Background: Platynosomum spp. it is a trematode that has a predilection for the liver and biliary tissues whose infection is acquired through the ingestion of metacercarian gecko viscera. Felines are the definitive hosts and clinical signs are variable. The diagnosis is through history, hematological and biochemical exams, ultrasound, bile cytology or histopathology. The treatment of choice is cholecystoduodenostomy. This paper aims to report the case of a cat who was treated at the Uberaba Veterinary Hospital with chronic cholangitis secondary to platinosomosis, but there was a transfusion reaction and she died.Case: A 4-year-old, uncastrated SRD cat was treated at the Uberaba Veterinary Hospital complaining of severe episodes of vomiting three days ago, hyporexia and darkened urine. The general clinical examination showed moderate dehydration, jaundice and hepatomegaly. The animal was hospitalized for better investigation of its condition. Increased values of ALT, alkaline phosphatase and all bilirubins were observed. Ultrasound showed liver suggestive of liver disease and steatosis, and gallbladder without alteration. During hospitalization, she remained jaundiced and hypoxic, and the esophageal tube was placed. The initial clinical suspicion was cholangiohepatitis. Liver biopsy and cholecystoduodenostomy were then suggested, with refusal by the tutor. The ultrasound was repeated and showed the same alterations described, besides cholangitis. Stool examination was negative for Platynosomum spp. and positive for Isospora spp. The patient was treated with anthelmintic for three days and received supportive treatment for another week until the tutor authorized cholecystoduodenostomy. During surgery, cholecystocentesis was performed and the parasite Platynosomum spp. in adult form. After four days, a new blood count was done and the animal was still anemic and the blood transfusion was chosen. The patient died within moments of the transfusion procedure.Discussion: Platynosomum spp. it is a trematode whose ultimate host is the domestic felines and inhabits liver, gallbladder and bile ducts causing biliary obstruction and even fibrosis. In the present report, the tutor reports that the cat had several episodes of vomiting and reduced appetite. Feline jaundice is normal in cases where cholestasis causes a two to three-fold increase in bilirubinemia from normal values. The increase was verified in the analyzed feline. Physical examination revealed jaundice and abdominal palpation suggestive of hepatomegaly. Ultrasound suggested cholangiohepatitis. Without improvement, liver biopsy and cholecystoduodenostomy were suggested, with tutor refusal. After repeated ultrasound, the images suggested cholangitis and the stool examination was negative for Platynosomum spp. The definitive diagnosis for this disease is through liver biopsy, visualization of the operated eggs or the adult form of the parasite in feces or bile as suggested in this case. However, in cases where there is total obstruction of the bile ducts, the eggs are not eliminated in the digestive system and the examination may be false negative as in this case. After the exams, the cat was submitted to cholecystoduodenostomy surgery where gallbladder puncture was performed for microscopic evaluation, and the parasite Platynosomum spp. in adult form. Most cats have blood type A, but even when the donor has the same blood type, cross-reaction may occur, so compatibility testing should be performed prior to any transfusion, thus reducing the risk of transfusion reactions. The patient died within moments of the transfusion procedure.
The epiplastic foramen is a natural opening in the thoracic cavity that communicates with the abdominal cavity, located dorsally to the cleft of the liver, contacting the caudal vena cava, portal vein, pancreas, hepatoduodenal ligament and with the small intestine loops. Horses diagnosed with intestinal loop incarceration in the epiplastic foramen require surgical treatment, with a prognosis of being reserved to unfavorable, and the ileum is the intestinal segment most affected in this disease. In addition, because of a strangulative process, the animal shows signs of abdominal discomfort called colic and enterogastric reflux, but clinical signs are variable. Some animals in the palpation present palpable small intestine or not and abdominal discomfort varying from mild to severe. The objective of this work is to report a case of a 5-year-old female Quarter Horse, weighing 430 kg, with a history of abdominal discomfort two days ago and with intermittent pains, from the municipality of Batatais, Veterinary Hospital of Batatais, addressing the animal clinic, diagnosis and treatment. In the rectal palpation he identified slightly distended loops and palpable small intestine and puncture of the peritoneal fluid through the abdominocentesis showed a reddish coloration. The animal was under observation, but even with all the clinical interventions, the pain picture increased and with that it was submitted to exploratory laparotomy, where the incarceration was diagnosed in the epiplastic foramen. In view of the clinical case, it was concluded that the incarceration of the epiplastic foramen may lead to significant intestinal loops involvement, progressing to destabilization of the general state of the animal, being aggravating factors for the surgical procedure, becoming a case of risk of the patient. The animal in this report was submitted to euthanasia due to the great compromise of the intestinal loops. It is concluded that the diagnosis should be performed as early as possible, increasing the chance of resolution with favorable prognosis.
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