RESUMO

Este estudo teve como objetivo avaliar achados ultrassonográficos de cães e gatos diagnosticados com colestase, correlacionando alterações concomitantes com espécies, sexo, idade, peso, sinais clínicos e dilatação das vias biliares. O sistema biliar de pequenos animais é composto pela vesícula biliar e a árvore biliar. Desta forma, os felinos apresentam mais alterações nestas estruturas devido à anatomia diferenciada. A redução do fluxo biliar, conhecida como colestase, ocorre por inúmeras situações, sendo o ultrassom o principal exame diagnóstico empregado na medicina veterinária. Ductos biliares de 4 e 3mm de diâmetro são considerados normais para felinos e caninos, respectivamente. Neste estudo, os sistemas biliares de 41 animais, incluindo felinos e caninos, foram avaliados por ultrassonografia no Setor de Diagnóstico por Imagem do Hospital Veterinário de janeiro de 2019 a fevereiro de 2020, demonstrando a presença de cálculos vesicais em ambas as populações, assim como alterações em ducto cístico associados à pancreatite em cães.

This study aimed to evaluate ultrasound findings of dogs and cats diagnosed with cholestasis, correlating concomitant alterations with species, sex, age, weight, clinical signs, and dilation of bile ducts. The biliary system of small animals is composed of the gallbladder and the biliary tree. Thus, the felines show more alterations in these structures due to their differentiated anatomy. The reduction of the bile flow, known as cholestasis, occurs as a result of numerous situations, with ultrasound being the main diagnostic exam applied in veterinary medicine. Bile ducts of 4 and 3mm diameter are considered normal for felines and canines, respectively. In this study, the biliary systems of 41 animals, including felines and canines, were evaluated using ultrasound at the Diagnostic Imaging Sector of the Veterinary Hospital from January 2019 to February 2020, demonstrating the presence of bladder stones in both populations, as well as changes in the cystic duct associated with pancreatitis in dogs.

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Background: Platynosomum spp. it is a trematode that has a predilection for the liver and biliary tissues whose infection isacquired through the ingestion of metacercarian gecko viscera. Felines are the definitive hosts and clinical signs are variable.The diagnosis is through history, hematological and biochemical exams, ultrasound, bile cytology or histopathology. Thetreatment of choice is cholecystoduodenostomy. This paper aims to report the case of a cat who was treated at the UberabaVeterinary Hospital with chronic cholangitis secondary to platinosomosis, but there was a transfusion reaction and she died.Case: A 4-year-old, uncastrated SRD cat was treated at the Uberaba Veterinary Hospital complaining of severe episodesof vomiting three days ago, hyporexia and darkened urine. The general clinical examination showed moderate dehydration, jaundice and hepatomegaly. The animal was hospitalized for better investigation of its condition. Increased valuesof ALT, alkaline phosphatase and all bilirubins were observed. Ultrasound showed liver suggestive of liver disease andsteatosis, and gallbladder without alteration. During hospitalization, she remained jaundiced and hypoxic, and the esophageal tube was placed. The initial clinical suspicion was cholangiohepatitis. Liver biopsy and cholecystoduodenostomywere then suggested, with refusal by the tutor. The ultrasound was repeated and showed the same alterations described,besides cholangitis. Stool examination was negative for Platynosomum spp. and positive for Isospora spp. The patientwas treated with anthelmintic for three days and received supportive treatment for another week until the tutor authorizedcholecystoduodenostomy. During surgery, cholecystocentesis was performed and the parasite Platynosomum spp. in adultform. After four days, a new blood count was done and the animal was still anemic and the blood...(AU)

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RESUMO

Background: Platynosomum spp. it is a trematode that has a predilection for the liver and biliary tissues whose infection isacquired through the ingestion of metacercarian gecko viscera. Felines are the definitive hosts and clinical signs are variable.The diagnosis is through history, hematological and biochemical exams, ultrasound, bile cytology or histopathology. Thetreatment of choice is cholecystoduodenostomy. This paper aims to report the case of a cat who was treated at the UberabaVeterinary Hospital with chronic cholangitis secondary to platinosomosis, but there was a transfusion reaction and she died.Case: A 4-year-old, uncastrated SRD cat was treated at the Uberaba Veterinary Hospital complaining of severe episodesof vomiting three days ago, hyporexia and darkened urine. The general clinical examination showed moderate dehydration, jaundice and hepatomegaly. The animal was hospitalized for better investigation of its condition. Increased valuesof ALT, alkaline phosphatase and all bilirubins were observed. Ultrasound showed liver suggestive of liver disease andsteatosis, and gallbladder without alteration. During hospitalization, she remained jaundiced and hypoxic, and the esophageal tube was placed. The initial clinical suspicion was cholangiohepatitis. Liver biopsy and cholecystoduodenostomywere then suggested, with refusal by the tutor. The ultrasound was repeated and showed the same alterations described,besides cholangitis. Stool examination was negative for Platynosomum spp. and positive for Isospora spp. The patientwas treated with anthelmintic for three days and received supportive treatment for another week until the tutor authorizedcholecystoduodenostomy. During surgery, cholecystocentesis was performed and the parasite Platynosomum spp. in adultform. After four days, a new blood count was done and the animal was still anemic and the blood...

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Os métodos de diagnóstico por imagem para investigação das obstruções biliares atualmente disponíveis na medicina veterinária apresentam algumas limitações, como sensibilidade diagnóstica insuficiente e alto custo. Neste contexto, o presente trabalho objetivou padronizar e descrever a técnica de colangiografia transcolecística percutânea em cães e gatos, consistindo na injeção de contraste no interior das vias biliares por colecistocentese ecoguiada seguida de avaliação radiográfica abdominal. Os animais não apresentaram quaisquer efeitos colaterais decorrentes da técnica e a mesma apresentou eficácia na demonstração radiográfica da árvore biliar, possibilitando a investigação diagnóstica das enfermidades obstrutivas que acometem as vias biliares nas espécies canina e felina.(AU)

Imaging methods for investigation of biliary obstructions currently available in veterinary medicine present some limitations, such as insufficient diagnostic sensitivity and high cost. In this context, the objective of the present study was to standardize and describe the technique of percutaneous transcholecystic cholangiography in dogs and cats, consisting of the injection of contrast inside the bile ducts by ultrasound-guided cholecystocentesis followed by abdominal radiographic evaluation. The animals did not present any side effects resulting from the technique and it showed efficacy in the radiographic demonstration of the biliary tree, making possible the diagnostic investigation of the obstructive diseases that affect the bile ducts in the canine and feline species.(AU)

Los métodos de diagnóstico por imagen para investigación de las obstrucciones biliares actualmente disponibles en la medicina veterinaria presentan algunas limitaciones, como sensibilidad diagnóstica insuficiente y alto costo. En este contexto, el presente trabajo objetivó estandarizar y describir la técnica de colangiografía transcolecística percutánea en perros y gatos, consistente en la inyección de contraste en el interior de las vías biliares por colecistocentes y ecoguiada seguida de evaluación radiográfica abdominal. Los animales no presentaron efectos colaterales derivados de la técnica y la misma presentó eficacia en la demostración radiográfica del árbol billar, posibilitando la investigación diagnóstica de las enfermedades obstructivas que acomete las vías biliares en las especies canina y felina.(AU)

Assuntos

RESUMO

Os métodos de diagnóstico por imagem para investigação das obstruções biliares atualmente disponíveis na medicina veterinária apresentam algumas limitações, como sensibilidade diagnóstica insuficiente e alto custo. Neste contexto, o presente trabalho objetivou padronizar e descrever a técnica de colangiografia transcolecística percutânea em cães e gatos, consistindo na injeção de contraste no interior das vias biliares por colecistocentese ecoguiada seguida de avaliação radiográfica abdominal. Os animais não apresentaram quaisquer efeitos colaterais decorrentes da técnica e a mesma apresentou eficácia na demonstração radiográfica da árvore biliar, possibilitando a investigação diagnóstica das enfermidades obstrutivas que acometem as vias biliares nas espécies canina e felina.

Imaging methods for investigation of biliary obstructions currently available in veterinary medicine present some limitations, such as insufficient diagnostic sensitivity and high cost. In this context, the objective of the present study was to standardize and describe the technique of percutaneous transcholecystic cholangiography in dogs and cats, consisting of the injection of contrast inside the bile ducts by ultrasound-guided cholecystocentesis followed by abdominal radiographic evaluation. The animals did not present any side effects resulting from the technique and it showed efficacy in the radiographic demonstration of the biliary tree, making possible the diagnostic investigation of the obstructive diseases that affect the bile ducts in the canine and feline species.

Los métodos de diagnóstico por imagen para investigación de las obstrucciones biliares actualmente disponibles en la medicina veterinaria presentan algunas limitaciones, como sensibilidad diagnóstica insuficiente y alto costo. En este contexto, el presente trabajo objetivó estandarizar y describir la técnica de colangiografía transcolecística percutánea en perros y gatos, consistente en la inyección de contraste en el interior de las vías biliares por colecistocentes y ecoguiada seguida de evaluación radiográfica abdominal. Los animales no presentaron efectos colaterales derivados de la técnica y la misma presentó eficacia en la demostración radiográfica del árbol billar, posibilitando la investigación diagnóstica de las enfermedades obstructivas que acomete las vías biliares en las especies canina y felina.

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To examine the therapeutic effect of curcumin and/or vitamin B6 in treatment of cholestasis, a model of cholestasis was induced in mice using lithocholic acid (LCA). Alterations in biochemical parameters and liver histopathological and histochemical changes were examined in cholestatic mice and after treatments with curcumin, vitamin B6 and combination of both. Moreover, hepatic expressions of bilirubin-metabolizing enzymes, their regulatory nuclear receptors, and bile acid lipid transporters were examined using RT-PCR. Cholestatic mice showed an increase in the blood levels of AST, ALT, ALP, direct and total bilirubin and a decrease in cholesterol levels that were ameliorated by treatments. Liver histopathology showed multiple necrotic foci of different sizes spread all over the liver with congestion of hepatic blood vessels in LCA group. These foci were regenerated in hepatic tissues after administration of curcumin and vitamin B6. Immunohistochemical examination of liver showed an increase in glutathione and NF-kB expressions in treated mice. Cholestatic mice showed down-regulation of mRNA expression of hepatic bile acid and bilirubin-metabolizing/detoxifying enzymes (Cyp2b10, Ugt1a1, Sult2a1), their regulatory nuclear receptors (CAR, PXR, farnesoid X receptor), and bile acid/organic anion and lipid transporters (Oatp2, Bsep, Mrp2, Abcg8, Asbt). These changes were ameliorated and restored by treatment with curcumin, vitamin B6 and both. Only of examined genes, NTCP was up-regulated in cholestatic mice. In conclusion, treatment with curcumin mainly, vitamin B6 or the combination of them has the potential to ameliorate changes observed in induced cholestasis.

Assuntos

RESUMO

To examine the therapeutic effect of curcumin and/or vitamin B6 in treatment of cholestasis, a model of cholestasis was induced in mice using lithocholic acid (LCA). Alterations in biochemical parameters and liver histopathological and histochemical changes were examined in cholestatic mice and after treatments with curcumin, vitamin B6 and combination of both. Moreover, hepatic expressions of bilirubin-metabolizing enzymes, their regulatory nuclear receptors, and bile acid lipid transporters were examined using RT-PCR. Cholestatic mice showed an increase in the blood levels of AST, ALT, ALP, direct and total bilirubin and a decrease in cholesterol levels that were ameliorated by treatments. Liver histopathology showed multiple necrotic foci of different sizes spread all over the liver with congestion of hepatic blood vessels in LCA group. These foci were regenerated in hepatic tissues after administration of curcumin and vitamin B6. Immunohistochemical examination of liver showed an increase in glutathione and NF-kB expressions in treated mice. Cholestatic mice showed down-regulation of mRNA expression of hepatic bile acid and bilirubin-metabolizing/detoxifying enzymes (Cyp2b10, Ugt1a1, Sult2a1), their regulatory nuclear receptors (CAR, PXR, farnesoid X receptor), and bile acid/organic anion and lipid transporters (Oatp2, Bsep, Mrp2, Abcg8, Asbt). These changes were ameliorated and restored by treatment with curcumin, vitamin B6 and both. Only of examined genes, NTCP was up-regulated in cholestatic mice. In conclusion, treatment with curcumin mainly, vitamin B6 or the combination of them has the potential to ameliorate changes observed in induced cholestasis.(AU)

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As doenças do trato biliar são as patologias hepato-biliares de maior ocorrência em felinos, comumente associadas a processos inflamatórios intestinais e pancreáticos. A obstrução do ducto biliar comum está associada a alta mortalidade e morbidade e pode ocorrer devido doenças inflamatórias, colelitíases, neoplasias, dentre outras causas menos comum. As manifestações clínicas iniciais são inespecíficas, mas a progressão da doença leva a icterícia, emese, anorexia, perda de peso e fezes acólicas. O diagnóstico se dá através de exames laboratoriais e ultrassonografia. A definição de obstrução total do ducto biliar comum requer intervenção cirúrgica, e a definição da técnica irá depender da possível desobstrução do ducto ou restabelecimento do fluxo biliar através da colecistoduodenostomia, ou colecistojejunostomia, associadas a um grande risco cirúrgico e anestésico. Este relato apresenta um caso de um paciente com obstrução total do ducto biliar comum, diagnosticado através da ultrassonografia, sinais clínicos e exames laboratoriais e sua resolução cirúrgica através da técnica de colecistoduodenostomia, que se mostrou efetiva para a melhora clínica do paciente.

Diseases of the biliary tract are the most frequent hepatic biliary diseases in felines, commonly associated with inflammatory bowel and pancreatic processes. Obstruction of the common bile duct is associated with high mortality and morbidity and can occur due to inflammatory diseases, cholelithiasis, neoplasias, among other less common causes. Initial clinical manifestations are nonspecific, but progression of the disease leads to jaundice, emesis, anorexia, weight loss, and stool. The diagnosis is made through laboratory tests and ultrasonography. The definition of total obstruction of the common bile duct requires surgical intervention, and the definition of the technique will depend on the possible duct clearance or reestablishment of the biliary flow through cholecystoduodenostomy, or cholecystochejunostomy, associated with a great surgical and anesthetic risk. This report presents a case of a patient with total obstruction of the common bile duct, diagnosed through ultrasonography, clinical signs and laboratory tests and their surgical resolution through the cholecystoduodenostomy technique, which proved to be effective for the patient’s clinical improvement.

Assuntos

RESUMO

As doenças do trato biliar são as patologias hepato-biliares de maior ocorrência em felinos, comumente associadas a processos inflamatórios intestinais e pancreáticos. A obstrução do ducto biliar comum está associada a alta mortalidade e morbidade e pode ocorrer devido doenças inflamatórias, colelitíases, neoplasias, dentre outras causas menos comum. As manifestações clínicas iniciais são inespecíficas, mas a progressão da doença leva a icterícia, emese, anorexia, perda de peso e fezes acólicas. O diagnóstico se dá através de exames laboratoriais e ultrassonografia. A definição de obstrução total do ducto biliar comum requer intervenção cirúrgica, e a definição da técnica irá depender da possível desobstrução do ducto ou restabelecimento do fluxo biliar através da colecistoduodenostomia, ou colecistojejunostomia, associadas a um grande risco cirúrgico e anestésico. Este relato apresenta um caso de um paciente com obstrução total do ducto biliar comum, diagnosticado através da ultrassonografia, sinais clínicos e exames laboratoriais e sua resolução cirúrgica através da técnica de colecistoduodenostomia, que se mostrou efetiva para a melhora clínica do paciente.(AU)

Diseases of the biliary tract are the most frequent hepatic biliary diseases in felines, commonly associated with inflammatory bowel and pancreatic processes. Obstruction of the common bile duct is associated with high mortality and morbidity and can occur due to inflammatory diseases, cholelithiasis, neoplasias, among other less common causes. Initial clinical manifestations are nonspecific, but progression of the disease leads to jaundice, emesis, anorexia, weight loss, and stool. The diagnosis is made through laboratory tests and ultrasonography. The definition of total obstruction of the common bile duct requires surgical intervention, and the definition of the technique will depend on the possible duct clearance or reestablishment of the biliary flow through cholecystoduodenostomy, or cholecystochejunostomy, associated with a great surgical and anesthetic risk. This report presents a case of a patient with total obstruction of the common bile duct, diagnosed through ultrasonography, clinical signs and laboratory tests and their surgical resolution through the cholecystoduodenostomy technique, which proved to be effective for the patients clinical improvement.(AU)

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Despite of being a relatively rare disease in horses, cholelithiasis is the most common cause of biliary obstructionin this species. Simultaneous intrahepatic and extrahepatic gallstones are the most frequent presentation. Usually, there areno clinical signs associated with this condition, although biliary obstruction could occur as a consequence. Two cases ofcholelithiasis in horses, including gross and histopathological findings are described. In one of the cholelithiasis cases therewas no association with clinical signs or cause of death, but in the other one, chronic loss of weight may have been causedby cholelithiasis.

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