Pesq. Vet. Bras. 33(6) Hospital or nosocomial infections are infections acquired during patient hospitalization, and that can be related to surgical and invasive procedures performed during the hospital admission. The present study aimed to investigate the occurrence of nosocomial infection in animals treated at a Veterinary Surgical Center of Small Animals, submitted to surgical or invasive procedures, to discuss the possible causes of infection, to detect the bacteria present when possible, and to verify the antimicrobial sensitivity of these agents. The study was developed through daily monitoring of 131 animals admitted in this surgical center and doing active surveillance of cases of nosocomial infection. In 104 animals (91 dogs and 13 cats), 113 surgical procedures were performed, and in 27 animals were performed non-surgical procedures such monitoring of delivery and postpartum, urethral catheterization and placement of splints. All animals were submitted to catheter placement for fluid therapy and application of medications and/or anesthetic at some point during hospitalization. The rate of surgical site infection was 7.96%, and by categories was 4.54% in clean surgeries, 4.25% in clean-contaminated surgeries, 10.53% in contaminated surgeries, and 16% in infected surgeries. The rate of non-surgical nosocomial infection in surgical patients was 2.88% and in the non-surgical patient was 3.7%. Bacteria were cultured as follows: Pseudomonas sp. (3), Streptococcus sp. (2), Acinetobacter sp. (1) and Gram negative bacilli (1), and high bacterial multidrug resistance were observed in all isolates. The duration of surgery and pre and postoperative time of hospitalization did not affect the occurrence of nosocomial infection, but factors that probably contributed to the occurrence of infections in this study were the severity of the condition responsible for the treatment, the kind of procedure performed and the severity of lesions.
Resumo: As neoplasias no sistema nervoso central (SNC) de animais de companhia são frequentemente diagnosticadas, no entanto dados sobre prevalência são escassos. O objetivo deste estudo foi avaliar retrospectivamente a ocorrência de neoplasias primárias de SNC em cães atendidos em um Hospital-Escola Veterinário e descrever aspectos clínicos, histopatológicos e imuno-histoquímicos dos tumores mais frequentes. Quatorze casos (prevalência de 0,27%) de neoplasias primárias de SNC foram identificados no período de 1998 a 2013 e destes, 11 tiveram o diagnóstico de meningiomas. A idade média dos animais com meningioma foi 10 anos, sendo machos (7/11) e a raça Boxer (3/11) os mais afetados. Sete meningiomas eram espinhais e quatro intracranianos, sendo os principais sinais clínicos alteração na locomoção e convulsões, respectivamente. Metástase pulmonar ocorreu em dois casos. Em seis animais com meningioma espinhal foi realizada a mielografia, sendo que em um também foi realizada a tomografia. Em todos os casos os exames foram efetivos na visualização de desvio ou interrupção da coluna de contraste, com alterações sugestivas da presença de massa. Em cinco animais realizou-se cirurgia exploratória visando a confirmação da suspeita clínica ou retirada da massa, sendo que a sobrevida variou de 85 a 960 dias. Na avaliação histopatológica, os meningiomas foram classificados em transicional (4/11), meningotelial (2/11), papilar (2/11), angiomatoso (1/11), microcístico (1/11) e anaplásico (1/11). Destes, oito (8/11) apresentaram marcação positiva para tricrômio de Masson e um para vermelho congo nas técnicas histoquímicas. No painel imuno-histoquímico, todos os casos apresentaram imunomarcação positiva para vimentina, mas imunomarcação negativa para fator VIII e p53. A imunomarcação para S100 (6/11), GFAP (5/11) e pancitoqueratina (3/11) foi de intensidade variável. Na graduação histológica, dez meningiomas eram grau I e um grau III. O índice médio de proliferação celular foi de 3,2 figuras de mitose e 3,4% avaliando a expressão de Ki-67. Os resultados confirmaram que os meningiomas são a neoplasia primária de SNC mais prevalente em cães, com variação nos subtipos histológicos. A caracterização histoquímica e imuno-histoquímica contribuiu com a determinação do diagnóstico, no entanto, estudos envolvendo a expressão de outros genes são necessários para auxiliar no prognóstico dessas neoplasias.
A mielomalácia hemorrágica progressiva (MHP) é uma afecção rara e fatal, em que ocorre necrose aguda isquêmica e progressiva do parênquima da medula espinhal, levando à liquefação da mesma. Pode ocorrer após extrusão do disco intervertebral, trauma medular ou embolismo fibrocartilaginoso. Este estudo teve como objetivo avaliar casos de mielomalácia hemorrágica progressiva em cães atendidos no Hospital Veterinário da Universidade Estadual de Londrina entre os anos 2000 e 2011, realizando-se a análise dos prontuários de atendimento e acompanhamento dos casos. Os animais do presente estudo atendiam a alguns critérios de inclusão, como histórico de paraplegia com sinais de neurônio motor superior, piora dos sinais progredindo para tetraplegia flácida, alterações clínicas progressivas e/ou alterações nos exames complementares. Foram analisados os aspectos epidemiológicos (raça, idade e sexo), clínicos (evolução dos sinais clínicos e neurológicos), laboratoriais (análise do líquido cefalorraquidiano), radiográficos (radiografias simples e contrastadas) e o tempo decorrido desde o início dos sinais clínicos até óbito ou eutanásia. A raça Teckel foi a mais acometida (43%), a média de idade foi de 5,04 anos e no atendimento inicial a síndrome toracolombar grau V foi a alteração mais encontrada, além de hiperpatia e progressão cranial da diminuição do reflexo cutâneo do tronco. Em sete cães a causa da MHP foi a doença do disco intervertebral toracolombar, em um cão a causa foi o trauma medular, em dois cães a MHP foi decorrente de linfoma e em quatro cães a causa provável foi doença de disco intervertebral. Alterações na análise do líquido cerebroespinhal, na mielografia e na evolução dos sinais clínicos e neurológicos foram extremamente importantes para diagnosticar a MHP. Seis animais progrediram para tetraplegia e quatro cães já apresentavam tetraplegia flácida no atendimento inicial. Em outros quatro pacientes, a identificação de sinais sugestivos de MHP antes desta progressão levou à indicação de eutanásia. Como o prognóstico é ruim e ocasiona sofrimento ao animal, o clínico deve estar atento ao histórico de paraplegia com posterior mudança da síndrome de neurônio motor superior para neurônio motor inferior, diminuição do reflexo cutâneo do tronco cranialmente e presença de respiração abdominal, sendo que algumas alterações em exames complementares encontradas neste trabalho também podem auxiliar no diagnóstico precoce da MHP, como o líquido cerebroespinhal xantocrômico com aumento de proteínas, hemácias e pleocitose. Na mielografia o edema medular e a presença de contraste no interior do tecido nervoso, frente às alterações clínicas e liquóricas, são sugestivas de MHP.
Bahr Arias M.V., Padilha F.N. & Perugini M.R.E. 2017. Deep tissue culture and hemoculture in dogs with wounds and sepsis. Pesquisa Veterinária Brasileira 37(12):1483-1490. Contaminated and infected wounds occur very frequently in veterinary medicine and can cause systemic inflammatory response syndrome, sepsis, and death. This study aimed to test the feasibility of collecting wound material by deep-tissue or punch biopsy for microbial culture, determine the frequency of bacteria in the wound(s) and blood cultures and the susceptibility of these microbes to antimicrobials, and evaluate clinical parameters that could be related to prognosis. Thirty dogs with wounds and signs of SIRS/sepsis were included in this study. Bacteria were isolated from all wounds and 41 bacterial isolates could be identified based on culture of the materials collected by punch biopsy; 53.66% of the isolates were gram-negative, mainly involving Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus spp., and 46.34% were gram-positive bacteria such as Streptococcus spp., Enterococcus spp., and Staphylococcus spp. The survival rate was 66.67%. Based on blood culture analysis, we identified bacteremia in seven patients, predominantly of gram-negative bacteria, which negatively affected patient survival, as six dogs died. Hypoglycemia (≤60mg/dL) and severe hyperglycemia (≥180mg/dL) also negatively affected survival as 23.33% of the hypo/hyperglycemic dogs died. Factors such as blood lactate level at admission and hematocrit levels, and mean arterial pressure were not significantly correlated with death or survival of the dogs.
ResumoA protrusão do disco intervertebral pode provocar compressão progressiva crônica da medula espinhal e os sinais neurológicos associados variam de acordo com a localização anatômica, duração e força dinâmica da compressão. A doença do disco tipo II não é totalmente compreendida, havendo muitas controvérsias sobre seu significado clínico e melhor forma de tratamento. O aspecto mais importante do tratamento conservador refere-se ao repouso associado à fisioterapia e exercícios leves, além de uso de corticoesteróides para diminuir o edema vasogênico. A descompressão medular por meio de cirurgia para remoção de material do disco do interior do canal medular é o tratamento cirúrgico de eleição na doença do disco tipo I, mas apresenta limitações quanto à técnica e ao resultado na doença do disco do tipo II. O objetivo deste trabalho é revisar a fisiopatologia e o tratamento da doença do disco intervertebral crônica e discutir as controvérsias existentes no tratamento médico bem como o uso de técnicas cirúrgicas tradicionais e novas técnicas. Palavras-chave: Degeneração do disco intervertebral, medula espinhal, descompressão AbstractProtrusion of the intervertebral disc can cause chronic progressive compression of the spinal cord, and the neurological associated signs vary according to anatomical location, duration and dynamic force of compression. The type II disc disease is not fully understood, and there are many controversies about is clinical significance and best form of treatment. The most important aspect of conservative treatment is rest and physiotherapy associated with mild exercise, and use of corticosteroids to reduce vasogenic edema. The spinal decompression by surgery for removal of disc material from within the medullary canal is the surgical treatment of choice in type I disc disease, but has technical limitations in the type II disc disease. The purpose of this paper is to review the pathophysiology and treatment of chronic intervertebral disc disease and discuss the controversies in medical treatment and the use of some traditional and new surgical techniques.
Traumatic events such as a motor vehicle accident or falling from heights are very common in veterinary medicine and often lead to vertebral fracture-luxation with concomitant spinal cord injuries, mostly in the thoracolumbar spine. The purpose of this cadaveric biomechanical study was to determine the feasibility of the three-column concept in canine thoracolumbar segments with induced fractures. Eighteen Functional Spinal Units (FSU) of the thoracolumbar segments (T12-L2) were collected from 18 medium-sized adult dog cadavers and were subjected to flexion-extension and lateral bending tests so that range of motion (ROM) was recorded with a goniometer. Fractures were induced by compressive loads applied by a universal testing machine (EMIC®). After this, specimens were screened using computed tomography (CT) and the fractures were graded as affecting one, two or three columns, and divided into groups A, B, and C, respectively. Post-fracture range of motion (ROM) was compared with the previous results. Groups B and C (with fractures in two or three columns) had instability in the two axes evaluated (P<0.05). The outcomes of this study support the applicability of the three-column theory to thoracolumbar spines of dogs, as the FSUs that suffered fractures in two or more columns showed axial instability.
An adult male crossbred dog was referred with a history of a road traffic accident that took place 1 month earlier. Neurological examination revealed paraplegia with absent nociception in the pelvic limbs. On epaxial palpation, significant curvature of the anatomical axis of the spine between the third and fourth lumbar vertebrae was observed, with the presence of a bone end almost piercing the dog's skin. Survey radiographs of the lumbar spine revealed severe dislocation between L3 and L4 vertebrae. During surgery, the spinal cord was not visible between the dislocated segments. Because of difficulties in reducing the lumbar luxation during surgery, vertebrectomy and vertebral shortening were performed. After alignment between vertebrae L3 and L5, eight cortical orthopaedic screws and bone cement were used for fixation. After 30 days, the dog started to use a wheelchair and was considered by its owner to have a good quality of life with no evidence of pain. To the authors' knowledge, this is the first case of severe luxation treated by total vertebrectomy and spine shortening in a dog. This surgery can be considered as an option in the management of severe spine luxation when the spinal cord is physically transected.
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