Ocorrência simultânea de teratoma ovariano e hiperplasia endometrial cística com piometra em cadela Labrador Retriever / Simultaneous occurrence of ovarian teratoma and endometrial cystic hyperplasia with pyometra in a Labrador Retriever bitch

Background: Ovarian teratoma is a rare tumor that occurs in dogs. Its origin comes from embryonic cells of the notochord and it is a unipotent tumor. Pyometra is the accumulation of purulent content in the uterine lumen. Cystic endometrial hyperplasia is one of the factors predisposing a dog to the development of pyometra. The safest and most efficient treatment for pyometra is ovariohysterectomy. The purpose of this report was to describe a case of ovarian teratoma and cystic endometrial hyperplasia with concomitant pyometra in a Labrador Retriever Bitch. Case: A 10-year-old bitch Labrador Retriever, weighing 42 kg, was evaluated at Animal Care Barueri Veterinary Clinic, in Barueri, São Paulo. The patient was referred from another veterinary service to our clinic for an ovariohysterectomy and removal of an intestinal foreign body as previous ultrasonography (US) had indicated the presence of pyometra and a foreign body in the descending colon (she had ingested cloth according to the owner's report). Laboratory tests, complete blood count, alanine aminotransferase, alkaline phosphatase, urea, and creatinine levels did not show any significant changes. Upon examination, the clinical signs were mucopurulent vaginal discharge, 5% dehydration, rectal temperature 39.1°C, mild abdominal pain on palpation, normophagy, normodipsia, and normal defecation and urination. Laboratory tests and a new US were requested on which the uterus was observed with the presence of luminal anechoic content and increased uterine diameter (uterine horns 3.97 cm), an acoustic intestinal shadow supposedly from a foreign body, and on the leukogram, leukocytosis (23,600/mm3) due to neutrophilia with a right shift (20,532/mm3) was observed. Therapeutic ovariohysterectomy and exploratory celiotomy were chosen as therapeutic options. Celiotomy with caudoumbilical mid ventral access was performed. When the left uterine horn was identified, an attempt was made to pull it in order to expose the left ovary, but this maneuver was not successful. For this reason, the abdominal incision was enlarged cranially. At that point, a huge mass was observed in the ovary (which was supposedly the acoustic shadow of the foreign body in the descending colon/left ovary). The intestines appeared normal. Macroscopically, the mass had an irregular surface, round shape, firm consistency, and was 15 cm long x 10 cm wide. Once removed, the mass was incised in the transversal direction, purulent content, hair, and mineralized areas inside it were observed. Histopathological examination showed neoplastic proliferation, consisting of cells with elongated epithelioid shape that were arranged in long irregular bundles among well-differentiated adipose tissue. An exuberant eosinophilic matrix with extensive cystic areas filled with lamellar keratin and hairy stems covered by squamous epithelium was also observed. Extensive areas exhibiting nervous tissue with minimal atypia are shown. The morphological picture was compatible with teratoma. Discussion: The present report describes the concomitant presence of ovarian teratoma and pyometra in a dog. The diagnosis of pyometra requires complementary tests (laboratory and imaging). The intestinal acoustic shadow observed on the two US images obtained by two different professionals was suggestive of intestinal foreign body but was also a wrong diagnosis, which was confirmed after an exploratory celiotomy when the mass in the left ovary was identified. On the histopathological examination of this present case, epithelial, nervous, and cartilaginous tissues were observed. This differentiation of tissues corroborated the teratoma diagnosis. Thus, the importance of an accurate diagnosis contributes to the resolution of a surgical conditions that may have had a poor prognosis when the procedure took a longer time to perform.(AU)

Correção de luxação valga da articulação rádio-cárpica em um cão através da reconstrução ligamentar com fio sintético: uma alternativa à artrodese / Correction of valgus dislocation of the radio-carpal joint in a dog through ligament reconstruction with synthetic wire: an alternative to arthrodesis

Background: Radio-carpal dislocations are normally related to situations of trauma and may be treated with open or closed reduction, reconstruction of injured structures or arthrodesis. The treatment aims to eliminate pain, abnormal joint movement and restore member functions, avoiding or minimizing the development of arthrosis. Notwithstanding the literature on the treatment options, few of them explain the restorative technical applications and their evolution in a later postoperative period. The aim of the present report is to discuss extra-articular joint reconstruction with nylon wire in a canine patient with radio-carpal joint dislocation and ligament rupture. Case: A 10-year-old mixed-breed bitch, weighing 10 kg, after an 8-meter fall, received care at Animal Care Barueri Clínica Veterinária. The animal presented left thoracic member functional impotence and radio-carpal joint valgus dislocation, pain and joint swelling. The patient was sedated and medium-lateral and dorso-palmar X-rays of the distal area of the thoracic member were performed, showing radio-carpal dislocation and a slight radiotransparent line in caudal cortical of the middle third of the left radium, possibly related to an incomplete fracture due to compaction. At this point, the choice was for a closed reduction performed by means of traction followed by internal rotation of the distal extremity of the member. An immobilization device was placed using a vinyl splint for 4 days, until the date of the surgery. For the surgical procedure, a dorso-medial access was opened in the left radio-carpal joint, restoring the short radium collateral joint with nylon 0 suture, anchored on 3 pathways opened in the bones (2 pathways in the radium and 1 in the carpo-radial bone), forming one knot. The subcutaneous tissue was closed and sutured using absorbable wire of 2-0 polyglycolic acid. The skin was sutured using nonabsorbable wire of 3-0 nylon. The immediate postoperative X-rays showed the pathways created, conservation of the bone structures and restoration of the anatomic axis of the radio-carpal joint. The member was again immobilized for 70 days and, 30 days after removal of the splint, the animal could already bear load over the member, without lameness. At 10 months after the surgery, the patient performed X-rays of the medium-lateral and dorso-palmar projections, showing absence of the signs of arthrosis or any joint impairment. There was also absence of lameness and pain, however with reduction in joint movement amplitude, with total extension but more limited flexion. Discussion: Through comparison with the literature it was possible to find similarities with the joint injury approach reported, mainly regarding the form of the suture and the clinical alterations observed, such as short radium collateral ligament rupture related to joint valgus deviation. The treatment strategy in the case combined temporary closed reduction of the joint, immobilization, later joint access and restoration with synthetic wire and long-term immobilization. The postoperative results obtained showed favorable evolution, without signs of joint degeneration, pain or lameness. Possible unwanted consequences related to arthrodesis make the options for reconstruction techniques seem more interesting; however, further information of their application and the combination of its variations in a more directed fashion are still required. Understanding the types of injuries, together with the development of research that assess their diagnosis and evolution, may help treatments to show even better perspectives.