Accuracy and reliability of tele-ultrasonography in detecting gastrointestinal obstruction in dogs and cats.

OBJECTIVES: To assess the accuracy and interobserver agreement of tele-ultrasonography for the diagnosis of gastrointestinal obstruction in small animals by radiologists with different levels of experience. MATERIALS AND METHODS: A retrospective cross-sectional study including dogs and cats admitted with gastrointestinal signs, between 2017 and 2019, that had abdominal ultrasonographic (US) examination performed and images saved for review. Patients were classified into two categories based on final diagnosis: animals with or without complete or partial gastrointestinal obstruction. Observers with four experience levels interpreted the archived ultrasound examinations, simulating a tele-ultrasonography consultation. Analyses of accuracy, sensitivity, specificity, positive and negative predictive values were obtained for each observer for detection of gastrointestinal obstruction. Agreement between observers for the gastrointestinal obstruction diagnosis was assessed using Fleiss's Kappa statistics. RESULTS: Ninety patients with gastrointestinal signs were included. Of these, 23 of 90 had partial or complete gastrointestinal obstruction. Interpretation of the images by observers via tele-ultrasonography showed intervals of accuracy, sensitivity, specificity, positive and negative predictive values, respectively, of 78.9% to 87.8%, 73.9% to 100%, 77.6% to 89.6%, 55.9% to 70.8% and 90.9% to 100% for diagnosis of gastrointestinal obstruction. Agreement for the gastrointestinal obstruction diagnosis across all reviewers was moderate (Kappa 0.6). CLINICAL SIGNIFICANCE: Tele-ultrasonography had good accuracy for detection of gastrointestinal obstruction, however had a rather low positive predictive value and only moderate interobserver agreement. Therefore, this technique should be used with caution in this clinical context, given the potential surgical decision at hand.

Large bowel obstruction by enteroliths and/or foreign bodies in domestic equids: retrospective study of cases seen from January 2003 to March 2020 / [Obstrução do intestino grosso por enterólitos e/ou por corpos estranhos em equídeos domésticos: estudo retrospectivo de casos observados de janeiro de 2003 a março de 2020]

This retrospective study was based on data extracted from medical records of 48 horses with intestinal obstruction caused by enteroliths and/or foreign bodies seen over the course of 17 years. Data analysis was aimed at describing the major features of this type of colic. Obstructions caused by enteroliths, foreign bodies or both accounted for 40 (83.34%), 6 (12.50%) and 2 (4.16%) cases in this sample respectively. Affected horses were aged 1 to 32 years (mean age 9.5 years) and 14 horses were fed alfalfa. Alfalfa is thought to contribute to enterolith formation. Foreign bodies and enteroliths were found in the transverse (12 cases, 25%), the large or the small colon (10 cases, 20.83% respectively). Concurrent obstruction of different intestinal segments was also recorded. These involved the small and the large colon in 10 cases (20.83%), the transverse and the large colon in 4 cases (8.33%), the small and the transverse colon in 1 case (2.08%) and the transition from the large to the transverse colon in one case (2.08%). Short term survival was 77.08% overall and 87.50% when only patients submitted to postoperative treatment were accounted for. Survival data are consistent with survival rates of 91% reported in literature.

Este estudo retrospectivo foi baseado em dados extraídos de prontuários de 48 cavalos com obstrução intestinal causada por enterólitos e / ou corpos estranhos observados ao longo de 17 anos. A análise dos dados teve como objetivo descrever as principais características desse tipo de cólica. Obstruções provocadas por enterólitos, corpos estranhos ou ambos foram responsáveis por 40 (83,34%), seis (12,50%) e dois (4,16%) casos nesta amostra, respectivamente. Os cavalos afetados tinham entre um e 32 anos (idade média de 9,5 anos), e 14 cavalos foram alimentados com alfafa. Acredita-se que a alfafa contribua para a formação de enterólitos. Corpos estranhos e enterólitos foram encontrados no cólon transverso (12 casos, 25%), maior ou menor (10 casos, 20,83%, respectivamente). A obstrução simultânea de diferentes segmentos intestinais também foi registrada. Estes envolveram o cólon menor e o cólon maior em 10 casos (20,83%), o cólon transverso e o cólon maior em quatro casos (8,33%), o cólon menor e o transverso em um caso (2,08%) e a transição do cólon maior para o cólon transverso em um caso (2,08%). A sobrevida em curto prazo foi de 77,08%, em geral, e de 87,50% quando contabilizados apenas os pacientes submetidos ao tratamento pós-operatório. Os dados de sobrevivência são consistentes com as taxas de sobrevivência de 91% relatadas na literatura.

Síndrome gastrointestinal em coelho (Oryctolagus cuniculus) / Gastrointestinal syndrome in a rabbit (Oryctolagus cuniculus)

Background: The term “rabbit gastrointestinal syndrome” (RGIS) refers to a decrease in peristaltic movements, which insome cases can progress to absolute inactivity of the digestive apparatus. This condition is mostly secondary to others thatpromote changes in gastrointestinal motility, such as dehydration, fiber deficiency, excess carbohydrates in diets, stress,and acute or chronic painful processes. Clinical manifestations are mostly nonspecific. Thus, a case of RGIS resultingfrom environmental change in a domestic rabbit (Oryctolagus cuniculus) is reported.Case: A 4-month-old male domestic rabbit weighing 0.962 kg was referred to a university veterinary hospital. The patient had a history of absence of defecation and anorexia for the past two days. The owner reported that the patient wasapathetic but became aggressive when manipulated. The changes started after a move of residence. On physical evaluation, an increase in abdominal volume and a painful response to touch on the abdomen were observed. Complementaryexaminations were performed, such as a blood count and an ultrasound study. The blood tests showed no alterations,but the ultrasound evaluation showed the presence of free abdominal fluid, dilated intestinal loops due to fluid content,reduced gastrointestinal motility, and a hyperechoic structure associated with acoustic shading in the small intestine, allfindings suggestive of obstruction. Given the failure of clinical management, the patient was referred for an exploratorylaparotomy procedure followed by enterotomy. The obstruction point was located near the ileocecal junction. After surgery,analgesics, antibiotics, fluid therapy, anti-inflammatory drugs, intestinal motility inducers, and probiotics were prescribed.One week after the surgical procedure, the patient showed improvement in the clinical condition, with normal appetite,defecation, and docility...(AU)

Síndrome gastrointestinal em coelho (Oryctolagus cuniculus) / Gastrointestinal syndrome in a rabbit (Oryctolagus cuniculus)

Background: The term “rabbit gastrointestinal syndrome” (RGIS) refers to a decrease in peristaltic movements, which insome cases can progress to absolute inactivity of the digestive apparatus. This condition is mostly secondary to others thatpromote changes in gastrointestinal motility, such as dehydration, fiber deficiency, excess carbohydrates in diets, stress,and acute or chronic painful processes. Clinical manifestations are mostly nonspecific. Thus, a case of RGIS resultingfrom environmental change in a domestic rabbit (Oryctolagus cuniculus) is reported.Case: A 4-month-old male domestic rabbit weighing 0.962 kg was referred to a university veterinary hospital. The patient had a history of absence of defecation and anorexia for the past two days. The owner reported that the patient wasapathetic but became aggressive when manipulated. The changes started after a move of residence. On physical evaluation, an increase in abdominal volume and a painful response to touch on the abdomen were observed. Complementaryexaminations were performed, such as a blood count and an ultrasound study. The blood tests showed no alterations,but the ultrasound evaluation showed the presence of free abdominal fluid, dilated intestinal loops due to fluid content,reduced gastrointestinal motility, and a hyperechoic structure associated with acoustic shading in the small intestine, allfindings suggestive of obstruction. Given the failure of clinical management, the patient was referred for an exploratorylaparotomy procedure followed by enterotomy. The obstruction point was located near the ileocecal junction. After surgery,analgesics, antibiotics, fluid therapy, anti-inflammatory drugs, intestinal motility inducers, and probiotics were prescribed.One week after the surgical procedure, the patient showed improvement in the clinical condition, with normal appetite,defecation, and docility...

Ultrasonographic diagnosis of ileal intussusception in calf

Background: Intussusception, characterized by invagination of an intestinal segment into the lumen of the adjacent segment, is one of the main causes of intestinal obstruction in cattle, and occurs more frequently in calves. The diagnosis of the disease is based on the history, clinical examination, and complementary exams, which are a challenge in this species, especially in calves, in which transrectal palpation is limited. As it is a non-invasive, effective, and low-cost test, ultrasonography could be an important tool in the diagnosis of intestinal obstructions, in which time is essential for the prognosis. Therefore, the objective was to report a case of intussusception in a calf diagnosed by ultrasound. Case: A 4-month-old calf, weaned at 3 months and raised intensively, was treated at the Clínica de Bovinos de Garanhuns, campus of the Universidade Federal Rural de Pernambuco (CBG/UFRPE), with a history of apathy, anorexia, and dyschezia for 3 days. On physical examination, fever, moderate dehydration, tachycardia, tachypnea with polypnea, bilaterally bulging abdomen, sound of fluid on ballottement, ruminal and intestinal hypomotility, and melena were observed. The hematological findings revealed leukocytosis due to neutrophilia (degenerate neutrophils), hypoproteinemia, and hyperfibrinogenemia. The analysis of the ruminal fluid showed compromised microbiota and increased chloride content. The transabdominal ultrasonography demonstrated, in the right ventral region, hypermotile and full small bowel loops and an increase in the volume of the peritoneal fluid. In addition, there was a segment of the small intestine which, in cross-section, showed multiple concentric rings ("onion rings", "target pattern", or "bull's eye") and adherence to adjacent loops, compatible with intestinal obstruction due to intussusception. Due to the seriousness of the clinical condition and the ultrasound findings, the animal was euthanized and the necropsy revealed focal fibrinous peritonitis and intestinal obstruction due to intussusception in ileum intestinal segments. Discussion: Intussusception has previously been reported in calves, however this is the first report of ultrasound diagnosis of the disease in Brazil. Although the etiology is rarely confirmed, the age group and recent changes in diet (weaning) were predisposing factors. The history, clinical signs, and laboratory tests were similar to those described in cattle with intussusception, however they may be present in other gastrointestinal illnesses. Other authors have also reported that the nonspecificity of the signs and the impossibility of performing transrectal palpation made it difficult to diagnose intestinal obstruction in calves without the use of other diagnostic tools. As it is a non-invasive and accurate technique, ultrasound has been used in ruminants for diagnostic purposes, including intestinal obstructions. In the present case, the main findings are described as the presence of a lesion with the appearance of multiple concentric rings, hypermotile, dilated, and full intestinal loops. The pathological findings were compatible with the ultrasound images and similar to those described by other authors, confirming the diagnosis. The use of ultrasonography as a diagnostic tool in cattle should be expanded, aiming at the early determination of diagnosis and prognosis, to reduce producer costs and animal discomfort. In cases of intussusception, late diagnosis makes treatment unfeasible.

Small intestine strangulating obstruction by mesenteric pedunculated lipoma in a criollo mare

Background: The abdominal lipomas are benign tumors of hyperplastic growth that originate from mesenteric adiposetissue, most commonly in the small intestine. Pedunculated lipoma strangulation occurs when the pedicle wraps aroundan intestinal loop and its mesentery, obstructing the intestinal lumen and blood supply of the affected segment. The aim ofthe present study is to report a case of a Criollo mare presenting a strangulating obstruction of the jejunum and ileum bya pedunculated lipoma, focusing the discussion in the causes and epidemiology of this alteration.Case: A 24-year-old Criollo mare with a body condition score 8 out of 9 was referred to the Veterinary Clinical Hospitalof the Federal University of Pelotas (HCV-UFPel) presenting acute abdominal pain. At the hospital, the mare was presenting mild signs of abdominal discomfort. At the initial clinical exam, the mare had an increased heart and respiratory rates,normal body temperature, hyperemic mucous membranes, capillary refil time of 3 s and absent gut sounds in all fourquadrants during auscultation. Mild dehydration was present, increased fibrinogen and serum lactate. Rectal palpationrevealed distention of the small intestine by gas, during abdominal ultrassonography the small intestinal wall thicknesswas increased Peritoneal lactate was 11 mmol/L and protein was 6 mg/dL. Due to the clinical findings during the exam, anexploratory celiotomy was performed. Necrosis of the final third of jejunum and the entire extension of ileum was found.Examining the compromised intestinal portion, it was observed a linear structure strangulating two segments of the smallintestine. Taking into account the extensive area of irreversible necrosis and the advanced age of the patient, euthanasiawas performed. The mare was then referred for necropsy and findings confirmed...(AU)

Small intestine strangulating obstruction by mesenteric pedunculated lipoma in a criollo mare

Background: The abdominal lipomas are benign tumors of hyperplastic growth that originate from mesenteric adiposetissue, most commonly in the small intestine. Pedunculated lipoma strangulation occurs when the pedicle wraps aroundan intestinal loop and its mesentery, obstructing the intestinal lumen and blood supply of the affected segment. The aim ofthe present study is to report a case of a Criollo mare presenting a strangulating obstruction of the jejunum and ileum bya pedunculated lipoma, focusing the discussion in the causes and epidemiology of this alteration.Case: A 24-year-old Criollo mare with a body condition score 8 out of 9 was referred to the Veterinary Clinical Hospitalof the Federal University of Pelotas (HCV-UFPel) presenting acute abdominal pain. At the hospital, the mare was presenting mild signs of abdominal discomfort. At the initial clinical exam, the mare had an increased heart and respiratory rates,normal body temperature, hyperemic mucous membranes, capillary refil time of 3 s and absent gut sounds in all fourquadrants during auscultation. Mild dehydration was present, increased fibrinogen and serum lactate. Rectal palpationrevealed distention of the small intestine by gas, during abdominal ultrassonography the small intestinal wall thicknesswas increased Peritoneal lactate was 11 mmol/L and protein was 6 mg/dL. Due to the clinical findings during the exam, anexploratory celiotomy was performed. Necrosis of the final third of jejunum and the entire extension of ileum was found.Examining the compromised intestinal portion, it was observed a linear structure strangulating two segments of the smallintestine. Taking into account the extensive area of irreversible necrosis and the advanced age of the patient, euthanasiawas performed. The mare was then referred for necropsy and findings confirmed...

An Outbreak of Intestinal Obstruction by Ascaridia Galli in Broilers in Minas Gerais

Industrial broilers raised on helminthic medication-free feed were diagnosed with a severe disease caused by Ascaridia galli, characterized by intestinal hemorrhage and obstruction. A. galli was identified based on the morphological features of the nematode. Broilers were raised for a longer period (63 days) for weight recovery, grouped as stunted (n=500), had low body score and had fetid diarrhea. The duodenum-jejunum segment was the most severely affected with obstruction and had localized accumulation of gas. The intestinal mucosa was severely congested with petechial and suffusive hemorrhages. The outbreak resulted in morbidity of about 10% and mortality of up to 4% and was associated to the absence of preventive medication on feed and slack biosecurity. The reemergence of A. galli is discussed in view of the alternative poultry management and raising conditions for drug free and welfare.

An Outbreak of Intestinal Obstruction by Ascaridia Galli in Broilers in Minas Gerais

Industrial broilers raised on helminthic medication-free feed were diagnosed with a severe disease caused by Ascaridia galli, characterized by intestinal hemorrhage and obstruction. A. galli was identified based on the morphological features of the nematode. Broilers were raised for a longer period (63 days) for weight recovery, grouped as stunted (n=500), had low body score and had fetid diarrhea. The duodenum-jejunum segment was the most severely affected with obstruction and had localized accumulation of gas. The intestinal mucosa was severely congested with petechial and suffusive hemorrhages. The outbreak resulted in morbidity of about 10% and mortality of up to 4% and was associated to the absence of preventive medication on feed and slack biosecurity. The reemergence of A. galli is discussed in view of the alternative poultry management and raising conditions for drug free and welfare.(AU)

Hipertrofia muscular intestinal da válvula íleo-ceco-cólica em cão / Intestinal muscular hipertrophy of ileus-cecal-colic valve in a dog

O presente relato tem o objetivo de alertar o clínico quanto à dificuldade diagnóstica e a importância da hipertrofia íleo-ceco-cólica em obstruções intestinais em cães. As obstruções intestinais são afecções frequentemente encontradas, sendo a ingestão de corpos estranhos a principal causa. A hipertrofia muscular intestinal pode ser causada por estenose ou por origem idiopática, sendo incomum na espécie canina. Os sinais clínicos são inespecíficos, havendo necessidade de exame histopatológico. Foi atendido um cão com quadro de vômito, anorexia e aquesia há 20 dias. Os estudos de imagem revelaram obstrução total na região do intestino delgado com distensão de alças, mas não foi possível elucidar a localização precisa e nem a causa da mesma. O paciente foi encaminhado para a celiotomia exploratória com suspeita de obstrução intestinal de origem a esclarecer. Durante a cirurgia, notou-se uma alteração na região da válvula íleo-ceco-cólica, e a mesma foi removida e encaminhada para análise histopatológica, que confirmou a hipertrofia muscular intestinal. No entanto, as sequelas da obstrução completa e crônica do intestino culminaram como óbito do paciente.

In the small animal clinical routine, intestinal obstructions are frequently encountrered, and foreign body intake is the main cause. However, there are other causes of digestive tract obstructions. The intestinal muscular hipertrophy can be caused by stenosis or idiopathic origin. It’s frequenly reported in horse ileus, but little reported in canines. The clinical signs include emesis, diarrhea and anorexia, among other signs of intestinal obstruction, but by having nonspecific signs, there is difficulty in closing diagnosis, requiring histopathological exam. A dog with vomiting, anorexia and dyskinesia about 20 days ago was seen at HUVet. A general physical examination, complete blood count, serious biochemistry, abdominal ultrasonography and simple and contrasting abdominal radiographs were performed. The patient was referred to an exploratory laparotomy with suspected intestinal obstruction and paralytic ileus. During surgery, a change was observed in the ileus-cecal-colic valve region, and it was removed and referred for histopathological analysis, which confirmed intestinal muscular hypertrophy.

Hipertrofia muscular intestinal da válvula íleo-ceco-cólica em cão / Intestinal muscular hipertrophy of ileus-cecal-colic valve in a dog

O presente relato tem o objetivo de alertar o clínico quanto à dificuldade diagnóstica e a importância da hipertrofia íleo-ceco-cólica em obstruções intestinais em cães. As obstruções intestinais são afecções frequentemente encontradas, sendo a ingestão de corpos estranhos a principal causa. A hipertrofia muscular intestinal pode ser causada por estenose ou por origem idiopática, sendo incomum na espécie canina. Os sinais clínicos são inespecíficos, havendo necessidade de exame histopatológico. Foi atendido um cão com quadro de vômito, anorexia e aquesia há 20 dias. Os estudos de imagem revelaram obstrução total na região do intestino delgado com distensão de alças, mas não foi possível elucidar a localização precisa e nem a causa da mesma. O paciente foi encaminhado para a celiotomia exploratória com suspeita de obstrução intestinal de origem a esclarecer. Durante a cirurgia, notou-se uma alteração na região da válvula íleo-ceco-cólica, e a mesma foi removida e encaminhada para análise histopatológica, que confirmou a hipertrofia muscular intestinal. No entanto, as sequelas da obstrução completa e crônica do intestino culminaram como óbito do paciente.(AU)

In the small animal clinical routine, intestinal obstructions are frequently encountrered, and foreign body intake is the main cause. However, there are other causes of digestive tract obstructions. The intestinal muscular hipertrophy can be caused by stenosis or idiopathic origin. Its frequenly reported in horse ileus, but little reported in canines. The clinical signs include emesis, diarrhea and anorexia, among other signs of intestinal obstruction, but by having nonspecific signs, there is difficulty in closing diagnosis, requiring histopathological exam. A dog with vomiting, anorexia and dyskinesia about 20 days ago was seen at HUVet. A general physical examination, complete blood count, serious biochemistry, abdominal ultrasonography and simple and contrasting abdominal radiographs were performed. The patient was referred to an exploratory laparotomy with suspected intestinal obstruction and paralytic ileus. During surgery, a change was observed in the ileus-cecal-colic valve region, and it was removed and referred for histopathological analysis, which confirmed intestinal muscular hypertrophy.(AU)

Alterações hemogasométricas em equinos submetidos à distensão do cólon menor / Blood gas alterations in horses subjected to small colon distention

O objetivo do presente estudo foi avaliar a hemogasometria venosa de equinos com lesões isquêmicas induzidas experimentalmente no cólon menor. Foram utilizados oito equinos sadios, com idades entre cinco e oito anos, sem raça definida. Os animais foram submetidos à celiotomia e a quatro horas de obstrução intraluminal do cólon menor. Foram realizadas coletas de amostras de sangue imediatamente antes da indução anestésica (T0), no momento em que a anestesia foi estabilizada (T1), quatro horas após a obstrução intraluminal (T4), e, durante o pós-cirúrgico, as coletas foram realizadas em intervalos de 12 horas até completar 72 horas (T16, T28, T40, T52, T64 e T76). Notou-se em T4 alcalose metabólica, com compensação respiratória por meio da hipoventilação. Esse quadro de alcalose foi brando e transitório, retornando os valores normais para a espécie em T16, com 12 horas de desobstrução intestinal.(AU)

The objective of this study was to evaluate the blood gas analysis of venous blood of horses with experimentally induced ischemic lesions on the lower colon. Eight healthy horses were used, with ages between five and eight years, mixed breed. The animals were subjected to celiotomy and four hours of lower colonic intraluminal obstruction. The harvests were made with the blood samples immediately before induction of anesthesia (T0), when the anesthesia was stabilized (T1), 4 hours after the intraluminal obstruction (T4) and during postsurgical times were performed at intervals of 12 hours to complete 72 hours (T16, T28, T40, T52, T64 and T76). The occurrence of metabolic alkalosis on T4 with respiratory compensation by hypoventilation was noted, this alkalosis period was bland and transient, returning the normal values for the specie on T16, 12 hours after the intestinal obstruction.(AU)

Alterações hemogasométricas em equinos submetidos à distensão do cólon menor / Blood gas alterations in horses subjected to small colon distention

O objetivo do presente estudo foi avaliar a hemogasometria venosa de equinos com lesões isquêmicas induzidas experimentalmente no cólon menor. Foram utilizados oito equinos sadios, com idades entre cinco e oito anos, sem raça definida. Os animais foram submetidos à celiotomia e a quatro horas de obstrução intraluminal do cólon menor. Foram realizadas coletas de amostras de sangue imediatamente antes da indução anestésica (T0), no momento em que a anestesia foi estabilizada (T1), quatro horas após a obstrução intraluminal (T4), e, durante o pós-cirúrgico, as coletas foram realizadas em intervalos de 12 horas até completar 72 horas (T16, T28, T40, T52, T64 e T76). Notou-se em T4 alcalose metabólica, com compensação respiratória por meio da hipoventilação. Esse quadro de alcalose foi brando e transitório, retornando os valores normais para a espécie em T16, com 12 horas de desobstrução intestinal.(AU)

The objective of this study was to evaluate the blood gas analysis of venous blood of horses with experimentally induced ischemic lesions on the lower colon. Eight healthy horses were used, with ages between five and eight years, mixed breed. The animals were subjected to celiotomy and four hours of lower colonic intraluminal obstruction. The harvests were made with the blood samples immediately before induction of anesthesia (T0), when the anesthesia was stabilized (T1), 4 hours after the intraluminal obstruction (T4) and during postsurgical times were performed at intervals of 12 hours to complete 72 hours (T16, T28, T40, T52, T64 and T76). The occurrence of metabolic alkalosis on T4 with respiratory compensation by hypoventilation was noted, this alkalosis period was bland and transient, returning the normal values for the specie on T16, 12 hours after the intestinal obstruction.(AU)

Utilização Da Ultrassonografia Transabdominal Para Auxilio Propedêutico Em Equinos Com Síndrome Cólica: Relato De Casos / Using Transabdominal Ultrasound As Support Diagnosis In Equine With Colic Syndrome: Cases Reports / Uso Del Ultrasonido Transabdominal Como Apoyo Diagnóstico En Equinos Con Síndrome Cólico: Série De 16 Casos

O abdome agudo na espécie equina é considerado uma emergência, sendo de grande importância a determinação precoce da necessidade ou não da intervenção cirúrgica como medida terapêutica. Os objetivos dessa descrição de casos foram: identificar quais os achados ultrassonográficos (US) que auxiliam na determinação do paciente clínico ou cirúrgico, qual a possibilidade de identificação da causa da cólica e expor as dificuldades de execução da técnica. Foi realizado um estudo prospectivo observacional para análise ultrassonografica transabdominal em 16 equinos com sinais de dor abdominal aguda. Um aparelho portátil de alta resolução, acoplado a um transdutor convexo multifrequencial de 2,5 a 5,0 MHz foi utilizado. Como resultados verificou-se que o exame US transabdominal contribuiu para a determinação da conduta a ser adotada em todos os casos. Propiciando o diagnóstico final, detectando achados sugestivos de processo obstrutivo ou descartando-o. Os achados importantes para tomada de decisão e que indicam processo obstrutivo foram: a identificação de anormalidades na topografia intestinal, alterações de motilidade e grau de distenção intestinal, principalmente em intestino delgado, alterações no conteúdo intraluminal e em alguns casos do espessamento de parede intestinal. A atitude do animal em resposta a dor, como agitação/excitação, tremores musculares e eventualmente o tipo de conteúdo intraluminal são alguns fatores que podem prejudicar a análise. Concluiu-se que o exame US transabdominal auxilia na determinação da próxima conduta a ser adotada, cirúrgica ou clínico dos animais com síndrome cólica.

The acute abdomen in the equine species is considered an emergency. In these cases, it is of great importance the early determination of whether or not a surgical intervention is needed. The aims of this cases descriptions were to identify which sonographic findings help to differ the clinical or surgical patient, to define which lesions can be diagnosed sonographically and to determine the difficulties of the exam. A cross-sectional study was conducted. Sixteen horses with signs of acute abdominal pain were evaluated by means of transabdominal ultrasonography. Ultrasound examination was performed using a portatil high resolution machine with a 2.5 to 5,0MHz, multifrequential convex probe. All abdominal cavity was examined using the starndart ultrasound techinique previous reported. Ultrasound contributed to determine the therapeutic approach in all cases, helping in final diagnosis, and detecting findings of gastrointestinal obstructive process or excluded. The mainly findings in detecting obstructive intestinal process are abnormalities in intestinal topography, pattern of motility and diameter distension, predominantly in small intestine, different intraluminal content and in some cases thickening of intestinal wall. The attitude of the animal in response to pain, agitation/excitement, muscle trembling and sometimes changes in the type of intraluminal content, were factors that interfered in the images. We concluded that transabdominal ultrasonography can assist in determining the next conduct to be adopted, surgical or clinical therapeutics in horses with colic syndrome.

El abdomen agudo en la especie equina se considera una emergencia y en esos casos es de gran importancia determinar precozmente si una intervención quirúrgica será necesaria o no. Los objetivos al describir esta serie de casos fueron: identificar los hallazgos ultrasonográficos importantes para determinar si los casos eran clínicos o quirúrgicos; verificar la posibilidad de identificar la causa del cólico; y exponer las dificultades al realizar el examen ultrasonográfico en esos casos. De forma prospectiva, fueron incluidos 16 equinos con signos de dolor abdominal agudo. Para el examen ultrasonográfico transabdominal (USTA) fue usado un transductor convexo multifrecuencial de 2,5 a 5,0 MHz acoplado a un ecografo portátil de alta resolución. Fue verificado que el USTA contribuyó para determinar la conducta a ser adoptada en todos los casos; posibilitó llegar a un diagnóstico final; y permitió detectar hallazgos sugestivos de proceso obstructivo e descartar obstrucción. Los hallazgos importantes para tomar decisiones y que indicaron procesos obstructivos fueron: identificación de anormalidades en la topografía intestinal, alteraciones de motilidad y distensión intestinal, principalmente en intestino delgado, alteraciones en el contenido intraluminal y, en algunos casos, espesamiento de la pared intestinal. La actitud del animal en respuesta al dolor, como agitación/excitación, temblores musculares y, eventualmente, el tipo de contenido intraluminal, son algunos factores que pueden perjudicar el examen. Concluimos que el USTA auxilia a determinar si la próxima conducta a ser adoptada en equinos con síndrome cólica será clínica o quirúrgica.

Utilização Da Ultrassonografia Transabdominal Para Auxilio Propedêutico Em Equinos Com Síndrome Cólica: Relato De Casos / Using Transabdominal Ultrasound As Support Diagnosis In Equine With Colic Syndrome: Cases Reports / Uso Del Ultrasonido Transabdominal Como Apoyo Diagnóstico En Equinos Con Síndrome Cólico: Série De 16 Casos

O abdome agudo na espécie equina é considerado uma emergência, sendo de grande importância a determinação precoce da necessidade ou não da intervenção cirúrgica como medida terapêutica. Os objetivos dessa descrição de casos foram: identificar quais os achados ultrassonográficos (US) que auxiliam na determinação do paciente clínico ou cirúrgico, qual a possibilidade de identificação da causa da cólica e expor as dificuldades de execução da técnica. Foi realizado um estudo prospectivo observacional para análise ultrassonografica transabdominal em 16 equinos com sinais de dor abdominal aguda. Um aparelho portátil de alta resolução, acoplado a um transdutor convexo multifrequencial de 2,5 a 5,0 MHz foi utilizado. Como resultados verificou-se que o exame US transabdominal contribuiu para a determinação da conduta a ser adotada em todos os casos. Propiciando o diagnóstico final, detectando achados sugestivos de processo obstrutivo ou descartando-o. Os achados importantes para tomada de decisão e que indicam processo obstrutivo foram: a identificação de anormalidades na topografia intestinal, alterações de motilidade e grau de distenção intestinal, principalmente em intestino delgado, alterações no conteúdo intraluminal e em alguns casos do espessamento de parede intestinal. A atitude do animal em resposta a dor, como agitação/excitação, tremores musculares e eventualmente o tipo de conteúdo intraluminal são alguns fatores que podem prejudicar a análise. Concluiu-se que o exame US transabdominal auxilia na determinação da próxima conduta a ser adotada, cirúrgica ou clínico dos animais com síndrome cólica.(AU)

The acute abdomen in the equine species is considered an emergency. In these cases, it is of great importance the early determination of whether or not a surgical intervention is needed. The aims of this cases descriptions were to identify which sonographic findings help to differ the clinical or surgical patient, to define which lesions can be diagnosed sonographically and to determine the difficulties of the exam. A cross-sectional study was conducted. Sixteen horses with signs of acute abdominal pain were evaluated by means of transabdominal ultrasonography. Ultrasound examination was performed using a portatil high resolution machine with a 2.5 to 5,0MHz, multifrequential convex probe. All abdominal cavity was examined using the starndart ultrasound techinique previous reported. Ultrasound contributed to determine the therapeutic approach in all cases, helping in final diagnosis, and detecting findings of gastrointestinal obstructive process or excluded. The mainly findings in detecting obstructive intestinal process are abnormalities in intestinal topography, pattern of motility and diameter distension, predominantly in small intestine, different intraluminal content and in some cases thickening of intestinal wall. The attitude of the animal in response to pain, agitation/excitement, muscle trembling and sometimes changes in the type of intraluminal content, were factors that interfered in the images. We concluded that transabdominal ultrasonography can assist in determining the next conduct to be adopted, surgical or clinical therapeutics in horses with colic syndrome.(AU)

El abdomen agudo en la especie equina se considera una emergencia y en esos casos es de gran importancia determinar precozmente si una intervención quirúrgica será necesaria o no. Los objetivos al describir esta serie de casos fueron: identificar los hallazgos ultrasonográficos importantes para determinar si los casos eran clínicos o quirúrgicos; verificar la posibilidad de identificar la causa del cólico; y exponer las dificultades al realizar el examen ultrasonográfico en esos casos. De forma prospectiva, fueron incluidos 16 equinos con signos de dolor abdominal agudo. Para el examen ultrasonográfico transabdominal (USTA) fue usado un transductor convexo multifrecuencial de 2,5 a 5,0 MHz acoplado a un ecografo portátil de alta resolución. Fue verificado que el USTA contribuyó para determinar la conducta a ser adoptada en todos los casos; posibilitó llegar a un diagnóstico final; y permitió detectar hallazgos sugestivos de proceso obstructivo e descartar obstrucción. Los hallazgos importantes para tomar decisiones y que indicaron procesos obstructivos fueron: identificación de anormalidades en la topografía intestinal, alteraciones de motilidad y distensión intestinal, principalmente en intestino delgado, alteraciones en el contenido intraluminal y, en algunos casos, espesamiento de la pared intestinal. La actitud del animal en respuesta al dolor, como agitación/excitación, temblores musculares y, eventualmente, el tipo de contenido intraluminal, son algunos factores que pueden perjudicar el examen. Concluimos que el USTA auxilia a determinar si la próxima conducta a ser adoptada en equinos con síndrome cólica será clínica o quirúrgica.(AU)

Fibroplasia esclerosante eosinofílica gastrointestinal felina: relato de caso / Feline gastrointestinal eosinophilic sclerosing fibroplasia: case report

A fibroplasia esclerosante eosinofílica gastrointestinal felina (FEEGF) é uma condição inflamatória que acomete gatos domésticos, cuja etiologia é desconhecida. A principal forma de apresentação da doença é uma massa intramural, firme e irregular, localizada na região do trato gastrointestinal. Objetivou-se relatar o caso de um gato persa diagnosticado com FEEGF. O animal apresentava histórico de vômito e diarreia. No exame físico foi verificado espessamento de alças intestinais, confirmado com o exame ultrassonográfico. Optou-se por uma celiotomia exploratória e remoção do tecido intestinal afetado, que incluiu pilorectomia associada à gastroduodenostomia. Fragmentos de intestino e pâncreas foram enviados para histopatológico, sendo os achados compatíveis com FEEGF e pancreatite, respectivamente. Observou-se também extensão focal do processo inflamatório para tecido adiposo mesogástrico. O envolvimento pancreático e hepático pode ter contribuído para a piora do animal, que veio a óbito algumas semanas após cirurgia. Com o presente trabalho, pudemos contribuir para um maior entendimento da FEEGF, principalmente, em suas características clínicas, diagnósticas, histopatológicas e terapêuticas.(AU)

Feline gastrointestinal eosinophilic sclerosing fibroplasia (FEEGF) is an inflammatory condition affecting domestic cats, the etiology of which is unknown. The main form of presentation of the disease is anintramural, firm and irregular mass, located in the region of the gastrointestinal tract. The objective was to report the case of a persian cat diagnosed with FEEGF. The animal has a history of vomiting and diarrhea. Physical examination revealed thickening of intestinal loops, confirmed by ultrasonographic examination. We chose an exploratory celiotomy and removal of affected intestinal tissue, which included pilorectomy associated with gastroduodenostomy. Fragments of intestine and pancreas were sent to histopathological, and the findings were compatible with FEEGF and pancreatitis, respectively. It was also observed focal extension of the inflammatory process to mesogastric adipose tissue. Pancreatic and hepatic involvement may have contributed to a worsening animal, which died a few weeks after surgery. With the present study we could contribute to a greater understanding of FEEGF, mainly in its clinical, diagnostic, histopathological and therapeutic characteristics.(AU)

Remoção de corpo estranho linear através de técnica de colocação de tubo intestinal / Removal of linear foreign body through intestinal tube placement technique

The present work had as objective to report the technique of using silicone tube forremoval of linear foreign body in dog. It was taken to animal care with vomiting anddiarrhea during three days, after it had ingested dental floss. After ultrasonographicexamination, the linear foreign body was seen from the stomach to the colon. During thesurgical procedure for removal was used silicone tube. The use of the tube reduced thequantity of enterotomies as well as the injury to the intestinal lumen by the traction of thelinear foreign body, indicating its use in cases in which the foreign body is located in alarge part of the gastrointestinal tract.(AU)

Remoção de corpo estranho linear através de técnica de colocação de tubo intestinal / Removal of linear foreign body through intestinal tube placement technique

The present work had as objective to report the technique of using silicone tube forremoval of linear foreign body in dog. It was taken to animal care with vomiting anddiarrhea during three days, after it had ingested dental floss. After ultrasonographicexamination, the linear foreign body was seen from the stomach to the colon. During thesurgical procedure for removal was used silicone tube. The use of the tube reduced thequantity of enterotomies as well as the injury to the intestinal lumen by the traction of thelinear foreign body, indicating its use in cases in which the foreign body is located in alarge part of the gastrointestinal tract.

Fibroplasia esclerosante eosinofílica gastrointestinal felina: relato de caso / Feline gastrointestinal eosinophilic sclerosing fibroplasia: case report

A fibroplasia esclerosante eosinofílica gastrointestinal felina (FEEGF) é uma condição inflamatória que acomete gatos domésticos, cuja etiologia é desconhecida. A principal forma de apresentação da doença é uma massa intramural, firme e irregular, localizada na região do trato gastrointestinal. Objetivou-se relatar o caso de um gato persa diagnosticado com FEEGF. O animal apresentava histórico de vômito e diarreia. No exame físico foi verificado espessamento de alças intestinais, confirmado com o exame ultrassonográfico. Optou-se por uma celiotomia exploratória e remoção do tecido intestinal afetado, que incluiu pilorectomia associada à gastroduodenostomia. Fragmentos de intestino e pâncreas foram enviados para histopatológico, sendo os achados compatíveis com FEEGF e pancreatite, respectivamente. Observou-se também extensão focal do processo inflamatório para tecido adiposo mesogástrico. O envolvimento pancreático e hepático pode ter contribuído para a piora do animal, que veio a óbito algumas semanas após cirurgia. Com o presente trabalho, pudemos contribuir para um maior entendimento da FEEGF, principalmente, em suas características clínicas, diagnósticas, histopatológicas e terapêuticas.

Feline gastrointestinal eosinophilic sclerosing fibroplasia (FEEGF) is an inflammatory condition affecting domestic cats, the etiology of which is unknown. The main form of presentation of the disease is anintramural, firm and irregular mass, located in the region of the gastrointestinal tract. The objective was to report the case of a persian cat diagnosed with FEEGF. The animal has a history of vomiting and diarrhea. Physical examination revealed thickening of intestinal loops, confirmed by ultrasonographic examination. We chose an exploratory celiotomy and removal of affected intestinal tissue, which included pilorectomy associated with gastroduodenostomy. Fragments of intestine and pancreas were sent to histopathological, and the findings were compatible with FEEGF and pancreatitis, respectively. It was also observed focal extension of the inflammatory process to mesogastric adipose tissue. Pancreatic and hepatic involvement may have contributed to a worsening animal, which died a few weeks after surgery. With the present study we could contribute to a greater understanding of FEEGF, mainly in its clinical, diagnostic, histopathological and therapeutic characteristics.

Partial obstruction of the small intestine by a trichobezoar in a dog

Background: Bezoars are accumulations of foreign material and indigestible organic substances in the gastrointestinal tract. There are different classifications for bezoars based on its primary composition. The trichobezoars are concretions composed of hair or hair-like fibers and are often associated with trichophagia in humans. The obstruction by a trichobezoar occurring in the stomach, with its tail extending to or beyond the ileocecal valve or jejunum is rare in humans. This condition is called Rapunzel Syndrome. Obstruction by trichobezoar has been reported few times in cats and dogs. This paper aims to describe an uncommon clinical presentation of a young dog with partial obstruction of the small intestine by a trichobezoar. Case: A 2-year-old, 5.5 kg, intact male poodle was referred due to kyphosis and a history of pain in the thoracolumbar region for approximately 10 months. Physical examination revealed that the dog walked without any difficulty or ataxia, but had pain on palpation of the lumbar vertebral column. Thoracolumbar spine radiographies failed to show any sign of disease. Conservative therapy for intervertebral disk disease did not shown any improvement. In addition, the dog showed signs of pain on abdominal palpation and 18-month history of hyporexia, apathy and dark colored diarrhea. Abdominal ultrasonography detected a 5-cm intraluminal intestinal structure at the ileo-jejunal junction, forming an acoustic shadow, with focal thickening of the intestinal wall. Exploratory celiotomy followed by jejunal enterotomy revealed a trichobezoar consisting of undigested hair and textile fibers partially obstructing that segment. The intestinal wall in that region formed a sacculation, so a 5 cm jejunal resection with end-to-end anastomosis was performed. Histopathology of this segment did not show any neoplastic formation. After 20 days of surgical procedure, no clinical […]