Anestesia total intravenosa para tratamento endodôntico em Panthera leo ­ relato de caso / Total intravenous anesthesia for endodontic treatment in Panthera leo ­ case report

Animais presentes em zoológicos frequentemente necessitam de captura e anestesia para a realização de procedimentos clínicos e cirúrgicos. A anestesia total intravenosa apresenta vantagens como redução do estresse cirúrgico e menor depressão cardiovascular e respiratória. Entretanto, ainda são escassas as pesquisas dedicadas dentro deste contexto. Nesse sentido, o objetivo deste relato foi avaliar o protocolo anestésico empregado, visando um procedimento seguro e passível de reversão para a espécie silvestre selecionada. Acompanhou-se a anestesia de um leão (Panthera leo), macho, adulto, proveniente do Zoológico Municipal de Curitiba, submetido a procedimento endodôntico. A medicação pré-anestésica constituiu-se de dexmedetomidina (6 µg/kg), metadona (0,2 mg/kg), midazolam (0,1 mg/kg) e tiletamina-zolazepam (1,2 mg/kg). A indução foi realizada com propofol (1,5 mg/kg) e o animal foi intubado. Visando promover analgesia local, foi realizado bloqueio infraorbitário esquerdo com 5 mL de lidocaína a 2%. A manutenção foi realizada por meio do fornecimento de propofol (0,02-0,1 mg/kg/h), dexmedetomidina (0,5 µg/kg/h) e remifentanil (5 µg/kg/h). O paciente apresentou sedação profunda e foi mantido em plano anestésico cirúrgico; todos os parâmetros fisiológicos monitorados permaneceram estáveis durante todo o procedimento. Após 55 minutos de anestesia o paciente apresentava sustentação espontânea da cabeça, quando foi novamente transportado ao zoológico para soltura no recinto. A ambulação foi considerada normal pelos observadores no zoológico seis horas após a anestesia. Pôde-se concluir que o protocolo realizado se mostrou tanto eficaz quanto seguro para a referida espécie encaminhada ao procedimento em questão.

Zoo animals often require capture and anesthesia in order to undergo clinical and surgical procedures. Total intravenous anesthesia has advantages such as reduced surgical stress and less cardiovascular and respiratory depression. However, specific research on this matter is still scarce. Therefore, the present report aims to evaluate the anesthetic protocol employed, seeking a safe and reversible procedure for the selected wild species. A male adult lion (Panthera leo), from the Zoológico Municipal de Curitiba, was subjected to an endodontic anesthesia, under close monitoring. The pre-anesthetic medication consisted of dexmedetomidine (6 µg/kg), methadone (0.2 mg/kg), midazolam (0.1 mg/kg) and tiletamine-zolazepam (12 mg/kg). Induction was performed with propofol (1 mg/kg) and the animal was intubated. In order to promote local analgesia, a left infraorbital block was implemented with 5 mL of 2% lidocaine. Maintenance was undertaken by supplying propofol (0.02-0.1 mg/kg/min), dexmedetomidine (0.5 µg/kg/h) and remifentanil (5 µg/kg/h). The patient exhibited deep sedation and followed the surgical anesthetic plan; all the monitored physiological parameters remained stable throughout the procedure. After 55 minutes of anesthesia the patient showed spontaneous head support, when it was transported back to the zoo. The ambulation was considered normal by the zoo observers 6 hours after the anesthesia. It was concluded that the protocol was both effective and safe for the referred species undergone the procedure reported.

Use of the angularis oris axial pattern buccal flap for the correction of facial defects in six dogs

Background: Reconstructive surgery is an important area of veterinary surgery because it allows the reconstruction of large cutaneous defects in areas where a primary approach is not possible. Axial patterns flaps are composed by one direct cutaneous artery and vein, leading to a better blood supply with a good survival outcome. The angularis oris axial pattern buccal flap was introduced for correction of facial defects, but its versatility is not really explored in the existing literature. This article reports the use and complications of the angularis oris axial pattern buccal flap in six dogs, to treat defects in mandibular, temporal or labial regions. Cases: Five mixed breed dogs and one Labrador, with age between 4 and 9-year-old were submitted for surgery and the angularis oris axial pattern buccal flap was used to close the different defects. Causes of defect included a lesion caused by myiasis in three of the dogs, and tumoral removal in the other three, where two were mast cell tumors and one a keratinizing basal cell carcinoma. The regions affected included rostral mandible with oral mucosa, intermandibular region, temporal region and upper lip. Before flap confection the tissue was cleaned, resected and prepared properly, according to each cause of lesion. The flap was made with two parallel incisions, which center was usually the labial commissure, with the dorsal limits at the ventral aspect of the zygomatic arch, and the ventral incision on the ventral aspect of the mandibular ramus. Caudal extension was based on the length needed for surgical closure, but stained between the vertical auditory canal or up to atlas wing. Suture size and pattern depend the region and patient size. Patients were observed closely for any complication in the surgical site. From the six dogs presented here, five got some complications in the surgical site, including: lymphedema (2), suture dehiscence (4) and hematoma (1); however...(AU)

Open surgical thrombectomy and coronary stent placement for treatment of aortic thrombotic disease in a bitch

Background: The thrombotic aortic disease in dogs and cats is characterized by the pathological formation of blood clots that can rupture and obstruct the blood flow. Abdominal ultrasonography can identify the location and extension of thrombus in the main vasculature and using the doppler it is possible to observe the blood flow around the thrombus. Stents are expandable tube-shaped endoprosthesis characterized as a metal mesh and used to prevent or repair stenoses, allowing liquid, gas, or solids to flow. This report aims to describe the surgical and medical treatment of aortic thrombotic disease followed by coronary stents placement in a bitch. Case: An 8-year-old Shih Tzu bitch, presented for evaluation of a 1-month progressive hind limbs paresis. Nociception was present in both limbs, but the patient presented discomfort and vocalization when manipulating the pelvic limbs. A complete blood count demonstrated anemia, mild neutrophilia, and lymphopenia. Serum biochemistry found an increase in ALT, ALP, blood urea nitrogen, and CK. Abdominal ultrasonography detected mild bulging of the caudal aorta and trifurcation of the iliac arteries. Increased intraluminal echogenicity and absence of blood flow were also detected using duplex doppler. The initial medical treatment was ineffective in improving clinical signs, therefore surgical repair was performed. The aorta was isolated and clamped with Satinsky forceps and incised. The thrombus fragmented during removal. A non-compliant high-pressure balloon was used to dilated and remove small fragments of blood clots from the right and left external iliac arteries. Coronary stents of 32 mm length by 2.75 mm diameter were placed to keep both iliac arteries free. Immediately after the procedure, there was a detectable distal pulse in both hind limbs...(AU)

Open surgical thrombectomy and coronary stent placement for treatment of aortic thrombotic disease in a bitch

Background: The thrombotic aortic disease in dogs and cats is characterized by the pathological formation of blood clots that can rupture and obstruct the blood flow. Abdominal ultrasonography can identify the location and extension of thrombus in the main vasculature and using the doppler it is possible to observe the blood flow around the thrombus. Stents are expandable tube-shaped endoprosthesis characterized as a metal mesh and used to prevent or repair stenoses, allowing liquid, gas, or solids to flow. This report aims to describe the surgical and medical treatment of aortic thrombotic disease followed by coronary stents placement in a bitch. Case: An 8-year-old Shih Tzu bitch, presented for evaluation of a 1-month progressive hind limbs paresis. Nociception was present in both limbs, but the patient presented discomfort and vocalization when manipulating the pelvic limbs. A complete blood count demonstrated anemia, mild neutrophilia, and lymphopenia. Serum biochemistry found an increase in ALT, ALP, blood urea nitrogen, and CK. Abdominal ultrasonography detected mild bulging of the caudal aorta and trifurcation of the iliac arteries. Increased intraluminal echogenicity and absence of blood flow were also detected using duplex doppler. The initial medical treatment was ineffective in improving clinical signs, therefore surgical repair was performed. The aorta was isolated and clamped with Satinsky forceps and incised. The thrombus fragmented during removal. A non-compliant high-pressure balloon was used to dilated and remove small fragments of blood clots from the right and left external iliac arteries. Coronary stents of 32 mm length by 2.75 mm diameter were placed to keep both iliac arteries free. Immediately after the procedure, there was a detectable distal pulse in both hind limbs...

Use of the angularis oris axial pattern buccal flap for the correction of facial defects in six dogs

Background: Reconstructive surgery is an important area of veterinary surgery because it allows the reconstruction of large cutaneous defects in areas where a primary approach is not possible. Axial patterns flaps are composed by one direct cutaneous artery and vein, leading to a better blood supply with a good survival outcome. The angularis oris axial pattern buccal flap was introduced for correction of facial defects, but its versatility is not really explored in the existing literature. This article reports the use and complications of the angularis oris axial pattern buccal flap in six dogs, to treat defects in mandibular, temporal or labial regions. Cases: Five mixed breed dogs and one Labrador, with age between 4 and 9-year-old were submitted for surgery and the angularis oris axial pattern buccal flap was used to close the different defects. Causes of defect included a lesion caused by myiasis in three of the dogs, and tumoral removal in the other three, where two were mast cell tumors and one a keratinizing basal cell carcinoma. The regions affected included rostral mandible with oral mucosa, intermandibular region, temporal region and upper lip. Before flap confection the tissue was cleaned, resected and prepared properly, according to each cause of lesion. The flap was made with two parallel incisions, which center was usually the labial commissure, with the dorsal limits at the ventral aspect of the zygomatic arch, and the ventral incision on the ventral aspect of the mandibular ramus. Caudal extension was based on the length needed for surgical closure, but stained between the vertical auditory canal or up to atlas wing. Suture size and pattern depend the region and patient size. Patients were observed closely for any complication in the surgical site. From the six dogs presented here, five got some complications in the surgical site, including: lymphedema (2), suture dehiscence (4) and hematoma (1); however...

Phmetria Esofágica Em Cães / Esophageal Ph-Metry In Dogs / Ph-Metría Esofágica En Perros

A avaliação da phmetria esofágica é um método sensível e especifico para detectar a ocorrência de refluxo gastroesofágico, bem como sua frequência, duração e até mesmo determinar a origem. O conteúdo do refluxo gastroesofágico pode ter origem somente gástrica, duodenal ou de ambos, demonstrando características únicas em relação a valores ácido-base e graus de severidade diferentes. O objetivo deste trabalho foi determinar o valor do pH esofágico em cães anestesiados, e avaliar a ocorrência de episódios de refluxo gastroesofágico durante as intervenções cirúrgicas. Foram utilizados nove cães machos e fêmeas adultos saudáveis, com peso corporal médio de 15,0 ± 5,4 kg. A pHmetria esofágica foi realizada pela inserção de um cateter pela nasofaringe em 9 cães anestesiados com cetamina, midazolan e metadona; propofol e isoflurano, submetidos as intervenções de mastectomia, orquiectomia e ovariosalpingohisterectomia eletiva. Em nove cães que foram realizadas a passagem do cateter, apenas um animal submetido a ovariosalpingohisterectomia apresentou episódio de refluxo gastroesofágico; comprovado por esofagoscopia. A phmetria foi realizada até 180 minutos pós-anestesia, sem alterações significativas da mensuração do pH (P<0,05) em todos os tempos. Os animais foram acompanhados até 30 dias de pós-operatório sem sinais clínicos de esofagite. A média de todas as mensurações de pH foi de 6.229 +- 0.5245.(AU)

Esophageal pHmetry evaluation is a sensitive and specific method to detect gastroesophageal reflux, as weel as its frequency, duration, and origin. Gastroesophageal reflux content can be originated from stomach, duodenal or both, showing unique features of acid-base values and different severity degrees. The aim of this study was to stablish esophageal pH values in anesthetized dogs, and to evaluate the occurrence of gastroesophageal reflux episodes during surgical intervention. Were used 9 female and male healthy dogs, with mean body weight of 15.0 ±5.4 kg. Esophageal pHmetry was performed throght the insertion of a catheter on the nasopharinx in 9 dogs anesthetized with ketamine, midazolam, methadone, propofol e isoflurane, subject to mastectomy, orchiectomy and elective ovariosalpingohysterectomy. Of all 9 dogs in which the catheter was applied, only one animal, subject to ovariosalpingohysterectomy, has shown a gastroesophageal reflux episode, proved by esofagoscopy. pHmetry was performed until 180 minutes post-anesthesia, without significative changes on pH mesurement (P<0.05) at all times. The animals had follow ups until 30 days of post-operative with no clinical signs of esophagitis. The mean pH measurement was 6.222 ± 0.5245.(AU)

La evaluación del pHmetría esofágica es un método específico y sensible para detectar la aparición de reflujo gastroesofágico, así como su frecuencia, duración e incluso determinar el origen. El contenido del reflujo gastroesofágico puede tener origen sólo gástrica, duodenal, o ambos, demostrando características únicas con respecto a los valores de acido-base y distintos grados de severidad. El objetivo de este estudio fue determinar el valor del pH del esófago en perros anestesiados y evaluar la ocurrencia de episodios de reflujo gastroesofágico durante las intervenciones quirúrgicas. Fueron utilizados nueve perros adultos saludables, machos y hembras, con medio peso de 15.0 ± 5,4 kg. El monitoreo del pH esofágico fué realizado insertando un catéter a través de la nasofaringe en 9 perros anestesiados con ketamina, midazolam y metadona; propofol y isoflurane, sometidos a intervenciones de mastectomía, orquiectomía y ovariosalpingohisterectomia electiva. En los nueve perros que fueron hechos el paso del catéter, sólo 1 animal sometido a ovariosalpingohisterectomia presentó episodio de reflujo gastroesofágico; probado por esofagoscopia. El monitoreo del pH fue realizado en 180 minutos pós-anestesia, sin cambios significativos en la medición del pH (P < 0.05) en todos los tiempos. Los animales fueron acompañados hasta 30 días después de la quirugía sin signos clínicos de esofagitis. El promedio de todas las mediciones de pH fue de 6229 +- 0.5245.(AU)

Phmetria Esofágica Em Cães / Esophageal Ph-Metry In Dogs / Ph-Metría Esofágica En Perros

A avaliação da phmetria esofágica é um método sensível e especifico para detectar a ocorrência de refluxo gastroesofágico, bem como sua frequência, duração e até mesmo determinar a origem. O conteúdo do refluxo gastroesofágico pode ter origem somente gástrica, duodenal ou de ambos, demonstrando características únicas em relação a valores ácido-base e graus de severidade diferentes. O objetivo deste trabalho foi determinar o valor do pH esofágico em cães anestesiados, e avaliar a ocorrência de episódios de refluxo gastroesofágico durante as intervenções cirúrgicas. Foram utilizados nove cães machos e fêmeas adultos saudáveis, com peso corporal médio de 15,0 ± 5,4 kg. A pHmetria esofágica foi realizada pela inserção de um cateter pela nasofaringe em 9 cães anestesiados com cetamina, midazolan e metadona; propofol e isoflurano, submetidos as intervenções de mastectomia, orquiectomia e ovariosalpingohisterectomia eletiva. Em nove cães que foram realizadas a passagem do cateter, apenas um animal submetido a ovariosalpingohisterectomia apresentou episódio de refluxo gastroesofágico; comprovado por esofagoscopia. A phmetria foi realizada até 180 minutos pós-anestesia, sem alterações significativas da mensuração do pH (P<0,05) em todos os tempos. Os animais foram acompanhados até 30 dias de pós-operatório sem sinais clínicos de esofagite. A média de todas as mensurações de pH foi de 6.229 +- 0.5245.

Esophageal pHmetry evaluation is a sensitive and specific method to detect gastroesophageal reflux, as weel as its frequency, duration, and origin. Gastroesophageal reflux content can be originated from stomach, duodenal or both, showing unique features of acid-base values and different severity degrees. The aim of this study was to stablish esophageal pH values in anesthetized dogs, and to evaluate the occurrence of gastroesophageal reflux episodes during surgical intervention. Were used 9 female and male healthy dogs, with mean body weight of 15.0 ±5.4 kg. Esophageal pHmetry was performed throght the insertion of a catheter on the nasopharinx in 9 dogs anesthetized with ketamine, midazolam, methadone, propofol e isoflurane, subject to mastectomy, orchiectomy and elective ovariosalpingohysterectomy. Of all 9 dogs in which the catheter was applied, only one animal, subject to ovariosalpingohysterectomy, has shown a gastroesophageal reflux episode, proved by esofagoscopy. pHmetry was performed until 180 minutes post-anesthesia, without significative changes on pH mesurement (P<0.05) at all times. The animals had follow ups until 30 days of post-operative with no clinical signs of esophagitis. The mean pH measurement was 6.222 ± 0.5245.

La evaluación del pHmetría esofágica es un método específico y sensible para detectar la aparición de reflujo gastroesofágico, así como su frecuencia, duración e incluso determinar el origen. El contenido del reflujo gastroesofágico puede tener origen sólo gástrica, duodenal, o ambos, demostrando características únicas con respecto a los valores de acido-base y distintos grados de severidad. El objetivo de este estudio fue determinar el valor del pH del esófago en perros anestesiados y evaluar la ocurrencia de episodios de reflujo gastroesofágico durante las intervenciones quirúrgicas. Fueron utilizados nueve perros adultos saludables, machos y hembras, con medio peso de 15.0 ± 5,4 kg. El monitoreo del pH esofágico fué realizado insertando un catéter a través de la nasofaringe en 9 perros anestesiados con ketamina, midazolam y metadona; propofol y isoflurane, sometidos a intervenciones de mastectomía, orquiectomía y ovariosalpingohisterectomia electiva. En los nueve perros que fueron hechos el paso del catéter, sólo 1 animal sometido a ovariosalpingohisterectomia presentó episodio de reflujo gastroesofágico; probado por esofagoscopia. El monitoreo del pH fue realizado en 180 minutos pós-anestesia, sin cambios significativos en la medición del pH (P < 0.05) en todos los tiempos. Los animales fueron acompañados hasta 30 días después de la quirugía sin signos clínicos de esofagitis. El promedio de todas las mediciones de pH fue de 6229 +- 0.5245.

Retalho padrão axial de ilíaca circunflexa profunda para tratamento de hemangiopericitoma em cão / Axial pattern flap of deep iliac circumflex treatment of hemangiopericytoma in dog

Hemangiopericitoma canino é uma neoplasia de origem mesenquimal comum que afeta tecidos moles.Frequentemente atinge tecido subcutâneo e região distal de membros, é localmente infiltrativa e o tumorraramente faz metástase. O hemangiopericitoma, geralmente recidiva após o procedimento cirúrgico,pela dificuldade em identificar as suas margens durante a excisão cirúrgica e pela sua localização,que muitas vezes ocorre em região de membros onde se encontra maior dificuldade em obter amplas margens de segurança. O melhor tratamento consiste na remoção cirúrgica inicial e agressiva, associada à radioterapia, que conseguem controlar a neoplasia e aumentar o tempo de vida do paciente, já a quimioterapia se mostra sem sucesso. Foi atendido na unidade hospitalar para animais de companhia da PUCPR, uma cadela, adulta, sem raça definida, com tumor na região lateral da coxa. Ao exame fisíco este tumor apresentava-se eritematoso, de abrangência epidermodermal, consistência firme, superfície ulcerada e com secreção purulenta. O exame histopatológico foi conclusivo de hemangiopericitoma. O paciente foi encaminhado para exérese tumoral e cirurgia plástico reparadora, que requereu retalho deilíaca circunflexa profunda.AU

Hemangiopericytoma in dogs is a common malignancy that affects soft tissues and has mesenquimal origin. Often affects the subcutaneous tissue of the distal limbs, is a locally infiltrative tumorand rarely metastatic. Hemangiopericytoma usually relapse after surgery, due to the difficulty of identifying tumor margins during surgical excision, and location of these tumors that often occur in the limbs where it is more difficultto obtain wide margins of safety. The best treatment is early and aggressive surgical procedure, associated with radiotherapy, wich can control the tumor growth and increase the lifetime of the patient, chemotherapy has shown without success.Was referred to the veterinary hospital of PUCPR a female canine, adult, mixed breed, with a history of tumor in the lateral aspect of the thigh. Physical examination showed an erythematous tumor, spanning epidermodermal,firm consistency, ulcerated surface and purulent. Histopathological exam was conclusivefor hemangiopericytoma. The patient was referred for tumor resection and reconstructive plastic surgery, which required deep circumflex iliac flap.AU

Retalho padrão axial de ilíaca circunflexa profunda para tratamento de hemangiopericitoma em cão / Axial pattern flap of deep iliac circumflex treatment of hemangiopericytoma in dog

Hemangiopericitoma canino é uma neoplasia de origem mesenquimal comum que afeta tecidos moles.Frequentemente atinge tecido subcutâneo e região distal de membros, é localmente infiltrativa e o tumorraramente faz metástase. O hemangiopericitoma, geralmente recidiva após o procedimento cirúrgico,pela dificuldade em identificar as suas margens durante a excisão cirúrgica e pela sua localização,que muitas vezes ocorre em região de membros onde se encontra maior dificuldade em obter amplas margens de segurança. O melhor tratamento consiste na remoção cirúrgica inicial e agressiva, associada à radioterapia, que conseguem controlar a neoplasia e aumentar o tempo de vida do paciente, já a quimioterapia se mostra sem sucesso. Foi atendido na unidade hospitalar para animais de companhia da PUCPR, uma cadela, adulta, sem raça definida, com tumor na região lateral da coxa. Ao exame fisíco este tumor apresentava-se eritematoso, de abrangência epidermodermal, consistência firme, superfície ulcerada e com secreção purulenta. O exame histopatológico foi conclusivo de hemangiopericitoma. O paciente foi encaminhado para exérese tumoral e cirurgia plástico reparadora, que requereu retalho deilíaca circunflexa profunda.

Hemangiopericytoma in dogs is a common malignancy that affects soft tissues and has mesenquimal origin. Often affects the subcutaneous tissue of the distal limbs, is a locally infiltrative tumorand rarely metastatic. Hemangiopericytoma usually relapse after surgery, due to the difficulty of identifying tumor margins during surgical excision, and location of these tumors that often occur in the limbs where it is more difficultto obtain wide margins of safety. The best treatment is early and aggressive surgical procedure, associated with radiotherapy, wich can control the tumor growth and increase the lifetime of the patient, chemotherapy has shown without success.Was referred to the veterinary hospital of PUCPR a female canine, adult, mixed breed, with a history of tumor in the lateral aspect of the thigh. Physical examination showed an erythematous tumor, spanning epidermodermal,firm consistency, ulcerated surface and purulent. Histopathological exam was conclusivefor hemangiopericytoma. The patient was referred for tumor resection and reconstructive plastic surgery, which required deep circumflex iliac flap.