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 The medications were slowly withdrawn, and the clinical discharge occurred after 4 weeks.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.

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.

Malignant tumor of peripheral nerve sheath in the thoracolumbar region in a cat

Background: In veterinary medicine, peripheral nerve tumors (PNST) are classified from the cellular pattern and as benign and malignant (MPNST). The majorities of cases are benign and usually involve the skin and subcutaneous tissue of the head, neck, and limbs. Animals with MPTNS usually have spinal cord and spinal canal involvement and are also described in the small and large intestine, oral cavity, perirenal region, and urinary bladder. Treatment is performed according to the location of the neoplasm and metastasis is rarely described. The present article aims to report a case of a malignant tumor in the peripheral nerve sheath of a cat. Case: A 8-year-old domestic cat was presented with a history of progressive paresis in the pelvic limbs. On neurological evaluation, proprioceptive ataxia and proprioception deficit in the pelvic limbs were observed, suggestive of thoracolumbar injury. Blood work and serum biochemistry showed results within the reference for the species and the bi-directional immunochromatography test for FIV and FeLV were negative. The radiographs of the thoracolumbar segment did not show significant changes. Myelography with iodinated contrast and collection of cerebrospinal fluid (CSF) were performed. On myelography examination, iodinated contrast loss was found between the 6th and 7th thoracic vertebrae, while the CSF analysis was normal. The patient underwent laminectomy and durotomy for excision of a mass found dorsally to the spinal cord, with intradural location. The tumor was sent for histopathological examination. Microscopic analysis showed neoplastic proliferation of spindle-shaped cells with predominance of the Antoni A pattern. Immunohistochemical analysis demonstrated intense cytoplasmic staining of the neoplastic cells for vimentin and S100 protein. Based on these findings, the diagnosis of malignant peripheral nerve sheath tumor was made. Radiotherapy was suggested as adjuvant treatment after surgical procedure. However, the owner refuse to follow this recommendation due to cost restriction. The patient had a satisfactory clinical recovery, he has no longer presented proprioceptive ataxia or proprioception deficits in three months after the surgical procedure. Discussion: In the case described, the feline patient presented a history, clinical signs, and findings in the myelography exam related to MPNST in the region of the vertebral canal. This neoplasm usually involves the spinal canal or spinal cord, but has been described in other locations, such in the small and large intestine, oral cavity, perirenal region, and urinary bladder. Based on the findings of the physical examination and complementary exams, a surgical procedure was recommended. Then, laminectomy and dutoromy were performed to remove the mass. The treatment described in the literature in cases of MPTNS is surgery, which can be curative, but in some cases, the use of radiotherapy may be necessary. The histological patterns observed in this neoplasm are the Antoni A and B, in the case described the Antoni A pattern was observed. The definitive diagnosis was made by immunohistochemistry with vimentin and S100 protein. MPNST are few described in the thoracolumbar region in cats. The surgical treatment was curative, where improvement of the clinical signs could be observed three months after surgery. In addition, monitoring of patients is recommended to ascertain relapses and metastases.

Tratamento de tromboembolismo e preparo para implantação de prótese osteointegrada com oxigenioterapia hiperbárica em uma gata / Treatment of tromboembolism and preparation for an osseointegrated prothesis fixation with hyperbaric oxygen therapy in a kitten

Background: Ischemic neuromyopathy is the most common reason for amputation in cats. In veterinary medicine, the use of prosthetic limbs is not widespread; therefore, in most cases total limb amputation is indicated. However, hyperbaric oxygen therapy (HBOT) is an alternative with several benefits for the treatment of vascular disorders with reperfusion, ischemia, and infection. Therefore, this study aimed to report the positive effects of HBOT on the treatment of ischemic neuromyopathy secondary to arterial thromboembolism on the patient's clinical improvement, and on the preparation of the patient for insertion of an osseointegrated prosthesis. Case: A 6-month-old mixed-breed kitten returned for treatment after undergoing surgery seven days earlier for reduction of traumatic diaphragmatic hernia, during which it suffered a cardiorespiratory arrest. The patient presented with acute pelvic limb paralysis with 24-h evolution, absent femoral pulse, plantar cushions and dorsal part of the limbs cold and pale. After supportive therapy and diagnosis of aortic thromboembolism by arterial Doppler, the patient started adjunctive treatment with HBOT from the first day of hospitalization. Sessions took place in an exclusive hyperbaric chamber for animals and lasted 60 min at a pressure of 2.5 absolute atmospheres and 100% oxygen, initially every 12 h. However, during the first 5 days of hospitalization, the distal region of both pelvic limbs began to show tissue devitalization and edema, and hematologic parameters showed changes on the 7th day. The right pelvic limb (RPL) showed more involvement of superficial tissues, extending to the tarsometatarsal joint region. After 8 days of hospitalization, the devitalized tissue was debrided. The RPL had an extensive devitalized area with exposed bone in the phalanges and necrosis in the pads. The left pelvic limb (LPL) suffered minor complications, with involvement of the phalangeal region. After 12 days, with HBOT every 48 h, exuberant granulation tissue was observed. After 17 days, the patient was discharged, and HBOT sessions were performed weekly. Gangrene of the midfoot and lack of proprioception were observed in RPL, while LPL showed bone divulsion of the 1st, 3rd, and 4th phalanges. Because of the poor prognosis for limb viability, the RPL was partially amputated, and a self-threaded intraosseous prosthesis was inserted. Discussion: The cardiorespiratory arrest that occurred during the surgical procedure to reduce the diaphragmatic hernia without thromboprophylaxis may have contributed to the peripheral ischemia. HBOT was proposed for the adjuvant treatment of ischemic injury because it is especially indicated for cases of ischemia-reperfusion injury. The main hematological parameters were evaluated at an average interval of 7 days. While the platelet count and hematocrit increased, the leukocytosis decreased. This demonstrates the benefit of oxygen therapy in the reported patient. The use of HBOT in orthopedic injuries is known to result mainly in stimulation of osteoblasts, promoting osseointegration of the prosthesis. We conclude that the adjuvant treatment with HBOT helped to preserve a large segment of both pelvic limbs, prevent the progression of necrosis, and provide a healthy bed for fixation of an osseointegrated prosthesis in the RPL, resulting in clinical improvement of the patient.

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.

Tratamiento de la reacción inflamatoria cerebral después de un accidente vascular cerebral (acv) y traumatismo cerebral (tec) en un perro / Treatment of inflammatory brain reaction after brain vascular accident (cva) and traumatic brain injury (tbi) in a dog / Tratamento de reação inflamatória cerebral após acidente vascular encefálico (ave) e trauma cranioencefálico (tce) em cão

El presente reporte de caso tiene como objetivo describir la aparición de una condición neurológica tardía, posterior a un traumatismo craneoencefálico en un paciente canino, atendido en una clínica veterinaria privada. El animal fue evaluado clínicamente, con alteraciones neurológicas severas de ataxia vestibular, marcha compulsiva, paresia, pérdida de propiocepción en las cuatro extremidades, miosis bilateral, anisocoria, entre otras. El diagnóstico fue presuntivo, ayudado por resonancia magnética y basado en una historia clínica detallada. El tratamiento clínico se determinó empíricamente, a base de dexametasona comercial, asociada a metionina, nicotinamida y piridoxina. El paciente presentó una rápida mejoría clínica, sin cuadro neurológico.

The present case report aims to describe the occurrence of a late neurological condition, after traumatic brain injury in a canine patient, treated at a private veterinary clinic. The animal was clinically evaluated, with severe neurological alterations of vestibular ataxia, compulsive gait, paresis, loss of proprioception in all four limbs, bilateral miosis, anisocoria, among others. Diagnosis was presumptive, aided by MRI, and based on detailed history. Clinical treatment was empirically determined, based on commercial dexamethasone, associated with methionine, nicotinamide and pyridoxine. The patient showed rapid clinical improvement, with no neurological picture.

O presente relato de caso tem por objetivo descrever a ocorrência de quadro neurológico tardio, pós-trauma cranioencefálico em um paciente canino, atendido em clínica veterinária particular. O animal foi avaliado clinicamente, com alterações neurológicas intensas de ataxia vestibular, andar compulsivo, paresia, perda de propriocepção nos quatro membros, miose bilateral, anisocoria, entre outros. O diagnóstico foi presuntivo, auxiliado por ressonância magnética, e baseado no histórico detalhado. O tratamento clínico foi determinado empiricamente, a base de dexametasona comercial, associada a metionina, nicotinamida e piridoxina. O paciente apresentou melhora clínica rápida, diminuindo inflamação encefálica e desaparecimento de quadro neurológico.

Canine hypothyroidism with neurological disorders

Background: Hypothyroidism is characterized by hypofunction of the thyroid gland. It results in deficient production of thyroid hormones. Neurological disorders resulting from hypothyroidism are rare, which highlights the importance of this study. This study reports a case of hypothyroidism in a dog with neurological clinical signs, that was treated at the Universidade Estadual de Santa Cruz's Veterinary Hospital (HV-UESC). Case: A 4-year-old male intact Dogo Argentino breed dog, weighing 64 kg, presenting obesity, anorexia, prostration, walking in circles, and chronic dermatopathy was presented at HV-UESC. Upon physical examination, the animal presented a deficit of proprioception in the 4 limbs, with preserved superficial and deep pain. No alteration was observed in the ears, that could explained the clinical signs. In terms of dermatopathy, the animal presented symmetrical alopecia in the lateral region of the thighs and tail. Blood samples were collected for a complete blood count and biochemical tests of urea, creatinine, ALT, AST and cholesterol. Imaging radiography and ultrasonography were performed, which ruled out thoracic and abdominal changes that could be related to the case. Prior to receiving the blood test results, idiopathic encephalitis was suspected and enrofloxacin and prednisone were prescribed for 7 days. During the medication period, previous exams were provided, which indicated only increased cholesterol (500 mg/dL). The animal showed no improvement with the prescribed medication. In view of the clinical signs presented by the patient and the results of the additional tests, hormonal disease was suspected, compatible with hypothyroidism. Thus, hormonal tests of total T4, free T4, and TSH were requested, leading to verification of reduced total T4 (0.3 ng/dL) and free T4 (0.15 ng/dL) levels, and confirming the dysfunction of the thyroid gland. The previous treatment was suspended and thyroid hormone replacement was initiated. After 3 days of treatment, the neurological signs regressed and the animal became more active; after 30 days, the areas of alopecia decreased. Although the patient did not receive the recommended clinical follow-up for such cases, it was possible to establish the ideal levothyroxine dosage for the dog after appropriate adjustments, which permitted thyroid hormone levels to return to normal. Discussion: This report refers to a case of hypothyroidism in a giant dog breed. The dog in the report showed clinical signs of a dermatological, metabolic, and neurological nature, which is consistent with a lack of thyroid hormone. The main signs presented by the animal were neurological, such as walking in circles and a deficit of proprioception in the four limbs. These clinical signs are rarely mentioned in the literature associated with hypothyroidism. Laboratory abnormalities are correlated with the severity and chronicity of the disease. The animal showed a decrease in total T4 and free T4, which is to be expected in a hypothyroid animal. As a result, levothyroxine replacement treatment was initiated. The dose used for the dog, which is the recommended dose in the literature, greatly increased its total T4 levels. As a result, the dose was readjusted after a new clinical evaluation. The rate of metabolism and absorption of levothyroxine varies widely and is independent of weight. The patient showed quickly improvement in neurological signs, activity level, and serum cholesterol rate. Regarding dermatological signs and body condition, there was a more gradual improvement. This corroborates what is mentioned in the literature, which indicates that improvements can take many months

Polymyositis associated with brainstem signs in a dog

Background: Polymyositis is a generalized inflammatory myopathy which can lead to rhabdomyolysis. This affection may have several origins, including degenerative, metabolic, autoimmune, infectious, inflammatory, ischemic, traumatic, by drug use, induced by toxins and also of idiopathic origin. Diagnosis is made with seric dosage, electrodiagnostic tests and muscle biopsy. Lesions in the rostral oblong medulla may affect the central vestibular system, and there may be signs such as opisthotonos, nystagmus, and strabismus. The aim of this report is to describe a case of a mixed breed dog with manifestation of polymyositis associated with brainstem signs of probable idiopathic origin. Case: A 5-year-old mixed breed male dog was attended with opisthotonos episodes for 2 days, and pelvic limbs extension and thoracic limbs flexion that lasted 10 to 20 min at intervals of approximately 1 h. The animal was anorexic and had also presented one episode of emesis. Upon neurological examination, ventromedial strabismus and Horner's syndrome was observed on the right side, besides vertical nystagmus, flaccid tetraparesis and absence of proprioception in the four limbs. Biochemical analyses revealed creatine kinase (CK) increased (2,433.9 UI/L - reference: 1.5-28.4 UI/L), and urinalysis showed dark color and presence of occult blood without, however, erythrocyturia. Electrocardiogram (ECG) showed QS wave and deviation of the electrical axis. Treatment with prednisolone (1 mg/kg, BID), phenobarbital (2 mg/kg, BID), maropitant citrate (1 mg/kg in 2 doses), and crystalloid fluid therapy (50 mL/kg/day) were prescribed. On the 4th day, the dog was more active and feeding without a tube, so it recommended keep the treatment at home. On the 10th day, the animal had proprioception present on the 4 limbs and normorexia. Biochemical analyses and urinalysis showed no alterations, but normochromic normochromic anemia with thrombocytopenia and leukocytosis by neutrophilia showed in blood count exam. PCR to Ehrlichia canis, Hepatozoon sp., and Babesia canis resulted negative. On the 15th day, blood count, biochemical analyses and urinalysis showed no alterations. Neurological examination revealed only positional vertical nystagmus. which remained as a sequel. Discussion: Polymyositis may be accompanied by rhabdomyolysis, characterized by acute muscle necrosis, increased CK and myoglobinuria. The animal had polymyositis of acute onset, with myoglobinuria and elevated CK values, whose presentation included myalgia and muscle weakness. In humans, polymyositis is accompanied by changes in electrocardiographic tracing without clinical alterations. In dogs, the first report that showed cardiac involvement was compatible with myocarditis. The changes in ECG in the present case was attributed to failure in myocardial electrical conduction. The patient also showed signs of brainstem and central vestibular system injuries. Stress myopathy, intoxication, snakebite, infectious, and metabolic diseases were discarded leading to a clinical suspicion as idiopathic origin. Similar to a published case, the patient of this report received symptomatic and supportive treatment, being discharged from the hospital 20 days after the onset of clinical signs. Thus, polymyositis may be accompanied by signs indicative of brainstem injury. Patients with rhabdomyolysis require intense monitoring due to the high risk of developing acute renal failure. Since no causative agent was identified, symptomatic treatment combined with the prevention of possible complications were fundamental for the maintenance of the animal's life.

Tratamento de reação inflamatória cerebral após Acidente Vascular Encefálico (AVE) e Trauma Cranioencefálico (TCE) em cão / Treatment of inflammatory brain reaction after Brain Vascular Accident (CVA) and Traumatic Brain Injury (TBI) in a dog / Tratamiento de la reacción inflamatoria cerebral después de un Accidente Vascular Cerebral (ACV) y Traumatismo Cerebral (TEC) en un perro

O presente relato de caso tem por objetivo descrever a ocorrência de quadro neurológico tardio, pós-trauma cranioencefálico em um paciente canino, atendido em clínica veterinária particular. O animal foi avaliado clinicamente, com alterações neurológicas intensas de ataxia vestibular, andar compulsivo, paresia, perda de propriocepção nos quatro membros, miose bilateral, anisocoria, entre outros. O diagnóstico foi presuntivo, auxiliado por ressonância magnética, e baseado no histórico detalhado. O tratamento clínico foi determinado empiricamente, a base de dexametasona comercial, associada a metionina, nicotinamida e piridoxina. O paciente apresentou melhora clínica rápida, diminuindo inflamação encefálica e desaparecimento de quadro neurológico.

The present case report aims to describe the occurrence of a late neurological condition, after traumatic brain injury in a canine patient, treated at a private veterinary clinic. The animal was clinically evaluated, with severe neurological alterations of vestibular ataxia, compulsive gait, paresis, loss of proprioception in all four limbs, bilateral miosis, anisocoria, among others. Diagnosis was presumptive, aided by MRI, and based on detailed history. Clinical treatment was empirically determined, based on commercial dexamethasone, associated with methionine, nicotinamide and pyridoxine. The patient showed rapid clinical improvement, with no neurological picture.

El presente reporte de caso tiene como objetivo describir la aparición de una condición neurológica tardía, posterior a un traumatismo craneoencefálico en un paciente canino, atendido en una clínica veterinaria privada. El animal fue evaluado clínicamente, con alteraciones neurológicas severas de ataxia vestibular, marcha compulsiva, paresia, pérdida de propiocepción en las cuatro extremidades, miosis bilateral, anisocoria, entre otras. El diagnóstico fue presuntivo, ayudado por resonancia magnética y basado en una historia clínica detallada. El tratamiento clínico se determinó empíricamente, a base de dexametasona comercial, asociada a metionina, nicotinamida y piridoxina. El paciente presentó una rápida mejoría clínica sin cuadro neurológico.

Feline aortic thromboembolism diagnosed by thermography

Background: In cats, arterial thromboembolism is one of the most devastating diseases, with an acute presentation, andis often caused by undiagnosed cardiomyopathy. Defined as the obstruction of one or more arterial lumens by emboli,the arterial thromboembolism is responsible for hypoperfusion signs. As the temperature of the skin surface is directlyrelated to tissue perfusion, thermography can be promising for the early diagnosis of thromboembolism. Therefore, thisstudy reports the importance of thermography as a complementary examination for the diagnosis of thromboembolism inthe abdominal aorta of a domestic cat.Case: A 4-year-old mixed-breed cat weighing 2.95 kg was presented with a history of sudden onset paraplegia, apathy,and pain when handled, with greater intensity in the sacro-coccidian region. During physical exam, it was noted that thefemoral artery pulse was undetectable bilaterally during manual pulse measurement. Superficial and deep sensitivity inthe pelvic limbs and proprioception were also absent and the plantar cushions and nail beds of the posterior limbs werepale to cyanotic. Thermographic images revealed that the temperature of both hind limbs was lower than that of forelimbs,with difference of 3.2ºC and 2.9ºC between the left and right limbs, respectively. Doppler ultrasonography revealed theabsence of pulse and flow in the femoral arteries bilaterally. Electrocardiography revealed sinus tachycardia, with a heartrate of 250 bpm. Echocardiography revealed dilation of the left atrium and concentric cardiac hypertrophy. After 24 h, dueto the worsening of the clinical condition and unfavorable prognosis, the animal was euthanized and sent for necropsy.Necropsy revealed that the arterial lumen of the caudal abdominal aorta and bifurcation of the iliac arteries were obliterated...

Feline aortic thromboembolism diagnosed by thermography

Background: In cats, arterial thromboembolism is one of the most devastating diseases, with an acute presentation, andis often caused by undiagnosed cardiomyopathy. Defined as the obstruction of one or more arterial lumens by emboli,the arterial thromboembolism is responsible for hypoperfusion signs. As the temperature of the skin surface is directlyrelated to tissue perfusion, thermography can be promising for the early diagnosis of thromboembolism. Therefore, thisstudy reports the importance of thermography as a complementary examination for the diagnosis of thromboembolism inthe abdominal aorta of a domestic cat.Case: A 4-year-old mixed-breed cat weighing 2.95 kg was presented with a history of sudden onset paraplegia, apathy,and pain when handled, with greater intensity in the sacro-coccidian region. During physical exam, it was noted that thefemoral artery pulse was undetectable bilaterally during manual pulse measurement. Superficial and deep sensitivity inthe pelvic limbs and proprioception were also absent and the plantar cushions and nail beds of the posterior limbs werepale to cyanotic. Thermographic images revealed that the temperature of both hind limbs was lower than that of forelimbs,with difference of 3.2ºC and 2.9ºC between the left and right limbs, respectively. Doppler ultrasonography revealed theabsence of pulse and flow in the femoral arteries bilaterally. Electrocardiography revealed sinus tachycardia, with a heartrate of 250 bpm. Echocardiography revealed dilation of the left atrium and concentric cardiac hypertrophy. After 24 h, dueto the worsening of the clinical condition and unfavorable prognosis, the animal was euthanized and sent for necropsy.Necropsy revealed that the arterial lumen of the caudal abdominal aorta and bifurcation of the iliac arteries were obliterated...(AU)

Utilização da fisioterapia na reabilitação de bezerro com poliartrite e paresia neuromuscular: relato de caso / Use of physiotherapy in the rehabilitation of calves with polyarthritis and neuromuscular paresis: case report / Uso de la fisioterapia en la rehabilitación de un ternero con poliartritis y parisia neuromuscular: reporte de caso

A reabilitação animal na medicina veterinária é um campo recente, porém crescente a cada dia. Neste sentido, a fisioterapia veterinária atua trazendo inúmeros benefícios, como melhoria dos movimentos, redução da dor, edema e outras. Interfere ainda no tempo de recuperação, redução de custos para o proprietário, podendo ser hoje utilizada como um tratamento na recuperação pós-cirúrgica. Desta forma, objetivou-se relatar o uso da fisioterapia em uma bezerra com poliartrite e paresia neuromuscular. O animal apresentou um aumento de volume nas articulações cárpicas e társicas após histórico de onfalite, permanecendo em decúbito esternal por vários dias. O proprietário resolveu aplicar ferro dextrano na região glútea do animal, o que causou uma lesão de nervo isquiático. Foram instituídos protocolos medicamentosos e fisioterápicos, que culminaram no estímulo da marcha, propriocepção, além de hipertrofia muscular. Porém, em virtude de complicações resultantes de onfalite, o animal veio a óbito.(AU)

Animal rehabilitation in veterinary medicine is a recent field, but growing every day. In this sense, veterinary physiotherapy works bringing numerous benefits, such as improved movements, reduced pain, edema and others. Reducing the recovery time, reducing costs for the owner, and today it can be used as a treatment in post-surgical recovery. In this sense, the objective was to report the use of physiotherapy in a heifer with polyarthritis and neuromuscular paresis. The animal showed an increase in volume in the carpal and tarsal joints after a history of omphalitis, remaining in sternal decubitus for several days. The owner decided to apply iron dextran to the animal's gluteal region, which caused an injury to the sciatic nerve. Medicinal and physical therapy protocols were instituted, which culminated in the stimulation of gait, proprioception, in addition to muscle hypertrophy. However, due to complications resulting from omphalitis, the animal died.(AU)

La rehabilitación animal en medicina veterinaria es un campo reciente, pero en crecimiento cada día. En este sentido, la fisioterapia veterinaria actúa aportando numerosos beneficios, como mejora de los movimientos, reducción del dolor, edemas y otros. Disminución del tiempo de recuperación, reducción de costos para el propietario, pudiendo ser utilizado hoy en día como tratamiento en la recuperación posquirúrgica. En ese sentido, el objetivo fue reportar el uso de fisioterapia en una vaquilla con poliartritis y paresia neuromuscular. El animal presentó un aumento de volumen en las articulaciones del carpo y del tarso tras un antecedente de onfalitis, permaneciendo en decúbito esternal durante varios días. El propietario decidió aplicar hierro dextrano en la región glútea del animal, lo que provocó una lesión en el nervio ciático. Se instauraron protocolos farmacológicos y de fisioterapia, que culminaron con estimulación de la marcha, propiocepción, además de hipertrofia muscular. Sin embargo, debido a complicaciones derivadas de la onfalitis, el animal falleció.(AU)

Anestesia multimodal em cachorro-do-mato (Cerdocyon thous) submetido à hemilaminectomia e estabilização sacrococcígea / Multimodal anaesthesia in a crab-eating fox (Cerdocyon thous) undergoing hemilaminectomy and sacrococcygeal stabilization

Background: Several researches have shown the impacts of roads more directly to wildlife in Brazil. The crab-eating fox(Cerdocyon thous) is a frequent run over victim. Dissociative drugs are commonly used, but inhalation anesthesia is indicatedin cases of extensive and prolonged surgeries. Despite their similarity with domestic dogs, the literature is scarce regarding theassociation of new anesthetic techniques and protocols in wild canids. The aim of this paper was to report the viability of multimodal anesthesia in a crab-eating fox, victim of running over, undergoing hemilaminectomy and sacrococcygeal stabilization.Case: An adult male specimen of crab-eating fox was rescued after being run over and taken to a wild animal screening center.Physical examination showed superficial and deep pain, lack of support for the pelvic limbs and proprioception, increasedreflexes, and reduced tail mobility. Chemical restraint with intramuscular (IM) tiletamine-zolazepam (6.0 mg/kg) and morphine (0.5 mg/kg) was performed. Meloxicam (0.2 mg/kg IM) and enrofloxacin (5.0 mg/kg IM) were also administered. Theanimal was sequentially admitted to the veterinary hospital. Radiographic images showed compaction of the spinal columnof the T10 and T11 thoracic vertebrae and the sacrococcygeal region. Sixty min after chemical restraint, the anesthesia wassupplemented with IM tiletamine-zolazepam (4.5 mg/kg), and fluid therapy with 0.9% NaCl (10 mL/kg/h) was started. Ten minlater, intravenous propofol dose-effect (2.5 mg/kg) was administered and general anesthesia was maintained with isoflurane(FiO2 = 1.0). Thirty min after the induction of anesthesia, the animal was urdergoing hemilaminectomy and sacrococcygealstabilization. Constant rate infusions (CRI) of dexmedetomidine (0.5 μg/kg/h) and ketamine (0.6 mg/kg/h) were started. Lidocaine (7.0 mg/kg) and bupivacaine (2.0 mg/kg) were administered into the surgical site on the T10 and T11 vertebrae at 35...(AU)

Anestesia multimodal em cachorro-do-mato (Cerdocyon thous) submetido à hemilaminectomia e estabilização sacrococcígea / Multimodal anaesthesia in a crab-eating fox (Cerdocyon thous) undergoing hemilaminectomy and sacrococcygeal stabilization

Background: Several researches have shown the impacts of roads more directly to wildlife in Brazil. The crab-eating fox(Cerdocyon thous) is a frequent run over victim. Dissociative drugs are commonly used, but inhalation anesthesia is indicatedin cases of extensive and prolonged surgeries. Despite their similarity with domestic dogs, the literature is scarce regarding theassociation of new anesthetic techniques and protocols in wild canids. The aim of this paper was to report the viability of multimodal anesthesia in a crab-eating fox, victim of running over, undergoing hemilaminectomy and sacrococcygeal stabilization.Case: An adult male specimen of crab-eating fox was rescued after being run over and taken to a wild animal screening center.Physical examination showed superficial and deep pain, lack of support for the pelvic limbs and proprioception, increasedreflexes, and reduced tail mobility. Chemical restraint with intramuscular (IM) tiletamine-zolazepam (6.0 mg/kg) and morphine (0.5 mg/kg) was performed. Meloxicam (0.2 mg/kg IM) and enrofloxacin (5.0 mg/kg IM) were also administered. Theanimal was sequentially admitted to the veterinary hospital. Radiographic images showed compaction of the spinal columnof the T10 and T11 thoracic vertebrae and the sacrococcygeal region. Sixty min after chemical restraint, the anesthesia wassupplemented with IM tiletamine-zolazepam (4.5 mg/kg), and fluid therapy with 0.9% NaCl (10 mL/kg/h) was started. Ten minlater, intravenous propofol dose-effect (2.5 mg/kg) was administered and general anesthesia was maintained with isoflurane(FiO2 = 1.0). Thirty min after the induction of anesthesia, the animal was urdergoing hemilaminectomy and sacrococcygealstabilization. Constant rate infusions (CRI) of dexmedetomidine (0.5 μg/kg/h) and ketamine (0.6 mg/kg/h) were started. Lidocaine (7.0 mg/kg) and bupivacaine (2.0 mg/kg) were administered into the surgical site on the T10 and T11 vertebrae at 35...

Segmental hypoplasia of the spinal cord and syringomyelia in a calf / Hipoplasia segmentar de medula espinhal e siringomielia em um bezerro

Congenital malformations are functional and structural changes in organ systems, tissues, or organs that may develop during the embryonic or fetal phase. Spinal cord malformations, such as segmental hypoplasia of the spinal cord (SHSC) and syringomyelia, are rare in bovines. A Girolando calf from Valença, Rio de Janeiro, was admitted to the Veterinary Hospital of Universidade Federal Rural do Rio de Janeiro because of motor incoordination. Clinical evaluation revealed a 5-cm depression area in the spine at the dorsal line of the thoracic region. Neurological examination revealed reduced proprioception, pelvic limb extension with increased nociceptive activity, and reduced anal reflex. In radiographic examination, the body of the T11 vertebra had a trapezoidal wedge shape with ventral hemivertebra, probable agenesis or hypoplasia of the T11-T12 spinous processes, and fusion of the T9-T10 spinous processes. Myelography revealed extradural spinal compression caused by vertebral malformations. Necropsy showed no spinous processes (T11-T12), cranial stenosis in the medullary canal (T11-T13), and 1-3-mm pores in the white matter of the thoracic spinal cord (T8-T11). Microscopy revealed cystic dilatations in the white matter (T9-T11), cystic areas of varying sizes (T8-T9), and moderate reduction in the gray matter around the central canal of the medulla (T11-T13). Here, we reported the clinical and pathological findings of SHSC and syringomyelia in a Girolando calf. The features should be differentiated from other spinal cord syndromes. Congenital malformations are of economic importance, and their etiology and diagnosis are fundamental to disease control and progenitor-selection programs.(AU)

Malformações congênitas são alterações funcionais e estruturais dos sistemas, tecidos ou órgãos que podem ocorrer na fase embrionária ou fetal. Malformações na medula espinhal, como hipoplasia segmentar da medula espinhal (HSME) e siringomielia, possuem raras descrições em bovinos. Uma bezerra Girolando, proveniente do Município de Valença, RJ, foi atendida no Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro (UFRRJ), com quadro de incoordenação motora. À avaliação clínica, na coluna vertebral, à linha dorsal da região torácica havia uma área com depressão de 5 cm. Ao exame neurológico foi observado propriocepção reduzida, extensão de membros pélvicos com aumento da atividade nociceptiva e redução de reflexo anal. Ao exame radiográfico, o corpo vertebral T11 apresentou forma trapezoidal em cunha com hemivértebra ventral, provável agenesia ou hipoplasia dos processos espinhosos T11-T12 e fusão dos processos espinhosos T9-T10. À mielografia indicou compressão medular extradural provocada pelas malformações vertebrais. À necropsia não foram observados os processos espinhosos T11-T12, o canal medular apresentou estenose cranial (T11-T13) e, na medula espinhal torácica (T8-T11) foram observados poros de 1-3 mm na substância branca. À microscopia, os segmentos T9-T11 apresentaram dilatações císticas na substância branca e os segmentos T8-T9, formações de áreas císticas de tamanhos variados; nos segmentos T11-T13 denotou-se moderada redução da substância cinzenta ao redor do canal central da medula. O presente trabalho tem o objetivo de apresentar os achados clínicos e patológicos desta bezerra Girolando com HSME e siringomielia, que devem ser diferenciadas de outras síndromes da medula espinhal. As malformações congênitas possuem importância econômica e sua etiologia e diagnóstico são fundamentais para a condução de programas de controle de doenças e seleção de progenitores.(AU)

Steinmann pins and polymethylmethacrylate repair of fourth lumbar vertebral fracture and dorsocranial luxation in puppy

Background: Acute spinal traumas can lead to irreversible damage associated with vascular and inflammatory changes in neural tissue. Since spine and spinal cord traumas have an unfavorable prognosis in small animals, and reports of the use of Steinmann pins and polymethylmethacrylate repair of lumbar vertebra fracture-luxation in puppies are rare in the literature, the present paper aimed to report the surgical treatment of transversal fracture through the body of the fourth lumbar vertebra, with dorsocranial displacement of the caudal fragment by using Steinmann pins and polymethylmethacrylate in a 7-month-old Labrador Retriever male dog. Case: A 7-month-old intact male Labrador Retriever dog, weighing 24.0 kg was attended at School Veterinary Hospital with a history of hit by car and paraplegia of the hind limbs. On neurological examination was observed no proprioception and no deep pain sensitivity on the both pelvic limbs. The lumbar spinal palpation showed intense pain, and the motor function and patellar reflexes were reduced. The values of haematological and biochemical analysis remained within the reference values for the species. Radiographs revealed a transversal fracture through the body of the fourth lumbar vertebra, with dorsocranial displacement of the caudal fragment, and was decided to perform a surgical treatment by open reduction and internal fixation of the fracture. The dog was positioned in ventral recumbency for surgery, and a dorsal midline incision was made from the second lumbar vertebra to the sixth lumbar vertebra. Two crossed 1.5 mm Kirschner wires were placed through the caudal articular facets of the fourth lumbar vertebra to provide initial stability...

Steinmann pins and polymethylmethacrylate repair of fourth lumbar vertebral fracture and dorsocranial luxation in puppy

Background: Acute spinal traumas can lead to irreversible damage associated with vascular and inflammatory changes in neural tissue. Since spine and spinal cord traumas have an unfavorable prognosis in small animals, and reports of the use of Steinmann pins and polymethylmethacrylate repair of lumbar vertebra fracture-luxation in puppies are rare in the literature, the present paper aimed to report the surgical treatment of transversal fracture through the body of the fourth lumbar vertebra, with dorsocranial displacement of the caudal fragment by using Steinmann pins and polymethylmethacrylate in a 7-month-old Labrador Retriever male dog. Case: A 7-month-old intact male Labrador Retriever dog, weighing 24.0 kg was attended at School Veterinary Hospital with a history of hit by car and paraplegia of the hind limbs. On neurological examination was observed no proprioception and no deep pain sensitivity on the both pelvic limbs. The lumbar spinal palpation showed intense pain, and the motor function and patellar reflexes were reduced. The values of haematological and biochemical analysis remained within the reference values for the species. Radiographs revealed a transversal fracture through the body of the fourth lumbar vertebra, with dorsocranial displacement of the caudal fragment, and was decided to perform a surgical treatment by open reduction and internal fixation of the fracture. The dog was positioned in ventral recumbency for surgery, and a dorsal midline incision was made from the second lumbar vertebra to the sixth lumbar vertebra. Two crossed 1.5 mm Kirschner wires were placed through the caudal articular facets of the fourth lumbar vertebra to provide initial stability...(AU)

Ependimoma anaplásico em cão / Anaplasic ependymoma in a dog

Background: Anaplastic ependymoma is a rare primary intracranial neoplasm in dogs and cats, which originates fromependymal cells that line the ventricular system of the brain and spinal cord. Normally, this neoplasm occurs as a single,expansive mass that develops mainly in the lateral ventricles, and neurological changes are due to local tissue impairmentand peritumoral tissue compression. This article reports a case of anaplastic ependymoma in a dog treated at the VeterinaryHospital of the Federal University of Mato Grosso do Sul (UFMS), emphasizing and describing the neurological signsand histopathology of this tumor.Case: This article reports the case of a 11-year-old mongrel dog with a history of butting its head against obstacles, ofcompulsive walking, and altered proprioception of the right side limbs. The condition evolved to positional strabismus ofthe left eye, left lateral deviation of the head, vertical nystagmus, decreased level of consciousness, and constant lateraldecubitus. Due to the suspicion of intracranial neoplasia and worsening of its clinical condition, the animal was euthanized. Necropsy of its body revealed a mass of approximately 3 cm in diameter in the third ventricle (in the left lateralregion). A histological examination revealed random clusters of ependymal cells with a few rosettes and pseudorosettes.The cells were cuboid to cylindrical in shape, with moderate eosinophilic cytoplasm with indistinct borders, and round tooval moderately hyperchromatic nuclei with 1-2 visible nucleoli. Based on these findings, the tumor was characterized asanaplastic ependymoma.Discussion: Intracranial tumors occur more frequently in older animals, and usually neurological signs tend to evolve progressively. Most affected dogs are mongrels, like the dog described in this report, but Golden Retrievers, Boxers, LabradorRetrievers...(AU)

Ependimoma anaplásico em cão / Anaplasic ependymoma in a dog

Background: Anaplastic ependymoma is a rare primary intracranial neoplasm in dogs and cats, which originates fromependymal cells that line the ventricular system of the brain and spinal cord. Normally, this neoplasm occurs as a single,expansive mass that develops mainly in the lateral ventricles, and neurological changes are due to local tissue impairmentand peritumoral tissue compression. This article reports a case of anaplastic ependymoma in a dog treated at the VeterinaryHospital of the Federal University of Mato Grosso do Sul (UFMS), emphasizing and describing the neurological signsand histopathology of this tumor.Case: This article reports the case of a 11-year-old mongrel dog with a history of butting its head against obstacles, ofcompulsive walking, and altered proprioception of the right side limbs. The condition evolved to positional strabismus ofthe left eye, left lateral deviation of the head, vertical nystagmus, decreased level of consciousness, and constant lateraldecubitus. Due to the suspicion of intracranial neoplasia and worsening of its clinical condition, the animal was euthanized. Necropsy of its body revealed a mass of approximately 3 cm in diameter in the third ventricle (in the left lateralregion). A histological examination revealed random clusters of ependymal cells with a few rosettes and pseudorosettes.The cells were cuboid to cylindrical in shape, with moderate eosinophilic cytoplasm with indistinct borders, and round tooval moderately hyperchromatic nuclei with 1-2 visible nucleoli. Based on these findings, the tumor was characterized asanaplastic ependymoma.Discussion: Intracranial tumors occur more frequently in older animals, and usually neurological signs tend to evolve progressively. Most affected dogs are mongrels, like the dog described in this report, but Golden Retrievers, Boxers, LabradorRetrievers...

Sciatic nerve injection palsy in a dog: electrodiagnostic testing and microsurgical treatment

Background: Iatrogenic damage to the ischiatic nerve is considered uncommon and may cause dysfunction with variable clinical signs dependent on type and severity of injury. Due to important role of this nerve in locomotion and weightbearing limb, a poor prognosis for recovery may be observed in many cases. Electromyography analysis may suggest the neuroanatomic localization, diagnosis information, and severity of lesion to determine better therapeutic intervention. Therefore, the aim of this report is to describe the possible cause, diagnosis and treatment of a postinjection ischiatic nerve injury in a dog with complete recovery.Case: A 3-year-old neutered male dachshund dog was referred to the Veterinary Hospital due to inability to weight support in the right hind limb after diminazene diaceturate intramuscular injection. The gait evaluation showed dropped-hock and knuckling into the digits of the right hind limb and neurologic examination revealed moderate muscle atrophy below to femorotibial joint of the right hind limb with sensory analgesia (superficial and deep) on the lateral, dorsal, and plantar surfaces, absent patellar reflex, and proprioceptive deficit. Electrophysiologic testing was done under general anesthesia in a 2-channel Nicolet Compass Meridian apparatus. Absence of compound muscle action potentials after right fibular and tibial nerve stimulations, and abnormal spontaneous activity in cranial tibial, gastrocnemius and deep digital extensor muscles were observed. A diagnosis of moderate/severe axonotmesis of sciatic nerve was achieved. Under microscope magnification, all adherent adjacent tissue and epineural sheat were removed. Due this, a small epineural window was created. On neurological examination performed 30 days after surgery, complete recovery of sensitivity of the right hind limb, and normal proprioception were observed. The muscle atrophy was also noted to have improved.[...]