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1.
Schweiz Arch Tierheilkd ; 158(11): 749-754, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27821378

RESUMO

INTRODUCTION: Osteochondrosis (OC) is common in large-breed dogs. According to the breeding guidelines of the Swiss kennel clubs, the shoulder joints are included in the radiographic screening for joint diseases in the Greater Swiss Mountain dog (GSMD) and the Border Collie (BC) since 1993 and 2003, respectively. The aim of this study was to estimate the overall prevalence of humeral head OC in these 2 breeds in Switzerland based on the data of the Swiss National Dysplasia Committees. All radiographs were re-evaluated to assess single radiographic changes. From 1993 and 2003, accordingly, until 2013, the overall prevalence was 14% for the GSMD and 8% for the BC, respectively. Affected joints showed a focally reduced opacity or a flattened/indented contour of the caudal section of the humeral head. Articular flaps were only seen occasionally. Degenerative joint disease was significantly more common in OC affected joints (GSMD: 32%; BC: 20%) than in joints without OC. The present study is the first report on the prevalence of humeral head OC in a large cohort of GSMD and the BC over a long study period. In comparison to other breeds, the herein reported prevalences are in the mid to upper range. Results of the present study should alert veterinarians to the disease in these breeds and may serve as a starting point for further epidemiological and genetic studies.


INTRODUCTION: L'ostéochondrose (OC) est fréquente chez les chiens de grande race. Conformément aux prescriptions d'élevage des clubs cynologiques suisses, l'articulation de l'épaule est incluse dans le dépistage radiologique des affections articulaires chez le Grand bouvier suisse (GBS) et le Border Collie (BC) et ceci depuis 1993 respectivement 2003. Le but de la présente étude était d'estimer la prévalence de l'OC de la tête humérale chez ces deux races en Suisse, sur la base des données des commissions nationales suisses de dysplasie. Toutes les radiographies ont été réévaluées pour repérer des altérations radiologiques isolées. Depuis 1993 respectivement 2003 jusqu'en 2013, la prévalence était de 14% chez le GBC et de 8% chez le BC. Les articulations affectées montraient une opacité localement réduite ou un contour aplati/ dentelé de la partie caudale de la tête humérale. Des souris articulaires n'étaient constatées qu'occasionnellement. Les affections articulaires dégénératives étaient significativement plus fréquentes sur les articulations affectées d'OC que sur les autres (GBS: 32%; BC: 20%). La présente étude rapporte pour la première fois la prévalence de l'OC de la tête humérale sur une large cohorte de GBS et de BC sur une longue période. En comparaison avec d'autres races, les prévalences constatées se situent entre la moyenne et le niveau supérieur. Les résultats de cette étude doivent alerter les vétérinaires au sujet de cette affection chez ces races et peut server de pont de départ pour de futures recherches épidémiologiques et génétiques.


Assuntos
Doenças do Cão/epidemiologia , Cabeça do Úmero/patologia , Artropatias/veterinária , Osteocondrose/veterinária , Animais , Doenças do Cão/diagnóstico por imagem , Cães , Cabeça do Úmero/diagnóstico por imagem , Cabeça do Úmero/fisiopatologia , Artropatias/diagnóstico por imagem , Artropatias/epidemiologia , Osteocondrose/diagnóstico por imagem , Osteocondrose/epidemiologia , Suíça/epidemiologia
2.
Schweiz Arch Tierheilkd ; 158(5): 331-9, 2016 May.
Artigo em Alemão | MEDLINE | ID: mdl-27518578

RESUMO

INTRODUCTION: Diffuse idiopathic skeletal hyperostosis (DISH) is a common, non-inflammatory, systemic disease of the spine and the abaxial skeleton in humans and dogs. Spondylosis deformans (SD) must be considered as an important differential diagnosis which in humans, unlike DISH, is always accompanied by degenerative disc disease. In the veterinary literature, usually no difference is made between these diseases. The aim of the present review is to summarize essentials of DISH regarding its definition, etiology, prevalence, clinical findings and therapy in both, the human and dog. In particular, the various classification schemes and the most important differential diagnoses are discussed. Specific aspects of canine DISH are highlighted.


INTRODUCTION: L'hyperostose squelettique idiopathique diffuse (DISH) est une affection systémique non-inflammatoire de la colonne vertébrale et du squelette périphérique chez l'homme et le chien. La spondylose déformante (SD) qui, chez l'homme, contrairement à la DISH, s'accompagne d'une atteinte dégénérative des disques intervertébraux et représente donc une entité pathologique propre constitue un diagnostic différentiel important. Dans la littérature vétérinaire, par contre, on ne distingue souvent pas de façon explicite entre SD et DISH. Le but du présent travail est de donner un aperçu de la définition, de l'étiologie, de la prévalence, de la clinique et du traitement de la DISH chez l'homme et le chien. On discute en particulier les divers schémas de classification et les principaux diagnostics différentiels et on relève particulièrement les aspects spécifiques de l'affection chez le chien.


Assuntos
Doenças do Cão , Hiperostose Esquelética Difusa Idiopática/veterinária , Animais , Diagnóstico Diferencial , Doenças do Cão/diagnóstico , Doenças do Cão/epidemiologia , Doenças do Cão/patologia , Doenças do Cão/terapia , Cães , Humanos , Hiperostose Esquelética Difusa Idiopática/diagnóstico , Hiperostose Esquelética Difusa Idiopática/patologia , Hiperostose Esquelética Difusa Idiopática/terapia
3.
Ultrasonics ; 52(3): 447-55, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22112792

RESUMO

Passive localization of an object from its emission can be based on time difference of arrival or phase shift measurements for different receiver groups in sensor arrays. The accuracy of the localization primarily depends on accurate time and/or phase measurements. The frequency of the emission and the number and arrangement of the receivers mainly effect the resolution of the emitter localization. In this paper optimal receiver positions for passive localization methods are proposed, resulting in a maximal resolution for the emitter location estimate. The optimization is done by analyzing the uncertainty of the emitted signal, including its frequency. The technique has been developed specifically for ultrasound signals obtained from omnidirectional transducers, although the results apply for other application using passive localization techniques.


Assuntos
Ultrassom/métodos , Transdutores
6.
Schweiz Arch Tierheilkd ; 148(6): 281-8, 2006 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-16826705

RESUMO

A retrospective study to evaluate the genetic predisposition for histiocytic sarcoma in the Swiss population of purebred Bernese mountain dogs identified 51 histologically confirmed cases between 1997 and 2003. Segregation analysis using five major genetic modes was used to evaluate the 51 cases. The general mode yielded the best results suggesting a genetic predisposition for histiocystic sarcoma in this breed. The disease was found in all families analyzed, therefore elimination of the disease through seletive breeding of certain family lines is not possible.


Assuntos
Doenças do Cão/genética , Predisposição Genética para Doença , Sarcoma Histiocítico/veterinária , Sarcoma/veterinária , Animais , Cruzamento , Doenças do Cão/patologia , Cães , Feminino , Sarcoma Histiocítico/genética , Sarcoma Histiocítico/patologia , Masculino , Linhagem , Estudos Retrospectivos , Sarcoma/genética , Sarcoma/patologia , Suíça
7.
Schweiz Arch Tierheilkd ; 147(11): 491-7, 2005 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-16315851

RESUMO

Results from the elbow dysplasia screening program in Bernese Mountain Dogs of Germany were analysed in respect to its relevance for genetic evaluation and breeding. In total 2677 gradings were used. The grading was performed radiographically according to the recommendations of the International Elbow Working Group (IEWG). 75.8% of the dogs were free from visible dysplastic signs, 10.8%, 6.8% and 5.5% were classified to be of Grade 1, 2 and 3, respectively. 1.1% were classified as a borderline case between ED-free and Grade 1. A slight reduction of ED could be observed over years. Males had a 3.1 higher rate of dysplasia than females. Treating ED as a numerical trait, coded proportional to the severity of clinical relevant signs, gave a heritability estimation of 0.188 and a maternal effect of 0.07. From different mating combinations it was found, that ED average was higher in the progeny if one mate was affected but there was no increase in the prevalence with increasing grade of ED in the affected mates. About 10% more affected dogs could be observed, if one mate is affected. Heritability for dichotomic coding the trait was found to be 0.20. From these results can be suggested, that the differentiation in various grades of ED to describe the clinical relevance for the specific dog is helpfull, however, from a breeders point of view, dogs with ED should be treated equally for genetic evaluation.


Assuntos
Doenças do Cão/genética , Artropatias/veterinária , Articulações/fisiopatologia , Animais , Cruzamento , Cães , Feminino , Testes Genéticos , Alemanha , Artropatias/genética , Coxeadura Animal/genética , Masculino , Linhagem , Fatores Sexuais
8.
J Small Anim Pract ; 46(12): 571-7, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16355731

RESUMO

OBJECTIVES: To investigate the clinical signs and causes of lower urinary tract disease (LUTD) in 77 cats. METHODS: Cats diagnosed with LUTD over a two-year period were included in the study. RESULTS: The study population comprised 67 male and 10 female cats. Uroliths occurred in 17 of the 77 cats (22 per cent), urethral plugs in eight cats (10 per cent) and urinary tract infection in six cats (8 per cent). In 44 cats (57 per cent), no specific cause for the disease was found and they were classified as having idiopathic LUTD. In two of the 77 cats (3 per cent) no definitive diagnosis was established. Pain was less common in cats with uroliths and haematuria was more often seen in cats with urinary tract infection. At presentation, urethral obstruction was diagnosed in 45 of the 77 cats (58 per cent). CLINICAL SIGNIFICANCE: The causes of LUTD found in cats in this study are similar to those that have been previously documented, and idiopathic LUTD is the most frequent diagnosis. However, the rate of urethral obstruction, particularly in cats with idiopathic LUTD, was higher than in other reports. The cause of this difference is unknown.


Assuntos
Doenças do Gato/etiologia , Doenças do Gato/patologia , Obstrução Uretral/veterinária , Infecções Urinárias/veterinária , Doenças Urológicas/veterinária , Animais , Doenças do Gato/epidemiologia , Gatos , Feminino , Masculino , Estudos Prospectivos , Suíça/epidemiologia , Obstrução Uretral/epidemiologia , Obstrução Uretral/etiologia , Obstrução Uretral/patologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologia , Infecções Urinárias/patologia , Doenças Urológicas/epidemiologia , Doenças Urológicas/etiologia , Doenças Urológicas/patologia
9.
Schweiz Arch Tierheilkd ; 146(9): 431-5, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15481589

RESUMO

A mammary gland tumour (MGT) was clinically diagnosed in 136 dogs. Histologically 71% were malignant and 29% benign. Intrathoracic metastatic disease was noted or suspected radiographically in 13.5% of the dogs with malignant and in 2.5% of the dogs with benign MGT. Six dogs with malignant MGT were necropsied, 5 had pulmonary metastases but only 1 had radiographic signs of intrathoracic metastatic disease. We conclude that radiographs are not very sensitive for detection of early intrathoracic metastatic disease of MGT.


Assuntos
Doenças do Cão/diagnóstico por imagem , Glândulas Mamárias Animais/patologia , Neoplasias Mamárias Animais/diagnóstico por imagem , Radiografia Torácica/veterinária , Neoplasias Torácicas/veterinária , Animais , Diagnóstico Diferencial , Doenças do Cão/diagnóstico , Doenças do Cão/patologia , Cães , Feminino , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/veterinária , Masculino , Neoplasias Mamárias Animais/patologia , Radiografia Torácica/métodos , Estudos Retrospectivos , Sensibilidade e Especificidade , Neoplasias Torácicas/diagnóstico por imagem , Neoplasias Torácicas/secundário
10.
J Vet Med A Physiol Pathol Clin Med ; 51(1): 27-32, 2004 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15086508

RESUMO

The clinical and radiological incidence of lumbosacral (LS) disease was studied on 57 German Shepherd dogs (GSDs) used in active service. The study included a clinical history, a neurological examination, and plain radiographs of the caudal lumbar vertebrae. The neurological examinations revealed lower back pain and/or neural deficits in 21 dogs, of which 14 had a history of pain or pelvic gait abnormalities. Radiographic findings were spondylosis at L7-S1, degeneration of L7-S1 disc, LS malalignment, transitional LS vertebrae and/or primary spinal canal stenosis in 15 dogs with neurological abnormalities and/or back pain and in 18 dogs with no clinical signs. No correlation between the neurological and the radiographic findings were found. This study demonstrates that even prominent radiographic LS abnormalities are of minimal value in the evaluation of LS disease in the GSD.


Assuntos
Doenças do Cão/diagnóstico por imagem , Doenças do Cão/epidemiologia , Vértebras Lombares , Síndromes de Compressão Nervosa/veterinária , Estenose Espinal/veterinária , Animais , Cães , Feminino , Incidência , Coxeadura Animal/etiologia , Dor Lombar/etiologia , Dor Lombar/veterinária , Masculino , Síndromes de Compressão Nervosa/complicações , Síndromes de Compressão Nervosa/diagnóstico por imagem , Síndromes de Compressão Nervosa/epidemiologia , Linhagem , Radiografia , Estenose Espinal/complicações , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/epidemiologia , Suíça/epidemiologia
13.
Schweiz Arch Tierheilkd ; 145(4): 169-75, 2003 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-12741094

RESUMO

The goal of this study was to describe the findings in four cows with non-magnetic reticular foreign bodies composed of copper. The cows were referred to our clinic because of reduced appetite and a marked decrease in milk production. Based on the clinical findings, a tentative diagnosis of traumatic reticuloperitonitis was made in all cows. The reticulum of all cows was then examined ultrasonographically and radiographically. In all cows, radiographs of the reticulum showed wire-shaped foreign bodies, ranging from 3 to 7 cm in length, which appeared to have penetrated the reticular wall. Two cows (No. 3, 4) had a magnet in the reticulum close to the foreign body but there was no direct contact between the two. A magnet was administered to cows No. 1 and 2, and radiography of the reticulum was performed for a second time the following day. The magnets were observed in the reticulum; however, they did not contact the foreign bodies. Because all the magnets were correctly placed in the reticulum yet, despite close proximity, did not contact the foreign bodies, the latter were thought to be non-magnetic. Cow No. 1 was slaughtered. Left flank laparoruminotomy was performed in the remaining three cows. In all cows, copper foreign bodies ranging in length from 3.0 to 7.0 cm, were found in the reticulum. They had penetrated the reticular wall and were not attached to magnets. The radiographic findings described in the present study are strongly indicative of a non-magnetic foreign body. Ruminotomy is the treatment of choice but slaughter may also be considered.


Assuntos
Doenças dos Bovinos/diagnóstico por imagem , Corpos Estranhos/veterinária , Peritonite/veterinária , Retículo/diagnóstico por imagem , Animais , Bovinos , Doenças dos Bovinos/diagnóstico , Doenças dos Bovinos/cirurgia , Cobre/fisiologia , Feminino , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Magnetismo , Peritonite/diagnóstico por imagem , Peritonite/cirurgia , Radiografia , Retículo/patologia , Ultrassonografia
14.
J Small Anim Pract ; 44(3): 109-12, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12653324

RESUMO

The purpose of this study was to assess radiographically the healing process in dogs which had undergone dorsal pancarpal arthrodesis with autologous cancellous bone grafting. The medical records of 17 dogs that had undergone dorsal pancarpal arthrodesis with complication-free dynamic compression plate fixation were reviewed. Postoperative healing was evaluated radiographically. It started five weeks after surgery and progressed for six to 12 weeks in all dogs. After this time period no further progression of healing was observed. Between weeks 6 and 8, bony fusion progressed significantly more rapidly in the intercarpal joint than in the radiocarpal joint. The following criteria had no influence on healing time: gender, age, bodyweight, and immediate versus delayed surgery after trauma. The major difficulties noted with respect to the interpretation of postoperative radiographs were irregular bony bridging, mainly caused by inadequate palmar curettage, and oblique projection of articular surfaces resulting in superimposition of joint spaces and solid bone.


Assuntos
Artrodese/veterinária , Transplante Ósseo/veterinária , Carpo Animal/lesões , Cães/lesões , Consolidação da Fratura , Fraturas Ósseas/veterinária , Animais , Placas Ósseas/veterinária , Transplante Ósseo/diagnóstico por imagem , Carpo Animal/diagnóstico por imagem , Carpo Animal/cirurgia , Cães/cirurgia , Feminino , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Masculino , Radiografia , Registros/veterinária , Estudos Retrospectivos
15.
Vet Rec ; 152(9): 258-60, 2003 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-12638911

RESUMO

This study was carried out to determine whether the administration of atropine, scopolamine or xylazine to cows before the administration of a magnet orally would help to position it in the reticulum. The transit time of the magnet through the oesophagus was also measured. Sixty Swiss Braunvieh cows were examined by radiography and ultrasonography to locate the reticulum. They were then divided into six groups of 10. Before the administration of the magnet, a control group received 4 ml saline solution subcutaneously, one group received 0.10 mg/kg of atropine subcutaneously, a second received 0.05 mg/kg of atropine intravenously, a third received 0.15 mg/kg of scopolamine intravenously, a fourth group received 0.02 mg/kg of xylazine intravenously, and the cows in the fifth group were positioned so that their forelimbs were 30 cm lower than their hindlimbs during the administration of the magnet. The passage of the magnet through the oesophagus was timed with a stopwatch and monitored with a compass. In the control group the magnet passed through in less than 60 seconds, but in four of the cows receiving either atropine or xylazine intravenously, or having their forelimbs positioned lower than their hindlimbs, it took longer than 60 seconds. In the cows receiving atropine subcutaneously or scopolamine intravenously, it took the same time as in the control group. All the cows were radiographed one-and-a-half hours after the administration of the magnet to determine its location. In seven of the 10 cows in the control group, the magnet was located in the reticulum, but in the other three it was in the cranial dorsal blind sac of the rumen. In the other five groups the magnet was located in the reticulum of between four and seven of the 10 cows, but in the cranial dorsal sac of the rumen, the rumen or in other sites in the other cows.


Assuntos
Atropina/farmacologia , Magnetismo/uso terapêutico , Peritonite/veterinária , Retículo/efeitos dos fármacos , Escopolamina/farmacologia , Xilazina/farmacologia , Administração Oral , Animais , Atropina/administração & dosagem , Bovinos , Motilidade Gastrointestinal/efeitos dos fármacos , Injeções Intravenosas , Peritonite/terapia , Retículo/diagnóstico por imagem , Escopolamina/administração & dosagem , Ultrassonografia , Xilazina/administração & dosagem
16.
Schweiz Arch Tierheilkd ; 144(4): 174-9, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12038215

RESUMO

Crenosoma (C.) vulpis infection was diagnosed in 10 dogs aged between 0.5 and 12 years (median 4 years) during a 4-year period. The predominant clinical sign in all dogs was coughing which lasted from 1 day to > 4 months. Hematological abnormalities included eosinophilia in 5/9 dogs, basophilia in 3/9 dogs, and mild monocytosis in 6/9 dogs. Thoracic radiographs (n = 9) were normal in 1 dog, showed a mild bronchial or interstitial pattern in 4 dogs, and moderate to marked changes (bronchial-interstitial to alveolar) in 4 dogs. Endoscopic findings (n = 9) varied from mild erythematous bronchitis (n = 3) to marked bronchitis with accumulation of large amounts of mucus (n = 2), irregular nodular mucosal surface (n = 2), accumulation of pus (n = 1), and bronchial hemorrhage (n = 1). Adult worms were observed in 2 dogs. Bronchial lavage cytology revealed inflammation with predominance of eosinophils in 7/10 dogs, eosinophils and neutrophils in 2/10 dogs, and neutrophils in 1/10 dogs. C. vulpis larvae were identified in the BAL of 5/10 dogs. Fecal examinations with the Baermann technique was the most sensitive method and positive in all 10 dogs. C. vulpis infection has to be considered in the differential diagnosis in dogs of all ages presenting with acute or chronic cough.


Assuntos
Bronquite/veterinária , Doenças do Cão/diagnóstico , Pneumopatias Parasitárias/veterinária , Metastrongyloidea/isolamento & purificação , Infecções por Strongylida/veterinária , Animais , Bronquite/diagnóstico , Bronquite/parasitologia , Líquido da Lavagem Broncoalveolar , Tosse/etiologia , Tosse/veterinária , Diagnóstico Diferencial , Doenças do Cão/parasitologia , Cães , Eosinofilia/parasitologia , Eosinofilia/veterinária , Fezes/parasitologia , Feminino , Pulmão/citologia , Pulmão/parasitologia , Pulmão/patologia , Pneumopatias Parasitárias/diagnóstico , Masculino , Radiografia Torácica/veterinária , Infecções por Strongylida/diagnóstico
18.
Vet Rec ; 150(7): 209-13, 2002 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-11878438

RESUMO

This paper describes the clinical, ultrasonographic, radiographic and postmortem findings in 12 cows with thrombosis of the caudal vena cava. The principal clinical signs were chronic bronchopneumonia and fever in 11 cows; one cow had epistaxis and one cow bled from the mouth; eight cows had anaemia and leucocytosis, and the clotting time for the glutaraldehyde test was markedly decreased in all the cows; in nine of the cows the activity of gamma-glutamyltransferase was high, suggesting chronic hepatic congestion. The most important ultrasonographic finding was congestion of the caudal vena cava attributable to thrombosis of the vein. In all the cows the caudal vena cava was round to oval on cross-section, rather than the normal triangular shape. The hepatic, splenic and portal veins were dilated in five, three and one cow, respectively. The results of radiography and endoscopy supported a diagnosis of bronchopneumonia, but there were radiographic changes in the diaphragmatic lung lobes that supported a diagnosis of vena caval disease in only four cows. Postmortem there was a thrombosis of the caudal vena cava in all the cows, and the thrombi were located in the thoracic, subphrenic and abdominal part of the caudal vena cava at the level of the liver in four, one and seven cows, respectively. In three cows, the thrombus was situated where a hepatic abscess had broken into the caudal vena cava, and in one cow it was at the site of a diaphragmatic abscess. In another cow, there was a fistula between the major bronchus of the right diaphragmatic lung lobe and the caudal vena cava where the thrombus was situated. Three cows had liver abscesses that had not broken into the caudal vena cava. There was severe bronchopneumonia in 11 of the cows, some of which also had multiple pulmonary abscesses.


Assuntos
Broncopneumonia/veterinária , Doenças dos Bovinos/diagnóstico por imagem , Trombose/veterinária , Veia Cava Superior/diagnóstico por imagem , Animais , Broncopneumonia/fisiopatologia , Bovinos , Feminino , Trombose/diagnóstico por imagem , Trombose/fisiopatologia , Ultrassonografia , Veia Cava Superior/patologia
19.
Vet Radiol Ultrasound ; 42(4): 305-7, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11499704

RESUMO

Thoracic radiographs of 4 dogs with confirmed and 1 dog with suspected leptospirosis were reviewed. In all dogs a reticulonodular pulmonary opacity was noted, affecting the entire lung in 3 and predominantly the caudodorsal lung field in 2 dogs. The radiographic lung pattern described is associated with pulmonary hemorrhage probably due to endothelial damage and vasculitis. Pulmonary manifestations in dogs with leptospirosis may be misinterpreted and attributed to neoplasia, pneumonia, edema, hemorrhage due to disseminated intravascular coagulopathy, adult respiratory distress syndrome and pulmonary thromboembolism.


Assuntos
Doenças do Cão/diagnóstico por imagem , Leptospirose/veterinária , Animais , Cães , Feminino , Leptospirose/diagnóstico por imagem , Masculino , Radiografia
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