Obstrução da veia safena em equino por linfoma multicêntrico: relato de caso / Saphenous vein obstruction in horses due to multicentric lymphoma: case report

Os tumores hemolinfáticos são incomuns em cavalos, porém, o linfoma é o mais frequente deles. Os sinais clínicos variam dependendo da localização do tumor, sendo os mais comuns: depressão, perda progressiva de peso e linfadenopatia e anemia. O objetivo do presente estudo é relatar o caso de uma obstrução da veia safena por linfoma multicêntrico em uma égua de 13 anos, sem raça definida, apresentando ferida com tecido de granulação exuberante na região da articulação metatársica falangeana do membro posterior esquerdo, anemia e perda de peso. Devido ao estado debilitado e ao decúbito persistente, a égua foi eutanasiada. O exame pós-morte revelou um trombo mediu 15 cm de comprimento por 11 cm de diâmetro com aparência nodular e esbranquiçada. Em humanos, existe uma correlação entre doença linfoproliferativa e doença autoimune, pois o estímulo antigênico e a resposta inflamatória gerada pela doença autoimune pode ser capaz de transformar uma população de linfócitos policlonais em uma população monoclonal, compatível com uma linfoproliferação. No caso da égua, não houve doença autoimune, mas a inflamação crônica causada pela lesão da pitiose pode ter sido a causa do desenvolvimento do linfoma, já que este era único e no mesmo membro do tecido de granulação exuberante.

Hemolymphatic tumors are uncommon in horses, however, lymphoma is the most frequent of them. Clinical signs vary depending on the location of the tumor, with the most common being depression, progressive weight loss andlymphadenopathy, and anemia. The aim of this study is to report the case of an obstruction of saphenous vein bymulticentric lymphoma in a mare 13 years old, presenting wound with exuberant granulation tissue in the metatarsal phalangeal joint region of the left hind limb, anemia and loss of weight. Due to weakened state and persistent decubitus, the mare was euthanized. Postmortem examination revealed a thrombus measuring 15 cm in length by 11 cm in diameter with nodular and whitish appearance. In humans, there is a correlation between lymphoproliferative diseaseand autoimmune disease, since the antigenic stimulus and the inflammatory response generated by the autoimmune disease may be able to transform a population of polyclonal lymphocytes into a monoclonal population, compatible with a lymphoproliferation. In the case of mare, there was no autoimmune disease, but the chronic inflammation caused by pythiosis injury may have been the cause of lymphoma development, since lymphoma was unique and in the samelimb of exuberant granulation tissue.

Obstrução da veia safena em equino por linfoma multicêntrico: relato de caso / Saphenous vein obstruction in horses due to multicentric lymphoma: case report

Os tumores hemolinfáticos são incomuns em cavalos, porém, o linfoma é o mais frequente deles. Os sinais clínicos variam dependendo da localização do tumor, sendo os mais comuns: depressão, perda progressiva de peso e linfadenopatia e anemia. O objetivo do presente estudo é relatar o caso de uma obstrução da veia safena por linfoma multicêntrico em uma égua de 13 anos, sem raça definida, apresentando ferida com tecido de granulação exuberante na região da articulação metatársica falangeana do membro posterior esquerdo, anemia e perda de peso. Devido ao estado debilitado e ao decúbito persistente, a égua foi eutanasiada. O exame pós-morte revelou um trombo mediu 15 cm de comprimento por 11 cm de diâmetro com aparência nodular e esbranquiçada. Em humanos, existe uma correlação entre doença linfoproliferativa e doença autoimune, pois o estímulo antigênico e a resposta inflamatória gerada pela doença autoimune pode ser capaz de transformar uma população de linfócitos policlonais em uma população monoclonal, compatível com uma linfoproliferação. No caso da égua, não houve doença autoimune, mas a inflamação crônica causada pela lesão da pitiose pode ter sido a causa do desenvolvimento do linfoma, já que este era único e no mesmo membro do tecido de granulação exuberante.(AU)

Hemolymphatic tumors are uncommon in horses, however, lymphoma is the most frequent of them. Clinical signs vary depending on the location of the tumor, with the most common being depression, progressive weight loss andlymphadenopathy, and anemia. The aim of this study is to report the case of an obstruction of saphenous vein bymulticentric lymphoma in a mare 13 years old, presenting wound with exuberant granulation tissue in the metatarsal phalangeal joint region of the left hind limb, anemia and loss of weight. Due to weakened state and persistent decubitus, the mare was euthanized. Postmortem examination revealed a thrombus measuring 15 cm in length by 11 cm in diameter with nodular and whitish appearance. In humans, there is a correlation between lymphoproliferative diseaseand autoimmune disease, since the antigenic stimulus and the inflammatory response generated by the autoimmune disease may be able to transform a population of polyclonal lymphocytes into a monoclonal population, compatible with a lymphoproliferation. In the case of mare, there was no autoimmune disease, but the chronic inflammation caused by pythiosis injury may have been the cause of lymphoma development, since lymphoma was unique and in the samelimb of exuberant granulation tissue.(AU)

Use of total venous inflow occlusion to enable correction of an atrial septal defect in a dog

Background: Atrial septal defects are generally classified into three types: ostium secundum, ostium primum, and sinus venosus. Diagnose is normaly confirmed with Doppler echocardiography, which can identify and classify atrial septal defects types. This cardiac anomaly may be corrected by different surgical approaches, such as cardiopulmonary bypass or transvenous approaches. Therefore, we chose to close the atrial septal defect using a total venous inflow occlusion technique (TIVO), which has been successfully used in other procedures without major postoperative complications, and are notably cheaper and requires no specialized equipment, been able to be done in different places.Case: An American Pit Bull Terrier was referred to our surgical service for ostium secundum atrial septal defect correction, by the time of surgery the patient presented dyspneic; normal capillary refill time and rectal temperature; the owner mentioned the patient exhibited exercise intolerance and delayed development compared to other dogs of the same age or from the same litter. Cardiac auscultation revealed a systolic murmur at the left base, femoral pulse was normokinetic, and patient was emaciated and prostrated at the time of clinical evaluation. Atrial septal defect was suspected and then confirmed by Doppler echocardiography that revealed a discontinuous area in the interatrial septum, and by color doppler images an aliased signal, that extended through the interatrial septum and shunted from the left to the right atria, was visualized, confirming an ostium secundum atrial septal defect. After a right intercostal thoracotomy, a subphrenic pericardiectomy was performed to provide access to the heart. Cranial and caudal vena cava as well as the azygos vein, were dissected, which allowed placement of a Satinsky’s clamp to proceed with TIVO. Before TIVO initiation, a pursestring suture with 3-0 polypropylene was applied to the right atrium.[...]

Use of total venous inflow occlusion to enable correction of an atrial septal defect in a dog

Background: Atrial septal defects are generally classified into three types: ostium secundum, ostium primum, and sinus venosus. Diagnose is normaly confirmed with Doppler echocardiography, which can identify and classify atrial septal defects types. This cardiac anomaly may be corrected by different surgical approaches, such as cardiopulmonary bypass or transvenous approaches. Therefore, we chose to close the atrial septal defect using a total venous inflow occlusion technique (TIVO), which has been successfully used in other procedures without major postoperative complications, and are notably cheaper and requires no specialized equipment, been able to be done in different places.Case: An American Pit Bull Terrier was referred to our surgical service for ostium secundum atrial septal defect correction, by the time of surgery the patient presented dyspneic; normal capillary refill time and rectal temperature; the owner mentioned the patient exhibited exercise intolerance and delayed development compared to other dogs of the same age or from the same litter. Cardiac auscultation revealed a systolic murmur at the left base, femoral pulse was normokinetic, and patient was emaciated and prostrated at the time of clinical evaluation. Atrial septal defect was suspected and then confirmed by Doppler echocardiography that revealed a discontinuous area in the interatrial septum, and by color doppler images an aliased signal, that extended through the interatrial septum and shunted from the left to the right atria, was visualized, confirming an ostium secundum atrial septal defect. After a right intercostal thoracotomy, a subphrenic pericardiectomy was performed to provide access to the heart. Cranial and caudal vena cava as well as the azygos vein, were dissected, which allowed placement of a Satinskys clamp to proceed with TIVO. Before TIVO initiation, a pursestring suture with 3-0 polypropylene was applied to the right atrium.[...](AU)

Persistência da veia cava cranial esquerda em cão / Persistent Left Cranial Vena Cava in a Dog

Background: Persistent left cranial vena cava with absent right cranial vena cava is a rare anomaly. Congenitally persistent left cranial vena cava is the most common variant of the systemic venous return to the heart, embryologically resulting from failure of the anterior cardinal vein in becoming obliterated. Persistent left cranial vena cava is the most common form of anomalous venous drainage involving the cranial vena cava, and represents persistence of the left horn of the embryonic sinus venosus, which normally involutes during normal development, becoming the coronary sinus. Usually, persistent left cranial vena cava enters the right atrium through the orifice of an enlarged coronary sinus. Persistent left cranial vena cava is an uncommon congenital cardiovascular anomaly in dogs, generally coexisting with other more serious cardiac defects. The condition is rare as an isolated single defect. The left cranial vena cava is observed only among domestic mammals, but it is a relatively rare anomaly that can be found in other species, including man, without causing clinical problems. The objective of this study was to report the occurence of a rare vascular formation of the cranial vena cava, which caused the persistence of the left cranial vena cava instead of the right one. Case: At the anatomy laboratory of the Faculty of Veterinary of the UFGRS, a male dog was identified with a persistent left cranial vena cava and absent right cranial vena cava.[...]

Persistência da veia cava cranial esquerda em cão / Persistent Left Cranial Vena Cava in a Dog

Background: Persistent left cranial vena cava with absent right cranial vena cava is a rare anomaly. Congenitally persistent left cranial vena cava is the most common variant of the systemic venous return to the heart, embryologically resulting from failure of the anterior cardinal vein in becoming obliterated. Persistent left cranial vena cava is the most common form of anomalous venous drainage involving the cranial vena cava, and represents persistence of the left horn of the embryonic sinus venosus, which normally involutes during normal development, becoming the coronary sinus. Usually, persistent left cranial vena cava enters the right atrium through the orifice of an enlarged coronary sinus. Persistent left cranial vena cava is an uncommon congenital cardiovascular anomaly in dogs, generally coexisting with other more serious cardiac defects. The condition is rare as an isolated single defect. The left cranial vena cava is observed only among domestic mammals, but it is a relatively rare anomaly that can be found in other species, including man, without causing clinical problems. The objective of this study was to report the occurence of a rare vascular formation of the cranial vena cava, which caused the persistence of the left cranial vena cava instead of the right one. Case: At the anatomy laboratory of the Faculty of Veterinary of the UFGRS, a male dog was identified with a persistent left cranial vena cava and absent right cranial vena cava.[...](AU)

Fístula arteriovenosa congênita em cão da raça basset hound – relato de caso / Congenital arteriovenous fistula in a Basset Hound – case report / angiografía, diosmina, flavonoides

A fístula arteriovenosa se refere a uma comunicação anormal e permanente entre uma artéria e uma veia que cursa com dilatação venosa e consequente estagnação do sangue, levando a aumento da pressão local, edema e prejuízo da nutrição tecidual. Relata-se o caso de um filhote da raça basset hound, encaminhado para avaliação cardiovascular devido a um edema persistente do membro torácico esquerdo. Após a realização do eletrocardiograma, observou-se diminuição da frequência cardíaca quando se realizava compressão vascular do membro (Nicoladoni-Branhan positivo), comum em pacientes com fístula arteriovenosa. O paciente foi submetido a uma angiografia que confirmou o diagnóstico presuntivo de fístulas arteriovenosas múltiplas a partir da artéria braquial. Devido à complexidade das fístulas, foi instituído tratamento clínico com fármacos diosmina e flavonoides, que diminuíram o edema e evitaram as ulcerações de pele, proporcionando assim a melhora da qualidade de vida do paciente.

An arteriovenous fistula is an abnormal and permanent communication between an artery and a vein, which leads to venous dilation and consequent stagnation of blood, increased local pressure, edema and impairment of tissue nutrition. We here report the case of a basset hound puppy that was referred for cardiovascular evaluation due to a persistent edema of the left forelimb. After completion of the electrocardiogram, a decrease in heart rate was observed upon vascular compression of the limb (Nicoladoni-Branham positive), which is common in patients with arteriovenous fistula. The patient was submitted to an angiography, which confirmed the presumptive diagnostic of multiple arteriovenous fistulas from the brachial artery. Due to the complexity of the fistulas, a treatment with diosmin and flavonoids was instituted to decrease the edema and prevent skin ulcerations, providing an improvement in life quality to the patient.

La fístula arterio venosa es una comunicación anormal y permanente entre una arteria y una vena, que cursa con dilatación venosa y consecuente estasis del flujo sanguíneo y aumento de la presión local, edema y compromiso nutricional de los tejidos. Se presenta un caso de cachorro Basset hound que fue encaminado para evaluación cardiovascular, debido a un edema persistente en el miembro anterior izquierdo. Después de realizado el electrocardiograma se pudo observar una disminución en la frecuencia cardíaca cuando se hacía la compresión vascular del miembro (signo de Nicoladoni-Branhan positivo), algo común en pacientes con fístula arterio venosa. El paciente fue sometido a una angiografía que confirmó el diagnostico presuntivo de fístulas arterio venosas múltiples con origen en la arteria braquial. Debido a la complejidad de las fístulas, se realizó un tratamiento clínico con diosmina y flavonoides, que disminuyeron el edema y evitaron las úlceras de piel, proporcionando una mejoría en la calidad de vida del paciente.

Fístula arteriovenosa congênita em cão da raça basset hound relato de caso / Congenital arteriovenous fistula in a Basset Hound case report / angiografía, diosmina, flavonoides

A fístula arteriovenosa se refere a uma comunicação anormal e permanente entre uma artéria e uma veia que cursa com dilatação venosa e consequente estagnação do sangue, levando a aumento da pressão local, edema e prejuízo da nutrição tecidual. Relata-se o caso de um filhote da raça basset hound, encaminhado para avaliação cardiovascular devido a um edema persistente do membro torácico esquerdo. Após a realização do eletrocardiograma, observou-se diminuição da frequência cardíaca quando se realizava compressão vascular do membro (Nicoladoni-Branhan positivo), comum em pacientes com fístula arteriovenosa. O paciente foi submetido a uma angiografia que confirmou o diagnóstico presuntivo de fístulas arteriovenosas múltiplas a partir da artéria braquial. Devido à complexidade das fístulas, foi instituído tratamento clínico com fármacos diosmina e flavonoides, que diminuíram o edema e evitaram as ulcerações de pele, proporcionando assim a melhora da qualidade de vida do paciente.(AU)

An arteriovenous fistula is an abnormal and permanent communication between an artery and a vein, which leads to venous dilation and consequent stagnation of blood, increased local pressure, edema and impairment of tissue nutrition. We here report the case of a basset hound puppy that was referred for cardiovascular evaluation due to a persistent edema of the left forelimb. After completion of the electrocardiogram, a decrease in heart rate was observed upon vascular compression of the limb (Nicoladoni-Branham positive), which is common in patients with arteriovenous fistula. The patient was submitted to an angiography, which confirmed the presumptive diagnostic of multiple arteriovenous fistulas from the brachial artery. Due to the complexity of the fistulas, a treatment with diosmin and flavonoids was instituted to decrease the edema and prevent skin ulcerations, providing an improvement in life quality to the patient.(AU)

La fístula arterio venosa es una comunicación anormal y permanente entre una arteria y una vena, que cursa con dilatación venosa y consecuente estasis del flujo sanguíneo y aumento de la presión local, edema y compromiso nutricional de los tejidos. Se presenta un caso de cachorro Basset hound que fue encaminado para evaluación cardiovascular, debido a un edema persistente en el miembro anterior izquierdo. Después de realizado el electrocardiograma se pudo observar una disminución en la frecuencia cardíaca cuando se hacía la compresión vascular del miembro (signo de Nicoladoni-Branhan positivo), algo común en pacientes con fístula arterio venosa. El paciente fue sometido a una angiografía que confirmó el diagnostico presuntivo de fístulas arterio venosas múltiples con origen en la arteria braquial. Debido a la complejidad de las fístulas, se realizó un tratamiento clínico con diosmina y flavonoides, que disminuyeron el edema y evitaron las úlceras de piel, proporcionando una mejoría en la calidad de vida del paciente.(AU)