Tranexamic Acid in Reducing Intraoperative Bleeding in Dogs Undergoing Thoracolumbar and Lumbar Hemilaminectomy and Intervertebral Disc Fenestration.

Hemilaminectomy associated with intervertebral disc fenestration (HF) is the most used spinal decompression surgical technique for the treatment of intervertebral disc extrusion (IVDE). The surgical procedure can be hampered by excessive bleeding from the venous sinuses; however, tranexamic acid intravenously (IV) is a possible adjunct to hemostasis in these patients. This study aimed to verify the effectiveness of tranexamic acid in reducing intraoperative bleeding in dogs with thoracolumbar and lumbar IVDE submitted to HF. Sixteen dogs with IVDE undergoing HF were included. These were distributed into a TXA group (tranexamic acid 20 mg/kg IV bolus, followed by 2 mg/kg/h IV continuous infusion) (n = 8) and a control group, with saline solution (n = 8). Blood loss was measured using the gravimetric method. The difficulty of operative visualization due to bleeding was classified by the surgeon. Median blood loss (%) in patients in the TXA group was lower than those in the control group (2.75 ± 1.23 and 4.99 ± 4.44, respectively) (P = .028). Intraoperative visualization difficulty due to bleeding occurred in 10 patients in the control group, and in no patients in the TXA group. A severe arterial thromboembolic complication was recorded, potentially due to tranexamic acid. The use of intraoperative tranexamic acid was effective in reducing bleeding and facilitating operative visualization in dogs with IVDE undergoing hemilaminectomy and intervertebral disc fenestration.

Clinical and Histopathological Findings of Hemorrhagic Progressive Myelomalacia after Lumbar Tap in 2 Dogs: Case Report.

Bichon frise (1) and Boxer (2), both with epileptic seizures, underwent lumbar taps for cerebrospinal fluid collection. After the procedure, the first dog became paraplegic, and the second dog did not recover from anesthesia and remained in a coma. Both dogs were euthanatized 12 h after the examination. The dogs were diagnosed with idiopathic epilepsy and fibrillar astrocytoma, respectively, after postmortem examination. They were also diagnosed with progressive myelomalacia, involving C1-C5 until the L4-S3 spinal segments. Since it was not possible to attribute the development of myelomalacia to the primary diseases observed, the lumbar tap likely caused this severe spinal cord injury. These reports highlight myelomalacia as a possible complication of lumbar taps.

Muscular and collagenous cerebellar choristoma in a dog.

This report aims to describe the first case of muscular and collagenous choristoma in a dog. A 10-yr-old female mixed-breed dog presented with lateral recumbence, vocalization, positional vertical nystagmus, divergent strabismus, anisocoria, and status epilepticus. The clinical condition evolved to stupor and ultimately, death. Necropsy revealed a white mass causing an irregular increase in the volume of the cerebellar vermis. In histological analysis, a well circumscribed, unencapsulated mass was observed in the cerebellum, consisting of fibers of striated skeletal muscle and collagen fibers, mostly mineralized. Based on the histopathological and histochemical findings, a diagnosis of muscular and collagenous cerebellar choristoma was made.

Clinical aspects, food management, and clinical evolution of a cat with hypertrophic muscular dystrophy / Aspectos clínicos, manejo alimentar e evolução clínica de um gato com distrofia muscular hipertrófica

Hypertrophic feline muscular dystrophy (HFMD), rarely reported in the literature, is a disease caused by a hereditary recessive dystrophin deficiency linked to the X chromosome, mainly affecting young male cats. Here, we presented the clinical aspects, food management, and clinical evolution of a seven-year-old mixed-breed cat diagnosed with HFMD, having a primary history of progressive tongue protrusion.

A distrofia muscular hipertrófica felina é uma doença causada por uma deficiência da distrofina com caráter hereditário recessivo ligado ao cromossomo X, com poucos registros de ocorrência na literatura, que acomete principalmente gatos machos jovens. Neste trabalho, são relatados os aspectos clínicos, manejo alimentar e evolução clínica de um gato, sem raça definida, de sete anos com histórico principal de protrusão progressiva da língua e diagnosticado com distrofia muscular hipertrófica felina.

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion / A necessidade de opioide na analgesia pós-operatória de cães submetidos à hemilaminectomia devido à extrusão do disco intervertebral

The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.(AU)

O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.(AU)

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion

ABSTRACT: The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.

RESUMO: O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.

Clinical management of dogs with presumptive diagnosis of thoracolumbar intervertebral disc disease: 164 cases (2006-2017) / Tratamento clínico de cães com diagnóstico presuntivo de doença do disco intervertebral toracolombar: 164 casos (2006-2017)

This study aimed to identify dogs with presumptive diagnosis of cervical intervertebral disc disease (IVDD) submitted to clinical management and to evaluate the outcomes. Data were obtained from the medical records of patients with neurological dysfunction assisted at a University Veterinary Hospital from 2006 to 2017. In addition to the patients' records, dog owners responded to a questionnaire on the success of therapy. Four hundred and thirteen neurological records were evaluated, and 164 met the inclusion criteria of the study. The most common breed was Dachshund, followed by mongrels. Classification of neurological dysfunction in the study sample was as follows: 15.9% with grade I, 25.6% with grade II, 26.8% with grade III, 8.5% with grade IV, and 23.2% with grade V. Outcome was satisfactory in 71.6% of the dogs and unsatisfactory in 28.4% of them. Recurrence was observed in 27.7% of those with satisfactory outcomes. The clinical treatment of dogs with thoracolumbar IVDD is satisfactory, particularly for animals with milder disease grades (I, II, and III). There is possibility of recurrence with conservative therapy and clinical signs may be more severe.(AU)

O objetivo desse estudo foi identificar cães com diagnóstico presuntivo de DDIV toracolombar submetidos ao tratamento clínico, a fim de avaliar a resposta à terapia instituída. Foram revisados os registros neurológicos de cães atendidos pelo Serviço de Neurologia e Neurocirurgia Veterinária no período de 2006 a 2017 de um Hospital Veterinário Universitário. Foi realizada coleta de dados a partir dos registros e por meio de um questionário respondido pelos tutores. Foram avaliadas 413 fichas neurológicas de cães e obtidas informações para inclusão no estudo em 164 delas. As raças mais frequentes foram dachshunds, seguido de cães sem raça definida. Quanto ao grau de disfunção neurológica foi definido como grau I para 15,9% dos cães, grau II para 25,6%, grau III para 26,8%, grau IV para 8,5% e grau V para 23,2%. A recuperação foi satisfatória em 71,6% dos cães e insatisfatória em 28,4%. Dos que se recuperaram satisfatoriamente, 27,7% tiveram recidivas. Com base nos resultados obtidos pode-se concluir que o tratamento clínico em repouso absoluto e administração de anti-inflamatórios e analgésicos opióides para cães com DDIV toracolombar é efetivo, principalmente para cães em graus mais leves da doença (grau I, II e III). Há possibilidade de recidiva com esse tipo de terapia cujos sinais clínicos poderão ser mais graves.(AU)

Physical therapy treatment in the functional recovery of dogs submitted to head and femoral neck ostectomy: 20 cases / Tratamento fisioterapêutico na recuperação funcional de cães submetidos à ostectomia da cabeça e colo femoral: 20 casos

ABSTRACT: Patients who undergo excisional surgical procedures such as femoral head and neck ostectomy (FHO) require a postoperative rehabilitation plan which includes different physical therapy modalities. Therefore, this retrospective study was done to demonstrate the different physical therapy modalities utilized in 20 dogs who were subjected to FHO, and to provide data on the frequency of physical therapy modalities, the protocol duration and time interval from the commencement of physiotherapy and surgery and the patient's functional recovery. All the protocols included the modalities of thermotherapy (heat), massage, passive stretching and passive joint movement. In the initial phase, electrotherapy and therapeutic ultrasound were most often used, while the water treadmill was continued until the treatment was completed. Physiotherapy sessions varied from 3 to 50 in number, and physiotherapy was commenced from day 5 until day 214 post the surgical procedure. The functional recovery of the limb was in the following range: 65% (13/20) satisfactory, 25% (5/20) partially satisfactory and 10% (2/20) unsatisfactory. Physical therapy treatment was thus concluded to be most influential in the functional recovery of the limb, even if was started late.

RESUMO: Um plano de reabilitação no pós-operatório incluindo diferentes modalidades fisioterapêuticas é de suma importância em pacientes submetidos à procedimentos cirúrgicos excisionais como a ostectomia da cabeça e colo femoral (OCCF). Sendo assim, o objetivo desse estudo retrospectivo foi demonstrar as diferentes modalidades fisioterapêuticas empregadas nos 20 cães após OCCF e fornecer dados referentes à frequência das modalidades fisioterapêuticas, a duração dos protocolos e o tempo entre o início da fisioterapia e a cirurgia e a recuperação funcional do paciente. A termoterapia (calor), a massagem, o alongamento passivo e a movimentação passiva articular foram as modalidades empregadas em todos os protocolos. A eletroterapia e o ultrassom terapêutico foram as mais utilizadas na fase inicial e, a esteira aquática foi mantida até o final do tratamento. O número de sessões de fisioterapia variou de 3 a 50 e o início da fisioterapia de 5 a 214 dias após o procedimento cirúrgico. Quanto à recuperação funcional do membro, em 65% (13/20) foram satisfatórias, em 25% (5/20) parcialmente satisfatórias e em 10% (2/20) insatisfatórias. Pode-se concluir que o tratamento fisioterapêutico influenciou na recuperação funcional do membro, mesmo que iniciado tardiamente.

Ventral slot in the clinical recovery of dogs with lateralized compression as a result of cervical intervertebral disc disease - 20 cases (2008-2018) / Fenda (slot) ventral na recuperação clínica de cães com compressões lateralizadas em decorrência da doença do disco intervertebral cervical - 20 casos (2008-2018)

ABSTRACT: The objective of this study was to verify the clinical recovery of dogs that underwent ventral slot surgical decompression with lateralized compressions of the cervical spinal cord caused by intervertebral disc disease (IVDD). Twenty patients were selected in different degrees of neurological dysfunction with definitive diagnosis of lateralized compression by cervical IVDD. Postoperative clinical recovery was assessed in patients who had undergone at least two months of the surgical procedure. There was a satisfactory recovery in 19 dogs (95%) and unsatisfactory recovery in another (5%), showing a significant clinical improvement (p<0.05) in the use of this technique in lateralized compression cases. The ventral slot promotes satisfactory clinical recovery of dogs with lateralized compression of the spinal cord caused by cervical IVDD and may be indicated as a surgical alternative.

RESUMO: O objetivo desse estudo foi verificar a recuperação clínica de cães submetidos a descompressão cirúrgica por fenda ventral em compressões lateralizadas da medula espinhal cervical ocasionada pela doença do disco intervertebral (DDIV). Foram selecionados 20 pacientes em diferentes graus de disfunção neurológica com diagnóstico definitivo de compressões lateralizadas por DDIV cervical. A recuperação clínica pós-operatória foi avaliada nos pacientes decorridos, no mínimo, dois meses do procedimento cirúrgico. Houve recuperação satisfatória em 19 cães (95%) e um insatisfatório (5%), demonstrando melhora clínica significativa (p<0,05) no emprego desta técnica em casos de compressões lateralizadas. A fenda ventral promove recuperação clínica satisfatória de cães com compressões lateralizadas da medula espinhal, ocasionadas pela DDIV cervical, e pode ser indicada como alternativa cirúrgica.

A rare retrobulbar and chiasmal meningioma in a dog / Meningioma raro retrobulbar e de quiasma óptico em cão

ABSTRACT: A 14-year-old female Dachshund was referred to a veterinary hospital with a history and signalment of head pressing, compulsive walking, and right circling. At ophthalmologic examination, a mature cataract and absence of photomotor reflex in the right eye were observed. The neurological exam revealed multifocal encephalic signs. At necropsy, a conical solid tan mass was observed involving the right optic nerve throughout its extension to the optic chiasm. Histopathological findings confirmed a retrobulbar papillary meningioma, considered rare and seldom included as differential diagnosis in patients with neurological signs.

RESUMO: Uma fêmea Dachshund de 14 anos de idade foi encaminhada para um hospital veterinário universitário com histórico e manifestação de "head pressing", andar compulsivo e em círculos para o lado direito. No exame oftalmológico foi diagnosticado catarata matura bilateral e ausência de reflexo fotomotor pupilar no olho direito. O exame neurológico revelou sinais encefálicos multifocais. Na necropsia, uma massa sólida cônica, branco-amarelada, foi observada envolvendo o nervo óptico em toda a sua extensão até o quiasma óptico. O exame histopatológico confirmou diagnóstico de meningioma papilar retrobulbar, considerado raro e pouco incluído no diagnóstico diferencial de pacientes com sinais neurológicos.