Severe mammary fibroepithelial hyperplasia due to single injection of medroxyprogesterone acetate in two male cats / Hiperplasia fibroadenomatosa mamária felina secundária à aplicação única de acetato de medroxiprogesterona em dois felinos machos

ABSTRACT: Thirty and forty days after a 50 mg medroxyprogesterone acetate injection, respectively, two mixed-breed, 7 and 8-month-old entire male cats presented diffuse enlargement of thoracic and abdominal mammary glands, with ulceration, abscessation and necrosis. One patient was treated with 10 mg/kg aglepristone, antibiotic therapy, analgesic and non-steroidal anti-inflammatory compound; however a worse enlargement of mammary glands, necrosis and clinical condition was noted two days after antiprogestin injection. The second patient was submitted to surgical procedure without previous medical treatment. A partial bilateral mastectomy and conventional orchiectomy were performed, and both patients presented no clinical abnormalities 10 days after surgical treatment. In the male cat, the interruption of progesterone associated mammary fibroepithelial hyperplasia cannot be based in gonadectomy, being antiprogestin treatment the primary approach. Mastectomy can be a treatment option in selected cases, such as the two cases presented here, in case of antiprogestin treatment failure or in case of extensive ulceration, necrosis and risk of sepsis.

RESUMO: Trinta e quarenta dias após aplicação de acetato de medroxiprogesterona, dois gatos SRD machos não castrados, de sete e oito meses respectivamente, apresentaram aumento difuso de volume em glândulas mamárias torácicas e abdominais, com ulceração, abscedação e necrose. Um paciente foi tratado com 10 mg/kg de aglepristone, terapia antimicrobiana, analgésicos e anti-inflamatório não-esteroidal. Entretanto, apresentou piora dos sinais clínicos, da abscedação e necrose dois dias após a aplicação. O outro paciente foi submetido a procedimento cirúrgico sem tratamento clínico prévio. Mastectomia parcial bilateral e orquiectomia convencional foram realizadas e, ambos os pacientes se apresentaram sem alterações clínicas e receberam alta após 10 dias do procedimento cirúrgico. No felino macho, a interrupção da ação da progesterona associada à ocorrência de hiperplasia fibroadenomatosa mamária, não pode ser obtida por meio de gonadectomia, portanto, o tratamento de eleição deve ser realizado com utilização de antiprogestágeno. Em alguns casos, mastectomia parcial ou total é recomendada quando o tratamento clínico com antiprogestágeno falha ou, em casos de sepse, ulceração extensa e necrose, como nos pacientes deste relato.

Ovariohysterectomy requires more post-operative analgesia than orchiectomy in dogs and cats.

The requirement for post-operative analgesia after ovariohysterectomy (OH) versus orchiectomy in dogs and cats was compared. Twelve male and 12 female cats and 12 male and 12 female dogs received meloxicam, 0.1 mg/kg body weight, PO, 2 h before surgery. Eleven female cats and 3 female dogs received rescue analgesia (P = 0.002). No male of either species required rescue analgesia. The number of cats receiving rescue analgesia was greater in females than in males (P < 0.0001). One should not rely solely on preoperative short-acting opioid and preemptive use of NSAIDs to control postoperative pain following OH, in dogs or cats. Postoperative pain after OH should be assessed for at least 2 h for cats and 4 h for dogs, using species-specific validated tools, to ensure proper postoperative pain diagnosis and management. Male dogs and cats subjected to orchiectomy required less postoperative analgesia intervention than female dogs and cats submitted to OH.

L'ovariohystérectomie nécessite d'avantage d'antalgiques post-opératoires que l'orchiectomie chez les chiens et les chats. Dans cette étude, nous avons comparé le besoin en antalgiques post-opératoires après l'OH versus l'orchiectomie chez les chiens et les chats. Douze mâles et 12 femelles, chats et chiens, ont reçu 0,1 mg/kg de Méloxicam par voie orale, 2h avant chirurgie. Onze chattes et trois chiennes ont eu besoin d'antalgiques de secours (P = 0,002). Aucun mâle de l'une ou l'autre espèce n'en a eu besoin. Chez les chats, les besoins en antalgiques de secours étaient plus élevés chez les femelles que les mâles (P < 0,0001). Il est donc primordial de ne pas se fier uniquement aux opioïdes à action courte préopératoire, et à l'utilisation préventive des AINS, pour contrôler la douleur post-opératoire après OH, tant chez le chien que chez le chat. L'évaluation de la douleur post-opératoire après l'OH devrait être suivie pendant au moins 2 heures pour les chats, et 4 heures pour les chiens, en utilisant des outils validés et spécifiques pour chaque espèce, afin d'assurer un diagnostic et une prise en charge post-opératoire appropriés à la douleur. Chez les chiens et les chats, les mâles soumis à l'orchiectomie ont nécessité moins d'intervention d'antalgiques post-opératoires que les femelles soumissent à l'OH.(Traduit par les auteurs).

Effect of deslorelin acetate treatment in oocyte recovery and in vitro embryo production in domestic cats.

Objectives The present study investigated the effect of contraceptive treatment with deslorelin acetate on in vitro embryo production and oocyte recovery in domestic queens. Methods Twenty-one mature domestic cats were used. Eleven queens (treated group) and one tom were kept in an experimental cattery, and 10 queens were privately owned (control group). When in interestrus or diestrus (day 0) a deslorelin acetate implant (Suprelorin, 4.7 mg/animal) was inserted into the subcutaneous tissue of the interscapular region in all queens in the treated group. After 6 months of treatment, all animals were ovariohysterectomized, and the ovaries were used for in vitro embryo production. Percentage of cleavage was determined 18 h after oocyte insemination and blastocyst formation was assessed on the eighth day of culture. The rate of cumulus-oocyte complexes (COCs) recovery was analyzed by an unpaired t-test. The cleavage and blastocyst rates were expressed as percentages and analyzed by Fisher's exact test. All analyses were performed using GraphPad Prism v5.0, with P <0.05 set as the level of significance. Results In the treated group, we recovered 8.3 ± 1.15 grade I COCs per queen; the cleavage rate was 60% and the blastocyst rate was 36%. In the control group, we recovered 18.4 ± 3.21 grade I COCs per queen; the cleavage rate was 55.97% and the blastocyst rate was 34%. Forty percent of treated females did not produce any blastocysts. In the treated group, we observed a significant decrease in COC recovery. Although there was no significant difference in cleavage and blastocyst rates between groups, 40% of treated females did not produce any blastocysts. Conclusions Recovery of grade I COCs is negatively affected by deslorelin treatment in domestic cats. Regarding embryo production, new studies are still necessary to evaluate the success of this technique owing to the individual effect caused by deslorelin acetate.

Mechanical nociceptive thresholds using four probe configurations in horses.

OBJECTIVE: To examine the relationship between probe tip size and force readings of mechanical nociceptive thresholds (MTs) to identify appropriate probes for horses. STUDY DESIGN: Randomized, crossover study. ANIMALS: Eight adult, mixed-breed horses aged 5-10 years, weighing 268-460 kg. METHODS: Four probe configurations (PCs) were used in random sequence: 1.0 mm diameter (SHARP); 3.2 mm (BLUNT); spring-mounted 1.0 mm (SPRING), and 3 × 2.5 mm (3PIN). A remote-controlled unit on the horse increased force (1.2 N second(-1)) in a pneumatic actuator on the metacarpus. Mean MT for each PC was calculated from 10 readings for each horse. Data were log-transformed for analysis using mixed-effects anova/linear regression (p < 0.05). Variability of data for each PC was assessed using the coefficient of variation (CV). RESULTS: Mean ± standard deviation MTs were: SHARP, 5.6 ± 2.3 N; BLUNT, 11.4 ± 3.4 N; 3PIN, 9.6 ± 4.6 N, and SPRING 6.4 ± 1.8 N. Mean MT for SHARP was significantly lower than for BLUNT (p < 0.001) and 3PIN (p < 0.001), but not different from SPRING (p > 0.05). Mean MT was significantly higher for BLUNT than for 3PIN (p < 0.05) and SPRING (p < 0.001). Mean MT for 3PIN was significantly higher than for SPRING (p < 0.001). Larger contact area PCs produced higher MTs than smaller PCs, but the relationship was not linear. BLUNT (area: 10-fold greater) gave a MT two-fold higher than SHARP. 3PIN (area: 20-fold greater) produced more variable MTs, less than two-fold higher than SHARP. SPRING was similar to SHARP. CVs were: SHARP, 22.9%; BLUNT, 72.3%; 3PIN, 44.2%, and SPRING, 28.7%. CONCLUSIONS AND CLINICAL RELEVANCE: The PC has nonlinear effects on MT. Therefore, it is important to define PC when measuring MT. Smaller probe tips may be preferable as MT data are less variable.

Effect of tepoxalin on renal function and hepatic enzymes in dogs exposed to hypotension with isoflurane.

OBJECTIVE: To evaluate the possible renal and hepatic toxicity of tepoxalin in dogs exposed to hypotension during isoflurane anesthesia. STUDY DESIGN: Prospective, randomized experimental study. ANIMALS: Twenty adult mixed-breed dogs, weighing 18.8 ± 2.8 kg. METHODS: The animals received 10 mg kg(-1) tepoxalin orally 2 hours before the anesthetic procedure (PRE; n = 6), or 30 minutes after anesthesia (POST; n = 6), along with a control group (CON; n = 8), which were only anesthetized. The PRE and POST groups also received the same dose of tepoxalin for 5 days post-procedure. All dogs were anesthetized with propofol and maintained with isoflurane and the end-tidal isoflurane (Fe'Iso) was increased until mean arterial pressure decreased to 50-60 mmHg. These pressures were maintained for 60 minutes. Heart rate, arterial pressures and Fe'Iso were recorded at 0, 10 and every 10 minutes up to 60 minutes of hypotension. Blood gases, pH, electrolytes and bleeding time were analyzed before and at 30 and 60 minutes of hypotension. Renal and hepatic changes were quantified by serum and urinary biochemistry and creatinine clearance. RESULTS: Serum concentrations of alanine amino transferase (ALT), alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT), blood urea nitrogen (BUN) and creatinine (Cr), and urinary output, urinary Cr, Cr clearance, and GGT:Cr ratio remained stable throughout the evaluations. During the anesthetic procedure there were no important variations in the physiological parameters. No side effects were observed in any of the groups. CONCLUSIONS AND CLINICAL RELEVANCE: Tepoxalin did not cause significant effects on renal function or cause hepatic injury in healthy dogs exposed to hypotension with isoflurane, when administered pre- or postanesthetic and continued for five consecutive days.

Tepoxalin on renal function and liver enzymes in cats exposed to hypotension with isoflurane / Tepoxalina sobre a função renal e as enzimas hepáticas em gatos submetidos à hipotensão com isofluorano

This study aimed to evaluate the possible renal and hepatic toxicity of tepoxalin administered before or after isoflurane-induced hypotension, as well as for five consecutive days. Twelve healthy mixed-breed cats, adult males, weighing 4.0±0.8kg were allocated into two groups. They received 25mgkg-1 of tepoxalin orally, two hours before the anesthetic procedure (PRE) or after the procedure (POST) and daily for five days. Cats were anesthetized with isoflurane and the concentration was increased until mean arterial pressure reached 40-60mmHg and kept at this level for 60 minutes. During hypotension, the physiological variables were measured at time 0 and every 10 minutes until 60 minutes, and bleeding time was measured at time 0, 30 and 60 minutes. Blood samples were drawn for a hemogram and determination of concentrations of alanine aminotransferase, alkaline phosphatase, urea, creatinine and Na+ at baseline, 24 hours, 48 hours and 7 days post-hypotension. Urine was collected at baseline, 24 hours, 48 hours and 7 days post-hypotension for determination of concentrations of creatinine, gamma-glutamyltransferase, urine specific gravity, protein, albumin and Na+. During the anesthetic procedure there were no important variations in physiological variables and bleeding time. There were differences only in fractional excretion of Na+, which was elevated at 7 days of evaluation in PRE and in the urine protein/creatinine ratio in PRE, which was higher than in POST at 24 and 48 hours post-hypotension. We conclude that tepoxalin does not cause alterations in hepatic enzymes but can cause discrete renal injury, resulting in proteinuria, in cats subjected to 60min of hypotension.

Este estudo teve como objetivo a avaliação da possível toxicidade renal e hepática da tepoxalina administrada antes ou após hipotensão induzida por isofluorano, assim como a sua administração nos cinco dias seguintes à hipotensão. 12 gatos adultos hígidos, machos, sem raça definida e com peso de 4,0±0,8kg foram alocados em dois grupos (n=6). Os animais receberam 25mgkg-1 de tepoxalina pela via oral, duas horas antes do procedimento anestésico (PRE) ou após o procedimento (POST) e diariamente por cinco dias consecutivos. Os gatos foram anestesiados com isofluorano, aumentando-se a sua concentração até que se atingisse uma pressão arterial média entre 40 e 60mmHg, sendo mantida durante 60 minutos. Durante o procedimento de hipotensão, os parâmetros fisiológicos foram mensurados no tempo 0 e a cada dez minutos até o fim do procedimento. O tempo de sangramento da mucosa oral foi avaliado no tempo 0 e aos 30 e 60 minutos de hipotensão. Amostras sanguíneas foram colhidas para a determinação de hemograma, alanina aminotransferase, fosfatase alcalina, ureia, creatinina e sódio no período basal e às 24 horas, 48 horas e sete dias pós-hipotensão. Amostras de urina foram colhidas por meio de cistocentese para a determinação de creatinina, gammaglutamiltransferase, densidade específica, proteínas, albumina e sódio. Durante o período anestésico, não ocorreram alterações referentes aos parâmetros fisiológicos e ao tempo de sangramento. Ocorreram alterações apenas na excreção fracionada de sódio, a qual demonstrou elevação no PRE aos sete dias, e na razão proteína/creatinina na urina, a qual demonstrou elevação do PRE em relação ao POST às 24 e às 48 horas de avaliação. Concluiu-se que a tepoxalina não causou alterações nas enzimas hepáticas, mas pode causar discreta injúria renal, com a presença de proteinúria, em gatos que foram submetidos à hipotensão.

Evaluation of analgesic and physiologic effects of epidural morphine administered at a thoracic or lumbar level in dogs undergoing thoracotomy.

OBJECTIVE: To evaluate the analgesic and physiological effects of epidural morphine administered at the sixth and seventh lumbar or the fifth and sixth thoracic vertebrae in dogs undergoing thoracotomy. STUDY DESIGN: Prospective, randomized, blinded trial. ANIMALS: Fourteen mixed-breed dogs, weighing 8.6 ± 1.4 kg. METHODS: The animals received acepromazine (0.1 mg kg⁻¹) IM and anesthesia was induced with propofol (4 mg kg)⁻¹ IV. The lumbosacral space was punctured and an epidural catheter was inserted up to the region between the sixth and seventh lumbar vertebrae (L, n = 6) or up to the fifth or sixth intercostal space (T, n = 8). The dogs were allowed to recover and after radiographic confirmation of correct catheter position, anesthesia was reinduced with propofol IV and maintained with 1.7% isoflurane. Following stabilization of monitored parameters, animals received morphine (0.1 mg kg⁻¹) diluted in 0.9% NaCl to a final volume of 0.25 mL kg⁻¹ via the epidural catheter, and after 40 minutes, thoracotomy was initiated. Heart rate and rhythm, systolic, mean and diastolic arterial pressures, respiratory rate, arterial hemoglobin oxygen saturation, partial pressure of expired CO2 and body temperature were measured immediately before the epidural administration of morphine (0 minute) and every 10 minutes during the anesthetic period. The Melbourne pain scale and the visual analog scale were used to assess postoperative pain. The evaluation began 3 hours after the epidural administration of morphine and occurred each hour until rescue analgesia. RESULTS: There were no important variations in the physiological parameters during the anesthetic period. The post-operative analgesic period differed between the groups, being longer in T (9.9 01.6 hours) compared with L (5.8 ± 0.8 hours). CONCLUSIONS: The use of morphine, at a volume of 0.25 mL kg 0.1, administered epidurally over the thoracic vertebrae provided longer lasting analgesia than when deposited over the lumbar vertebrae.

Epidural anesthesia and postoperatory analgesia with alpha-2 adrenergic agonists and lidocaine for ovariohysterectomy in bitches.

The aim of this study was to determine the viability and cardiorespiratory effects of the association of epidural alpha-2 adrenergic agonists and lidocaine for ovariohysterectomy (OH) in bitches. Forty-two bitches were spayed under epidural anesthesia with 2.5 mg/kg body weight (BW) of 1% lidocaine with adrenaline (CON) or in association with 0.25 mg/kg BW of xylazine (XYL), 10 µg/kg BW of romifidine (ROM), 30 µg/kg BW of detomidine (DET), 2 µg/kg BW of dexmedetomidine (DEX), or 5 µg/kg BW of clonidine (CLO). Heart rate (HR), respiratory rate (fR) and arterial pressures were monitored immediately before and every 10 min after the epidural procedure. Blood gas and pH analysis were done before, and at 30 and 60 min after the epidural procedure. Animals were submitted to isoflurane anesthesia if they presented a slightest sign of discomfort during the procedure. Time of sensory epidural block and postoperative analgesia were evaluated. All animals in CON and DEX, 5 animals in ROM and CLO, 4 animals in XYL, and 3 in DET required supplementary isoflurane. All groups, except CLO, showed a decrease in HR. There was an increase in arterial pressures in all groups. Postoperative analgesia lasted the longest in XYL. None of the protocols were totally efficient to perform the complete procedure of OH; however, xylazine provided longer postoperative analgesia than the others.

Correlação entre as escalas visual analógica, de Melbourne e filamentos de Von Frey na avaliação da dor pós-operatória em cadelas submetidas à ovariossalpingohisterectomia / Correlation between visual analog scale, Melbourne pain scale and Von Frey filaments in post-operatory pain evaluation in bitches submitted to ovaryhysterectomy

A avaliação da dor em animais necessita da utilização de escalas de avaliação, que dependem da interpretação realizada por observadores. O objetivo do presente estudo foi avaliar a correlação entre a escala visual analógica (EVA), escala de Melbourne e os filamentos de Von Frey, na avaliação da dor pós-operatória em 42 cadelas adultas e saudáveis, submetidas à ovariossalpingohisterectomia (OSH). A dor pós-operatória foi avaliada por dois observadores cegos aos tratamentos analgésicos, em intervalos de uma hora, utilizando a EVA, a escala de Melbourne e os filamentos de Von Frey, aplicados ao redor da incisão cirúrgica. Foram considerados como critérios para realização da analgesia resgate uma pontuação de 50mm na EVA ou de 13 pontos na escala de Melbourne. A EVA revelou-se a escala mais sensível, uma vez que 100 por cento dos animais receberam resgate seguindo esse método. Os valores obtidos na EVA e na escala de Melbourne determinaram boa correlação, com r=0,74, o que não ocorreu com os filamentos de Von Frey (r=-0,18). Já a correlação entre a escala de Melbourne e os filamentos de Von Frey foi de -0.37. Apesar de a EVA e a escala de Melbourne apresentarem boa correlação, sugere-se que se considere uma pontuação menor na escala de Melbourne como critério para administração de analgesia resgate.

Pain evaluation in animals requires the use of evaluation scales, which depend on the interpretation made by observers. The present study aimed to evaluate the correlation between visual analog scale (VAS), Melbourne pain scale and Von Frey filaments in the evaluation of post-operatory pain in fourty two healthy adult bitches submited to ovariohysterectomy. Post-operatory pain was evaluated by two observers unaware of the analgesic protocol used, in one-hour intervals, using VAS, Melbourne pain scale and Von Frey filaments, applied around the surgical wound. A score of 50mm in VAS or 13 points in the Melbourne pain scale were considered as the criterion for analgesic administration. VAS and Melbourne pain scale showed a good correlation, with r=0.74. Correlation between VAS and Von Frey filaments was weak (r=-0.18). Correlation between Melbourne pain scale and Von Frey filaments was -0.37. VAS revealed to be the most sensitive scale. VAS and Melbourne pain scale showed a good correlation degree. It was concluded that a lower score in the Melbourne pain scale can be considered as criterion for analgesic administration.