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1.
Rev. bras. ciênc. vet ; 30(2): 49-54, abr./jun. 2023. il.
Artigo em Português | LILACS, VETINDEX | ID: biblio-1562841

RESUMO

Traumas torácicos são comuns em pacientes traumatizados e incluem principalmente contusão pulmonar, laceração pulmonar, pneumotórax, hemotórax, fraturas de costela e esterno e hérnia diafragmática. As principais causas são acidentes automobilísticos, quedas e mordeduras. Taquipneia ou dispneia são possíveis sinais clínicos, associados a choque hipovolêmico e sinais gastrointestinais. Lesões torácicas podem ser negligenciadas quando lesões distrativas, como fratura de membros, estão presentes. Assim, o exame clínico minucioso é obrigatório e os animais com insuficiência respiratória podem necessitar de estabilização e cirurgia de emergência. Considerando a importância do trauma torácico na prática clínica, o objetivo deste manuscrito é relatar o caso de hérnia espúria torácica associada a laceração traumática de lobo pulmonar caudal em uma cadela apresentando dispneia intensa após trauma automobilístico. Após uma avaliação emergencial e exames radiográficos, foi diagnosticado tórax instável, fraturas de costelas, contusão pulmonar e pneumotórax grave. Após estabilização clínica, foi realizado tratamento cirúrgico para estabilização do tórax instável. Durante a cirurgia, observou-se herniação e laceração do lobo caudal esquerdo do pulmão, sendo realizadas suturas para correção da laceração pulmonar e estabilização do gradil costal, além da toracostomia para controle do pneumotórax. Nos casos de tórax instável e encarceramento lobar, o tratamento cirúrgico é fundamental, como realizado neste caso, com o objetivo de reparar e reposicionar o lobo pulmonar e estabilizar o tórax instável. A herniação pulmonar traumática é um possível diagnóstico diferencial no tórax instável pós-traumático, assim como a reparação do lobo e a estabilização das costelas por meio de suturas são técnicas eficazes de tratamento cirúrgico.


Thoracic traumas are common in trauma patients and mainly include pulmonary contusion, pulmonary laceration, pneumothorax, hemothorax, rib and sternum fractures and diaphragmatic hernia. The main causes are car accidents, falls and bites. Tachypnea or dyspnea are possible clinical signs, associated with hypovolemic shock and gastrointestinal signs. Thoracic injuries may be overlooked when distracting injuries, such as limb fractures, are present. Thus, thorough clinical examination is mandatory and animals with respiratory failure may require stabilization and emergency surgery. Considering the importance of thoracic trauma in clinical practice, the manuscript aimed to report the case of spurious thoracic hernia associated with traumatic laceration of the caudal lung lobe in a bitch with severe dyspnea after car trauma. After an emergency evaluation and radiographic examinations, a flail chest, rib fractures, pulmonary contusion and severe pneumothorax were diagnosed. After clinical stabilization, surgical treatment was performed to stabilize the flail chest. During surgery, herniation and laceration of the left caudal lobe of the lung were observed, and sutures were performed to correct the pulmonary laceration and stabilize the rib cage, in addition to thoracostomy to control the pneumothorax. In cases of flail chest and lobar entrapment, surgical treatment is essential, as in this case, with the aim of repairing and repositioning the pulmonary lobe and stabilizing the flail chest. Traumatic pulmonary herniation is a possible differential diagnosis in post-traumatic flail chest, as well as repairing the lobe and stabilizing the ribs using sutures are effective surgical treatment techniques.


Assuntos
Animais , Cães , Fraturas das Costelas/veterinária , Cirurgia Veterinária/métodos , Traumatismos Torácicos/cirurgia , Cães/cirurgia , Lesão Pulmonar/veterinária , Hérnia Diafragmática Traumática/veterinária , Acidentes de Trânsito , Dispneia/veterinária
2.
Acta sci. vet. (Impr.) ; 51(supl.1): Pub. 894, 2023. ilus, tab
Artigo em Português | VETINDEX | ID: biblio-1444632

RESUMO

Background: The maned wolf (Chrysocyon brachyurus) is the largest canid in South America and the only representative of its genus. The scientific literature presents studies referring to the management and anaesthesia of the species but is scarce in case of emergency procedures, and to date, there are no reports of anaesthesia for emergency procedures in a neonatal maned wolf. Thus, this study aimed to report xenotransfusion and emergency anaesthesia for thoracic limb amputation in an approximately 8-days-old maned wolf pup. Case: A maned wolf pup, approximately 8-day-old, with a history of an accident with an agricultural machine, was referred to the Veterinary Hospital of the Federal University of Paraná - Palotina Sector (HVP - UFPR) with a grade III open fracture of left radius and ulna. At the physical evaluation, bullous rales were observed in the right caudal lobe on pulmonary auscultation, hypoglycemia and severe dehydration, the latter being determined by the occurrence of enophthalmos, increased capillary refill time and skin turgor (3 s). The hemogram revealed regenerative hypochromic macrocytic anaemia, thrombocytopenia and leukopenia, and the chest radiograph showed alveolar pattern opacification, associated with the presence of air bronchograms in the caudal lobes, more evident on the right side, suggestive of pulmonary contusion. Considering the laboratory alterations and the need for amputation of the thoracic limb, xenotransfusion was chosen before the anaesthetic procedure. The animal was pre-medicated with methadone 0.2 mg/kg and anaesthetic induction was performed with propofol titrated to effect, requiring 10 mg/kg. This was followed by endotracheal intubation and anaesthetic maintenance using the partial intravenous technique with an infusion of 5 µg/kg/h of remifentanil and Isoflurane vaporised through a non-rebreathing system in oxygen at 0.6. Anaesthetic monitoring included heart rate and electrocardiogram tracing, respiratory rate, oxyhemoglobin saturation, end-tidal partial pressure of carbon dioxide, systemic blood pressure by the oscillometric method, and oesophageal body temperature. Although the blood tests after the transfusion showed an increase in hematocrit, changes suggestive of a delayed hemolytic reaction because of the transfusion were also noticed. Discussion: Preanesthetic stabilisation is critical, as anaesthesia of unstable patients may result in a higher risk of anaesthetic complications. Critically ill patients may present systemic imbalances that can trigger pharmacokinetic and pharmacodynamic changes of anaesthetics and analgesics. Neonates have several marked physiological differences, since some organs are still immature, have a high body volume of water, and present a reduced amount of total fat and concentrations of circulating proteins, making it necessary to adjust protocols and doses used for these patients. Blood transfusion between the same species is always the best option, though xenotransfusion becomes an option when there is no homologous donor available. However, it can present a great risk to life, as there is a lack of studies regarding the blood typing of the species and blood compatibility tests. We concluded that there was an increase in hematocrit after 24 h of xenotransfusion and, even with signs of delayed hemolytic reaction observed in the blood test, the patient did not show specific clinical signs of transfusion reaction. The pup was sensitive to methadone but required a high dose of propofol for anaesthetic induction. The use of methadone as a pre-anaesthetic agent and the infusion of remifentanil provided adequate analgesia based on the parameters evaluated.


Assuntos
Animais , Transfusão de Sangue/veterinária , Canidae/fisiologia , Anestesia Intravenosa/veterinária , Amputação Cirúrgica/veterinária , Animais Recém-Nascidos/fisiologia
3.
Rev. bras. ciênc. vet ; 29(4): 159-163, out./dez. 2022. il.
Artigo em Português | LILACS, VETINDEX | ID: biblio-1426889

RESUMO

O complexo de desordens hiperostóticas é uma condição rara e autolimitante, que tem as mesmas características histopatológicas, que cursa com proliferação óssea de caráter não neoplásico. Acomete cães jovens de raças distintas, com variabilidade quanto ao tipo de proliferação óssea e quanto aos ossos acometidos. O complexo é composto pela osteopatia craniomandibular, hiperostose da calota craniana e osteodistrofia hipertrófica. Podendo estar presente nos ossos da calota craniana, mandíbulas, coluna cervical e esqueleto apendicular. O presente relato, descreveu o quadro de uma cadela, da raça American Bully, não castrada, três meses de idade, que foi atendida com queixa de aumento de volume doloroso das mandíbulas, hiporexia e sialorreia há 15 dias, apresentando ao exame físico, amplitude de movimento diminuída e sensibilidade dolorosa da articulação temporomandibular, espessamento firme bilateral do crânio em região de fossa temporal, espessamento palpável de consistência firme das mandíbulas e crepitação respiratória. Após avaliação clínica e realização de exames complementares, chegou-se ao diagnóstico presuntivo, de complexo de desordens hiperostóticas. Foi instituído como conduta terapêutica o suporte analgésico, sendo eficaz para a manutenção das necessidades fisiológicas até a paciente alcançar a fase adulta. O prognóstico para esta paciente foi considerado bom, uma vez que não havia indícios de anquilose da articulação temporomandibular e/ou manifestações neurológicas.


The complex of hyperostotic disorders is a rare and self-limiting condition, which has the same histophatological characteristics, which courses with non-neoplastic bone proliferations. It affects young dogs of different breeds, with variability the bones affected. The complex is composed of craniomandibular osteopathy, calvarial hyperostotic syndrome and hypertrophic osteodystrophy. It may be present in the bones of the skullcap, jaws, cervical spine and appendicular skeleton. The present report describes the condition of a female dog, American Bully breed, entire, three months old, with a complaint of painful swelling of the jaws, hyporexia and drooling for 15 days, presenting on physical examination, reduced amplitude and pain of the temporomandibular joint, bilateral firm thickening of the skull in the temporal fossa region, palpable firm-consistent thickening of the mandibles and respiratory crackle. After clinical evaluation and complementary tests, a presumptive diagnosis of hyperostotic disorders complex was reached. It was instituted pain management as a treatment, being effective for the maintenance of physiological needs until the patient reaches the adulthood. The prognosis for this patient was considered good, since there was no evidence of temporomandibular joint ankylosis and/or neurological manifestations.


Assuntos
Animais , Cães , Articulação Temporomandibular/anormalidades , Desenvolvimento Ósseo , Hiperostose/veterinária , Transtornos Craniomandibulares/veterinária , Cães/anormalidades , Ossos Faciais/patologia , Analgésicos/uso terapêutico
4.
J Feline Med Surg ; 24(12): 1253-1259, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35616047

RESUMO

OBJECTIVES: The aims of this study were to evaluate and compare the effects that dexmedetomidine and methadone, either alone or in combination, have on the ocular variables of healthy adult cats when administered intramuscularly, as well as their reversal with atipamezole. METHODS: A randomized crossover blinded study of 10 healthy cats was used to assess the effect of 0.2 mg/kg methadone (MET), 7.5 µg/kg dexmedetomidine (D7), 10 µg/kg dexmedetomidine (D10), 7.5 µg/kg dexmedetomidine and 0.2 mg/kg methadone (DM7) and 10 µg/kg dexmedetomidine and 0.2 mg/kg methadone (DM10) on intraocular pressure (IOP), tear production and pupil diameter (PD). The animals were evaluated for 30 mins. Afterwards, atipamezole was administered and ocular variables were evaluated for 30 mins. RESULTS: D10, DM7 and DM10 significantly decreased mean IOP but MET or D7 did not. Tear production decreased significantly in all treatments, corresponding to 18%, 59%, 63%, 86% and 98% in MET, D7, D10, DM7 and DM10, respectively. PD increased in all treatments, but MET showed the highest PD. Thirty minutes after atipamezole (RT30), IOP returned to baseline with no difference between groups, and there was a significant increase in tear production, but the means were still different from baseline. CONCLUSIONS AND RELEVANCE: Dexmedetomidine decreases IOP and tear production but increases PD in healthy cats. Atipamezole can partly reverse those alterations. Low-dose dexmedetomidine (7.5 µg/kg) promotes sedation without changing the IOP. All protocols significantly decrease tear production, and Schirmer tear test after sedation is not representative of non-sedated values. Methadone induces quick onset mydriasis without changing the IOP.


Assuntos
Metadona , Gatos , Animais
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