chondrosarcomas. An unfavorable prognosis is common in cases of primary or metastatic lung neoplasm since, in most cases, the condition is identified in the advanced stages of the disease, making therapeutic management challenging. Given the increase in the number of dog deaths due to neoplasms in recent years, this case report may contribute to a better understanding of the biological behavior of pulmonary chondrosarcoma and assist in the choice of treatment to be adopted when required.

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.

Hemangiosarcoma in the vastus lateralis musculature of a bitch - sonographic findings

Background: A 10-year-old spayed bitch with hip dysplasia was referred for periarticular ultrasound evaluation. A poorly marginated structure of mixed echogenicity, predominantly hypoechoic, with heterogeneous echotexture, was identified in the vastus lateralis muscle of the right pelvic limb with increased stiffness, assessed using acoustic radiation force impulse (ARFI) elastography, compared to that of the adjacent muscle tissues, and intense vascularization by pulsed Doppler and contrast-enhanced ultrasound (CEUS). Guided biopsy was performed to confirm the diagnosis of hemangiosarcoma. The objective of this study was to describe B-mode ultrasound, CEUS, and ARFI findings of hemangiosarcoma in the vastus lateralis musculature of a bitch. Case: A 10-year-old spayed bitch Golden Retriever weighing 36 kg was evaluated for pelvic limb lameness. The patient presented with bilateral pain during hip extension. The primary diagnostic suspicion was degenerative joint disease and secondary hip dysplasia. The patient was referred for imaging evaluation of the hip joints (radiography and ultrasound) under anesthesia. Right lateral and ventrodorsal projections with the pelvic limbs extended were obtained to confirm the diagnosis. In the right pelvic limb, an amorphous hypoechoic structure with irregular contours and heterogeneous echotexture was observed in the vastus lateralis muscle. In ARFI elastography, it was possible to identify differences in tissue stiffness between healthy and compromised portions. Pulsed-wave Doppler evaluation demonstrated an arterial waveform pattern with a peak systolic velocity of 38.8 cm/s, end-diastolic velocity of 6.9 cm/s, pulsatility index of 1.76, and resistive index of 0.82. CEUS study identified a mean peak of 27.26 %, mean time to peak of 39.95 s, and mean transmission time of 49.96 s. The popliteal lymph node was hyperechoic and heterogeneous in B-mode. In ARFI elastography, the average stiffness was 2.52 m/s, and the CEUS obtained an average peak of 19.98%, average time to peak of 17.52 s, and mean transit time of 22.83 s. Doppler assessment revealed no clear vascularization in the lymph node. Thoracic radiography in 3 projections and abdominal ultrasonography were performed. Radiographic evidence of pulmonary nodules was not observed. On abdominal ultrasound evaluation, it was possible to identify changes in the spleen, which presented with splenomegaly, mixed echogenicity, and heterogeneous echotexture. The animal underwent ultrasound-guided muscle biopsy, which confirmed the presence of hemangiosarcoma in the muscle. The bitch was referred for splenectomy and lymphadenectomy of the right popliteal, which confirmed neoplastic involvement of the same neoplasm. Discussion: On B-mode ultrasound, the observed changes were similar to those in a report of hemangiosarcoma in the muscles of the chest wall in dogs, which contributed to the diagnosis. Although it was only one patient, ARFI elastography results suggest that muscle hemangiosarcoma tends to follow the same elastographic characteristics as malignant lesions in other tissues. Additionally, the popliteal lymph node had a stiffness suggestive of malignancy (mean 2.52 m/s) because it presented a similar result and greater elasticity of metastatic axillary lymph nodes in bitches (>2.5 m/s) and women (> 1.44 m/s) with breast tumor. With CEUS, it was possible to identify vascularization in the sentinel lymph node that was not visible by pulsed Doppler, and in muscle mass. The findings of this report provided relevant results on muscle hemangiosarcoma in a bitch and demonstrated that the information obtained with the association of imaging methods supported the malignancy criteria described in other studies.

Thromboembolism in a bitch - diagnosis by infrared thermography

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

Cholangiocarcinoma in a bitch - multimodal diagnosis

Background: Hepatic tumors of primary origin account for 0.6% to 2.9% of cases in canine species, less common than hepatic metastases. The hepatic tumors are divided into hepatocellular tumors, neuroendocrine tumors, bile duct tumors or cholangiocarcinomas, and mesenchymal tumors. Cholangiocarcinomas, are classified according to their origin, being intrahepatic, extrahepatic, or gallbladder type. Cholangiocarcinomas are considered rare in dogs and cats with a ratio of 29% to 71% compared to hepatocellular carcinomas, accounting for 9% of the hepatic tumors. The present study aims to describe a case of cholangiocarcinoma in a bitch, focusing on the diagnostic approach. Case: A 10-year-old castrated bitch Poodle was attended presenting hypoglycemia and seizure crisis. The patient had previous exams of hemogram and serum biochemical profile, showing a discrete increase of the hepatic enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST), besides hypoglycemia. Previous ultrasound exam revealed the presence of a hepatic mass located between the right and square lobes, immeasurable, and significant splenomegaly. Abdominal palpation revealed the presence of immeasurable abdominal formation of undetermined origin. Abdominal computerized tomography (CT), glycemic curve, and insulin dosage were requested. Tomography exam showed an increase in hepatic volume with the presence of a heterogeneous formation in the right lateral lobe topography; increase in spleen dimensions and the presence of multiple nodules; and the presence of a nodule in the right lung, at the caudal thoracic region. The glycemic curve showed acute variations, and insulin dosage was between normal values. The animal was referred for surgery, as in abdominocentesis, it was observed the presence of hemorrhagic fluid, confirming active bleeding by ultrasonography. The owners chose for euthanasia. In the post-mortem evaluation the main lesion was confirmed of hepatic origin, with a massive, irregular, cavitary presentation, involving multiple hepatic lobes, and a single nodule was observed in the right caudal lobe of the right lung. Histopathological evaluation was considered inconclusive. Immunohistochemistry was performed and the association of the immunohistochemical profile with the morphological characteristics indicated diagnosis of cholangiocarcinoma. Discussion: The related symptomatology, in hepatic neoplasms, is generally considered non-specific, with reports of lethargy, vomiting, dyspnea, anorexia and weight loss, however, the dog in this study presented a unique manifestation of hypoglycemia and one episode of convulsive crisis resulting from it. The clinical manifestation observed was extremely unspecific making initial diagnosis difficult. The ultrasonographic examination was effective in evidencing the abdominal mass. In addition, abdominal CT was also performed, which confirmed the hepatic origin, detailing the macroscopic aspect. Biochemical analyses of ALT and AST showed a discrete increase. Biochemical changes may occur in dogs with hepatic neoplasms, although they are not specific. Functional pancreatic beta-cell tumors producing insulin are the most common cause of paraneoplastic hypoglycemia, although in the case the insulin dosage was within normal limits. In cases of nonislet cell tumor the mechanism is frequently associated with the production of insulin-like growth factor (IGF). In most cases the definitive diagnosis of cholangiocarcinoma can be obtained by histopathological examination, although in the present report the result obtained was inconclusive, requiring an immunohistochemical examination. Due to the aggressive and metastatic character of this neoplastic type, early detection becomes extremely important in order to maximize therapeutic chances, however, diagnosis may be difficult.

Mesotelioma pleural em mediastino em uma cadela - remoção com esternotomia mediana / Mediastinal mesothelioma in a bitch - removal with median sternotomy

Background: Malignant pleural mesothelioma (MPM) is a neoplasm with low incidence in small animals, and the possible causes are poorly elucidated but may be related to contact with asbestos. In the thoracic cavity, MMP can be localized or generalized to all cavity structures, and its clinical signs depend on this localization. Although some alternative therapies are being discussed, few studies are conclusive, with surgical intervention as the leading therapeutic option. Given this context, this report aimed to describe a case of MMP located in the mediastinum of a bitch treated with radical excision through mediated sternotomy. Case: A 7-year-old bitch of the Shar-pei breed was referred for care due to progressive weight loss and intense dyspnea. During the physical examination, dyspnea and muffled lung sounds were noted. The patient underwent hemodialysis, which showed neutrophilic leukocytosis. An abdominal ultrasound was also performed and revealed mild abdominal effusion, and chest radiography revealed an extensive tumor covering the entire chest cavity. Thoracocentesis was performed, and the material analyzed was a malignant exudate; the patient was referred to median sternotomy for exploratory purposes, and afterward, total macroscopic extirpation of the tumor was performed. A sample was sent for histopathology, and malignant mesothelioma was confirmed. The patient was discharged after 8 days of hospitalization with home treatment and did not return to the hospital. Upon contacting the guardian, we were informed that the animal had died 154 days after the procedure due to unknown causes. Discussion: Malignant pleural mesothelioma affects humans and animals; it is associated with the risk factor of contact with asbestos and the use of flea antiparasitic drugs. In small animals, its incidence is rare, albeit mesotheliomas have been reported in wild and large animals. The clinical signs are related to the location of the neoplasm. When it is located in the thoracic region, dyspnea, muffled lung sounds, cyanosis, and pleural effusion are observed in most cases. Diagnosis is usually late and incidental, although some tests, such as ultrasonography, magnetic resonance imaging, tomography, radiography, and needle biopsy, can help in the diagnosis. Histopathology is the exam of choice for definitive diagnosis, as it helps one observe the proliferation of neoplastic mesothelial cells, atypical mitosis figures, and marked cellular pleomorphism. Many therapeutic options have been discussed, including chemotherapy, immunotherapy, and anti-tumor immunization, although there is little scientific proof of their efficacy in animals. The current treatment of choice is tumor excision by surgical procedure with a palliative objective since the prognosis of the disease is unfavorable. Minimally invasive video surgery has been gaining more and more space in veterinary medicine and has proven successful in numerous cases of thoracic masses. In the present report, we chose to perform median sternotomy for total excision due to the extension of the mass that occupied the thoracic cavity practically in its entirety. Further research should be conducted to help in palliative treatments and increase the survival of patients with mesotheliomas, given that most studies are done in humans and not animals. We conclude that median sternotomy is still the therapeutic option of choice for the palliative treatment of patients with extensive thoracic pleural mesotheliomas.

Multilobular tumor of bone in bitches: clinical, histopathological, immunohistochemical and overall survival aspects

Background: Multilobular tumor of bone (MTB) is an unusual neoplasm with variable biologic behavior which originates primarily in bone tissues. Radiographs computed tomography (CT), and magnetic resonance imaging (MRI) are useful in diagnoses and surgical planning. Tumor removal with wide surgical margins is the treatment of choice. Immunohistochemistry has been shown as an important tool in veterinary oncology to define therapeutic and prognostic decisions. The goal of this study was to report 2 distinct cases of multilobular tumor of bone, their Cox-2 and Mib-1 immunohistochemical profile and its impact on overall survival. Case: Two bitches were presented at the Oncology Department of the Veterinary Hospital in the Veterinary School of Universidade Federal de Minas Gerais (UFMG). Both had a history of a progressive, painless, circumscribed, and firm facial mass. The 1st patient was a 8-year-old intact bitch mixed breed, weighing 50 kg, that presented a fast growing right infraorbital 3-cm mass, causing eye displacement. The 2nd patient was a 7-year-old spayed bitch Labrador retriever, weighing 28 kg, that presented a left temporal 8-cm mass. Neurologic examination of both bitches was normal. Skin over the nodules was strained, but with no ulceration. Radiographic exams of the head revealed lytic and proliferative bone reaction, with loss of cortical definition in both cases. These alterations were seen on the left zygomatic arch of the retrobulbar region, involving part of the mandible and of the nasal sinus lateral frontal bone in 1st patient, and on the right temporal process of the zygomatic bone in 2nd patient. The last one, also showed a granular solid mass with little contact with skull bones. Complete blood count, biochemistry profile, electrocardiogram, and 3-view thoracic radiographs were performed. Results were within normal ranges for the species and no signs of metastasis was seen on the radiographs. Location, size, and density of the mass, adjacent tissue compression, absence of cranial invasion, and lymph node size were rigorously evaluated with CT, allowing an individualized surgical planning to achieve complete mass removal and maintenance of the function of adjacent structures. Both animals were submitted to surgery. Both tumors were fixed on 10% neutral buffered formalin and sent to the Animal Pathology Department of UFMG for histopathological examination and margin assessment. Both tumors were diagnosed as grade I MTB. Tumor immunohistochemistry was performed to identify prognostic factors that could be used to better define therapeutic treatments and to try to clarify the discrepancy in disease progression between both tumors. The 1st patient expressed 20% of Mib-1 and was considered score 2 of Cox-2. The 2nd one expressed 5% of Mib-1 and was considered score 1 of Cox-2. Considering the diagnoses and histological characteristics of the tumors, it was decided for clinical follow-up of patients without additional therapeutic complementation. Even considering incomplete surgical margins in 2nd patient, adjuvant chemotherapy was not performed, due to low mitotic index and low histological grade. The 1st patient had an overall survival of 240 days, and death was due to recurrence and disease progression; and the 2nd did not show recurrence nor metastasis after 1200 days. Discussion: Proper and individualized surgical planning and histopathological evaluation are extremely important to guide treatment decisions. However, immunohistochemistry can be important in MTB cases, to help define which patients should be submitted to surgery alone and which patients could be benefited from adjuvant chemotherapy.

Antiparkinsoniano para tratamento de sequelas neurológicas causadas pela cinomose / Antiparkinsonian for treatment of neurological sequels caused by canine distemper

Background: Canine distemper (CD) is a highly contagious viral disease caused by the canine distemper virus (CDV). In dogs, CDV infection is characterized by the presentation of systemic and/or neurological signs with viral persistence in some organs, including the central nervous system (CNS). Neurological damages resulting from CD are a defiance for veterinarians, due to occasioned clinical sequels that influence the patient quality of life. The treatment of sequelae should seek to promote the resolution or decrease of the deleterious effects that impede the patient independence. Thus, the present report aims to describe the action of antiparkinsonian medication (levodopa associated with carbidopa) administered to 3 dogs who presented neurological sequels resulting from the canine distemper. Cases: Dog 1. A 9-month-old male mixed breed; Dog 2. A 6-month-old male Shih Tzu. Dog 3. A 8-years-old bitch mixed breed. All animals were referred for neurological care because presented neurological damages after distemper involvement. Only the Dog 2 was vaccinated to CD. Dog 1 (mixed male) had severe myoclonus, lack of proprioception, decreased of muscle tonus and paralysis in both pelvic limbs, associated with a marked thoracolumbar kyphosis. Dog 2 (a puppy Shih Tzu male) presented myoclonus in PL, proprioceptive loss in thoracic and pelvic limbs, absence of withdrawal reflex in thoracic and pelvic limbs, decrease in muscle tonus in pelvic limb and increase in thoracic limb. Dog 3 (adult unneutered bitch) presented intense myoclonus, absence of proprioception, decrease in muscle tonus and paresis of pelvic limb. All patients were treated with antiparkinsonian medication (levodopa 250 mg associated with carbidopa 25 mg) with following dosages: Dog 1 received a commercially available tablet, orally once a day for 30 days, while Dogs 2 and 3 had doses calculated by extrapolation allometric. For the Dog 2 it was prescribed 0.25 mg of levodopa and 0.025 mg of carbidopa daily for 30 days. Dog 3 was treated with 1 mg of levodopa and 0.1 mg of carbidopa patient day for the same period. Thirty days after starting the treatment, the 3 patients were evaluated again, and showed improvement of the motor signs, and the treatment was maintained. At the next return (30 days): Dog 1 showed significant improvement, however, Dog 2 started to present epileptic seizures and nystagmus that were treated with levetiracetam, while the Dog 3 not returned. As Dog 1 had a better prognosis, treatment was maintained for 1 year, with the frequency being changed from 24 h x 24 h to 48 h x 48 h after 30 days and 72x72 h after another 30 days. Unfortunately, Dog 2 had a worsening of epileptic condition and died, while Dog 3 died by road-kill. Discussion: The cases reported are uncommon, because not exist information about the use of antiparksonian to treatment of neurological damages occasioned by canine distemper. Although there are emerging therapies, such as the use of mesenchymal stem cells, that can reduce these sequels, the access is still restricted to a few professionals. Thus, the use of medications for demyelinating diseases, as antiparkinsonian, may be an alternative. In fact, the three reported patients showed recovery of the motor and sensorial damages observed, which corroborates with the possibility of a new treatment using antiparkinsonian or other drugs to demyelinating diseases.

Chronic superficial infection in a dog caused by multidrug-resistant Pseudomonas aeruginosa

Background: Pseudomonas aeruginosa is a gram-negative aerobic bacterium and non-glucose fermenting, that usually causes opportunistic infections in animals, including humans. It is rarely involved in primary disease. The antibioticresistant bacterial strains are mainly developed due to the inappropriate use of antibiotics, however treating P. aeruginosa infections can be difficult owing to their natural resistance to antibiotics. Furthermorer resistant microorganisms such as P. aeruginosa grow by developing biofilms. Inaccurate diagnoses and absence of adequate microbiological tests can cause difficulties in resolving cases. This report describes a case of chronic superficial infection in a bitch caused by multidrugresistant Pseudomonas aeruginosa (MDR-PA). Case: A 6-year-old bitch Shih Tzu, initially presented with an exudative erythematous lesion in the snout region, which progressed to deep lesions, and spread to the back and limbs; furthermore, the animal always experienced a fever before new wounds emerged. Lesion samples, collected using a swab and processed at the Veterinary Microbiology Laboratory of the Federal University of Jatai (UFJ), revealed the presence of Pseudomonas aeruginosa. The isolate was multidrug-resistant and a carrier of TEM and ppyR genes. In the diffusion disk antibiogram, the isolate was found resistant to 14 different antibiotics belonging to 6 classes. Antimicrobial resistance was also tested using the minimum inhibitory concentration (MIC) test against imipenem, ceftazidime, ciprofloxacin, ticarcillin + clavulanic acid and aztreonam present in the MIC test strip. Treatment with amikacin and muporicin proved to be effective; however, owing to lesions extending to the face and palpebral involvement, the animal lost its eyeballs. Discussion: Pseudomonas aeruginosa is frequently associated with nosocomial infections mainly affecting immunosuppressed patients. Among the antibiotics tested, the group with the highest number of ineffective antibiotics was beta-lactams, where sensitivity was only observed for ticarcillin and ceftazidime. Recent studies have demonstrated that ceftazidime can reduce biofilm volume, inhibit motility, and repress the expression of genes associated with bacterial adhesion in P. aeruginosa. Therefore, the production of biofilm in P. aeruginosa is an important virulence factor as it facilitates a stable environment for the microorganism, which protects the bacteria from contact with antimicrobials. In addition, prolonged exposure to a wide variety of antimicrobials creates an environment of selective pressure between microorganisms, facilitating the emergence of multidrug-resistant strains. Furthermore, it is now well recognized that low doses of antibiotics, administered during continuous and fluctuating treatments, can stimulate biofilm establishment and are partly responsible for biofilm-specific antimicrobial tolerance. The resistance profile of P. aeruginosa isolated from dogs varies considerably, and the presence of isolates with a possible biofilm production capacity represents a challenge for the interpretation of the antimicrobial susceptibility profile. Culture and antibiogram is fundamentally important, both clinically and in environmental monitoring, in addition to the use of antibiogram data for decision making in clinical treatment.

Pregnancy success in bitches - evaluation of interactions between artificial insemination method, serum progesterone concentration and vaginal cytology parameters

Background: The artificial insemination has become a well-established method in the breeding of bitches, and evaluation of the factors that may potentially affect pregnancy success is essential. For this reason, it is essential to evaluate the factors that may affect fertility of the bitch when artificial insemination is performed. Serum progesterone concentrations and vaginal cytology have been used to determine the time of ovulation and stage of the estrus cycle. This study aimed to evaluate the artificial insemination method, the serum progesterone concentration, the breed size, age, the whelping number, vaginal cytology parameters, and their interactions on pregnancy success in bitches. Materials, Methods & Results: A total of 607 bitches that had undergone reproductive consultation with the Mexican Canine Federation from January to December 2016 were enrolled in the present study and assigned to one of 2 artificial insemination methods (intravaginal and transcervical) using fresh semen. Determination of the estrus cycle phase and the time of Artificial insemination was based on vaginal cytology and serum progesterone concentrations. Bitches inseminated by the transcervical technique had a higher pregnancy rate with respect to females inseminated by the intravaginal technique (P < 0.05). Moreover, females with a serum progesterone concentration of 5-10 ng/mL had a greater probability (> 4 times) of getting pregnant than animals with lower or higher progesterone concentrations (P < 0.05). Bitches inseminated by the intravaginal technique and with serum progesterone concentrations >10 ng/mL had a considerable reduction in pregnancy (P < 0.05) compared with females with < 10 ng/mL serum progesterone or with bitches inseminated by the transcervical technique. Discusion: Serum progesterone concentration, the artificial insemination method, and superficial cells without a nucleus modified the pregnancy rate in bitches. Females inseminated by transcervical semen deposition had a higher pregnancy rate than females inseminated by the intravaginal technique. Using fresh or frozen-thawed semen produced a higher pregnancy rate in bitches inseminated by transcervical semen deposition than females inseminated by the intravaginal technique. Differences in the pregnancy rate between transcervical and intravaginal insemination could be associated with the correct semen disposition, the distance that the sperm must travel to reach the oocyte, as well as the number of sperm that reach the oviduct ampulla. Exist evidences that after ovulation, as progesterone rises, the cervix is closed, which may compromise the passage of the sperm deposited into the vagina. Therefore, it is likely that in females with a serum progesterone concentration > 10 ng/mL, the cervix was closed, compromising the ability of the sperm to access the oviduct. Thus, the use of intravaginal insemination should be done in bitches with a serum progesterone concentrations < 11 ng/mL to reduce the possibility of cervical closure and to increase the odds of pregnancy. It is well documented that the serum progesterone concentration and vaginal cytology parameters have a great influence on pregnancy success, and the results confirm these findings. In the present study, 96% of the bitches inseminated with a serum progesterone concentration of 5-10 ng/mL got pregnant and had higher odds of pregnancy than bitches with lower or higher serum progesterone concentrations.

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.

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

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

Diagnostic applicability of infrared thermography in the evaluation of canine mammary tumors / Aplicabilidade diagnóstica da termografia infravermelha na avaliação dos tumores mamários caninos

Mammary tumors have a high prevalence in bitches and women, and are related to high rates of morbidity and mortality. For the human species, thermography has stood out as a diagnostic tool for breast cancer. However, its clinical benefit in bitches remains unknown. Thus, the goal of the present study was to evaluate the diagnostic applicability of infrared thermography for canine mammary tumors, as well as to correlate tumor temperature with mitotic index and tumor volume. Thermographic and digital images of eight bitches with mammary neoplasms were captured. Thermograms were entered into the FLIR tools software and the temperature of 15 tumor and 15 healthy glands from the contralateral mammary chain was analyzed. There was no significant difference (p = 0.786) between the mean temperature of neoplastic (33.71°C ± 1.86) and healthy (33.54°C ± 1.59) glands. There was a negative and moderate correlation between tumor temperature and mitotic index (ρ = -0.52 p = 0.049). However, no correlation was detected between mammary temperature and tumor volume (p = 0.10). Although thermography allowed no distinction between neoplastic and healthy mammary glands in bitches, it may be promising to assess the proliferative rate of tumors. In addition, malignant neoplasms may be more often hypothermic than healthy tissue.(AU)

Os tumores mamários apresentam alta prevalência em cadelas e mulheres, sendo relacionados a elevadas taxas de morbidade e mortalidade. Para a espécie humana, a termografia tem se destacado como ferramenta diagnóstica do câncer de mama. Entretanto, o seu benefício clínico em cadelas permanece desconhecido. Assim, o objetivo do presente estudo foi ava-liar a aplicabilidade diagnóstica da termografia infravermelha para os tumores mamários caninos, bem como correlacionar a temperatura tumoral com o índice mitótico e volume tumoral. Foram capturadas imagens termográficas e digitais de oito cadelas com neoplasias mamárias. Os termogramas foram inseridos no software FLIR tools e analisou-se a temperatura de 15 mamas tumorais e 15 hígidas da cadeia mamária contralateral. Não houve diferença significativa (p = 0,786) entre a tempera-tura média das glândulas neoplásicas (33,71°C ± 1,86) e saudáveis (33,54°C ± 1,59). Houve correlação negativa e moderada entre a temperatura tumoral e índice mitótico (ρ = -0,52 p = 0,049). Entretanto, não foi observada correlação entre tempe-ratura e volume tumoral (p = 0,10). Apesar da termografia não ter permitido a diferenciação das mamas neoplásicas e saudá-veis de cadelas, ela pode ser uma forma promissora para avaliação da taxa proliferativa dos tumores. Além disso, as neoplasias malignas podem apresentar-se mais frequentemente hipotérmicas em relação ao tecido saudável.(AU)

Meningoencephalitis of unknown origin in dogs

Background: Meningoencephalitis of unknown origin (MUO) is a critical cause of neurological disorders in dogs, mainly affecting small young individuals. Its symptomatology is varied and depends on the affected neuroanatomic region. The ante mortem diagnosis of this condition is uncertain, being achieved by discarding other conditions and often occurring definitively only by performing a necropsy. Thus, this study aims to report 2 cases of meningoencephalitis, one necrotizing and the other granulomatous in dogs. Cases: Case 1. A 3-year-old, Shih Tzu bitch with a body weight of 4 kg, showing proprioceptive ataxia, behavior of walking in circles, and evolving rapidly to non-ambulatory paresis, was treated. The neurological examination showed a posture of decerebrate stiffness and absence of withdrawal reflex and proprioception, suggesting brainstem injury. Laboratory tests showed mild neutrophilia and lymphopenia, while the rapid test for distemper was non-reactive. The cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis, and the PCR tests of the CSF, blood, and urine for the detection of infectious diseases were negative, as well as the culture. With no improvement in clinical condition and exams showing a progressive degenerative condition unresponsive to available treatments, the tutor opted for euthanasia of the patient. The subsequently requested necropsy confirmed the diagnosis of granulomatous meningoencephalitis. Case 2. This case refers to a 1-year-and-5-month-old male Maltese breed weighing 4.8 kg. This animal presented walking in circles behavior and loss of vision for a week, with signs worsening rapidly. In the neurological evaluation, the patient presented sensitivity in the middle ear, difficulty opening the mouth, hearing deficit in the right ear, blindness in the right eye, a proprioceptive deficit in the right anterior limb, and head pressing. Laboratory tests showed nonregenerative anemia and mild lymphopenia. After 1 day of hospitalization, the patient showed worsening clinical condition, with obstruction, absence of facial and auricular sensitivity, and nasal stimulus. In addition, onset of generalized seizures was observed; therefore, CSF was analyzed, which did not present significant alterations except for detecting reactive lymphocytes. The bacteriological culture of CSF resulted in no bacterial growth. In addition, the same neurological PCR panel performed for the previous patient was negative. After 5 days of intensive care, the patient presented a cardiorespiratory arrest and died. The subsequently requested necropsy confirmed the diagnosis of necrotizing meningoencephalitis. Discussion: The 2 reported cases confirm that MUO should be considered during the differential diagnoses of patients with neurological alterations. It is known that small-breed dogs are predisposed to these diseases. Laboratory tests and medical imaging are crucial for clinical guidance, helping to discard other neurological pathologies, especially those due to bacterial, fungal, and/or viral agents. However, definitive diagnosis of MUO can only be performed through necropsy and histopathological analysis. For the reported cases, CSF analysis, neurological PCR panel for detecting possible infectious agents, and bacterial culture were essential to rule out other possible causes of meningoencephalitis. Unfortunately, MUO includes progressive neurological disorders causing the patient's death.

Cutaneous epitheliotropic lymphoma in a Lhasa Apso

Background: Lymphoma neoplasms originate from the lymphocytes. Anatomically, these tumors can be classified into multicentric, digestive, mediastinal, and cutaneous forms. The etiology of cutaneous lymphoma remains unclear; however, it has been associated with chronic skin inflammation. The definitive diagnosis is based on histological analysis and immunohistochemistry, although fine-needle aspiration cytology has shown good results. The aim of this paper is to describe the clinicopathological aspects of a case of cutaneous epitheliotropic T cell lymphoma, classified as mycosis fungoides, in a Lhasa Apso dog. Case: A 8-year-old bitch Lhasa Apso with multiple non-pruritic skin nodules and history of 10-day evolution was referred to the Veterinary Hospital of the Centro Universitário do Espírito Santo (UNESC), Colatina, ES, Brazil. The nodules were erythematous, exophytic, firm, circumscribed, and measured 0.2-4 cm in diameter in locations throughout the animal's body. An incisional biopsy was performed with an 8-mm punch and sent for histopathological examination. An infiltrative, poorly demarcated, non-encapsulated, densely cellular neoplasm, which was replacing the dermal collagen and displacing the adnexa, was observed in the dermis. The tumor was composed of a population of round cells, with generally distinct cell borders and a small-to-moderate amount of eosinophilic cytoplasm. The nuclei were irregularly rounded and occasionally edentulous, with vesicular chromatin, a visible nucleus, and 11 mitotic figures in an area of 2.37 mm2 . The immunohistochemical test, which was positive for the CD3 marker, confirmed the diagnosis of T cell lymphoma. On an ultrasound to identify metastasis, the liver showed heterogeneous parenchyma, heterogeneous expansive formation, areas of cavitary appearance, and cytology compatible with lymphoma. Antineoplastic chemotherapy was administered using the CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisone). However, the animal died after 45 days. Discussion: A diagnosis of the mycosis fungoides type of cutaneous epitheliotropic T cell lymphoma was established based on clinical, laboratory, anatomopathological, and immunohistochemical findings. Pruritus is a common clinical condition in animals with mycosis fungoides, particularly in those with the erythrodermic form of the disease. Epitheliotropic lymphomas have no sexual or racial predilections and usually affect dogs over 9 years of age. The Cocker Spaniel, English Bulldog, Boxer, Golden Retriever, Scottish Terrier, Briard, English Springer Spaniel, Beagle, German Shepherd, and English Cocker Spaniel breeds are frequently affected by these lymphomas. These neoplasms can have a primary skin origin, or they can be secondary and associated with lymphoma found elsewhere in the body. Chemotherapy is the treatment of choice, especially in cases with multifocal distribution. Protocol preference varies with disease stage, patient clinical and laboratory conditions, and the degree of toxicity. Commonly used chemotherapy regimens include L-CHOP (vincristine, cyclophosphamide, doxorubicin, L-asparaginase, and prednisolone), CHOP, COP (cyclophosphamide, vincristine, and prednisone), LAP (lomustine, L-asparaginase, and prednisolone), LOPP (lomustine, vincristine, procarbazine, prednisolone), chlorambucil, and prednisolone. The prognosis of canine epitheliotropic cutaneous lymphoma is unfavorable, with a survival time ranging from a few months to 2 years. The animal in this study survived for 105 days. In addition, epitheliotropic cutaneous T cell lymphoma is aggressive, which may result in a shorter survival time in animals affected by this type of tumor.

Interatrial septal aneurysm associated with patent foramen ovale in a dog - case report / Aneurisma de septo interatrial associado a forame oval patente em cão - relato de caso

Atrial septal aneurysm (ASA) is a rare congenital deformity of variable clinical relevance, often reported in association with patent foramen ovale (PFO). Transthoracic Doppler echocardiography (TTE) is the first choice for diagnosis, but complementary techniques, such as microbubble contrast, should be used. Despite its importance, in Veterinary Medicine, there is little information related to the subject, and the present study is the second report of this condition in dogs. The objective was to report a case of ASA type IV LR associated with PFO in a Shar Pei bitch, diagnosed by a combined approach of transthoracic echocardiography backed by agitated saline solution (microbubbles). During clinical care, the owners reported episodes of seizures as their main complaint. Echocardiographic examination revealed a type 4 LR atrial septal aneurysm and left ventricular systolic dysfunction. The use of microbubble contrast showed right-to-left shunt, confirming PFO. The recommended treatment was medication. It was concluded that the rarity of ASA in dogs may be due to incomplete diagnoses and the transthoracic echocardiographic examination allows its analysis and classification. Furthermore, ASA can be found in animals with or without evidence of heart disease and it should be investigated in patients with neurological alterations.

O aneurisma do septo atrial (ASA) é uma rara deformidade congênita, de relevância clínica variável, frequentemente relatado em associação a forame oval patente (PFO). O ecodopplercardiograma transtorácico (TTE) é a primeira escolha para o diagnóstico, mas técnicas complementares, como o contraste por microbolhas, devem ser utilizadas. Apesar da importância, em medicina veterinária existe uma carência de informações relacionadas ao tema, sendo esse o segundo relato dessa condição em cão. Objetivou-se relatar um caso de ASA tipo IV LR, associado a PFO, em uma cadela Shar Pei, diagnosticado por uma abordagem combinada por ecodopplercardiograma transtorácico e costrastado com solução salina agitada (microbolhas). Ao atendimento clínico, os proprietários relataram, como queixa principal, episódios de crises convulsivas. O exame ecocardiográfico revelou aneurisma de septo atrial tipo 4 LR e disfunção sistólica em ventriculo esquerdo. A utilização de contraste por microbolhas constatou shunt direita-esquerda, confirmando PFO. O tratamento recomendado foi medicamentoso. Concluiu-se que a raridade do ASA em cães pode ser devido a diagnósticos incompletos, e o exame ecocardiográfico transtorácico permite sua análise e classificação. Ainda, ASA pode ser encontrado em animais com ou sem evidências de cardiopatia e sua investigação deve ser feita em pacientes com alterações neurológicas.

Bloqueio do plano serrátil associado ao transverso do abdômen na mastectomia total unilateral em cadela / Blocking of the Serratus Plan associated with the Transverse Abdominis in a total unilateral mastectomy in bitch

A anestesia locorregional, em pequenos animais, está em crescente utilização como forma de promover analgesia para procedimentos cirúrgicos, através do bloqueio reversível da condução do impulso nervoso. Assim, o objetivo deste trabalho foi relatar o uso do bloqueio locorregional do plano serrátil (SP block) associado ao bloqueio locorregional do plano transverso do abdômen (TAP block) em uma cadela da raça Lhasa Apso. A associação de tais bloqueios visou à insensibilização da musculatura na região da cadeia mamária para um procedimento cirúrgico de mastectomia unilateral total. A cadela castrada, foi encaminhada para a mastectomia unilateral total direita, apresentando nódulos nas glândulas mamárias torácica caudal e inguinal. Os bloqueios foram realizados com a paciente em decúbito dorsal, utilizando-se bupivacaína a 0,25%. Em seguida, a paciente foi liberada para o procedimento, o qual foi monitorado. Os parâmetros de eletrocardiografia, frequência respiratória, frequência cardíaca, oximetria de pulso, pressão arterial oscilométrica (composta por pressão arterial sistólica, pressão arterial diastólica e pressão arterial média), capnografia e temperatura esofágica foram anotados a cada dez minutos em uma ficha de avaliação anestésica. Durante a recuperação pós-operatória, foi realizada a avaliação de dor aguda por meio da escala de dor da Universidade de Melbourne. Os resultados demonstram que a associação do TAP block com o SP block foi eficiente em promover analgesia para uma mastectomia total unilateral de cadela.

Locoregional anesthesia in small animals is increasingly used as a way to promote analgesia for surgical procedures, through a reversible block of nerve impulse conduction. Thus, the objective of this study was to report the use of locoregional block of the serratus plane (SP block) associated with the locoregional block of the transverse abdominis plane (TAP block) in a bitch of the Lhasa Apso breed. The association of such blocks aimed to desensitize the musculature in the region of the mammary chain for a surgical procedure of total unilateral mastectomy. The castrated bitch was referred for total right unilateral mastectomy, showing nodules in the caudal thoracic and inguinal mammary glands. The blocks were performed with the patient in dorsal decubitus, using 0.25% bupivacaine. Then, the patient was released for the procedure, which was monitored. The parameters of electrocardiography, respiratory rate, heart rate, pulse oximetry, oscillometric blood pressure (composed of systolic blood pressure, diastolic blood pressure, and mean blood pressure), capnography, and esophageal temperature were recorded every 10 minutes in an anesthetic evaluation form. During the postoperative recovery, acute pain was evaluated using the pain scale of the University of Melbourne. The results demonstrate that the association of TAP block with SP block was efficient in promoting analgesia for a total unilateral mastectomy in a bitch.

Mastocitoma cutâneo em uma cadela / Cutaneous mast cell tumor in a bitch

Background: The diagnostic of neoplasia in dogs has risen significantly in the last years and this fact is mostly attributed to the longer life expectancy of these animals, which contributes to a greater chance of exposure to carcinogenic agents. In between the diverse tumors that could compromise skin, the mastocytoma is the third most commonly diagnosed neoplasia. It is characterized by being a form of neoplasia with round cells, these being the mast cells. The objective of the present study consisted in relating a case of cutaneous mastocytoma in a 7-year-old bitch mixed-breed treated at the Veterinary Medical Teaching Hospital of the University of Uberaba (UNIUBE) - Uberaba, MG, Brazil. Case: The bitch initially presented a localized nodule external to the right ear pinna with cytology test suggesting a mastocytoma. The nodule was surgically removed and, posteriorly, an histopatholgy was not requested. After 5 months since the emergence of the nodule and a month after its surgical resection, the tutor noticed the presence of a new growth in the ipsilateral cervical region to the previous nodule. At this moment, the responsible veterinarian decided to refer the animal to an oncologist. During the appointment with the oncologist, alterations such as hyporexia and anemia were related, and the presence of a nodule in the right cervical region measuring 4.5 to 4 cm of diameter was verified. Material for cytologic evaluation of the neoplasia was collected and again the result suggested a mastocytoma. The new tumor was also surgically removed but was then referred to histopathological evaluation for diagnostic confirmation, grading and evaluation of surgical margins. The tumor was classified as an infiltrative subcutaneous mastocytoma presenting, additionally, compromised surgical margins. After its excision, the association with a chemotherapy treatment using a protocol of Vimblastina 2 mg/m², i.v. in unique dosage per section, associated with Predinisona 1 mg/kg, v.o, SID was indicated. Each section was realized with an interval of 7 days in between. Only 2 chemotherapy sessions took place. Because of the worsening of the clinical condition associated with a very weakened animal the veterinarian opted for the euthanasia of the animal. Discussion: The diagnostic of mastocytoma must be realized through the association of cytology and histopathology, in case histopathological evaluation is needed to confirm the obtained cytology result, to grade the tumor and to evaluate the compromising of surgical margins. In this sense, it was observed that the bitch was submitted only to cytology diagnostic when it presented the nodule in the ear pavilion. Yet, at the second approach realized by the oncologist, it was possible to realize adequate diagnose methods. However, the animal was not submitted to clinical staging of the mastocytoma due to the non-authorization of the exam by the tutor. Such measure is very important, as it reflects directly in the treatment and prognostic of the animal. Thus, image exams such as abdominal ultrasonography and chest X-ray should have been realized, as well as cytological and histopathological evaluation of the regional lymph nodes, in order to search for metastasis points in these places. As the data suggests, the importance of clinical staging of animals affected by this neoplasia and the importance of cytological evaluation associated with histopathology for a correct diagnosis, prognosis and mastocytoma treatment is noted. It is emphasized that many times veterinarians face impediment related to requesting all necessary exams coming from tutors, which compromises treatment success.