Trends in the Management of Fifth Metacarpal Neck Fractures.

PURPOSE: To describe management trends of fifth metacarpal neck (5MCN) fractures within a large health care system. We aimed to define patient and surgeon factors associated with nonsurgical versus surgical treatment, as well as to identify factors associated with receiving care only in the emergency department (ED). METHODS: We identified all 5MCN fractures within our system for the years 2012-2020 and recorded baseline demographics for cases. Injury, treatment, and fracture characteristics were all recorded. For fractures treated nonsurgically, we determined the type of immobilization used (if any) and recorded whether patients were seen only in the ED or received subsequent outpatient follow-up. Demographic comparisons were made between groups, and adjusted logistic regression models were generated to predict the odds of having a surgical 5MCN fracture or being seen in the ED only. RESULTS: There were 611 5MCN fractures over an 8-year period, of which 10% were treated surgically. During the first half of the study period, 8% of isolated cases were treated surgically compared with 7% of cases in the second half. Soft dressings were increasingly used. There were no nonsurgically managed cases that underwent subsequent surgical procedures for symptomatic nonunion or malunion. Twenty-one percent of patients were seen only in the ED. Fracture angulation, associated injuries, insurance status, and treatment by a hand surgeon were all significantly associated with an increased likelihood of surgery. CONCLUSIONS: Of the 611 5MCN fractures identified, 90% were treated nonsurgically. Patient and surgeon factors were associated with increased odds of surgery. Of patients who sought care for 5MCN injuries, >20% received no follow-up care outside of the ED. These data can be used to assess future changes in management trends and suggest that nonunion and symptomatic malunions are uncommon occurrences. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.

Intramedullary Fixation with Headless Screws versus Bouquet in Unstable Metacarpal Neck Fractures in Active Patients: A Randomized Study.

Objeticve To compare the range of motion (ROM), return-to-work time, visual analogue score (VAS), disability of the arm, shoulder, and hand (QuickDASH), and radiographic outcomes of two methods of definitive internal fixation in active patients with boxer's fractures, operated in the first week. Methods This was a prospective, randomized trial, in which 50 patients, with a mean age range of 18 to 40 years old, were randomized and treated to definitive intramedullary fixation using 2 headless screws ( n = 20) or bouquet (2 or 3 Kirschner wires) ( n = 20). The patients were assessed on return-to-work time, ROM, patient reported QuickDASH outcome, VAS, and radiographic evaluation at 6 months. Results At 6 months, there were no differences between the two groups in terms of ROM, postoperative pain (VAS), or QuickDASH score. The overall complication rate was 4.76% in the screw group, compared with 5% in the bouquet-fixation group. Conclusions In the treatment of the active patients with unstable boxer's fractures, headless screws and bouquet fixation proved to be a safe and reliable treatment. The outcomes were similar in both groups.

Intramedullary Fixation with Headless Screws versus Bouquet in Unstable Metacarpal Neck Fractures in Active Patients: A Randomized Study / Fixação intramedular com parafusos de compressão versus técnica do buquê em fraturas instáveis do colo do metacarpo em pacientes ativos: Ensaio clínico randomizado

Abstract Objeticve To compare the range of motion (ROM), return-to-work time, visual analogue score (VAS), disability of the arm, shoulder, and hand (QuickDASH), and radiographic outcomes of two methods of definitive internal fixation in active patients with boxer's fractures, operated in the first week. Methods This was a prospective, randomized trial, in which 50 patients, with a mean age range of 18 to 40 years old, were randomized and treated to definitive intramedullary fixation using 2 headless screws (n = 20) or bouquet (2 or 3 Kirschner wires) (n = 20). The patients were assessed on return-to-work time, ROM, patient reported QuickDASH outcome, VAS, and radiographic evaluation at 6 months. Results At 6 months, there were no differences between the two groups in terms of ROM, postoperative pain (VAS), or QuickDASH score. The overall complication rate was 4.76% in the screw group, compared with 5% in the bouquet-fixation group. Conclusions In the treatment of the active patients with unstable boxer's fractures, headless screws and bouquet fixation proved to be a safe and reliable treatment. The outcomes were similar in both groups.

Resumo Objetivo Comparar a amplitude de movimento (ADM), o tempo de retorno de trabalho, a pontuação na escala visual analógica (EVA), o escore no questionário abreviado incapacidade do braço, ombro e mão (QuickDASH, na sigla em inglês) e os resultados radiográficos de dois métodos de fixação interna definitiva em pacientes ativos com fraturas do boxer; operados na primeira semana. Métodos Este foi um ensaio prospectivo randomizado, no qual 50 pacientes, com idade mediana na faixa de 18 a 40 anos, foram randomizados e tratados com fixação intramedular definitiva utilizando 2 parafusos de compressão (n = 20) ou buquê (2 ou 3 fios de Kirschner) (n = 20). Os pacientes foram avaliados em relação ao tempo de retorno ao trabalho, à ADM, ao desfecho relatado pelo paciente no questionário QuickDASH, à EVA e à avaliação radiográfica aos 6 meses. Resultados Aos 6 meses, não houve diferenças entre os 2 grupos em termos de ADM, dor pós-operatória (EVA) ou escore no QuickDASH. A taxa global de complicações foi de 4,76% no grupo de fixação com parafusos, em comparação com 5% no grupo de fixação com a técnica do buquê. Conclusões Parafusos de compressão e fixação com buquês provaram ser tratamentos seguros e confiáveis para pacientes ativos com fraturas instáveis. Os resultados foram semelhantes nos dois grupos.

Electrocardiographic markers of myocardial conduction and repolarization in Boxer dogs / Marcadores eletrocardiográficos de condução e repolarização miocárdica em cães da raça Boxer

Electrocardiographic markers have been used in people to classify arrhythmogenic risk. The aims of this study were to investigate electrocardiographic markers of conduction and repolarization in Boxers and non-Boxer dogs, and compare such findings between groups. Ten-lead standard electrocardiograms of Boxer dogs and non-Boxers recorded from 2015 to 2018 were retrospectively reviewed. Dogs >/ 4 years of age and weighing > 20kg were included. Animals with valvular insufficiencies, congenital cardiopathies, cardiac dilation, suspected systolic dysfunction, biphasic T-wave, bundle branch blocks, and those receiving antiarrhythmics were excluded. Electrocardiographic markers of conduction, QRS duration (QRSd) and dispersion (QRSD), and repolarization (corrected QT interval, Tpeak-Tend, JT and JTpeak), as well as derived indices, were measured. Two hundred dogs met the inclusion/exclusion requirements, including 97 Boxers (8.1±2.5 years old; 30±7kg) and 103 non-Boxer (8.8±2.5 years old, 30±8kg). QRSd and QRSD, and repolarization markers in lead II and left precordial lead V4 were considered similar between groups. Dispersion of late repolarization on lead rV2, Tpeak-Tend interval, was considered longer in Boxers (45±8ms vs 38±10ms, P=0.01). The Tpeak-Tend/JTpeak and the JTpeak/JT also differed between groups. Our results indicate that the dispersion of myocardial late repolarization in lead rV2 is slower in Boxers than other dog breeds.(AU)

Marcadores eletrocardiográficos têm sido estudados em seres humanos para estratificação do risco arritmogênico. Os objetivos deste estudo foram investigar os marcadores eletrocardiográficos de condução e repolarização miocárdica em Boxers e em cães de outras raças, e comparar tais resultados entre os grupos. Para tal, a eletrocardiografia convencional de 10 derivações registradas de 2015 a 2018 foram avaliadas de maneira retrospectiva. Cães com idade igual ou superior a 4 anos e pesando > 20kg foram incluídos. Animais com insuficiência valvar, cardiopatias congênitas, dilatação cardíaca, suspeita de disfunção sistólica, onda T bifásica, bloqueio(s) de ramo(s), ou aqueles que recebiam antiarrítmicos foram excluídos. Variáveis eletrocardiográficas de condução, como a duração e dispersão do complexo QRS (QRSd e QRSD, respectivamente), e repolarização (intervalo QT corrigido, Tpico-Tfinal, JT e JTpico), bem como índices derivados, foram mensurados. Duzentos cães que se adequaram aos critérios de inclusão/exclusão foram incluídos, 97 Boxers (8,1±2,5 anos; 30±7kg) e 103 não Boxers (8,8±2,5 anos; 30±8kg). O QRSd e o QRSD, e os marcadores de repolarização nas derivações II e V4 foram similares entre os grupos. O marcador de dispersão da repolarização tardia na derivação rV2, Tpico-Tfinal, foi considerado mais longo no Boxers (45±8ms vs 38±10ms, P=0.01). O Tpico-Tfinal/JTpico e o JTpico/JT também diferiram entre os grupos. Nossos resultados indicam que a dispersão da repolarização miocárdica tardia na derivação precordial direita, rV2, é mais lenta no Boxer do que nas outras raças.(AU)

Electrocardiographic markers of myocardial conduction and repolarization in Boxer dogs / Marcadores eletrocardiográficos de condução e repolarização miocárdica em cães da raça Boxer

ABSTRACT: Electrocardiographic markers have been used in people to classify arrhythmogenic risk. The aims of this study were to investigate electrocardiographic markers of conduction and repolarization in Boxers and non-Boxer dogs, and compare such findings between groups. Ten-lead standard electrocardiograms of Boxer dogs and non-Boxers recorded from 2015 to 2018 were retrospectively reviewed. Dogs >/ 4 years of age and weighing > 20kg were included. Animals with valvular insufficiencies, congenital cardiopathies, cardiac dilation, suspected systolic dysfunction, biphasic T-wave, bundle branch blocks, and those receiving antiarrhythmics were excluded. Electrocardiographic markers of conduction, QRS duration (QRSd) and dispersion (QRSD), and repolarization (corrected QT interval, Tpeak-Tend, JT and JTpeak), as well as derived indices, were measured. Two hundred dogs met the inclusion/exclusion requirements, including 97 Boxers (8.1±2.5 years old; 30±7kg) and 103 non-Boxer (8.8±2.5 years old, 30±8kg). QRSd and QRSD, and repolarization markers in lead II and left precordial lead V4 were considered similar between groups. Dispersion of late repolarization on lead rV2, Tpeak-Tend interval, was considered longer in Boxers (45±8ms vs 38±10ms, P=0.01). The Tpeak-Tend/JTpeak and the JTpeak/JT also differed between groups. Our results indicate that the dispersion of myocardial late repolarization in lead rV2 is slower in Boxers than other dog breeds.(AU)

Marcadores eletrocardiográficos têm sido estudados em seres humanos para estratificação do risco arritmogênico. Os objetivos deste estudo foram investigar os marcadores eletrocardiográficos de condução e repolarização miocárdica em Boxers e em cães de outras raças, e comparar tais resultados entre os grupos. Para tal, a eletrocardiografia convencional de 10 derivações registradas de 2015 a 2018 foram avaliadas de maneira retrospectiva. Cães com idade igual ou superior a 4 anos e pesando > 20kg foram incluídos. Animais com insuficiência valvar, cardiopatias congênitas, dilatação cardíaca, suspeita de disfunção sistólica, onda T bifásica, bloqueio(s) de ramo(s), ou aqueles que recebiam antiarrítmicos foram excluídos. Variáveis eletrocardiográficas de condução, como a duração e dispersão do complexo QRS (QRSd e QRSD, respectivamente), e repolarização (intervalo QT corrigido, Tpico-Tfinal, JT e JTpico), bem como índices derivados, foram mensurados. Duzentos cães que se adequaram aos critérios de inclusão/exclusão foram incluídos, 97 Boxers (8,1±2,5 anos; 30±7kg) e 103 não Boxers (8,8±2,5 anos; 30±8kg). O QRSd e o QRSD, e os marcadores de repolarização nas derivações II e V4 foram similares entre os grupos. O marcador de dispersão da repolarização tardia na derivação rV2, Tpico-Tfinal, foi considerado mais longo no Boxers (45±8ms vs 38±10ms, P=0.01). O Tpico-Tfinal/JTpico e o JTpico/JT também diferiram entre os grupos. Nossos resultados indicam que a dispersão da repolarização miocárdica tardia na derivação precordial direita, rV2, é mais lenta no Boxer do que nas outras raças.(AU)

Prognostic value of coupling interval, prematurity index and heart rate variability in Boxer dogs / Valor prognóstico do intervalo de acoplamento, índice de prematuridade e variabilidade da frequência cardíaca em cães da raça Boxer

Boxer dogs with arrhythmogenic right ventricular cardiomyopathy (ARVC) can experience sudden cardiac death regardless of presence/absence of clinical signs. The aims of this retrospective study were two-fold: 1) to investigate the coupling interval (CI) and prematurity index (PI) of ventricular arrhythmias (VA), and the heart rate variability (HRV) in Boxers, and 2) to evaluate their impact on overall survival time. The first 24-hour Holter 36 client-owned Boxer dogs meeting inclusion/exclusion criteria were evaluated for the number, morphology, site of origin, complexity, CI and PI, of ventricular premature complexes (VPCs), and time domain HRV. The effect on survival was assessed, considering the presence/absence of ventricular tachycardia (VT), and syncope. All-cause mortality was considered as the end-point, with median survival times being obtained by Kaplan-Meier analyses and compared by log-rank test. Polymorphic VPCs were more common in symptomatic dogs than asymptomatic. VPCs in dogs with VT were less premature, due to the influence of heart rate on PI despite comparable CI. The PI and mean heart rate (HRme) were significantly different between VT and non-VT dogs but did not discriminate adequately between groups as standalone tests. Median survival time was shorter in Boxer dogs with VT (463 vs 1645 days, HR: 4.31, P=0.03). The HRV parameters, SDNN and SDANN, were both associated with prognosis. The CI and PI were not demonstrated to be prognostic surrogates in Boxer dogs with VA. HRme≥112bpm is 100% sensitive but only 46% specific for detecting VT in Boxers on the 24-hour Holter. Presence of VT, SDNN≤245ms, or SDANN≤134ms at the time of the first 24-hour Holter was associated with a shorter survival.(AU)

Cães da raça Boxer com cardiomiopatia arritmogênica do ventrículo direito (CAVD) podem apresentar morte súbita independentemente da presença/ausência de sinais clínicos. Os objetivos desse estudo retrospectivo foram: 1) investigar o intervalo de acoplamento (IA) e o índice de prematuridade (IP) das arritmias ventriculares e a variabilidade da frequência cardíaca (VFC) em Boxers, e 2) avaliar o impacto de tais características sob o tempo de sobrevida global. O primeiro Holter de 24 horas de 36 Boxers selecionados para os critérios de inclusão/exclusão foram avaliados para o número, morfologia, local de origem, complexidade, IA e IP dos complexos ventriculares prematuros (CVPs) e da VFC no domínio do tempo. O efeito na sobrevida foi avaliado, considerado a presença/ausência de taquicardia ventricular (TV), e síncope. O desfecho final foi a mortalidade global, com o tempo de sobrevida mediano sendo obtido pela análise de Kaplan-Meier e comparado pelo teste de log-rank. CVPs polimórficos foram mais comuns em cães sintomáticos. Os CVPs em Boxers com TV foram menos prematuros, devido à influência da frequência cardíaca (FC) sobre o IP, apesar de IA comparáveis. O IP e a FC média diferiram entre os cães com TV e os sem, mas não discriminam adequadamente os grupos como variáveis isoladas. A sobrevida global foi menor nos cães com TV (463 dias vs 1645 dias, HR=4,31, P=0,03). Os parâmetros da VFC, SDNN e SDANN, foram associados ao prognóstico. O IA e o IP não possuem valor prognóstico em Boxers com arritmias ventriculares. A FC média ≥112bpm é 100% sensível, mas apenas 46% específica para detectar Boxers com TV no Holter de 24 horas. A presença de TV, SDNN≤245ms, ou SDANN≤134ms no momento do primeiro Holter de 24 horas estão associados a menor sobrevida global no Boxer.(AU)

Prognostic value of coupling interval, prematurity index and heart rate variability in Boxer dogs / Valor prognóstico do intervalo de acoplamento, índice de prematuridade e variabilidade da frequência cardíaca em cães da raça Boxer

Boxer dogs with arrhythmogenic right ventricular cardiomyopathy (ARVC) can experience sudden cardiac death regardless of presence/absence of clinical signs. The aims of this retrospective study were two-fold: 1) to investigate the coupling interval (CI) and prematurity index (PI) of ventricular arrhythmias (VA), and the heart rate variability (HRV) in Boxers, and 2) to evaluate their impact on overall survival time. The first 24-hour Holter 36 client-owned Boxer dogs meeting inclusion/exclusion criteria were evaluated for the number, morphology, site of origin, complexity, CI and PI, of ventricular premature complexes (VPCs), and time domain HRV. The effect on survival was assessed, considering the presence/absence of ventricular tachycardia (VT), and syncope. All-cause mortality was considered as the end-point, with median survival times being obtained by Kaplan-Meier analyses and compared by log-rank test. Polymorphic VPCs were more common in symptomatic dogs than asymptomatic. VPCs in dogs with VT were less premature, due to the influence of heart rate on PI despite comparable CI. The PI and mean heart rate (HRme) were significantly different between VT and non-VT dogs but did not discriminate adequately between groups as standalone tests. Median survival time was shorter in Boxer dogs with VT (463 vs 1645 days, HR: 4.31, P=0.03). The HRV parameters, SDNN and SDANN, were both associated with prognosis. The CI and PI were not demonstrated to be prognostic surrogates in Boxer dogs with VA. HRme≥112bpm is 100% sensitive but only 46% specific for detecting VT in Boxers on the 24-hour Holter. Presence of VT, SDNN≤245ms, or SDANN≤134ms at the time of the first 24-hour Holter was associated with a shorter survival.(AU)

Cães da raça Boxer com cardiomiopatia arritmogênica do ventrículo direito (CAVD) podem apresentar morte súbita independentemente da presença/ausência de sinais clínicos. Os objetivos desse estudo retrospectivo foram: 1) investigar o intervalo de acoplamento (IA) e o índice de prematuridade (IP) das arritmias ventriculares e a variabilidade da frequência cardíaca (VFC) em Boxers, e 2) avaliar o impacto de tais características sob o tempo de sobrevida global. O primeiro Holter de 24 horas de 36 Boxers selecionados para os critérios de inclusão/exclusão foram avaliados para o número, morfologia, local de origem, complexidade, IA e IP dos complexos ventriculares prematuros (CVPs) e da VFC no domínio do tempo. O efeito na sobrevida foi avaliado, considerado a presença/ausência de taquicardia ventricular (TV), e síncope. O desfecho final foi a mortalidade global, com o tempo de sobrevida mediano sendo obtido pela análise de Kaplan-Meier e comparado pelo teste de log-rank. CVPs polimórficos foram mais comuns em cães sintomáticos. Os CVPs em Boxers com TV foram menos prematuros, devido à influência da frequência cardíaca (FC) sobre o IP, apesar de IA comparáveis. O IP e a FC média diferiram entre os cães com TV e os sem, mas não discriminam adequadamente os grupos como variáveis isoladas. A sobrevida global foi menor nos cães com TV (463 dias vs 1645 dias, HR=4,31, P=0,03). Os parâmetros da VFC, SDNN e SDANN, foram associados ao prognóstico. O IA e o IP não possuem valor prognóstico em Boxers com arritmias ventriculares. A FC média ≥112bpm é 100% sensível, mas apenas 46% específica para detectar Boxers com TV no Holter de 24 horas. A presença de TV, SDNN≤245ms, ou SDANN≤134ms no momento do primeiro Holter de 24 horas estão associados a menor sobrevida global no Boxer.(AU)

Prognostic value of coupling interval, prematurity index and heart rate variability in Boxer dogs

ABSTRACT: Boxer dogs with arrhythmogenic right ventricular cardiomyopathy (ARVC) can experience sudden cardiac death regardless of presence/absence of clinical signs. The aims of this retrospective study were two-fold: 1) to investigate the coupling interval (CI) and prematurity index (PI) of ventricular arrhythmias (VA), and the heart rate variability (HRV) in Boxers, and 2) to evaluate their impact on overall survival time. The first 24-hour Holter 36 client-owned Boxer dogs meeting inclusion/exclusion criteria were evaluated for the number, morphology, site of origin, complexity, CI and PI, of ventricular premature complexes (VPCs), and time domain HRV. The effect on survival was assessed, considering the presence/absence of ventricular tachycardia (VT), and syncope. All-cause mortality was considered as the end-point, with median survival times being obtained by Kaplan-Meier analyses and compared by log-rank test. Polymorphic VPCs were more common in symptomatic dogs than asymptomatic. VPCs in dogs with VT were less premature, due to the influence of heart rate on PI despite comparable CI. The PI and mean heart rate (HRme) were significantly different between VT and non-VT dogs but did not discriminate adequately between groups as standalone tests. Median survival time was shorter in Boxer dogs with VT (463 vs 1645 days, HR: 4.31, P=0.03). The HRV parameters, SDNN and SDANN, were both associated with prognosis. The CI and PI were not demonstrated to be prognostic surrogates in Boxer dogs with VA. HRme112bpm is 100% sensitive but only 46% specific for detecting VT in Boxers on the 24-hour Holter. Presence of VT, SDNN245ms, or SDANN134ms at the time of the first 24-hour Holter was associated with a shorter survival.

RESUMO: Cães da raça Boxer com cardiomiopatia arritmogênica do ventrículo direito (CAVD) podem apresentar morte súbita independentemente da presença/ausência de sinais clínicos. Os objetivos desse estudo retrospectivo foram: 1) investigar o intervalo de acoplamento (IA) e o índice de prematuridade (IP) das arritmias ventriculares e a variabilidade da frequência cardíaca (VFC) em Boxers, e 2) avaliar o impacto de tais características sob o tempo de sobrevida global. O primeiro Holter de 24 horas de 36 Boxers selecionados para os critérios de inclusão/exclusão foram avaliados para o número, morfologia, local de origem, complexidade, IA e IP dos complexos ventriculares prematuros (CVPs) e da VFC no domínio do tempo. O efeito na sobrevida foi avaliado, considerado a presença/ausência de taquicardia ventricular (TV), e síncope. O desfecho final foi a mortalidade global, com o tempo de sobrevida mediano sendo obtido pela análise de Kaplan-Meier e comparado pelo teste de log-rank. CVPs polimórficos foram mais comuns em cães sintomáticos. Os CVPs em Boxers com TV foram menos prematuros, devido à influência da frequência cardíaca (FC) sobre o IP, apesar de IA comparáveis. O IP e a FC média diferiram entre os cães com TV e os sem, mas não discriminam adequadamente os grupos como variáveis isoladas. A sobrevida global foi menor nos cães com TV (463 dias vs 1645 dias, HR=4,31, P=0,03). Os parâmetros da VFC, SDNN e SDANN, foram associados ao prognóstico. O IA e o IP não possuem valor prognóstico em Boxers com arritmias ventriculares. A FC média 112bpm é 100% sensível, mas apenas 46% específica para detectar Boxers com TV no Holter de 24 horas. A presença de TV, SDNN245ms, ou SDANN134ms no momento do primeiro Holter de 24 horas estão associados a menor sobrevida global no Boxer.

Valor prognóstico da variabilidade da frequência cardíaca e da eletrocardiografia ambulatorial em cães Boxer com cardiomiopatia arritmogênica do ventrículo direito / Prognostic value of heart rate variability and Holter monitoring in Boxer dogs with arrhythmogenic right ventricular cardiomyopathy

A cardiomiopatia arritmogênica do ventrículo direito (CAVD) é uma importante causa de morte súbita em cães da raça Boxer. A validação de fatores prognósticos para essa doença auxiliaria na detecção de animais mais gravemente afetados e sua exclusão dos programas de reprodução. O objetivo deste estudo foi avaliar o valor prognóstico da presença de manifestações clínicas, dos índices de variabilidade de frequência cardíaca (VFC) e das arritmias supraventriculares ou ventriculares registradas à monitorização eletrocardiográfica com Holter na sobrevida de cães Boxer em diferentes estágios da CAVD. Essas variáveis foram analisadas, de forma prospectiva, em 69 cães Boxer, divididos em cinco grupos: cães Boxer controle (grupo CB, <50 VPC/24 horas, n=28), cães Boxer suspeitos (grupo SB, 50 a 300 VPC/24 horas, n=8), cães Boxer com CAVD (grupo ARVC, >300 VPC/24 horas, n=19), cães Boxer com CAVD e disfunção sistólica sem insuficiência cardíaca congestiva (grupo SDB sem ICC, n=6) e com ICC (grupo SDB com ICC, n=8). A análise estatística compreendeu teste ANOVA, correlação de Pearson e análise de riscos proporcionais de Cox. Comparando-se com o grupo CB, não foi encontrada diminuição nos índices de VFC nos grupos SB, ARVC ou SDB sem ICC; por outro lado, o grupo SDB com ICC apresentou diminuição desses índices. Não houve relação entre os índices de VFC e a morte de origem cardíaca; porém, a presença de síncopes com ou sem sinais clínicos de ICC e o número de episódios de taquicardia ventricular (TV) correlacionaram-se com a sobrevida dos animais. Estes resultados permitem concluir que a presença de sinais clínicos de ICC, a presença de síncopes e o número de TV ao Holter apresentam valor prognóstico de sobrevida em cães Boxer com CAVD.(AU)

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden death in Boxer dogs. Validation of prognostic factors for this disease could help in detecting more severely affected animals and their exclusion from breeding programs. The aims of this study were to evaluate the prognostic significance of presence of symptoms, heart rate variability (HRV) indices and ventricular or supraventricular arrhythmias recorded by Holter monitoring on survival of Boxer dogs with ARVC at different stages. Symptoms, arrhythmias registered on Holter and five HRV indices were prospectively analyzed in 69 client-owned Boxer dogs divided into five groups: control Boxer dogs (CB group, <50 VPC/24 hours, n=28), suspicious Boxers (SB group, 50 to 300 VPC/24 hours, n=8), Boxers with ARVC (ARVC group, >300 VPC/24 hours, n=19), Boxers with ARVC and systolic dysfunction without congestive heart failure (SDB without CHF group, n=6) and with CHF (SDB with CHF group, n=8). Statistical analyses consisted of an ANOVA test, Pearson correlation and Cox's proportional hazards regression. Compared to the CB group, no decrease in HRV indices was found in SB, ARVCB or SDB without CHF groups; otherwise, SDB with CHF group had impaired indices. No relation was found between HRV indices and cardiac-related death, but the presence of syncopes with or without clinical signs of heart failure and number of ventricular tachycardia (VT), were correlated with survival. These results allow us to conclude that the presence of symptoms of heart failure, presence of syncopes and number of VT on Holter examination seem to have prognostic value in Boxer ARVC.(AU)

Valor prognóstico da variabilidade da frequência cardíaca e da eletrocardiografia ambulatorial em cães Boxer com cardiomiopatia arritmogênica do ventrículo direito / Prognostic value of heart rate variability and Holter monitoring in Boxer dogs with arrhythmogenic right ventricular cardiomyopathy

A cardiomiopatia arritmogênica do ventrículo direito (CAVD) é uma importante causa de morte súbita em cães da raça Boxer. A validação de fatores prognósticos para essa doença auxiliaria na detecção de animais mais gravemente afetados e sua exclusão dos programas de reprodução. O objetivo deste estudo foi avaliar o valor prognóstico da presença de manifestações clínicas, dos índices de variabilidade de frequência cardíaca (VFC) e das arritmias supraventriculares ou ventriculares registradas à monitorização eletrocardiográfica com Holter na sobrevida de cães Boxer em diferentes estágios da CAVD. Essas variáveis foram analisadas, de forma prospectiva, em 69 cães Boxer, divididos em cinco grupos: cães Boxer controle (grupo CB, <50 VPC/24 horas, n=28), cães Boxer suspeitos (grupo SB, 50 a 300 VPC/24 horas, n=8), cães Boxer com CAVD (grupo ARVC, >300 VPC/24 horas, n=19), cães Boxer com CAVD e disfunção sistólica sem insuficiência cardíaca congestiva (grupo SDB sem ICC, n=6) e com ICC (grupo SDB com ICC, n=8). A análise estatística compreendeu teste ANOVA, correlação de Pearson e análise de riscos proporcionais de Cox. Comparando-se com o grupo CB, não foi encontrada diminuição nos índices de VFC nos grupos SB, ARVC ou SDB sem ICC; por outro lado, o grupo SDB com ICC apresentou diminuição desses índices. Não houve relação entre os índices de VFC e a morte de origem cardíaca; porém, a presença de síncopes com ou sem sinais clínicos de ICC e o número de episódios de taquicardia ventricular (TV) correlacionaram-se com a sobrevida dos animais. Estes resultados permitem concluir que a presença de sinais clínicos de ICC, a presença de síncopes e o número de TV ao Holter apresentam valor prognóstico de sobrevida em cães Boxer com CAVD.(AU)

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden death in Boxer dogs. Validation of prognostic factors for this disease could help in detecting more severely affected animals and their exclusion from breeding programs. The aims of this study were to evaluate the prognostic significance of presence of symptoms, heart rate variability (HRV) indices and ventricular or supraventricular arrhythmias recorded by Holter monitoring on survival of Boxer dogs with ARVC at different stages. Symptoms, arrhythmias registered on Holter and five HRV indices were prospectively analyzed in 69 client-owned Boxer dogs divided into five groups: control Boxer dogs (CB group, <50 VPC/24 hours, n=28), suspicious Boxers (SB group, 50 to 300 VPC/24 hours, n=8), Boxers with ARVC (ARVC group, >300 VPC/24 hours, n=19), Boxers with ARVC and systolic dysfunction without congestive heart failure (SDB without CHF group, n=6) and with CHF (SDB with CHF group, n=8). Statistical analyses consisted of an ANOVA test, Pearson correlation and Cox's proportional hazards regression. Compared to the CB group, no decrease in HRV indices was found in SB, ARVCB or SDB without CHF groups; otherwise, SDB with CHF group had impaired indices. No relation was found between HRV indices and cardiac-related death, but the presence of syncopes with or without clinical signs of heart failure and number of ventricular tachycardia (VT), were correlated with survival. These results allow us to conclude that the presence of symptoms of heart failure, presence of syncopes and number of VT on Holter examination seem to have prognostic value in Boxer ARVC.(AU)

Ki67/KIT double immunohistochemical staining in cutaneous mast cell tumors from Boxer dogs.

Cutaneous mast cell tumors (MCTs) are among the most frequent malignant tumors in dogs and Boxer breed dogs have a higher incidence of this disease. Ki67 staining and KIT staining are widely used to predict natural behavior in canine MCT but no previous study has evaluated double staining of these proteins as a prognostic factor. Based on biological behavior predictors in canine MCT, the purpose of this study was to determine the Ki67 proliferative index in KIT positive cells using double stain immunohistochemistry technique. Sixty-nine MCTs from Boxer dogs were selected and a tissue microarray was constructed for the double stained immunohistochemistry. Double positivity (Ki67(+)/KIT(+)) was observed in 20/69 (29%) MCT, with a mean of 9.06 double positive cells per tissue core (range 0.48%-43.97%) and Ki67(-)/KIT(+) animals had a longer survival time than Ki67(+)/KIT(+) animals (p=0.03).

The Effect of Closed Reduction of Small Finger Metacarpal Neck Fractures on the Ultimate Angular Deformity.

PURPOSE: To assess whether or not attempted closed reduction of fifth metacarpal neck fractures results in decreased fracture angulation at final follow-up. METHODS: Retrospective chart review of all patients aged 18 and older managed for isolated fifth metacarpal neck fractures between 2004 and 2014. RESULTS: Sixty-six patients managed for an isolated boxer fracture met inclusion criteria. Twenty-three patients underwent attempted reduction and 43 patients did not. Patients undergoing attempted reduction had a statistically significant improvement in fracture angulation following reduction compared with patients not undergoing attempted reduction. At final follow-up, there was no difference in fracture angle between the 2 groups. CONCLUSIONS: Closed reduction and splint immobilization of fifth metacarpal neck fractures was not an effective means of maintaining a significant improvement in fracture alignment upon healing. Other means, such as closed reduction with pin fixation or open reduction internal fixation, should be considered when maintenance of reduction is desired. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.

Brainstem auditory-evoked potential in Boxer dogs / Potencial evocado auditivo de tronco encefálico em cães da raça Boxer

Brainstem auditory-evoked potential (BAEP) has been widely used for different purposes in veterinary practice and is commonly used to identify inherited deafness and presbycusis. In this study, 43 Boxer dogs were evaluated using the BAEP. Deafness was diagnosed in 3 dogs (2 bilateral and 1 unilateral) allowing the remaining 40 Boxers to be included for normative data analysis including an evaluation on the influence of age on the BAEP. The animals were divided into 2 groups of 20 Boxers each based on age. The mean age was 4.54 years (range, 1-8) in group I, and 9.83 years (range, 8.5-12) in group II. The mean latency for I, III, and V waves were 1.14 (±0.07), 2.64 (±0.11), and 3.48 (±0.10) ms in group I, and 1.20 (±0.12), 2.73 (±0.15), and 3.58 (±0.22) ms in group II, respectively. The mean inter-peak latencies for the I-III, III-V and I-V intervals were 1.50 (±0.15), 0.84 (±0.15), and 2.34 (±0.11) ms in group I, and 1.53 (±0.16), 0.85 (±0.15), and 2.38 (±0.19) ms in group II, respectively. Latencies of waves I and III were significant different between group I and II. For the I-III, III-V and I-V intervals, no significant differences were observed between the 2 groups. As far as we know, this is the first normative study of BAEP obtained from Boxer dogs.

O potencial evocado auditivo de tronco encefálico (PEATE) tem sido amplamente utilizado com diferentes finalidades na prática veterinária e é comumente usado para identificar a surdez hereditária e a presbiacusia. No presente estudo, 43 cães da raça Boxer foram pelo teste PEATE. Foi diagnosticada surdez em 3 cães (2 bilaterais e 1 unilateral), e 40 Boxers foram usados no estudo normativo incluindo avaliação da influência da idade no PEATE. Os animais foram divididos de acordo com a idade em 2 grupos de 20 Boxers cada. A idade media foi 4,54 anos (variação de 1-8) no grupo I e 9,83 anos (variação de 8,5-12) no grupo II. A latência media das ondas I, III e V foram: 1,14 (±0,07); 2,64 (±0,11) e 3,48 (±0,10) ms no grupo I; e 1,20 (±0,12); 2,73 (±0,15) e 3,58 (±0,22) ms no grupo II, respectivamente. A latência media para os intervalos I-III, III-V e I-V foram 1,50 (±0,15); 0,84 (±0,15) e 2,34 (±0,11) ms no grupo I; e 1,53 (±0,16); 0,85 (±0,15) e 2,38 (±0,19) ms no grupo II, respectivamente. As latências das ondas I e III foram estatisticamente diferentes entre os grupos I e II. Não foram observadas diferenças estatísticas entre os dois grupos para os intervalos I-III, III-V e I-V. De acordo com a revisão realizada, este é o primeiro estudo normativo de BAEP realizado em cães da raça Boxer.

Brainstem auditory-evoked potential in Boxer dogs / Potencial evocado auditivo de tronco encefálico em cães da raça Boxer

Brainstem auditory-evoked potential (BAEP) has been widely used for different purposes in veterinary practice and is commonly used to identify inherited deafness and presbycusis. In this study, 43 Boxer dogs were evaluated using the BAEP. Deafness was diagnosed in 3 dogs (2 bilateral and 1 unilateral) allowing the remaining 40 Boxers to be included for normative data analysis including an evaluation on the influence of age on the BAEP. The animals were divided into 2 groups of 20 Boxers each based on age. The mean age was 4.54 years (range, 1-8) in group I, and 9.83 years (range, 8.5-12) in group II. The mean latency for I, III, and V waves were 1.14 (±0.07), 2.64 (±0.11), and 3.48 (±0.10) ms in group I, and 1.20 (±0.12), 2.73 (±0.15), and 3.58 (±0.22) ms in group II, respectively. The mean inter-peak latencies for the I-III, III-V and I-V intervals were 1.50 (±0.15), 0.84 (±0.15), and 2.34 (±0.11) ms in group I, and 1.53 (±0.16), 0.85 (±0.15), and 2.38 (±0.19) ms in group II, respectively. Latencies of waves I and III were significant different between group I and II. For the I-III, III-V and I-V intervals, no significant differences were observed between the 2 groups. As far as we know, this is the first normative study of BAEP obtained from Boxer dogs.(AU)

O potencial evocado auditivo de tronco encefálico (PEATE) tem sido amplamente utilizado com diferentes finalidades na prática veterinária e é comumente usado para identificar a surdez hereditária e a presbiacusia. No presente estudo, 43 cães da raça Boxer foram pelo teste PEATE. Foi diagnosticada surdez em 3 cães (2 bilaterais e 1 unilateral), e 40 Boxers foram usados no estudo normativo incluindo avaliação da influência da idade no PEATE. Os animais foram divididos de acordo com a idade em 2 grupos de 20 Boxers cada. A idade media foi 4,54 anos (variação de 1-8) no grupo I e 9,83 anos (variação de 8,5-12) no grupo II. A latência media das ondas I, III e V foram: 1,14 (±0,07); 2,64 (±0,11) e 3,48 (±0,10) ms no grupo I; e 1,20 (±0,12); 2,73 (±0,15) e 3,58 (±0,22) ms no grupo II, respectivamente. A latência media para os intervalos I-III, III-V e I-V foram 1,50 (±0,15); 0,84 (±0,15) e 2,34 (±0,11) ms no grupo I; e 1,53 (±0,16); 0,85 (±0,15) e 2,38 (±0,19) ms no grupo II, respectivamente. As latências das ondas I e III foram estatisticamente diferentes entre os grupos I e II. Não foram observadas diferenças estatísticas entre os dois grupos para os intervalos I-III, III-V e I-V. De acordo com a revisão realizada, este é o primeiro estudo normativo de BAEP realizado em cães da raça Boxer.(AU)

Cardiomiopatia arritmogênica do ventrículo direito do boxer - revisãode literatura / Boxer arrhythmogenic right ventricular cardiomyopathy –- a review

A Cardiomiopatia Arritmogênica do Ventrículo Direito (CAVD) é uma cardiopatia genética, com proliferação de tecido fibro gorduroso entre os cardiomiócitos, levando a um consequente desarranjo do sistema de condução elétrico cardíaco, motivo pelo qual as arritmias cardíacas representam a principal característica desta cardiopatia. Clinicamente a CAVD varia desde uma forma assintomática a casos sintomáticos envolvendo síncope e insuficiência cardíaca, sendo que esta última síndrome acomete apenas um pequeno percentual dos casos. Seu diagnóstico baseia-se em dados como histórico, sinais clínicos, quando presentes, e exames complementares, como a eletrocardiografia e holter, principalmente. Seu tratamento baseia-se na administração de antiarrítmicos, embora nem sempre a conduta terapêutica mostre-se eficiente, com o animal evoluindo ao óbito súbito. O prognóstico comumente mostra-se de reservado a desfavorável.

Arrhythmogenic right ventricular cardiomyopathy is a genetic disease with proliferation of fibrous and fatty tissue between the cardiomyocytes, leading to a consequent derangement of cardiac electrical conduction system, reason that cardiac arrhythmias are the main feature of this disease. Clinically CAVD ranges from asymptomatic to a symptomatic cases involving syncope and heart failure, and the latter syndrome affects only a small percentage of cases. Its diagnosis is based on data such as historical, clinical signs, when present, and additional tests such as ECG and holter mainly. Histreatment is based on the administration of antiarrhythmic drugs, although not always the therapy proves-efficient, with the animal evolved to sudden death. The prognosis commonly oscillates between reserved and unfavorable.

Cardiomiopatia arritmogênica do ventrículo direito do boxer - revisãode literatura / Boxer arrhythmogenic right ventricular cardiomyopathy –- a review

A Cardiomiopatia Arritmogênica do Ventrículo Direito (CAVD) é uma cardiopatia genética, com proliferação de tecido fibro gorduroso entre os cardiomiócitos, levando a um consequente desarranjo do sistema de condução elétrico cardíaco, motivo pelo qual as arritmias cardíacas representam a principal característica desta cardiopatia. Clinicamente a CAVD varia desde uma forma assintomática a casos sintomáticos envolvendo síncope e insuficiência cardíaca, sendo que esta última síndrome acomete apenas um pequeno percentual dos casos. Seu diagnóstico baseia-se em dados como histórico, sinais clínicos, quando presentes, e exames complementares, como a eletrocardiografia e holter, principalmente. Seu tratamento baseia-se na administração de antiarrítmicos, embora nem sempre a conduta terapêutica mostre-se eficiente, com o animal evoluindo ao óbito súbito. O prognóstico comumente mostra-se de reservado a desfavorável.AU

Arrhythmogenic right ventricular cardiomyopathy is a genetic disease with proliferation of fibrous and fatty tissue between the cardiomyocytes, leading to a consequent derangement of cardiac electrical conduction system, reason that cardiac arrhythmias are the main feature of this disease. Clinically CAVD ranges from asymptomatic to a symptomatic cases involving syncope and heart failure, and the latter syndrome affects only a small percentage of cases. Its diagnosis is based on data such as historical, clinical signs, when present, and additional tests such as ECG and holter mainly. Histreatment is based on the administration of antiarrhythmic drugs, although not always the therapy proves-efficient, with the animal evolved to sudden death. The prognosis commonly oscillates between reserved and unfavorable.AU

Ultrassonografia bidimensional e doppler do trato reprodutor de cães / Ultrasonography two-dimensional doppler and tract breeding dogs

Este trabalho foi dividido em duas partes com o objetivo geral de caracterizar e mensurar a próstata e os testículos da raça Boxer e Buldogue Francês por meio da ultrassonografia bidimensional e Doppler. Na primeira parte foram utilizados 33 cães da raça Buldogue Francês saudáveis, sendo estes divididos em 3 grupos de acordo com a faixa etária: grupo 1 de 8 meses a 19 meses; grupo 2 de 24 a 36 meses e grupo 3 de 48 a 72 meses. Foram avaliados ultrassonograficamente uma única vez para as características ultrassonográficas, mensuração prostática e características Doppler colorido e espectral. Foi observada uma alta correlação positiva entre a idade e o volume prostático. Os parâmetros dopplervelocimétricos diferiram de acordo com a localização avaliada da artéria prostática. E foi encontrada diferença estatística entre os grupos 1 e 3. Na segunda parte, foram avaliados ultrassonograficamente a próstata e os testículos de 5 cães da raça Boxer de 4 a 7 anos saudáveis. Foi empregada a mesma metodologia do trabalho 1, acrescentando a avaliação testicular para os mesmos parâmetros. A próstata e os testículos direito e esquerdo apresentaram um volume médio de 18,20 0,14; 10,89 0,27 e 10,70 0,41, respectivamente. Os parâmetros Doppler colorido e espectral diferiram em todas as localizações de ambos os vasos, exceto quanto aos valores das velocidades de pico sistólico e diastólica final em todas as localizações da artéria prostática e os índices de pulsatilidade e resistência das localizações cranial e caudal da artéria prostática. Não foi encontrado diferença estatística nos dados avaliados entre o testículo direito e esquerdo. Conclui-se que a ultrassonografia bidimensional associada a Doppler pode servir como uma ferramenta a mais na avaliação reprodutiva de cães e que a localização, tanto da artéria prostática, como testicular irão influenciar os resultados encontrados. Além disso, a idade é uma variável importante na avaliação prostática. Desta forma, estudos adicionais devem ser realizados com o intuito de entender o comportamento das efermidades prostáticas e assim poder se utilizar desta técnica.

This study was divided into two parts with the overall objective of characterizing and measuring the prostate and testes Boxer and French Bulldog through two-dimensional and Doppler ultrasound. In the first part we used 33 dogs breed healthy French Bulldog, which are divided into 3 groups according to age: group 1 from 8 months to 19 months, group 2 of 24 to 36 months and group 3 of 48 to 72 months Were evaluated sonographically once for the sonographic features, prostatic measurement, color and spectral Doppler features. We observed a high positive correlation between age and prostate volume. The Doppler parameters differ according to the location evaluated prostatic artery. And statistical difference was found between groups 1 and 3. In the second part, were evaluated sonographically the prostate and testes of 5 Boxer dogs 4-7 healthy years. The same methodology was employed labor 1, adding testicular evaluation for the same parameters. The prostate and testicles right and left had an average volume of 18.20 0.14, 10.89 0.27 and 10.70 0.41, respectively. The color and spectral Doppler parameters differed in all locations from both vessels, except for the values of peak systolic velocity and end diastolic in all locations prostatic artery and the pulsatility and resistance indices of the locations cranial and caudal artery prostatic. No statistical difference was found in the data evaluated between right and left testicle. We conclude that the associated two-dimensional ultrasound Doppler can serve as an additional tool in assessing reproductive dogs and that the location of both the artery prostate, testicular as will influence the results. In addition, age is an important variable in assessing prostate. Thus, further studies should be conducted in order to understand the behavior of prostate efermidades and thus able to use this technique

Estudo retrospectivo do tratamento clínico da úlcera indolente em cães da raça Boxer / Retrospective study on clinical management of indolent ulcers in Boxer dogs

Indolent ulcers are superficial corneal ulcers secondary to several changes on the corneal surface. They are frequently observed in middle-aged Boxer dogs, cause pain of acute onset and requires appropriate treatment. Aiming to evaluate the efficacy of clinical managements on the rate of healing of indolent ulcers, a retrospective study was conducted (1997-2008). Results demonstrated that proteinase inhibitors were the most often prescribed medication, and its administration did not interfere on the healing rate, as well as observed in dogs that received 1 percent atropine, antibiotics and anti-inflammatory drugs. Healing was delayed in dogs administered orally with vitamin C, but the healing process was faster on those dogs that went through corneal debridement/cauterization. In conclusion, to know the various types of treatments seems to be fundamental for the rapid resolution of the disease. It is suggested that debridement/cauterization, administration of proteinase inhibitor eye drops, prophylactic topical antibiotics and oral vitamin C, should be considered as an effective clinical management for indolent ulcers in Boxer dogs.

Úlceras indolentes são úlceras corneais superficiais e espontâneas, que apresentam curso prolongado e que tendem a recidivar. Comumente observadas em cães de meia idade da raça Boxer, provoca dor de início agudo e necessita de tratamento específico, já que este, quando não realizado corretamente, pode prolongar o curso da lesão por semanas a meses. Com o objetivo de avaliar a eficácia dos tratamentos clínicos quanto à rapidez na resolução do quadro, realizou-se estudo retrospectivo (1997 a 2008). Observou-se que os inibidores das proteinases foram as medicações mais frequentemente prescritas e que sua administração não interferiu no tempo de cicatrização corneal, o que também foi observado nos casos em que se administrou antibióticos e antinflamatórios tópicos e sistêmicos e/ou atropina 1 por cento. A administração de vitamina C retardou, de maneira estatisticamente significante, o tempo de cicatrização. Por outro lado, a realização do debridamento/cauterização corneal acelerou, significativamente, o processo. Conhecer os diversos tipos de tratamentos parece ser fundamental no sucesso e rapidez da resolução da doença. Os autores sugerem que a realização do debridamento/cauterização corneal, administração de inibidores das proteinases e antibióticos tópicos, associados à vitamina C por via oral, seja considerado um tratamento clínico efetivo na rápida resolução da doença.

Estudo retrospectivo do tratamento clínico da úlcera indolente em cães da raça Boxer / Retrospective study on clinical management of indolent ulcers in Boxer dogs

Indolent ulcers are superficial corneal ulcers secondary to several changes on the corneal surface. They are frequently observed in middle-aged Boxer dogs, cause pain of acute onset and requires appropriate treatment. Aiming to evaluate the efficacy of clinical managements on the rate of healing of indolent ulcers, a retrospective study was conducted (1997-2008). Results demonstrated that proteinase inhibitors were the most often prescribed medication, and its administration did not interfere on the healing rate, as well as observed in dogs that received 1 percent atropine, antibiotics and anti-inflammatory drugs. Healing was delayed in dogs administered orally with vitamin C, but the healing process was faster on those dogs that went through corneal debridement/cauterization. In conclusion, to know the various types of treatments seems to be fundamental for the rapid resolution of the disease. It is suggested that debridement/cauterization, administration of proteinase inhibitor eye drops, prophylactic topical antibiotics and oral vitamin C, should be considered as an effective clinical management for indolent ulcers in Boxer dogs.(AU)

Úlceras indolentes são úlceras corneais superficiais e espontâneas, que apresentam curso prolongado e que tendem a recidivar. Comumente observadas em cães de meia idade da raça Boxer, provoca dor de início agudo e necessita de tratamento específico, já que este, quando não realizado corretamente, pode prolongar o curso da lesão por semanas a meses. Com o objetivo de avaliar a eficácia dos tratamentos clínicos quanto à rapidez na resolução do quadro, realizou-se estudo retrospectivo (1997 a 2008). Observou-se que os inibidores das proteinases foram as medicações mais frequentemente prescritas e que sua administração não interferiu no tempo de cicatrização corneal, o que também foi observado nos casos em que se administrou antibióticos e antinflamatórios tópicos e sistêmicos e/ou atropina 1 por cento. A administração de vitamina C retardou, de maneira estatisticamente significante, o tempo de cicatrização. Por outro lado, a realização do debridamento/cauterização corneal acelerou, significativamente, o processo. Conhecer os diversos tipos de tratamentos parece ser fundamental no sucesso e rapidez da resolução da doença. Os autores sugerem que a realização do debridamento/cauterização corneal, administração de inibidores das proteinases e antibióticos tópicos, associados à vitamina C por via oral, seja considerado um tratamento clínico efetivo na rápida resolução da doença.(AU)

Colite histiocítica ulcerativa em um cão boxer no Brasil / Histiocytic ulcerative colitis in a Boxer dog in Brazil

Background: Histiocytic ulcerative colitis (HUC), also known as granulomatous Boxer’s colitis or colitis similar to Whipple’s disease is a condition affecting especially Boxer dogs. The disease is characterized by chronic increase in the defecation frequency, tenesmus, fetid dark-brown stools with blood streaks and mucus. Histopathology of a colorectal biopsy confirms the clinical diagnosis, when infiltrates of markedly PAS-positive macrophages are observed in the colonic lamina propria and submucosa. This communication reports a case of histiocytic ulcerative colitis in a Boxer dog in Brazil. Case: A Boxer dog, with one year and three months of age had been presenting, since it was nine months old, increased frequency of defecation, tenesmus, intermittent diarrhea, loose stools with streaks of liquid blood, and coprophagy; however, no weight loss or appetite loss were noticed. After an initial period of three months experiencing the aforementioned signs, the dog started with persistent diarrhea with bright red blood, mild prostration, weight loss, and voracious appetite. Because of continuous deteriorating condition and treatment refractoriness, the dog was euthanized. At necropsy, the colon was decreased in size with thickened mucosa and foci of ulceration, apart of enlarged mesenteric lymph nodes. Tissue fragments were collected and fixed in 10% formalin, processed following standard procedures for histopathology, and stained with Hematoxylin-Eosin (HE). Selected sections from samples of intestines and mesenteric lymph nodes were also stained with Periodic Acid Shiff (PAS) and Brown-Hopps adapted Gram Staining. Microscopic findings in the colon included infiltration with rounded to oval bulky macrophages, with eccentric nuclei and abundant eosinophilic and slightly granular cytoplasm. These macrophages were distributed in the basal lamina propria and submucosa, and there also was diffuse infiltration of lymphocytes and plasma cells. Extensive multifocal mucosal ulcerations with exposure of the submucosa were also observed. The cytoplasm of macrophages was strongly marked when stained by Periodic Acid Schiff. Macrófagos do cólon e do linfonodo mesentérico não coraram pela técnica de Gram. Discussion: This diagnosis of histiocytic ulcerative colitis was based on the clinical and pathological findings, especially the association of the clinical signs with the infiltrates of markedly PAS-positive macrophages within the colonic lamina propria and submucosa, which is considered a typical characteristic of the condition. The disease afflicts mainly young Boxer dogs, as it was recorded here. In most cases, there is neither weight loss, nor appetite loss, and the hair coat maintains a healthy appearance. However, in chronic cases such this described here, the dogs may show wasting. Ultrastructural and immunohistochemical findings in macrophages of HUC have indicated the participation of Escherichia coli in the etiopathogeny of the disease. The Boxer dog’s predisposition to HUC has been attributed to a hereditary abnormality that confers invasion and persistence of an adherent E. coli group. This paper reports the importance of the histiocytic ulcerative colitis as an enteric condition affecting Boxer dogs also in Brazil.