The therapeutic benefits of combined MCT with cyclophosphamide plus celecoxib on mammary adenocarcinomas together with its very low toxicity profile warrant further study in an attempt to make the translation into the clinic.
Background: Hermaphroditism is a rare congenital disease that causes ambiguous sexual features. True hermaphrodites have testicular and ovarian tissue, whereas pseudohermaphrodites have only one type of gonadal tissue, genitalia, but secondary characteristics of the opposite sex. Pseudohermaphrodites are classified as male or female according to their gonads. Treatment of pseudohermaphroditism consists of surgical removal of the gonads including reconstruction of abnormal genitalia, especially if the urethra is involved. Therefore, the objective of this report is to describe a case of a male pseudohermaphrodite in a dog treated with clitoridectomy with urethrostomy.Case: A 7-month-old, mixed-breed dog was referred due to the presence of a flaccid structure similar to a small penis, containing an os clitoris, bulbourethral glands, and urethra protruding from the vulva. Physical examination, complete blood count and serum biochemistry were within normal ranges. Hormonal levels of estradiol, testosterone, and progesterone were 56.39 pg/mL, 127.9 ng/mL, and 0.892 ng/mL, respectively. The abdominal ultrasound and posteriorly the exploratory celiotomy found a normal size prostate and two round organs resembling testicles connected to a uterus-like tubular structure. The patient underwent surgical abdominal exploration that confirmed the ultrasonographic findings and led to gonadohysterectomy. Also, clitoridectomy and urethrostomy were performed to excise the protruded structure and maintain normal urethral patency. The histopathological examination of the clitoris and penis confirmed it was a male genital organ, however, the abdominal structures were compatible with the testicles, epididymis, uterus, and even a broad ligament. These organs are normally found in cases of male pseudohermaphroditism. The testicles were histologically composed of regular seminiferous tubules, single layer Sertoli cells but there were no spermatogenic cells. After ten months of follow-up, the patient was alive, without urination impairment or any other clinical signs.Discussion: The animal presented the protrusion of the penile structure as the sole clinical sign. The reproductive system had a female origin, been possible its masculinization due to high testosterone concentration that induced the development of Wolff ducts, resulting in the formation of the epididymis, deferent ducts, and seminal vesicles. In these cases, it led to an enlarged clitoris. The patient described had hormonal levels compatible with a neutered male/female or a female in anestrus. The clinical signs become evident as the clitoris gets hypertrophied increasing the sensibility, resulting in constant licking of the mucosa, chronic inflammation, and mucopurulent discharge. This patient was diagnosed with male pseudohermaphroditism as it had cryptorchid male gonads along with the uterus and external genitalia of a female dog but containing traces of male genitals such as the os clitoris. Surgery is indicated when there are clinical signs or when the clitoris had an os clitoris or urethra due to an intersex abnormality. The surgical resection of the external male genitalia associated with the excision of the internal reproductive tract treated while preserving the urethra in this animal. Clitorectomy is a simple technique and creates a normal female anatomy ending the clinical signs of the exposed clitoris and improving the quality of life.Clitoridectomy and Urethrostomy in a Pseudohermaphrodite Dog
Metronomic chemotherapy (MCT) refers to the chronic, equally spaced, delivery of low doses of different chemotherapeutic drugs, without extended interruptions. CY, administered in low dose, is able to modulate the immune response. It can also reduce tumor angiogenesis, like the COX-2 inhibitor CEL does. We have already demonstrated that the administration, as an intervention strategy, of metronomic CY + CEL in M-406 and M-234p mammary adenocarcinomas-bearing mice inhibited tumor growth, increasing the survival rate. Our present aim was to study the mechanism by which that therapeutic effect was achieved. CBi and Balb/c inbred mice were s.c. challenged on day 0 with M-406 or M-234p mammary tumors, respectively, and treated from day 8 (M-406) and 5 (M-234p) on with: I) no further treatment (controls); II) CY in the drinking water (25-30 mg/kg body weight/day); III) CEL (30 mg/kg p.o.), five times/week; IV) Treated as II + III. Blood samples were taken on days 0, 20 (M-406) and 30 (M-324p) to evaluate VEGF serum level determined by ELISA and the % of circulating regulatory T cells (Tregs) by flow cytometry. The same tumor challenges and therapeutic schedules were performed in nude mice. Tumors were excised on days 20 and 30 for M-406 and M-234p, respectively, fixed and paraffin embedded for detection by immunohistochemistry of CD34 and Ki67 molecules. The VEGF serum level of M-406-bearing control animals (group I) was, on day 20, significantly higher than that measured on day 0 (p<0,001), while groups II, III y IV showed, on day 20, lower values than group I (p<0.01) in the same day, and similar than those on day 0. The % of CD4+ CD25+ Foxp3+ Treg cells in serum showed no differences between days 0 and 20 in all the experimental groups. The antitumoral effect of MCT was the same in euthymic and athymic mice. Immunohistochemistry for CD34 showed slight differences between control and treated animals that were not significant. Also, the staining for the proliferation marker Ki67 did not evinced differences among the experimental groups. The results obtained with M-234p tumor model were similar to those of M-406. In conclusion, the antitumor effect of MCT with CY plus CEL in mammary tumor models would be achieved, at least in part, by the inhibition of tumor angiogenesis, without modulation of the antitumor immune response. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3655.
Background: The congenital flexural deformity is common in cattle, often affecting the metacarpophalangeal joint of the thoracic limbs. The deformity may be mild, moderate, or severe, and the therapy depends on the limb's degree of flexion and the affected joint. In severe deformities, tenotomy of the flexor tendons and desmotomy of the suspensor ligament is recommended. However, this surgical technique may not be sufficient to promote limb extension, and other interventions may be necessary. Thus, the purpose of this report is to describe a technique to correct severe flexural deformities of the metacarpophalangeal joint in calves.Case: A three-month-old, female, Dutch-bred calf weighing 46 kg was referred for treatment of congenital flexural deformity. On attendance, the patient presented severe deformity in the right thoracic limb and mild in the left thoracic limb both at the height of the metacarpophalangeal joints. During palpation it was possible to notice that the flexor tendons were contracted in both limbs. Radiographic exams were performed to rule out the presence of other diseases, confirming the diagnosis of flexural deformity. The patient was referred to surgery to correct the anatomical anomaly. The animal was submitted to general anesthesia and placed in right lateral decubitus. In the left thoracic limb, an incision was made in the medial region of the metacarpal bone, the tissues were divulsioned until the superficial digital and deep digital flexor tendons were exposed; these structures were sectioned with a scalpel, and the limb was extended, returning to the standard anatomical position. In the right thoracic limb, the same procedure was performed, but during the limb extension test, we observed that the limb remained flexed, we then followed with a second incision and section of the deep digital flexor tendon in the palmar region at the middle phalanx of the lateral and medial digits, with this procedure, the limb extended further. Nevertheless, the procedure was not enough to solve the problem in the right thoracic limb, and the patient needed a second surgical intervention, in which we performed again tenotomy of the flexor tendons and desmotomy of the digital annular, crossed sesamoid, and interdigital phalangiosamoid ligaments, associated to the capsule opening of the capsule from the affected right metacarpophalangeal joint. After this surgery, the patient recovered to the normal anatomical position of the right thoracic limb. The procedures were efficient in achieving the normality of both affected limbs, and the patient recovered without postoperative complications.Discussion: In severe flexural deformities of the metacarpophalangeal joint in bovines, the fetlock's flexor tendons and suspensory ligament are implicated in the limb contracture. For these cases the chosen treatment is surgery with sequential sectioning of the flexor tendons and the suspensory ligament until the extension of the flexed limb occurs. Although there are reports that confirm the efficacy of this technique, there are cases in which other anatomic structures are involved in the limb contracture. In addition, the desmotomy and tenotomy techniques are not enough to achieve the normality of the affected joint, with the limb remaining flexed, leading to euthanasia of the patient in some cases. In cattle, few reports demonstrate possible techniques for severe contractures of the metacarpophalangeal joint, requiring further studies and new techniques to achieve recovery of these patients. Keywords: bovine, congenital, anatomical anomaly, contracture, tendon, fetlock.Descritores: bovinos, congênita, anomalia anatômica, contratura, tendão, boleto.Título: Correção de deformidade flexural da articulação metacarpofalangeana em uma bezerra
Background: Megaesophagus is a chronic dilation of the esophagus rarely found in horses. It’s a non-specific disease that is associated with several causes, and esophageal hypomotility is the dysfunction that most commonly results in organ dilation. In the literature, there are few reports of megaesophagus in horses and, to date, no cases in mule have been reported. The objective of this work is to describe a case of a donkey with thoracic megaesophagus.Case: A 16 year-old donkey, castrated male, mixed breed weighing 195 kg, was referred for clinical care with a history of 5 days of anorexia. On physical examination, apathy, cachexia, 8% dehydration, moderate enophthalmos, ptialism, bilateral nasal discharge, dry and bristling hair were observed. Due to the poor general condition, a nasogastric tube was chosen to perform enteral nutrition, however, it was not possible to progress the tube to the stomach. In order to confirm the suspicion of a possible esophageal obstruction, gastroscopy was performed, where it was possible to observe an esophageal dilation filled with bulky food located in the thoracic portion of the esophagus. In an attempt to stimulate esophageal motility, in order to promote the progression of the material present in the region of dilation, intramuscular metoclopramide was administered (two applications every 6 h), however the treatment had no effect. Due to the unfavorable prognosis and financial limitations of the owner, euthanasia was performed, which was followed by autopsy and histopathological examination. At necropsy, a marked dilation of the esophagus was observed in the thoracic portion, which was filled with approximately 500 grams of bulky food (grass). In the mucosa of this area, multiple ulcers were observed that occasionally coalesce, covered by a moderate amount of friable and yellowish-white material.Discussion: Megaesophagus is characterized by organ dilatation and enlargement, absence of peristalsis, presence of tertiary contractions and non-total or partial relaxation of the lower sphincter. Its origin can be congenital or secondary (acquired). In the congenital form, which corresponds to the hypomotility and generalized dilation of the esophagus, the main consequence is the underdevelopment of the foal after weaning. The acquired form occurs due to motor changes in the esophagus or gastroesophageal sphincter, causing passive dilation of the organ. Lupus erythematosus, polymyositis, polyneuritis, degenerative neuropathies, hypoadrenocorticism, hypothyroidism, thiamine deficiency, heavy metal poisoning (Lead and Thallium), tumors (mainly thymoma) and cervical injuries are among the main causes of secondary megaesophagus. Animals with esophageal paralysis or some type of esophageal obstruction, usually present nasal and oral reflux of saliva and may develop aspiration pneumonia, accompanied by nutritional deficiencies, weight loss, changes in normal development and the presence of esophageal ulcers. With the exception of pneumonia, the animal in the present report had all these signs. The prognosis of animals affected by megaesophagus is unfavorable. One of the ways to alleviate this disease is surgical treatment, however, complications such as dehiscence are common after esophageal surgery, mainly due to the fact that this organ does not have a serous layer, resulting in delayed healing. For this reason, euthanasia is considered in most cases. Megaesophagus is a non-specific and multifactorial disease that affects horses, and there are no reports in the literature in mules. In this case, endoscopy allowed the diagnosis to be made while still alive, however it was not possible to determine the primary cause of the disease.
Lymphoma is a hematopoietic neoplasia which occurs due to the proliferation of malignant lymphocytes. It can be present in different forms, including alimentary, mediastinal, multicentric and extranodal. In both cases described in this report, signs consistent with chronic kidney disease were present. An ultrasound-guided fine-needle aspiration was performed and suggested a lymphocyte neoplastic process. Both cats received prednisolone and life support treatment, with mild improvement. One cat was euthanatized and the other died spontaneously, five and seven days after onset of treatment, respectively. The kidneys were enlarged, whitish, irregular, with a firm mass in the cortex. Histopathology confirmed that the lymphoma was restricted to the kidneys.
The aim of this paper is to report the Salpingopharyngeus fistula technique by means of videosurgery through a natural orifice (NOTES) in order to treat bilateral empyema. A mare was seen at the Large Animal Sector of UFPR, with a history of bilateral purulent nasal discharge associated with dysphagia lasting for ninety days. The animal was submitted to endoscopy, showing a moderate amount of purulent secretion in both guttural pouches. With no improvement on the clinical treatment, we opted for surgical treatment by endoscopy through Salpingopharyngeus fistula made with the aid of a device containing an electrical scalpel developed to perform this technique. It consisted of making an incision in the pharyngeal recess in order to access the guttural pouches and subsequently drain the purulent content. The patient was discharged at the same day and returned to work 30 days after the procedure. Surgical treatment for cases of guttural pouch empyema is indicated when the clinical resolution has not been effective, and the minimally invasive technique is indicated due to the reduction of risks and the easiness of postoperative management. Until this moment, there are no reports of the salpingopharyngeal fistula technique through video surgery for the treatment of guttural pouch empyema, which has proved to be efficient for the treatment of the disease.
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