Terapia con cánula nasal de alto flujo en pacientes pediátricos en domicilio / High flow nasal cannula therapy in pediatric patients at home

Se realiza comentario de estudio de Israel en el cual analizan 75 pacientes pediátricos que utilizaron cánula nasal de alto flujo (CNAF) en domicilio, evaluando la seguridad, las indicaciones, los parámetros de utilización, la duración del tratamiento, los resultados clínicos y la satisfacción de los padres. Se acompaña de una revisión de la literatura del tema.

A comment is made on a study conducted in Israel analyzing 75 pediatric patients who used high-flow nasal cannula at home, evaluating safety, indications, utilization parameters, treatment duration, clinical outcomes, and parental satisfaction. It is accompanied by a literature review on the topic.

Neurotoxicosis in horses associated with consumption of Trema micrantha.

BACKGROUND: Trema micrantha is a tree widely distributed throughout the Americas. The tree produces highly palatable leaves that have been associated with natural poisoning in goats, sheep and horses, in which hepatic necrosis and hepatic encephalopathy have been observed. OBJECTIVES: This study describes malacia and haemorrhage in the central nervous system (CNS) due to T. micrantha consumption, with minimal to absent hepatic lesions. STUDY DESIGN: Retrospective case series. METHODS: A total of 14 horses with a history of neurological signs and spontaneous consumption of T. micrantha leaves were submitted to necropsy and multiple samples were collected for histopathology. Details of clinical history and signs of the horses were obtained through inquiries to the owners and attending veterinarians. RESULTS: All the 14 horses had neurological signs of ataxia, severe sialorrhoea, involuntary running movements, sternal and lateral recumbency, and death after a clinical course that lasted from 24 h to 9 days. For a few days prior to onset of clinical signs, all horses had spontaneously consumed, potentially toxic doses of T. micrantha leaves. All 14 brains had diffuse yellowish discoloration affecting the rhombencephalon, mesencephalon, diencephalon, telencephalon and corpus striatum. In all cases, the most severe lesions were observed in the pons. Spinal cord lesions were observed affecting the lumbar intumescence, which was swollen with darken and depressed areas at the dorsal and ventral horns, and at the sacral level, which on cut surface displayed a friable and yellowish grey matter. The lesions observed grossly in brain and spinal cord consisted microscopically of severe vasculitis and liquefactive necrosis of white and grey matter of the brainstem, cerebellum and spinal cord. MAIN LIMITATIONS: This is a small retrospective series relying on clinical observations reported by owners and attending veterinarians. The mechanism of action of the plant toxin in the CNS is still unidentified. CONCLUSION: T. micrantha poisoning in horses causes predominantly a neurological disease, with minimal to absent hepatic lesions.

Intoxicação por antibióticos ionóforos e leucoencefalomalácia concomitantes pelo consumo de ração comercial contaminada em equinos / Concurrent ionophore poisoning and leukoencephalomalacia by consumption of contaminated commercial ration in horses

Background: Equidae nutritional change increased the frequency of diseases due to inappropriate administration and storage of rations. Although there are reports of ionophore poisoning (IP) and leukoencephalomalacia (LEM) in equidae from Brazil, the concurrent occurrence of both diseases by the same contaminated commercial ration is unprecedented. Therefore, the present paper aims to describe the epidemiological, clinical, laboratorial and pathological findings of concurrent IP and LEM outbreaks in horses.Cases: Eleven farmers from seven different locations in Distrito Federal, Midwestern Brazil, reported sudden clinical signs in 27 horses after the ingestion of commercial pelleted ration. During the farm visits, it was found that the ration brand and batches were identical, and macroscopic evaluation revealed no abnormalities. Eight horses were clinically evaluated and presented hyporexia, apathy, hypermetria, ataxia, dehydration, dyspnea, tongue hypotonia, muscle tremors, tachycardia, facial hypoalgesia, dysphagia, and sporadic or permanent recumbence. Laboratorial changes were restricted to creatine phosphokinase (mean: 1,573.4 ± 16.9 IU/L) and gammaglutamyl transferase (mean: 34.85 ± 29.14 IU/L) serum increases. Pathological evaluation has performed in eight horses presenting pallor and whitish striations in the gluteal, longissimus dorsi, femoral quadriceps muscles and myocardium, varying from mild to moderate. One horse also showed a soft and yellowish focal area on the right temporal lobe white matter. Microscopically, alterations in skeletal and cardiac muscle tissues included striated muscle fibers and cardiomyocytes segmental necrosis, characterized by sarcoplasmic fragmentation with clusters of eosinophilic debris, cellular retraction and hypereosinophilia. Histological alterations in the central nervous system of one horse were characteristic of LEM.[...](AU)

Intoxicação por antibióticos ionóforos e leucoencefalomalácia concomitantes pelo consumo de ração comercial contaminada em equinos / Concurrent ionophore poisoning and leukoencephalomalacia by consumption of contaminated commercial ration in horses

Background: Equidae nutritional change increased the frequency of diseases due to inappropriate administration and storage of rations. Although there are reports of ionophore poisoning (IP) and leukoencephalomalacia (LEM) in equidae from Brazil, the concurrent occurrence of both diseases by the same contaminated commercial ration is unprecedented. Therefore, the present paper aims to describe the epidemiological, clinical, laboratorial and pathological findings of concurrent IP and LEM outbreaks in horses.Cases: Eleven farmers from seven different locations in Distrito Federal, Midwestern Brazil, reported sudden clinical signs in 27 horses after the ingestion of commercial pelleted ration. During the farm visits, it was found that the ration brand and batches were identical, and macroscopic evaluation revealed no abnormalities. Eight horses were clinically evaluated and presented hyporexia, apathy, hypermetria, ataxia, dehydration, dyspnea, tongue hypotonia, muscle tremors, tachycardia, facial hypoalgesia, dysphagia, and sporadic or permanent recumbence. Laboratorial changes were restricted to creatine phosphokinase (mean: 1,573.4 ± 16.9 IU/L) and gammaglutamyl transferase (mean: 34.85 ± 29.14 IU/L) serum increases. Pathological evaluation has performed in eight horses presenting pallor and whitish striations in the gluteal, longissimus dorsi, femoral quadriceps muscles and myocardium, varying from mild to moderate. One horse also showed a soft and yellowish focal area on the right temporal lobe white matter. Microscopically, alterations in skeletal and cardiac muscle tissues included striated muscle fibers and cardiomyocytes segmental necrosis, characterized by sarcoplasmic fragmentation with clusters of eosinophilic debris, cellular retraction and hypereosinophilia. Histological alterations in the central nervous system of one horse were characteristic of LEM.[...]

Veinte años de experiencia en trasplante pulmonar: Complicaciones de la vía aérea: Rol de la tomografía computada multidetector / Twenty-Year Experience in Lung Transplantation: Complications of the Airways. The Role of Multidetector Computed Tomography

Introducción: Las complicaciones de la vía aérea (CVA) en pacientes trasplantados pulmonares ocupan una causa importante de morbimortalidad; llegan a presentarse (hasta en el 18% de los mismos). Se incluyen la dehiscencia, la estenosis y la malasia. Objetivo: Demostrar nuestra experiencia en pacientes con CVA sometidos a trasplante pulmonar. Objetivo secundario: Demostrar la utilidad de la tomografía computada multidetector (TCMD) para el diagnóstico y control post tratamiento de las CVA. Materiales y métodos: Se analizaron las historias clínicas de pacientes trasplantados pulmonares con diagnóstico broncográfico de CVA. Además se compararon los hallazgos tomográficos de estos pacientes con el de las FBC. Resultados: De 325 trasplantes realizados en 20 años, 65 (20%) de ellos presentaron alguna CVA. Se reportó estenosis en 51 pacientes (78,5%); malasia en un 15% y dehiscencia en un 13,5%. Los pacientes con estenosis o malasia recibieron dilatación endoscópica; 33 de ellos presentaron re estenosis, por lo que a 30 se les implantó un stent. Las dehiscencias fueron tratadas con corrección quirúrgica, stents o cierre con Histoacryl. De los 30 pacientes con sospecha de CVA a los que se les realizó TCMD, esta demostró ser diagnóstica en el 100% de los casos. Conclusión: Las CVA deben sospecharse en caso de disnea, fiebre o empeoramiento de la clase funcional con caída del volumen espiratorio forzado en 1 segundo (VEF1). La TCMD con reconstrucciones multiplanares o 3D demostró alta certeza para el diagnóstico de las CVA, planeamiento de su terapéutica y control posterior de la misma.

Introduction: The complications of airways in lung transplant recipients are an important cause of morbidity and mortality, reaching up to 18% of patients according to various reports. Dehiscence, stenosis and malacia are included. Objective: Describe our experience in patients with complications of airways after lung transplantation. Secondary Objective: Demonstrate the usefulness of multidetector computed tomography for the diagnosis, treatment and monitoring of airways complications in lungs transplanted patients. Materials and Methods: The medical records of lungs transplanted patients with bronchographic diagnosis of the airways complications were reviewed and analyzed. Furthermore CT findings of these patients were compared with the bronchoscopy diagnosis to determine their utility. Results: Among 325 lung transplants performed in 20 years, 65 (20%) showed airways complications. The most frequently reported complications were stenosis in 51 patients (78.5%), malacia (15%) and dehiscence (13.5%). All patients with stenosis or malacia received first a therapeutic endoscopic dilatation; 33 of them had re-stenosis and in 30 patients a stent was implanted. Dehiscences were treated with surgical intervention, stenting or closing with Histoacryl. In 30 patients with clinical suspicion of significant airways complications, MDCT proved to be diagnostic in 100% of cases. Conclusion: The airways complications should always be suspected in cases of dyspnea, fever or worsening functional class associated with spirometry forced expiratory volume decline in one second. Also, MDCT with multiplanar and 3D reconstructions showed high accuracy for diagnosis, therapy planning and subsequent control.

Necrotizing meningoencephalitis in cattle associated to Bovine Herpesvirus-5 in Pernambuco - Brazil / Meningoencefalite necrosante em bovinos associada ao herpesvírus bovino-5 em Pernambuco - Brasil

Background: Bovine Herpesvirus-5 (BoHV-5) is the most important cause of encephalopathy in cattle in Brazil. Necrotizing meningoencephalitis is an acute or subacute infectious disease that has low morbidity, higher fatal outcome and affects animals of all age groups, but especially young cattle under stress situations. The disease may occur like outbreaks or affect cattle alone. The mortality and morbidity varies from 75-100% and 0.05 to 22% respectively. This study aims to report the occurrence of two outbreaks of meningoencephalitis caused by bovine herpesvirus-5 diagnosed in the state of Pernambuco in the years 2011-2012. Cases: The epidemiological data and clinical signs were obtained with the veterinarians of two properties where the outbreaks occurred. Necropsies in two cattle were performed and samples of brain, spinal cord and tissues fragments from thoracic and abdominal cavities were collected. The material fixed in 10% buffered formalin was processed routinely for histopathological examination. After fixation of the brain, fragments of cerebral cortex, basal ganglia, thalamus, midbrain, cerebellar peduncles, cerebellum, bridge, medulla oblongata and cervical spinal cord were immunohistochemically processed for rabies. CNS samples were subjected to the technique of PCR for detection of BoHV-5. In affected cattle, the main clinical signs consisted of circling...

Necrotizing meningoencephalitis in cattle associated to Bovine Herpesvirus-5 in Pernambuco - Brazil / Meningoencefalite necrosante em bovinos associada ao herpesvírus bovino-5 em Pernambuco - Brasil

Background: Bovine Herpesvirus-5 (BoHV-5) is the most important cause of encephalopathy in cattle in Brazil. Necrotizing meningoencephalitis is an acute or subacute infectious disease that has low morbidity, higher fatal outcome and affects animals of all age groups, but especially young cattle under stress situations. The disease may occur like outbreaks or affect cattle alone. The mortality and morbidity varies from 75-100% and 0.05 to 22% respectively. This study aims to report the occurrence of two outbreaks of meningoencephalitis caused by bovine herpesvirus-5 diagnosed in the state of Pernambuco in the years 2011-2012. Cases: The epidemiological data and clinical signs were obtained with the veterinarians of two properties where the outbreaks occurred. Necropsies in two cattle were performed and samples of brain, spinal cord and tissues fragments from thoracic and abdominal cavities were collected. The material fixed in 10% buffered formalin was processed routinely for histopathological examination. After fixation of the brain, fragments of cerebral cortex, basal ganglia, thalamus, midbrain, cerebellar peduncles, cerebellum, bridge, medulla oblongata and cervical spinal cord were immunohistochemically processed for rabies. CNS samples were subjected to the technique of PCR for detection of BoHV-5. In affected cattle, the main clinical signs consisted of circling...(AU)

Aspergilose sistêmica em um cavalo relato de caso

A aspergilose é uma enfermidade micótica oportunista causada por Aspergillus fumigatus, A. nidulans, A. avus entre outros agentes. Estes se encontram no solo, matéria orgânica em decomposição e ar, sendo sua principal forma de entrada no organismo por via respiratória, pela inalação de esporos ou através de ingestão e inoculação transcutânea (trauma). Dentre os animais domésticos, a espécie equina é a terceira mais acometida por afecções micóticas, sendo pitiose a principal doença.

Complicações após a implantação de stent intraluminal de nitinol em cães com colapso da traqueia relato de três casos / Complications after the implantation of intraluminal nitinol stent in dogs with tracheal collapse a three-case report / Complicaciones posteriores a la colocación del stent intraluminal de nitinol en perros con colapso traqueal reporte de tres casos

O colapso da traqueia é uma doença caracterizada pela degeneração progressiva dos anéis cartilaginosos e pela frouxidão do músculo liso dorsaltraqueal, que acomete predominantemente cães de raças pequenas e toys. Os animais afetados podem apresentar tosse seca, ronqueira, dispneia, intolerância a exercícios físicos, cianose, síncopes e insuficiência respiratória. O tratamento é paliativo e tem 71% de eficácia com o uso de medicamentos, e não há cura definitiva. A implantação de stent intraluminal de nitinol é um procedimento minimamente invasivo, que tem mostrado resultado com eficácia de até 85% em cães que não responderam à terapia medicamentosa. É um procedimento considerado seguro, contudo não isento de complicações. Este trabalho objetivou relatar algumas das possíveis complicações em pacientes que foram submetidos à implantação do stent intraluminal de nitinol.(AU)

Tracheal collapse affects predominantly small and toy-breed dogs and is characterized by a progressive degenerative disease of the cartilage rings and laxity of the trachealis dorsalis muscle. Affected animals may present dry cough, honking, dyspnea, exercise intolerance, cyanosis, syncope episodes and respiratory insufficiency. There is no cure for this disease; the medical treatment is palliative and has shown 71% of success rate. Nitinol intraluminal tracheal stenting is a minimally invasive procedure that has yielded good results and a success rate up to 85% in dogs unresponsive to pharmacological therapy. Although it is not complication-free, the procedure is considered safe. This article reports some of the possible complications in patients who underwent the surgical procedure for implantation of a nitinol intraluminal stent.(AU)

El colapso de la tráquea es una enfermedad caracterizada por la degeneración progresiva del cartílago de los anillos, y por la laxitud del músculo liso dorsal de la tráquea. Los animales afectados, principalmente perros de razas pequeñas y toys, suelen presentar tos seca, ronquidos, disnea, intolerancia al ejercicio, cianosis, síncopes e insuficiencia respiratoria. El tratamiento es paliativo y tiene un 71% de eficiencia a través del uso de medicamentos; no hay cura definitiva de esta enfermedad. La implantación de un stent intraluminal de nitinol es un procedimiento de mínima invasión, que ha mostrado resultados con una eficiencia de hasta un 85% en los perros que no respondieron a la terapia con medicamentos. Es un procedimiento considerado como seguro, a pesar de que pueden presentarse complicaciones. Este trabajo tuvo como objetivo relatar algunas de las posibles complicaciones en pacientes que fueron sometidos a la implantación de stent intraluminal de nitinol.(AU)

Complicações após a implantação de stent intraluminal de nitinol em cães com colapso da traqueia – relato de três casos / Complications after the implantation of intraluminal nitinol stent in dogs with tracheal collapse – a three-case report / Complicaciones posteriores a la colocación del stent intraluminal de nitinol en perros con colapso traqueal – reporte de tres casos

O colapso da traqueia é uma doença caracterizada pela degeneração progressiva dos anéis cartilaginosos e pela frouxidão do músculo liso dorsaltraqueal, que acomete predominantemente cães de raças pequenas e toys. Os animais afetados podem apresentar tosse seca, ronqueira, dispneia, intolerância a exercícios físicos, cianose, síncopes e insuficiência respiratória. O tratamento é paliativo e tem 71% de eficácia com o uso de medicamentos, e não há cura definitiva. A implantação de stent intraluminal de nitinol é um procedimento minimamente invasivo, que tem mostrado resultado com eficácia de até 85% em cães que não responderam à terapia medicamentosa. É um procedimento considerado seguro, contudo não isento de complicações. Este trabalho objetivou relatar algumas das possíveis complicações em pacientes que foram submetidos à implantação do stent intraluminal de nitinol.

Tracheal collapse affects predominantly small and toy-breed dogs and is characterized by a progressive degenerative disease of the cartilage rings and laxity of the trachealis dorsalis muscle. Affected animals may present dry cough, honking, dyspnea, exercise intolerance, cyanosis, syncope episodes and respiratory insufficiency. There is no cure for this disease; the medical treatment is palliative and has shown 71% of success rate. Nitinol intraluminal tracheal stenting is a minimally invasive procedure that has yielded good results and a success rate up to 85% in dogs unresponsive to pharmacological therapy. Although it is not complication-free, the procedure is considered safe. This article reports some of the possible complications in patients who underwent the surgical procedure for implantation of a nitinol intraluminal stent.

El colapso de la tráquea es una enfermedad caracterizada por la degeneración progresiva del cartílago de los anillos, y por la laxitud del músculo liso dorsal de la tráquea. Los animales afectados, principalmente perros de razas pequeñas y toys, suelen presentar tos seca, ronquidos, disnea, intolerancia al ejercicio, cianosis, síncopes e insuficiencia respiratoria. El tratamiento es paliativo y tiene un 71% de eficiencia a través del uso de medicamentos; no hay cura definitiva de esta enfermedad. La implantación de un stent intraluminal de nitinol es un procedimiento de mínima invasión, que ha mostrado resultados con una eficiencia de hasta un 85% en los perros que no respondieron a la terapia con medicamentos. Es un procedimiento considerado como seguro, a pesar de que pueden presentarse complicaciones. Este trabajo tuvo como objetivo relatar algunas de las posibles complicaciones en pacientes que fueron sometidos a la implantación de stent intraluminal de nitinol.

Aspergilose sistêmica em um cavalo relato de caso

A aspergilose é uma enfermidade micótica oportunista causada por Aspergillus fumigatus, A. nidulans, A. avus entre outros agentes. Estes se encontram no solo, matéria orgânica em decomposição e ar, sendo sua principal forma de entrada no organismo por via respiratória, pela inalação de esporos ou através de ingestão e inoculação transcutânea (trauma). Dentre os animais domésticos, a espécie equina é a terceira mais acometida por afecções micóticas, sendo pitiose a principal doença.

Novos aspectos sobre a intoxicação por Trema micrantha (Cannabaceae) em equídeos / New aspects of Trema micrantha (Cannabaceae) poisoning in equids

Trema micrantha é uma planta arbórea distribuída amplamente no Brasil. Descrevem-se nesse trabalho novos aspectos epidemiológicos e patológicos relacionados com a intoxicação por essa planta em equídeos. Dois equinos adultos da raça Crioula e dois asininos, de localidades distintas, foram intoxicados naturalmente por Trema micrantha, após consumirem grande quantidade da planta que ficou disponível a eles após uma poda. Além disso, um cavalo adulto, de outra propriedade, que estava passando por restrição alimentar, se intoxicou após consumir as partes baixas de um grande número de árvores jovens de T. micrantha. Clinicamente, em todos os equídeos a doença se caracterizou por alterações neurológicas, que apareceram três a quatro dias após o consumo da planta, com curso clínico de dois a quatro dias (abreviadas por eutanásia). Os principais achados de necropsia foram observados no fígado, que estavam levemente aumentados e com padrão lobular evidente e no sistema nervoso central (SNC), com múltiplas áreas amareladas, focos de malacia e hemorragia, principalmente, no tronco cerebral e cerebelo. Histologicamente, havia necrose hepática aguda, edema acentuado no SNC com degeneração fibrinoide da parede de vasos associada a hemorragia e trombose e, frequentemente, com infiltrado de neutrófilos. Outras alterações observadas nos encéfalos foram: grande quantidade de astrócitos de Alzheimer tipo II na substância cinzenta, acúmulos de células Gitter e degeneração Walleriana próxima a focos de lesões vasculares. (AU)

Trema micrantha is a tree widely distributed in Brazil. This paper describes new epidemiological and pathological aspects of this plant poisoning in equids. Two adult horses, Criollo breed and two donkeys from different locations were naturally poisoned by Trema micrantha after consuming large amounts of the plant which was available to them due to pruning. Also an adult horse from another ranch, which was undergoing dietary restriction, was poisoned after consuming the lower parts of a large number of young T. micrantha trees. Clinically, in all cases, the disease was characterized by neurological symptoms that started 3 to 4 days after consumption of the plant, with a clinical course that varied 2 to 4 days (abbreviated by euthanasia). The main gross findings were in the liver, which had slightly increased lobular pattern evident, and in the central nervous system (CNS) with multiple yellowish areas, foci of malacia and hemorrhage, especially in the brainstem and cerebellum. Histologically, there was acute liver necrosis with marked edema of the CNS with fibrinoid vessel wall degeneration, hemorrhage and thrombosis as well as neutrophil infiltration. Other changes in the brain were Alzheimer type II astrocytes in the gray matter, accumulation of Gitter cells and Wallerian degeneration near to vascular lesion foci. (AU)

Novos aspectos sobre a intoxicação por Trema micrantha (Cannabaceae) em equídeos / New aspects of Trema micrantha (Cannabaceae) poisoning in equids

Trema micrantha é uma planta arbórea distribuída amplamente no Brasil. Descrevem-se nesse trabalho novos aspectos epidemiológicos e patológicos relacionados com a intoxicação por essa planta em equídeos. Dois equinos adultos da raça Crioula e dois asininos, de localidades distintas, foram intoxicados naturalmente por Trema micrantha, após consumirem grande quantidade da planta que ficou disponível a eles após uma poda. Além disso, um cavalo adulto, de outra propriedade, que estava passando por restrição alimentar, se intoxicou após consumir as partes baixas de um grande número de árvores jovens de T. micrantha. Clinicamente, em todos os equídeos a doença se caracterizou por alterações neurológicas, que apareceram três a quatro dias após o consumo da planta, com curso clínico de dois a quatro dias (abreviadas por eutanásia). Os principais achados de necropsia foram observados no fígado, que estavam levemente aumentados e com padrão lobular evidente e no sistema nervoso central (SNC), com múltiplas áreas amareladas, focos de malacia e hemorragia, principalmente, no tronco cerebral e cerebelo. Histologicamente, havia necrose hepática aguda, edema acentuado no SNC com degeneração fibrinoide da parede de vasos associada a hemorragia e trombose e, frequentemente, com infiltrado de neutrófilos. Outras alterações observadas nos encéfalos foram: grande quantidade de astrócitos de Alzheimer tipo II na substância cinzenta, acúmulos de células Gitter e degeneração Walleriana próxima a focos de lesões vasculares.

Trema micrantha is a tree widely distributed in Brazil. This paper describes new epidemiological and pathological aspects of this plant poisoning in equids. Two adult horses, Criollo breed and two donkeys from different locations were naturally poisoned by Trema micrantha after consuming large amounts of the plant which was available to them due to pruning. Also an adult horse from another ranch, which was undergoing dietary restriction, was poisoned after consuming the lower parts of a large number of young T. micrantha trees. Clinically, in all cases, the disease was characterized by neurological symptoms that started 3 to 4 days after consumption of the plant, with a clinical course that varied 2 to 4 days (abbreviated by euthanasia). The main gross findings were in the liver, which had slightly increased lobular pattern evident, and in the central nervous system (CNS) with multiple yellowish areas, foci of malacia and hemorrhage, especially in the brainstem and cerebellum. Histologically, there was acute liver necrosis with marked edema of the CNS with fibrinoid vessel wall degeneration, hemorrhage and thrombosis as well as neutrophil infiltration. Other changes in the brain were Alzheimer type II astrocytes in the gray matter, accumulation of Gitter cells and Wallerian degeneration near to vascular lesion foci.

Clinical and pathological findings of necrotizing meningoencephalitis in a maltese dog

A 2-year-old, intact female Maltese dog was presented to the veterinarian with a history of acute neurological signs. On neurological examination the dog showed deficit of mental status (apathy and depression), seizures, constant howling, head turn and compulsive circling to the right side and falls to the left side. The treatment protocol using prednisolone (for seizures remission) and cyclosporine (initiated in the chronic stage) did not stop the progression of the disease and euthanasia was elected 65 days later. Necropsy revealed mild cerebral asymmetry, and in the frontal ( more affected) parietal and occipital lobes of the right hemisphere there were friable, depressed and yellowish areas characterizing malacia. The left contralateral frontal lobe was edematous and slightly yellowish. At histopathology, the lesions were characterized by marked, multifocal to coalescing necrotizing meningoencephalitis, characterized by focally extensive areas of malacia, especially in the cortex of the frontal and right parietal lobes. Extension of lesions to white matter was observed only in the caudal region of the right frontal lobe. Plasma cells and lymphocytes infiltration was observed around vessels, leptomeninges and in the neuroparenchyma. In addition, the non-cavitation areas were also characterized by neuropil vacuolization, neuronal necrosis, neuronophagia, astroglyosis with...

Clinical and pathological findings of necrotizing meningoencephalitis in a maltese dog

A 2-year-old, intact female Maltese dog was presented to the veterinarian with a history of acute neurological signs. On neurological examination the dog showed deficit of mental status (apathy and depression), seizures, constant howling, head turn and compulsive circling to the right side and falls to the left side. The treatment protocol using prednisolone (for seizures remission) and cyclosporine (initiated in the chronic stage) did not stop the progression of the disease and euthanasia was elected 65 days later. Necropsy revealed mild cerebral asymmetry, and in the frontal ( more affected) parietal and occipital lobes of the right hemisphere there were friable, depressed and yellowish areas characterizing malacia. The left contralateral frontal lobe was edematous and slightly yellowish. At histopathology, the lesions were characterized by marked, multifocal to coalescing necrotizing meningoencephalitis, characterized by focally extensive areas of malacia, especially in the cortex of the frontal and right parietal lobes. Extension of lesions to white matter was observed only in the caudal region of the right frontal lobe. Plasma cells and lymphocytes infiltration was observed around vessels, leptomeninges and in the neuroparenchyma. In addition, the non-cavitation areas were also characterized by neuropil vacuolization, neuronal necrosis, neuronophagia, astroglyosis with...(AU)

Focal symmetrical encephalomalacia in sheep / Encefalomalacia focal simétrica em ovino

Focal symmetrical encephalomalacia (FSE) is the most prominent lesion seen in the chronic form of enterotoxemia by Clostridium perfringens type D. This paper reports FSE in sheep in Brazil. Six deaths occurred within a seven days period in a flock of 70, four to 30-month-old Santa Inês sheep in the state of Paraíba in the Brazilian semiarid. The flock was grazing a paddock of irrigated sprouting Cynodon dactylon (Tifton grass), and supplemented, ad libitum, with a concentrate of soybean, corn and wheat. Nervous signs included blindness and recumbence. A 19 month-old sheep was examined clinically and necropsied after a clinical course of three days. Gross lesions were herniation of the cerebellar vermis and multifocal, bilateral, symmetric brownish areas in the internal capsule, thalamus and cerebellar peduncles. Histologic lesions were multifocal, bilateral malacia with some neutrophils, swelling of blood vessels endothelium, perivascular edema, and hemorrhages. The flock was vaccinated, before the outbreak, with only one dose of Clostridium perfringens type D vaccine. Two factors are suggested to be important for the occurrence of the disease: insufficient immunity due to the incorrect vaccination; and high nutritional levels by the supplementation with highly fermentable carbohydrates.(AU)

Encefalomalacia focal simétrica (EFS) é a lesão mais proeminente vista nas formas subaguda ou crônica da enterotoxemia por Clostridium perfringens tipo D. Este trabalho relata EFS em ovinos no semiárido do estado da Paraíba. Seis ovinos morreram, em um período de sete dias, dentro de um rebanho de 70 animais, da raça Santa Inês, entre 4-30 meses de idade, que pastavam em piquete de Cynodon dactylon (capim Tifton), que estava rebrotando. Os ovinos eram suplementados com um concentrado de soja, trigo e milho. Os sinais nervosos incluíam cegueira e decúbito lateral. Um ovino de 19 meses de idade foi examinado clinicamente e necropsiado, depois de um curso clínico de 3 dias. Macroscopicamente foram observadas herniação do cerebelo e áreas acastanhadas, multifocais, simétricas e bilaterais na cápsula interna, tálamo e pedúnculo cerebelar. Histologicamente observou-se malacia, bilateral e simétrica, com alguns neutrófilos, tumefação das células endoteliais dos vasos sanguíneos, edema perivascular e hemorragia. O rebanho foi vacinado, antes do surto, com umaúnica dose de vacina para Clostridium perfringens tipo D. Dois fatores são sugestivos quanto a importância da ocorrência da enfermidade: imunidade insuficiente devida à vacinação incorreta; e altos níveis nutricionais da suplementação com carboidratos altamente fermentáveis.(AU)

Focal symmetrical encephalomalacia in sheep / Encefalomalacia focal simétrica em ovino

Focal symmetrical encephalomalacia (FSE) is the most prominent lesion seen in the chronic form of enterotoxemia by Clostridium perfringens type D. This paper reports FSE in sheep in Brazil. Six deaths occurred within a seven days period in a flock of 70, four to 30-month-old Santa Inês sheep in the state of Paraíba in the Brazilian semiarid. The flock was grazing a paddock of irrigated sprouting Cynodon dactylon (Tifton grass), and supplemented, ad libitum, with a concentrate of soybean, corn and wheat. Nervous signs included blindness and recumbence. A 19 month-old sheep was examined clinically and necropsied after a clinical course of three days. Gross lesions were herniation of the cerebellar vermis and multifocal, bilateral, symmetric brownish areas in the internal capsule, thalamus and cerebellar peduncles. Histologic lesions were multifocal, bilateral malacia with some neutrophils, swelling of blood vessels endothelium, perivascular edema, and hemorrhages. The flock was vaccinated, before the outbreak, with only one dose of Clostridium perfringens type D vaccine. Two factors are suggested to be important for the occurrence of the disease: insufficient immunity due to the incorrect vaccination; and high nutritional levels by the supplementation with highly fermentable carbohydrates.

Encefalomalacia focal simétrica (EFS) é a lesão mais proeminente vista nas formas subaguda ou crônica da enterotoxemia por Clostridium perfringens tipo D. Este trabalho relata EFS em ovinos no semiárido do estado da Paraíba. Seis ovinos morreram, em um período de sete dias, dentro de um rebanho de 70 animais, da raça Santa Inês, entre 4-30 meses de idade, que pastavam em piquete de Cynodon dactylon (capim Tifton), que estava rebrotando. Os ovinos eram suplementados com um concentrado de soja, trigo e milho. Os sinais nervosos incluíam cegueira e decúbito lateral. Um ovino de 19 meses de idade foi examinado clinicamente e necropsiado, depois de um curso clínico de 3 dias. Macroscopicamente foram observadas herniação do cerebelo e áreas acastanhadas, multifocais, simétricas e bilaterais na cápsula interna, tálamo e pedúnculo cerebelar. Histologicamente observou-se malacia, bilateral e simétrica, com alguns neutrófilos, tumefação das células endoteliais dos vasos sanguíneos, edema perivascular e hemorragia. O rebanho foi vacinado, antes do surto, com umaúnica dose de vacina para Clostridium perfringens tipo D. Dois fatores são sugestivos quanto a importância da ocorrência da enfermidade: imunidade insuficiente devida à vacinação incorreta; e altos níveis nutricionais da suplementação com carboidratos altamente fermentáveis.