Resumo
Nowadays, alternative methods that do not use formaldehyde to preserve cadavers must be used due to this substance's toxicity. Synthetic models are a training option for teaching, but cost makes their use unviable in most underdeveloped countries. The present study's main objective was to develop a model for education and researching thorax radiology in cadavers of chemically prepared dogs. Megaesophagus, pleural effusion, pneumothorax, and bronchography, as well as pulmonary insufflation, were simulated in 32 dogs cadavers, which received 150 mL/kg of pure ethyl alcohol solution with 5% glycerin followed by injection of 120 mL/kg of a solution containing 20% sodium chloride, 1% sodium nitrite and 1% sodium nitrate; they were kept refrigerated between 2 to 6 °C, for 30, 60, 90 or 120 days (G30, G60, G90, G120). There was no contamination, putrid odor, or subcutaneous emphysema. The pulmonary insufflation was kept, and the color and the consistency were similar to a fresh corpse after 120 days of conservation. It was possible to perform radiographic procedures, and almost all affections could be greatly mimicked. Megaesophagus and bronchography were easily simulated. Pneumothorax was the most challenging condition to be reproduced, especially in cadavers with some liquid in the thorax. The alcoholic and curing salt solutions are an embalming alternative with low financial and environmental costs and proved to preserve corpses.
Nos dias atuais, métodos alternativos e que não utilizem o formaldeído para conservação de cadáveres devem ser empregados, devido à toxicidade desse agente. Modelos sintéticos são opção de treinamento para o ensino, mas geralmente o preço inviabiliza seu uso na maioria dos países subdesenvolvidos. O objetivo do presente trabalho foi desenvolver um modelo visando ao ensino e pesquisa da radiologia torácica em cadáveres de cães quimicamente preparados. Foram simulados megaesôfago, efusão pleural, pneumotórax e broncografia, além de insuflação pulmonar, em 32 cadáveres de cães, que receberam 150 mL/kg de solução de álcool etílico puro com 5% de glicerina seguido de injeção de 120 mL/kg de solução contendo 20% de cloreto de sódio, 1% de nitrito de sódio e 1% de nitrato de sódio, mantidos sob refrigeração entre 2 e 6 graus, por 30, 60, 90 ou 120 dias (G30, G60, G90, G120). Não houve contaminação, odor pútrido ou enfisema subcutâneo. A insuflação pulmonar foi mantida, e a cor e a consistência foram semelhantes a um cadáver fresco após 120 dias de conservação. Em todos os grupos foi possível realizar os procedimentos radiográficos e quase todas afecções puderam ser grandemente mimetizadas. O megaesôfago e a broncografia foram facilmente simuladas. O pneumotórax foi a afecção mais difícil de ser simulada principalmente nos cadáveres com um pouco de líquido na cavidade torácica. A solução alcoólica e de sal de cura são uma alternativa de embalsamamento com baixo custo financeiro e ambiental e comprovadamente conservam cadáveres.
Assuntos
Animais , Cães , Radiologia , Embalsamamento , Caixa TorácicaResumo
Background: The giant anteater is a mammal that inhabits the entire national territory, but is found more frequently in the Brazilian cerrado. This mammal is threatened with extinction, a situation that may occur due to the occupation of areas intended for agriculture, predatory hunting, roadkill, injuries due to fires in its natural habitat and dog attacks. As a result of these situations, these animals can present several illnesses, such as fractures, pneumothorax or hemothorax, cranio-encephalic trauma, and come to death. The present work aims to report the treatment of pneumothorax in a giant anteater (Myrmecophaga tridactyla), cared at the Uniube Veterinary Hospital, Uberaba, MG. Case: A free-living, female giant anteater with a body weight of 31.5 kg, referred by the fire department, was admitted to the emergency service at the Uniube Veterinary Hospital. The animal presented a poor body condition, apathy, muffled pulmonary auscultation, a temperature of 35.1ºC, and unmeasurable systolic blood pressure. It was also observed that the animal was dyspneic and had burns on the palmar and plantar surfaces of all 4 paws. Due to the severity of the animal's respiratory condition, the thoracentesis procedure was performed as a means of diagnosis and it was observed that the animal had pneumothorax. Due to the lack of suction resistance and the worsening of the patient's condition, a bilateral thoracic drain was inserted for air drainage. As an analgesic and sedative protocol, ketamine at a dose of 2 mg/kg IV, midazolam at a dose of 0.1 mg/kg IV and morphine 0.5 mg/kg IM were used. Antibiotic therapy was instituted for secondary pulmonary and dermatological conditions, using amoxicillin with potassium clavulanate at a dose of 25 mg/kg TID and enrofloxacin 10 mg/kg SID, both for 7 days. As a non-steroidal anti-inflammatory drug, meloxicam was administered at a dose of 0.1 mg/kg SID, for 3 days. The patient received fluid therapy for fluid maintenance and volume replacement based on Ringers lactate at a rate of 70mL/kg/day. After several emptying of the drains and patient's stabilization, the animal was taken to the diagnostic imaging sector for radiological examinations. During the radiographic evaluation, the presence of radiolucent areas was observed in the ventrodorsal projection, suggesting accumulation of air in the pleural space, and in the lateral projections, dorsal displacement of the cardiac apex in relation to the sternum was observed, again suggesting the accumulation of air in the thoracic cavity. Even with all clinical-surgical and therapeutic interventions, the patient presented with acute pulmonary edema and died. The animal was referred to the pathology sector for necropsy, and the main necroscopic findings were pulmonary involvement, mainly on the left side, and pulmonary edema. Discussion: Due to the lack of evidence regarding the animal of this case having suffered any trauma and because it was a victim rescued from a forest fire, it is suggested that the cause of respiratory injuries, pneumothorax, pneumonia and pulmonary edema, may come from smoke inhalation. According to the literature, animals affected by forest fires can develop inhalation injuries due to contact with smoke or soot particles with the mucociliary epithelium. This contact leads to a defensive reaction by the respiratory system, with a decrease in ciliary movement and an increase in secretions due to inflammation. Although the animals condition evolved to death, the determined treatment with the placement of a bilateral vacuum thoracic drain had an effect and was essential for the animal's survival in the first twenty-four hours.
Assuntos
Animais , Pneumotórax/veterinária , Edema Pulmonar/veterinária , Vermilingua/fisiologia , Pneumopatias/veterinária , Animais SelvagensResumo
Traumas torácicos são comuns em pacientes traumatizados e incluem principalmente contusão pulmonar, laceração pulmonar, pneumotórax, hemotórax, fraturas de costela e esterno e hérnia diafragmática. As principais causas são acidentes automobilísticos, quedas e mordeduras. Taquipneia ou dispneia são possíveis sinais clínicos, associados a choque hipovolêmico e sinais gastrointestinais. Lesões torácicas podem ser negligenciadas quando lesões distrativas, como fratura de membros, estão presentes. Assim, o exame clínico minucioso é obrigatório e os animais com insuficiência respiratória podem necessitar de estabilização e cirurgia de emergência. Considerando a importância do trauma torácico na prática clínica, o objetivo deste manuscrito é relatar o caso de hérnia espúria torácica associada a laceração traumática de lobo pulmonar caudal em uma cadela apresentando dispneia intensa após trauma automobilístico. Após uma avaliação emergencial e exames radiográficos, foi diagnosticado tórax instável, fraturas de costelas, contusão pulmonar e pneumotórax grave. Após estabilização clínica, foi realizado tratamento cirúrgico para estabilização do tórax instável. Durante a cirurgia, observou-se herniação e laceração do lobo caudal esquerdo do pulmão, sendo realizadas suturas para correção da laceração pulmonar e estabilização do gradil costal, além da toracostomia para controle do pneumotórax. Nos casos de tórax instável e encarceramento lobar, o tratamento cirúrgico é fundamental, como realizado neste caso, com o objetivo de reparar e reposicionar o lobo pulmonar e estabilizar o tórax instável. A herniação pulmonar traumática é um possível diagnóstico diferencial no tórax instável pós-traumático, assim como a reparação do lobo e a estabilização das costelas por meio de suturas são técnicas eficazes de tratamento cirúrgico.
Thoracic traumas are common in trauma patients and mainly include pulmonary contusion, pulmonary laceration, pneumothorax, hemothorax, rib and sternum fractures and diaphragmatic hernia. The main causes are car accidents, falls and bites. Tachypnea or dyspnea are possible clinical signs, associated with hypovolemic shock and gastrointestinal signs. Thoracic injuries may be overlooked when distracting injuries, such as limb fractures, are present. Thus, thorough clinical examination is mandatory and animals with respiratory failure may require stabilization and emergency surgery. Considering the importance of thoracic trauma in clinical practice, the manuscript aimed to report the case of spurious thoracic hernia associated with traumatic laceration of the caudal lung lobe in a bitch with severe dyspnea after car trauma. After an emergency evaluation and radiographic examinations, a flail chest, rib fractures, pulmonary contusion and severe pneumothorax were diagnosed. After clinical stabilization, surgical treatment was performed to stabilize the flail chest. During surgery, herniation and laceration of the left caudal lobe of the lung were observed, and sutures were performed to correct the pulmonary laceration and stabilize the rib cage, in addition to thoracostomy to control the pneumothorax. In cases of flail chest and lobar entrapment, surgical treatment is essential, as in this case, with the aim of repairing and repositioning the pulmonary lobe and stabilizing the flail chest. Traumatic pulmonary herniation is a possible differential diagnosis in post-traumatic flail chest, as well as repairing the lobe and stabilizing the ribs using sutures are effective surgical treatment techniques.
Assuntos
Animais , Cães , Fraturas das Costelas/veterinária , Cirurgia Veterinária/métodos , Traumatismos Torácicos/cirurgia , Cães/cirurgia , Lesão Pulmonar/veterinária , Hérnia Diafragmática Traumática/veterinária , Acidentes de Trânsito , Dispneia/veterináriaResumo
ABSTRACT: Thoracoscopy is replacing open lung biopsies because it is less invasive, usually the technique is done using three portals and intracorporeal suture technique. This study described the feasibility and efficacy of a novel pre tied loop ligature and to propose a thoracoscopic access strategy with two portals to perform lung biopsy in patients under 5 kg. Ten rabbits were positioned in dorsal recumbency. Total thoracoscopic lung biopsy was performed using a combined transdiaphragmatic approach and a right intercostal approach. A pre tied loop ligature was placed to perform a caudal lung lobe biopsy. Insufflation of the thoracic cavity was not performed. The total surgery time was 41.4 ± 14.5 min. The procedure was carried out free of complications that prevented slippage or tightening the knot or that made it come loose after the lung biopsy; there was no serious complication during the surgical procedure. The samples obtained averaged 1x0.64x0.45 cm (Length, Width, Depth) and were considered satisfactory according to the histopathologic evaluation. Thorax radiographs taken before and after the surgeries were compared and showed no pneumothorax or hemothorax. Necropsy confirmed no knot failure occurred at the biopsy site. The use of the novel pre tied loop ligature is a safe and effective technique, avoiding problems with the limited size of the thoracic cavity in small patients.
RESUMO: A toracoscopia está substituindo as biópsias pulmonares abertas por ser menos invasiva. Usualmente a técnica é feita utilizando três portais e ligaduras feitas intra corporalmente. O objetivo deste estudo foi descrever a viabilidade e eficácia de uma nova ligadura com alça pré-amarrada e propor uma estratégia de acesso toracoscópico com dois portais para realizar biópsia pulmonar em pacientes com menos de 5kg. Dez coelhos foram posicionados em decúbito dorsal. A biópsia pulmonar por toracoscopia total foi feita pela abordagem combinada transdiafragmática e abordagem intercostal direita. Uma nova ligadura pré-amarrada foi colocada para realizar uma biópsia do lobo pulmonar caudal. Não foi realizada insuflação da cavidade torácica. O tempo total de cirurgia foi de 41,4 ± 14,5 min. Os procedimentos foram realizados sem complicações que impedissem o escorregamento ou aperto do nó ou que o soltassem após a biópsia pulmonar; não houve nenhuma intercorrência grave durante o procedimento cirúrgico. As amostras coletadas tinham tamanho médio 1x0,64x0,45 cm e foram consideradas satisfatórias de acordo com a avaliação histopatológica. As radiografias de tórax feitas antes e depois das cirurgias foram comparadas e não mostraram pneumotórax ou hemotórax. A necropsia confirmou que não ocorreu falha do nó no local da biópsia. Conclui-se que uso da nova ligadura com alça pré-amarrada é uma técnica segura e eficaz, evitando problemas com o tamanho limitado da cavidade torácica em pacientes pequenos.
Resumo
Thoracoscopy is replacing open lung biopsies because it is less invasive, usually the technique is done using three portals and intracorporeal suture technique. This study described the feasibility and efficacy of a novel pre tied loop ligature and to propose a thoracoscopic access strategy with two portals to perform lung biopsy in patients under 5 kg. Ten rabbits were positioned in dorsal recumbency. Total thoracoscopic lung biopsy was performed using a combined transdiaphragmatic approach and a right intercostal approach. A pre tied loop ligature was placed to perform a caudal lung lobe biopsy. Insufflation of the thoracic cavity was not performed. The total surgery time was 41.4 ± 14.5 min. The procedure was carried out free of complications that prevented slippage or tightening the knot or that made it come loose after the lung biopsy; there was no serious complication during the surgical procedure. The samples obtained averaged 1x0.64x0.45 cm (Length, Width, Depth) and were considered satisfactory according to the histopathologic evaluation. Thorax radiographs taken before and after the surgeries were compared and showed no pneumothorax or hemothorax. Necropsy confirmed no knot failure occurred at the biopsy site. The use of the novel pre tied loop ligature is a safe and effective technique, avoiding problems with the limited size of the thoracic cavity in small patients.
A toracoscopia está substituindo as biópsias pulmonares abertas por ser menos invasiva. Usualmente a técnica é feita utilizando três portais e ligaduras feitas intra corporalmente. O objetivo deste estudo foi descrever a viabilidade e eficácia de uma nova ligadura com alça pré-amarrada e propor uma estratégia de acesso toracoscópico com dois portais para realizar biópsia pulmonar em pacientes com menos de 5kg. Dez coelhos foram posicionados em decúbito dorsal. A biópsia pulmonar por toracoscopia total foi feita pela abordagem combinada transdiafragmática e abordagem intercostal direita. Uma nova ligadura pré-amarrada foi colocada para realizar uma biópsia do lobo pulmonar caudal. Não foi realizada insuflação da cavidade torácica. O tempo total de cirurgia foi de 41,4 ± 14,5 min. Os procedimentos foram realizados sem complicações que impedissem o escorregamento ou aperto do nó ou que o soltassem após a biópsia pulmonar; não houve nenhuma intercorrência grave durante o procedimento cirúrgico. As amostras coletadas tinham tamanho médio 1x0,64x0,45 cm e foram consideradas satisfatórias de acordo com a avaliação histopatológica. As radiografias de tórax feitas antes e depois das cirurgias foram comparadas e não mostraram pneumotórax ou hemotórax. A necropsia confirmou que não ocorreu falha do nó no local da biópsia. Conclui-se que uso da nova ligadura com alça pré-amarrada é uma técnica segura e eficaz, evitando problemas com o tamanho limitado da cavidade torácica em pacientes pequenos.
Assuntos
Animais , Coelhos , Cirurgia Torácica , Toracoscopia/veterinária , Biópsia/veterináriaResumo
Background: Pulmonary bullae are thin-walled cavitary lesions within the subpleural parenchyma. They are a result of thedestruction, dilatation and coalescence of bordering alveoli and their rupture is the most common cause of pneumothoraxin dogs. Radiographic and CT imaging are excellent tools for identifying and quantifying pneumothorax. Surgical treatment is considered standard for treatment of pneumothorax consequential to pulmonary bullae. The aim of this report wasto describe a case of pneumothorax secondary to pulmonary bullae in a dog.Case: A 5-year-old male crossbreed dog, weighing 11.5 kg, was presented to the Uberabas Veterinary Hospital due to becoming easily tired in the previous 3 weeks, and its worsening in the last 2 days by presenting panting. The dogs guardiandid not witness any traumas, but informed that the animal resided with other 14 dogs and also that it frequently collidedthe thorax against the door when it came down from the bed. Physical examination showed diaphragmatic breathing,inspiratory dyspnea and stridor lung sound. Thoracocentesis revealed presence of air in the pleural cavity and pneumothorax. Radiographic images confirmed this condition. The dog stayed in the hospital and chest drains were placed. Sincethe amount of sucked air did not reduce with time and due to the emergence of subcutaneous emphysema, the dog wentthrough exploratory thoracotomy that revealed impairment of the right caudal lung lobe, proceeding to lobectomy. Thedog stayed in the hospital with chest drains until the contents of the suctions reduced significantly. With the removal ofthe drains, the dog was sent home and had a full recovery. Histopathology of the impaired lung revealed pulmonary bullae.Discussion: The dog from this report presented clinical signs consistent with pneumothorax, such as dyspnea, diaphragmaticbreathing and exercise intolerance. Radiography of the chest region revealed...
Assuntos
Masculino , Animais , Cães , Dispneia/veterinária , Drenagem Postural/veterinária , Pneumotórax/cirurgia , Pneumotórax/veterinária , Pneumonectomia/veterinária , Toracotomia/tendênciasResumo
O presente trabalho relata um caso de pneumotórax espontâneo primário decorrente de bolha pulmonar em um cão. O paciente, fêmea, sem raça definida (SRD), de 25 kg e com dez anos de idade foi atendido com quadro de taquipneia e histórico de pneumotórax recorrente, a radiografia torácica confirmou o pneumotórax e a tomografia computadorizada realizada antes e após a toracocentese emergencial confirmou a presença de bolha pulmonar no lobo cranial esquerdo. O tratamento cirúrgico foi realizado com lobectomia parcial por toracotomia intercostal que, apesar de restrições, permitiu menor tempo cirúrgico e menor trauma. No acompanhamento pós-operatório de dez dias o paciente teve recuperação completa, sem complicações ou recidivas do quadro.
The present study reports a case of spontaneous primary pneumothorax due to a pulmonary bubble in a dog. The patient, female, without defined race (SRD), 25 kg and 10 years old, was treated with tachypnea and a history of recurrent pneumothorax, the chest radiography confirmed the pneumothorax and computed tomography performed before and after emergency thoracentesis confirmed the presence of a pulmonary bubble in the left cranial lobe. The surgical treatment was performed with partial lobectomy by intercostal thoracotomy, which is spite of some restrictions, allowed less surgical time and minor trauma. In the 10-day postoperative follow-up, the patient had complete recovery, without complications or recurrence of the condition.
Assuntos
Animais , Cães , Cães , Pneumotórax/classificação , Pneumotórax/diagnóstico , Pneumotórax/veterinária , TomografiaResumo
ABSTRACT Purpose To develop a specific device for pleural drainage in hypertensive pneumothorax. Methods The prototype was modeled from the free version of a 3D modeling application, printed on a 3D printer using ABS® plastic material, and tested in a pleural drainage simulator. Results Pleural drainage in the simulator using the prototype was feasible and reproducible. Conclusions While the prototype is functional in the simulator, it requires improvement and refinement for use in humans.
Assuntos
Humanos , Pneumotórax/cirurgia , Pleura , DrenagemResumo
Background: Pneumothorax is a clinical condition which can cause respiratory distress. It can have as its origin traumatic causes or even classified as spontaneous, mainly related to diseases of the lung parenchyma. Lipoid pneumonia is rarely described in dogs, and it is characterized by globules of lipid in the alveolar spaces. Endogenous lipoid pneumonia (EnLP) occurs when lesions on pulmonary cells release cholesterol and other lipids in the alveoli. There is no clinical approach established for EnLP in veterinary patients. The aim of this report is to describe a case of a young Maltese dog, with recurrent spontaneous pneumothorax in which EnLP was diagnosed post mortem. Case: A 2-year-old sexually intact male Maltese dog was evaluated for restrictive dyspnea. Clinicopathologic findings included cyanotic, muffled chest auscultation with hypersonic thoracic percussion. Chest x-ray demonstrated an increase in pleuropulmonary radio transparency and a floating-looking heart, indicating pneumothorax. Complete blood counts and biochemical panel results were normal. Dirofilaria immitis antigen test results were negative. Computed tomography demonstrated slightly hyper-expanded pulmonary fields, with slightly enlarged reticular marking with areas of mild multicentric panlobular emphysema and a fracture on the sixth left rib. The treatment was focused on improving the breathing pattern through sedation, supplementation with oxygen, and thoracentesis. Owing to the reserved prognosis of the case, the unknown etiology of the recurrent pneumothorax, and the clinical worsening of the patient, the owner opted for euthanasia. Necropsy displayed multiple, circular whitish areas in the lungs, distributed over the surface of all lobes. Histopathological examination revealed pulmonary tissue with the subpleural micronodular foci, multifocal to coalescent, with a moderate accumulation of foamy intra-alveolar macrophages, occasionally multinucleate, associated with cholesterol crystals compatible with endogenous lipid pneumonia. Discussion: The patient presented with clinical signs and physical examination characteristics of pneumothorax at the first visit. After the pneumothorax diagnosis, and clinical stabilization of the patient. No predisposing factor for the formation of the pneumothorax was identified as the radiography revealed only bronchitis and blood tests were normal, the patient was thus discharged after 24 h, with the recommendations for observing the breathing pattern. Initially, spontaneous pneumothorax was suspected. The antibiotics were administered since bacterial pneumonia, although not confirmed on chest x-ray, is the main cause of pneumothorax in dogs is lung parenchyma disease. With the worsening of the clinical condition of the patient, CT was performed and did not demonstrate any findings that would justify the presence of pneumothorax. Despite the placement of the chest tube for facilitating the management of thoracentesis, there was no stabilization of the condition, enhancing the frequency of centesis procedures, which led to the decision to euthanize. The microscopic examination of the pulmonary alterations was decisive for the diagnostic conclusion. The visualization of the accumulation of foamy intra-alveolar macrophages, occasionally multinucleate, associated with cholesterol crystals, was responsible for the diagnosis of EnLP. This condition is rarely described in dogs and as in the present report, it is a noninfectious inflammatory condition, characterized by intra- or extracellular globules of lipid in the alveolar spaces. In the present report, although it was not possible to determine the etiology of EnLP, we can conclude that although rare, it can affect dogs and can generate severe clinical repercussions.
Assuntos
Animais , Masculino , Cães , Pneumonia Lipoide/veterinária , Pneumotórax/diagnóstico , Pneumotórax/veterinária , Colesterol/análise , Dispneia/veterinária , Pneumopatias/veterináriaResumo
This is the case of a specimen of Didelphis albiventris with signs of respiratory difficulty after a dog attack. Thoracic radiographic examination revealed pneumothorax, pulmonary contusion, and rib fracture, but no alteration compatible with diaphragmatic hernia was observed. Pneumothorax was reduced and the other alterations were treated. However, clinical manifestations persisted, and thus a contrast-gastrointestinal radiographic study was performed, showing abdominal organs in the thoracic cavity and loss of diaphragmatic line. The surgical approach was instituted, with access to the diaphragm through median laparotomy. Through the diaphragmatic rupture, present in the left antimere, there were herniated liver and gastric portions, intestinal segments, and omentum. After inspection and repositioning of the abdominal organs, the diaphragm raffia was performed with single sutures interrupted with 3-0 Nylon thread. The patients complete recovery occurred 14 days after the surgical procedure, with remission of clinical manifestations and normality of thoracic images in radiographic studies.
Esse é o caso de um espécime de Didelphis albiventris com sinais de dificuldade respiratória após ataque por cão. O exame radiográfico torácico revelou pneumotórax, contusão pulmonar e fratura de costelas, porém nenhuma alteração com-patível com hérnia diafragmática foi observada. O pneumotórax foi reduzido e as demais alterações tratadas. Contudo; houve a persistência das manifestações clínicas, e dessa forma um estudo radiográfico gastrointestinal contrastado foi realizado, sendo evidenciados órgãos abdominais na cavidade torácica e perda da linha diafragmática. A abordagem cirúrgica foi instituída, com acesso ao diafragma por meio de laparotomia mediana. Através da ruptura diafragmática, presente no antímero esquerdo, estavam herniadas porções hepáticas e gástricas, segmentos intestinais e omento. Após inspeção e reposicionamento dos órgãos abdominais, a rafia do diafragma foi realizada com suturas simples interrompidas com fio Nylon 3-0. A recuperação completa do paciente ocorreu 14 dias após o procedimento cirúrgico, com remissão das manifestações clínicas e normalidade das ima-gens torácicas nos estudos radiográficos.
Assuntos
Animais , Didelphis/anatomia & histologia , Hérnia Diafragmática Traumática/cirurgia , Hérnia Diafragmática Traumática/diagnóstico , Hérnia Diafragmática Traumática/veterinária , Radiografia , Técnicas de Laboratório Clínico , Herniorrafia , LaparotomiaResumo
Background: Acute dyspnea is a clinical emergency with a presentation similar to several etiologies. Cats are usually referred with complaints of anorexia, abdominal breathing, cyanosis, and open mouth breathing, and veterinarians should stabilize the animals as soon as possible. The incidence of aspiration of foreign bodies is low, particularly in this species. The diagnosis consists of observing the foreign structure in the lumen of the trachea, commonly performed using radiography or bronchoscopy. This report describes a case of a feline with a tracheal foreign body, with a detailed description of the clinical findings and successful treatment. Case: A 10-year-old female feline exhibited severe dyspnea and cyanosis. During the anamnesis, the owner stated that the clinical signs suddenly presented one day prior, after the animal ingested a piece of fish. Physical examination revealed changes in pulmonary auscultation, which was bilaterally muffled, and intense respiratory distress, as observed by the evident signs of exhaustion (sternal decubitus, reduced muscle tone), in addition to cyanotic mucous membranes. The animal was intubated and maintained under anesthesia with propofol infusion and respiratory support (ambu) for 1 h, during which complementary examinations were performed. Chest radiography showed the presence of a radiopaque structure (approximately 0.5 cm) in the tracheal region. Thus, we decided to remove the structure using bronchoscopy. The foreign body was located above the main bronchial bifurcation and was removed. There was an improvement in oxygenation after 20 min of maintenance of ventilatory support, followed by weaning of the animal's successful respiratory support. Antibiotic therapy and analgesia were prescribed at home, and the animal exhibited full recovery after 10 days. Discussion: Dyspnea is a clinical sign that should be treated as an emergency, as it is associated with high mortality. In these cases, positive pressure ventilation is indicated in three situations: persistent hypoventilation, severe hypoxemia unresponsive to oxygen therapy, and excessive respiratory effort or fatigue. Dyspnea may be due to impairment of the upper or lower airway or restrictive conditions. Clinically, felines with tracheal foreign bodies have a sudden onset of dyspnea, tachypnea, cough, and lethargy. In these patients, the reduction in lung sounds is a common finding, as observed in the present case. The occurrence of tracheal foreign bodies in cats is rare and, depending on the type of foreign body and its location in the airway, complete obstruction of the respiratory tract may occur. In the present case, it was possible to observe the foreign body in the trachea on radiographic images. Felines with tracheal foreign bodies generally present a structure located close to the carina, as observed in the present case. Bronchoscopy using a flexible or rigid tube is considered the gold-standard technique for removing foreign bodies from the respiratory tract, and the greatest difficulty during the removal procedure is ensuring that the airways are not obstructed by the instruments used. The use of these materials is not free of complications, as they may be responsible for the development of pneumothorax, pneumomediastinum, dyspnea, and respiratory failure. In the present case, there were no complications during or after the procedure, and the patient recovered completely.(AU)
Assuntos
Animais , Feminino , Gatos , Cianose/veterinária , Obstrução das Vias Respiratórias/veterinária , Corpos Estranhos/veterinária , Doenças da Traqueia/veterinária , Dispneia/veterináriaResumo
Background: Pulmonary neoplasia is an abnormal proliferation of cells at the lung tissue, and may be classified as primary, secondary or metastatic, and multisystemic. However, primary neoplasia is rare in canids. Additionally, neoplasms may be classified according to their biological behavior as either malignant or benign. Malignant tumors are more prevalent. The diagnosis can be difficult due to nonspecific symptoms, taking into account that some affected patients do not have symptoms at all; thus, the real incidence of the disease might remain undiagnosed on certain occasions. Therefore, we aimed to report an unprecedented successful case of lung lobectomy surgery in dogs with the aid of infrared video thermometry, which showed real-time images during the surgical procedure. Case: A 10-year-old male dog, crossbreed with Cocker Spaniel, was attended with a history of lethargy, dullness, progressive weight loss, cough, and difficulty breathing. Due to the chronic severity of the clinical signs and the normal physiological clinical examination, complementary exams were requested, such as radiography of the cervical and thoracic regions, cranial and thoracoabdominal computed tomography (TCT). The results of the exams showed the presence of a nodule mass in the right caudal pulmonary lobe which caused a lateral deviation to the left hemithorax of the cardiac silhouette. The patient underwent a surgical procedure with an approach through the thoracic region, at the height of the seventh intercostal space, and a total lobectomy was performed. Throughout the surgical procedure, video thermometry in real-time through the MART station (Metabolic Activity in Real-Time FLIR SC325®) was used to determine the viability of adjacent tissues through temperature differences measured in degrees Celsius. The surgical fragment containing the direct caudal pulmonary lobe and the mass were sent to the pathology sector for anatomopathological evaluation. An abundant papillary epithelial proliferation was visualized through microscopy, presenting areas of necrosis and inflammatory polymorphonuclear infiltrate. The nodule was diagnosed as lung papillary adenocarcinoma. Discussion: Adenocarcinomas consist of papillary, acinar, solid, or mixed glandular structures. They may originate from the airways, bronchial glands, or bronchoalveolar region, and often show invasive growth presenting a rudimentary and irregular shape. The clinical signs are non-specific, including exercise intolerance, non-productive cough, chronic respiratory signs such as tachypnoea or dyspnea, reduced appetite, weight loss, lethargy, chest palpation pain, hemothorax, pneumothorax, and pleural effusion. The diagnosis is concluded through imaging diagnostic tests, of which chest radiography is the most important, followed by magnetic resonance and computed tomography. Also, histopathological examination is essential to determine a definitive diagnosis. The treatment of choice for adenocarcinoma nodules is a surgical excision of the tumor mass. However, the type of surgical approach is determined by different factors such as size, location, and involvement of adjacent structures. The ablation of pulmonary masses may be performed either via partial or total lobectomies. Nevertheless, partial lobectomy is more often performed on non-neoplastic masses or to obtain material for biopsy, whilst total lobectomy is recommended for a malignant neoplasm removal. The prognosis is always guarded, having a more favorable outcome in masses of the smaller diameter without the involvement of adjacent structures.(AU)
Assuntos
Animais , Masculino , Cães , Termografia/veterinária , Adenocarcinoma de Pulmão/cirurgia , Adenocarcinoma de Pulmão/veterinária , Adenocarcinoma de Pulmão/diagnóstico por imagem , Cirurgia Vídeoassistida/métodosResumo
Background: Chest trauma is one of the main thoracic injuries in dogs and cats, reaching a high morbidity and mortality. The tissue damage, in thoracic trauma, can be underappreciated by visual exam and traditional radiography. The thoracoscopy can provide information for a precise definitive diagnosis, by this technique bleeding or air leakage can be identified and corrected immediately and the diaphragm can be completely evaluated. The aim of this work was to describe the thoracoscopic approach in a case of diaphragmatic perforation caused by penetrating trauma in a dog. Case: A 6-year-old male dog mixed-breed dog, weighing 14 kg with thorax perforation was presented to the Veterinary Hospital. Clinical examination of the animal revealed the following: pale mucous membranes, moderate dyspnea, open pneumothorax, abdominal distension, heart rate of 108 beats per minute and respiratory rate of 64 breaths per minute. Physical examination confirmed a 3 cm perforation hemorrhagic lesion in the left ninth intercostal space. As an emergency treatment, oxygen therapy, tramadol hydrochloride [Cronidor® 2%, 4 mg/kg, i.v, TID], tranexamic acid [Transamin® 25 mg/kg, i.v, TID], ceftriaxone [Rocefin® 50 mg/kg, i.v, BID] and fluid therapy with lactated Ringer's solution were administered. The hair was removed, and then, wound cleaning and obliteration of the wall injury with sterile gauze was performed. After the emergency stabilization, the animal was anesthetized, followed by preventive thoracocentesis by an approach close to thoracic perforation and thoracoscopy without pneumoperitonea through this thoracic perforation with 0-degree rigid endoscope. About 100 mL of blood and air was drained and diagnosed perforation in the diaphragm and pulmonary atelectasis in the caudal and left cranial lobes. the edges of the incisional wound were debrided, and the closure of thoracic incision was performed usual way. After that, the air was removed by a catheter and syringe system. A flexible plastic tube was inserted through the chest wall and into the pleural space for drainage every 2 h for 24 h. There were no intercurrences during the first 24 h after the surgical procedure. The patient was discharged 48 h after the surgery. Cephalexin [75 mg, 30 mg/kg, v.o, TID, during 5 days), Ketoprofen [20 mg, 2 mg/kg, v.o, SID, during 5 days], Tramadol Hydrochloride [50 mg, 4 mg/kg, v.o, SID, during 2 days] and Rifamycin spray at the wound site was prescribed. Ten days after surgery, the patient returned to the hospital for suture removal and reassessment. Discussion: The prognosis of chest perforation depends on the severity and number of internal and external thoracic lesions, as well as cardiovascular status at the time of initial patient care. In cases of penetrating chest trauma, it is essential to thoroughly examine the thoracic cavity for bleeding, tissue tears, and diaphragm perforation. The use of the endoscope allowed for a more detailed exploration of the chest without the need to increase the incision. When the diaphragm lesion was found, it was also possible to perform the abdominal examination by videoendoscopy, through this perforation. Laparotomy and thoracotomy cause postoperative pain and discomfort, in addition to increasing recovery time, however, even with trauma, not performing a larger incision favored the recovery of this patient, without any intercurrence in the first 24 h after the procedure. In conclusion, the endoscopic approach was efficient for diagnosis, avoiding greater trauma and contributing to a better clinical recovery of the patient.
Assuntos
Animais , Masculino , Cães , Traumatismos Torácicos/cirurgia , Traumatismos Torácicos/veterinária , Traumatismos Abdominais/cirurgia , Traumatismos Abdominais/veterinária , Procedimentos Cirúrgicos Minimamente Invasivos/veterinária , Toracentese/veterináriaResumo
Background: Pneumothorax is the presence of free air in the pleural cavity. Air in the thoracic cavity causes respiratorydiscomfort, severe hypoxemia, decreased venous return, and haemodynamic instability, and it may lead to death. Pneumothorax can be triggered by wounds from firearm projectiles, bladed weapons, or sharp or piercing objects, as well asbites and barotrauma. The diagnosis of open pneumothorax is based on anamnesis, in combination with clinical signsobserved on physical examination. The objective of this report is to discuss the relevance of clinical-surgical managementto adequately treat evisceration of the pulmonary lobe caused by a bite in the thoracic region of a female dog.Case: This report discusses a 15-year-old female canine weighing approximately six kg with a history of wounds in thethoracic region and respiratory difficulty after being bitten by another dog. On clinical examination, she presented with abruised wound in the right thoracic region and another in the scapular region. The examination revealed evisceration of theright cranial lung lobe, which exhibited atelectasis. The animal was immediately referred to the Surgical Center. Anaesthesia was induced using propofol 2.0 mg/kg combined with ketamine hydrochloride 2.0 mg/kg, followed by intubation andmaintenance under inhalation anaesthesia with isoflurane and 100% oxygen and fentanyl 2.5 mcg/kg every 15 min. Thetemperature, non-invasive blood pressure, cardiac and respiratory frequency, pulse oximetry, capnography and electrocardiogram were monitored. Tricotomy and antisepsis of the wound were performed with 0.9% NaCl and 2% chlorhexidine.The eviscerated pulmonary lobe was immersed in saline solution, and positive pressure insufflation was performed in theinhalation circuit to verify the presence of perforation of the eviscerated lung, which was not observed. The lobe was repositioned in the correct anatomical location in the thoracic region...
Assuntos
Animais , Cães , Mordeduras e Picadas/cirurgia , Mordeduras e Picadas/veterinária , Pneumotórax/diagnóstico , Pneumotórax/veterinária , Traumatismos Torácicos/cirurgia , Traumatismos Torácicos/veterináriaResumo
Background: Pneumothorax is characterized by the accumulation of air in the pleural space, either due to trauma or secondary to other conditions. Typically, pneumothorax is correlated with blunt trauma of the pulmonary parenchyma or penetrating trauma of the thoracic cavity, such as on being trampled upon or bitten, respectively. The therapeutic approach of this condition is rarely described in wild animals; therefore, the present study aims to describe the clinical manifestations, diagnostic method, and therapeutic aproach in a specimen of Tamandua tetradactyla with closed pneumothorax received for emergency care after being hit by a vehicle.Case: A southern tamandua (T. tetradactyla) was received in our hospital after being hit by a vehicle. The patient presented with a state of stupor, nystagmus, a restrictive respiratory pattern, and muffling on auscultation of respiratory and cardiac sounds in the left antimer. Simultaneously with the physical examination, venous access was established, pain control was intravenously performed and oxygen therapy was started. After stabilization, the patient underwent abdominal ultrasound (abdominal-focused assessment with sonography for trauma) and thoracic radiographs. The abdominal ultrasound confirmed the presence of a small amount of free fluid in the evaluated recesses, i.e., hepatodiaphragmatic, splenorenal, cystocholic, and hepatorenal, suggesting the need for periodic ultrasonographic monitoring associated with the clinical evaluation of the patient because of suspicion of active hemorrhage. The thoracic radiographic image (ventrodorsal recumbency) revealed increased pulmonary opacity due to lobar retraction, marked by an enlarged gap between the pulmonary lobes and thoracic wall, and the formation of a radiolucent area between both structures. The lateral recumbency evidenced the dorsal displacement of the cardiac apex in relation to the sternum.[...]
Assuntos
Masculino , Animais , Adulto , Pneumotórax/diagnóstico por imagem , Pneumotórax/terapia , Pneumotórax/veterinária , Xenarthra/lesões , Animais SelvagensResumo
Relata-se um caso de pneumomediastino, pneumotórax e enfisema subcutâneo em um cão com pneumopatia associada à cinomose. As queixas principais eram tosse, secreção nasal purulenta, apatia e enfisema subcutâneo em face, região cervical e torácica. O exame radiográfico evidenciou pneumomediastino, pneumotórax e broncopneumopatia grave com áreas de consolidação pulmonar. Teste rápido imunocromatográfico para detecção de antígeno da cinomose foi positivo e houve melhora dos sinais respiratórios com antibioticoterapia, porém o quadro evoluiu para alterações neurológicas. De acordo com a revisão de literatura realizada, não há casos semelhantes relatados.(AU)
A case of pneumomediastinum, pneumothorax and subcutaneous emphysema in a dog with pneumopathy associated to distemper is reported. The main complaints were cough, purulent nasal discharge, lethargy and subcutaneous emphysema in the face, neck, and chest area. Radiographic examination showed pneumomediastinum, pneumothorax, and severe bronchopneumopathy with areas of pulmonary consolidation. Rapid test for canine distemper antigen detection was positive. After the antibiotic therapy there was an improvement of respiratory signs; however, the patient developed neurological symptomatology. As far as the author´s knowledge by literature review carried out, there are no similar cases reported.(AU)
Assuntos
Animais , Cães , Cinomose , Pneumopatias/veterinária , Enfisema Mediastínico/veterinária , Diagnóstico de Pneumomediastino , Pneumotórax/veterináriaResumo
Background: The ultrasound exam has always played a secondary role in pulmonary imaging, with its applicability restricted in emergency care to screen for pleural and/or pericardial effusion, pneumothorax and pulmonary contusion. The recognition of different reverberating artifacts arising from the normal aerated lungs (A lines) and in the presence of lungs with interstitial and/or alveolar infiltrates (B lines) led to wider application of the technique in patients with respiratory syndrome. The objective of this study was to describe the ultrasound imaging methodology and the aspects of the pleura, pleural space and lung fields in healthy dogs.Materials, Methods & Results: Twenty healthy dogs of different breeds and ages, males and females were evaluated in this study; good health status was confirmed by physical examination, electro and echocardiographic assessment, thoracic radiography and systemic arterial blood pressure measurements. Dogs were scanned by a single examiner experienced in diagnostic imaging and previously trained for 6 months in thoracic ultrasound image interpretation. A MyLab 40 with a microconvex multifrequency probe (5-8 MHz) was used in this study. Evaluation was performed in an orthopneic position (standing or sternal recumbecy) under manual containment. Ultrasound examinations were based on the VetBLUE (Veterinary Bedside Lung Ultrasound Exam) protocol. Lung fields were regionally scanned at the 2nd-3rd, 4-5th, 6-7th and 8-9th intercostal spaces in the right and left hemithorax. A subxiphoid window was added to screen for free fluid in the pleural space and/or pericardial sac. Pleural sliding and A lines, that are hyperechoic parallel equidistant lines arising from the visceral pleura-lung interface could be easily seen at all intercostal spaces in all dogs in this sample, with more difficult visualization at the 2nd-3rd intercostal space. B lines were observed in seven out of twenty dogs (35%).[...]
Assuntos
Masculino , Feminino , Animais , Cães , Pulmão/fisiologia , Tórax/fisiologia , Ultrassonografia/veterináriaResumo
Deve-se ter muito cuidado e ser muito criterioso quando à utilização de animais vivos no ensino na medicina veterinária. Novas técnicas e modelos sintéticos podem ser usados, desde que não haja grande prejuízo no aprendizado dos alunos. Este trabalho descreve algo inédito ao desenvolver o primeiro modelo visando ao ensino e pesquisa da radiologia torácica em cadáveres de cães quimicamente preparados. No capítulo 1, são feitas considerações gerais, incluindo introdução e foi realizada revisão de literatura sobre o uso de animais em pesquisa e ensino, sobre fixadores e conservantes em anatomia e seus efeitos nos tecidos, e sobre as alterações radiográficas do tórax que foram simulados nesse trabalho (megaesôfago, pneumotórax e efusão pleural), além de broncografia e insuflação pulmonar. O capítulo 2 se refere a um artigo no molde da Revista Arquivo Brasileiro de Medicina Veterinária e Zootecnia, contendo os tópicos de Introdução, com uma breve revisão de literatura, Material e Métodos, Resultados e Discussão. Nesse estudo, foram utilizados 32 cadáveres de cães (8 cadáveres por grupo), que receberam 150mL/kg de solução de álcool etílico puro com 5% de glicerina seguido de injeção de 120mL/kg de solução contendo 20% de cloreto de sódio, 1% de nitrito de sódio e 1% de nitrato de sódio, mantidos sob refrigeração entre 2 e 6 graus, por 30, 60, 90 ou 120 dias (G30, G60, G90, G120). Pode-se observar que em todos os grupos a técnica anatômica foi eficiente na conservação dos cadáveres e foi possível realizar insuflação pulmonar e os procedimentos radiográficos e as afecções puderam ser mimetizadas, além da broncografia. A técnica anatômica empregada possibilitou o desenvolvimento de um modelo visando ao ensino e pesquisa da radiologia em cadáveres de cães quimicamente preparados, a custo baixo e sem utilização de produtos tóxicos, com durabilidade de até 120 dias, apenas em refrigeração.
Nowadays, it is necessary to be careful and present discerning as for the use of live animals in the veterinary medicine teaching. New techniques and synthetic models can be used, as long as there is no major impairment in student learning. This study describes something new by developing the first model aiming the teaching and research of the thoracic radiology in chemically prepared dogs. In Chapter 1, general considerations were made, including introduction and literature review on the use of animals in research and teaching, about fixative and preservative substances used in anatomy and their effects on tissues and also on radiographic changes of the thorax that were simulated (megaesophagus, pneumothorax and pleural effusion), bronchography and pulmonary insufflation. Chapter 2 was about an article in The Brazilian Journal of Veterinary and Animal Sciences, containing Introduction, with a brief review of literature, Materials and Methods, Results and Discussion. In this study, 32 dog cadavers (8 cadavers for group) were used, which received 150mL / kg of pure ethyl alcohol solution with 5% glycerin followed by injection of 120mL / kg of solution containing 20% sodium chloride, 1 % sodium nitrite and 1% sodium nitrate, and kept refrigerated between 2 and 6°C, for 30, 60, 90 or 120 days (G30, G60, G90, G120). It could be seen that in all groups the anatomical technique was efficient in the cadavers preservation and it was possible to perform pulmonary insufflation and radiographic procedures, and affections could be simulated, in addition to bronchography. The anatomical technique applied enabled the development of a model aiming the radiology teaching and research in cadavers of chemically prepared dogs, at a low cost and without using toxic products, with a durability up to 120 days, only in refrigeration.
Resumo
Tracheal foreign bodies are rare emergency events. Several noninvasive methods are described for removal, such as bronchoscopy combined with appropriate grasping equipment or Foley catheter and forceps guided by fluoroscopy. However, complications can occur like pneumothorax, pneumomediastinum and irresponsive dyspnea as well as failure. Thus, pre-sternal tracheotomy combined with endoscopy or thoracotomy are attempted. Female cat, 1 year old, 1.6 kg had diagnosis of foreign body (0.7 x 0.5cm) with morphology of bird cervical vertebra at carina area, presenting one week of dyspnea, worsening with radiographic exam. It was performed emergency thoracotomy at left fifth intercostal space, followed by tracheotomy between the tracheal rings immediately cranial to the carina, allowing forceps removal. No foreign body was observed at radiograph after eight days and the patient was clinically well. Although, less invasive methods are preferable, they are not always available and they are not free from failures, leading to emergency tracheotomy as described in the present case report.
Corpos estranhos traqueais são eventos raros e emergenciais. Vários métodos não invasivos são descritos para a sua remoção, como broncoscopia combinada com equipamento apropriado de preensão ou cateter de Foley e pinça guiados por fluoroscopia. Entretanto, complicações como pneumotórax, pneumomediastino e dispneia irresponsiva assim como insucessos podem ocorrer. Portanto, traqueotomia preesternal combinada com endoscopia ou toracotomia são tentativas viáveis. Gata, 1 ano, 1.6kg teve diagnóstico de corpo estranho (0.7 x 0.5 cm) com morfologia de vértebra cervical de ave na região da carina. Apresentava há uma semana, dispnéia, piorando durante exame radiográfico. Foi realizado toracotomia de emergência no quinto espaço intercostal esquerdo, seguida de traqueotomia entre os anéis traqueais imediatamente cranial à carina, permitindo remoção por fórceps. Após oito dias, foi realizada radiografia controle e o paciente apresentava-se clinicamente bem. Embora, métodos menos invasivos sejam preferidos, não são isentos de falhas, necessitando toracotomia emergencial como a descrita no presente relato.
Assuntos
Feminino , Animais , Gatos , Corpos Estranhos/veterinária , Toracotomia/veterinária , Traqueotomia/veterinária , Cirurgia Torácica , Dispneia/veterináriaResumo
PURPOSE: To describe a novel approach for implanting intramuscular electrodes in the diaphragm through videolaparoscopy. METHODS: We used twelve pigs for this videolaparoscopic technique, which permits at the same time to explore the diaphragm, to locate its motor points and to fix the electrodes in the diaphragm bilaterally. In this technique we used three trocars: one portal for a 10-mm 0° viewing angle laparoscope, one portal for the manipulation of structures and another for electrode implantation. RESULTS: All animals survived the procedure without pneumothorax/capnothorax or other complication. Implanted electrodes provided an appropriate interface between the muscle and the electrical current generator, and electroventilation was satisfactorily generated in all animals. CONCLUSION: This videolaparoscopic technique with three trocars enables the exploration and identification of motor points and an efficient fixation of one or two electrodes in each hemidiaphragm.