Downer cow syndrome causing rhabdomyolysis and acute renal failure in a 17-month-old Guzerá heifer / Síndrome da vaca caída causando rabdomiólise e insuficiência renal aguda em uma novilha Guzerá de 17 meses

The downer cow syndrome (DCS) is characterized by an alert cow showing inability or reluctance to stand for 12 hours or more. This paper reported clinical, laboratory, and pathological findings in a Guzerá heifer with rhabdomyolysis, pigmenturia and acute renal failure following DCS. A 17-month-old Guzerá heifer was transported via a 350-km ride in a truck and showed sternal recumbency and severe difficulty in standing and walking. Neurological examination was unremarkable, and the heifer presented normal response to cranial nerves and spinal cord tests. Rectal palpation revealed a 5-month gravid uterus. No other abnormalities were noted in the pelvis or around the coxofemoral joints. Biochemical abnormalities included extremely high muscular enzyme activities (creatine phosphokinase and aspartate aminotransferase) and high creatinine levels. Urinalysis revealed blackish and cloudy urine, proteinuria, and a positive occult blood test. Spinal cord ultrasonography showed no abnormalities. This report highlighted an uncommon clinical presentation (myoglobinuria) and pathological findings in a heifer with DCS as a consequence of severe compressive muscle damage. Practitioners and producers must be aware of the risk of careless road transportation for long distances of cattle, especially obese cows, avoiding unnecessary suffering and expenses due to DCS.

A síndrome da vaca caída (SVC) é caracterizada por um bovino alerta que mostra incapacidade ou relutância em permanecer em estação por 12 horas ou mais. O objetivo deste trabalho é relatar os achados clínicos, laboratoriais e patológicos em uma novilha Guzerá com rabdomiólise, pigmentúria e insuficiência renal aguda após a SVC. Uma novilha da raça Guzerá, de 17 meses de idade, foi transportada de caminhão por 350 km e apresentou decúbito esternal, grande dificuldade para assumir estação e caminhar. O exame neurológico não demonstrou alterações, e a novilha possuía resposta normal aos testes de nervos cranianos e medula espinhal. A palpação retal revelou útero grávido de cinco meses. Nenhuma outra anormalidade foi observada na pelve ou na região das articulações coxofemorais. As anormalidades bioquímicas incluíram atividades de enzimas musculares (creatina fosfoquinase e aspartato aminotransferase) extremamente aumentadas e níveis elevados de creatinina. A urinálise revelou urina enegrecida e turva, proteinúria e teste de sangue oculto positivo. O exame ultrassonográfico da medula espinhal não apresentou anormalidades. Este relato evidencia uma apresentação clínica (mioglobinúria) e achados patológicos incomuns em uma novilha com SVC em consequência de extensa lesão muscular compressiva. Veterinários e produtores devem estar atentos aos riscos do transporte rodoviário descuidado por longas distâncias de bovinos, especialmente vacas obesas, evitando assim sofrimento e despesas desnecessárias decorrentes da SVC.

Impact of supine recumbency duration on the complications after lumbar puncture in children / 中华实用儿科临床杂志

Objective To evaluate the post-puncture complications in children,and to evaluate the difference in the occurrence rate of headache and backache between patients who had 1 hour of supine recumbency and those who had 4 hours of supine recumbency,to provide evidence for the standardized lumbar puncture (LP) procedure of children.Methods Inpatients who were older than 3 and had diagnostic LP in the course of their treatment between Nov.2012 and Apr.2013 were enrolled.The LP was performed by the same investigator under the standardized institutional guideline for LP and the information of number of LP attempts,duration of LP and cerebrospinal fluid (CSF) drainage volume were recorded.After the procedure,all the children were randomly assigned into 2 groups:the test group had supine recumbency for 1 hour after LP,and the control group had it for 4 hours.For the first 5 days following LP,reports of headache and backache were recorded by another physician who didn't participate in this study.The difference in the occurrence rate of headache and backache between test group and control group was assessed by the chi-square test or Fisher's probabilities in 2 × 2 table.And a Logistic regression analysis was performed to assess the risk factors for the occurrence of the headache and backache.Results The overall frequency of headache was 4.6％ (4/87 cases).The frequency of headache was not significantly different between the test group (2.4％) and control group (6.7％) (P =0.617).And the overall frequency of backache was 19.5 ％ (17/87 cases),and it was not significantly different between the 2 groups (test group:21.4％,control group:17.8 ％,P =0.668).In a Logistic regression analysis,age (P =0.011,OR:6.884,95％ CI:1.398-33.906) and the previous history of lumbar puncture (P =0.018,0R:0.126,95 ％ CI:0.026-0.618) were significant risk factors for the occurrence of backache.The risk of backache in children with more than 2 times of LP was decreased.And the risk was higher in the children older than 6 years than those younger than 6 years.Conclusions Headache and backache were the most frequent post-puncture complications in children.There was no difference between short duration (1 hour) of supine recumbency and long duration (4 hours) in preventing the occurrence of headache and backache after LP.

Efeitos do modo ventilatório sobre variáveis hemogasométricas em equinos submetidos à mudança de decúbito durante a anestesia geral inalatória com halotano / Effects of the ventilatory regimen on arterial blood gas variables in horses that underwent a change in body position during halothane anesthesia

Compararam-se os efeitos da ventilação espontânea (V E) e controlada (V C) em equinos submetidos à mudança de decúbito durante anestesia. Dezesseis animais foram equitativamente divididos em dois grupos: V E e V C. Os procedimentos cirúrgicos foram iniciados com os animais em decúbito lateral esquerdo (DLE) e, após 75 minutos, os animais foram reposicionados em decúbito lateral direito (DLD). Análises hemogasométricas do sangue arterial foram realizadas após 30 e 75 minutos com os animais posicionados em cada decúbito (M1 e M2 no DLE e M3 e M4 no DLD, respectivamente). Durante a V E, observaram-se hipercapnia (PaCO2 >45mmHg), acidose respiratória (pH <7,35), redução significativa da oxigenação sanguínea após 75min da mudança de decúbito (M4: 205,8±124,7mmHg) em relação aos valores de PaO2 observados antes da mudança de posicionamento (M1: 271,8±84,8mmHg). A Vc foi associada a valores de PaCO2 e pH mais próximos da normalidade bem como resultou em valores de PaO2 significativamente maiores (52 a 96 por cento de elevação nos valores médios) que a V E. Conclui-se que a mudança de decúbito, em equinos anestesiados com halotano e mantidos sob V E, resulta em hipercapnia, acidose respiratória e diminuição dos valores de PaO2. A instituição de V C, desde o início da anestesia, previne a acidose respiratória, além de resultar em valores de PaO2 mais próximos do ideal para animais respirando O2 a 100 por cento.

The effects of spontaneous (SV) and controlled ventilation (CV) were compared in horses undergoing changes in body position during anesthesia. Sixteen animals were equally distributed in two groups: SV and CV. All surgical procedures were commenced on left lateral recumbency (LLR) and 75 minutes later the animals were repositioned on right lateral recumbency (RLR). Arterial blood gas analyses were performed at 30 and 75 minutes after each recumbency (M1 and M2 for LLR and M3 and M4 for RLR). Hypercapnia (PaCO2 >45mmHg), respiratory acidosis (pH <7.35), and significant decrease in PaO2 after 75min of change in body position (M4: 205.8±124.7mmHg) in comparison to PaO2 values before the change of position (M1: 271.8±84.8mmHg) were observed during SV. When compared to the SV group, CV resulted in significantly higher PaO2 levels (52 to 96 percent increase). It was concluded that the change in the body position in spontaneously ventilating halothane-anesthetized horses causes impairment in arterial oxygenation. The use of CV since the beginning of anesthesia prevents the respiratory acidosis and maintains arterial oxygen levels that are closer to values expected during the use of 100 percent O2.