O hiperinsulinismo é uma patologia associada a presença de neoplasias nas células Beta do pancreas.Sendo essas celulas as reponsaveis pela secreção da insulina, hormônio cujo mecanismo de ação está relacionado com o aumento da atividade da enzima hexoquinase, facilitando a utilização da glicose pelos tecidos.A neoplasia das celulas beta é conhecida por insulinoma,sendo raros tomores secretores de insulina.Existe poucos relatos de caso em gatos,sendo mais prevalente em cães com idade ente 6 e 14 anos.Os pricipais sinais clinicos estão relacionados ao baixo aporte de glicose para o sistema nervoso central.Os perfis bioquímicos, hematológicos e análise de urina não fecham diagnóstico de Insulinoma,sendo a ecografia abdominal o exame confirmatório para diagnostico.O tratamento deve ser efetivo no controle dos sinais clínicos do paciente, estabilizando o cão para se realizar a cirurgia posteriormente.
Background: In recent decades the demand for unconventional pets has been relatively increasing, a situation that increasingly causes veterinarians to encounter these animals in medical and surgical practice. Of these animals, the birds stand out. Animals of the order Psittaciform are known as very curious and active creatures that have the tendency to chew objectsin their environment. Among the several occurrences that lead this animal to attend the veterinary clinic, we highlight the poisoning by heavy metals, especially lead poisoning (Pb) and zinc (Zn). The objective of this work was to report a case of heavy metal intoxication in cockatiel (Nymphicus hollandicus).Case: A cockatiel was taken to the veterinarian with a history of apathy, motor incoordination, exacerbated water consumption and regurgitation. Complete anamnesis was instrumental in directing suspected heavy metal intoxication. Radiopaque particles were visualized through radiographic examination, suggesting heavy metal intoxication. The diagnosis wasconcluded through complementary examinations since the clinical symptoms are nonspecific. The treatment was intended to provide emergency intervention, avoid further absorption, use of antidotes, provide supportive measures and provide guidance to the owner. It can be concluded that the diagnosis and treatment were successful.Discussion: Metal poisoning can kill birds. The veterinarian should always seek the literature in order to perform the best support and treatment. For this, detailed history and detailed medical history must be taken into account, since the time of ingestion and the type of metal interfere with the therapeutic conduct. The use of imaging tests such as x-rays andultrasound are essential to assist the clinician, especially in cases where the tutor does not know whether or not the animal has ingested an object. In the radiographic examination, the heavy metal has the characteristic of having high radiopacity, which was evidenced in the case in question. Radiographic positions should be considered in order to avoid false negatives. In the literature, the treatment of chelation therapy is prioritized to remove the circulating heavy metal and thus act on the cause of the problem. In the case in question calcium EDTA was used intramuscularly, which showed clinical improvement in the animal after the second application. Calcium EDTA binds to metals and facilitates their transport and excretion. The use of fluid therapy is necessary as a supportive treatment to prevent kidney damage, since heavy metals are highlyharmful to nephrons. Especially in cases where the animal stops feeding and ingesting water. The use of antibiotics is essential because in many cases the animal, in addition to not feeding, becomes prone to infections due to metal toxicity, therefore, prophylactic use is essential for a better prognosis. In the case in question, the use of enrofloxacin was effective,as reported in the literature. It is recommended that the diagnosis of serum lead and zinc dosage should be made, however, due to the difficulties of obtaining the samples, and since other metals may also cause intoxication, in the case in question the treatment was started without these results. According to the results obtained in this work, the treatment described in the literature is effective and can be performed immediately to save animal life without subsequent sequelae.Keywords: bird, lead, zinc, calcium EDTA.
Background: Extraluminal surgical procedures for intrathoracic tracheal collapse in dogs are not routinely performed. The patients are normally treated with different drugs or by intraluminal stents. However, in more severe cases, drug treatment does not always have good outcomes, and intraluminal prostheses can be correlated to several postoperative problems. In order to obtain better results, we aimed to develop a surgical technique for implantation of a new extraluminal helical prosthesis in the thoracic segment of the trachea through cervical access, associated with pneumatic mediastinoscopy for certification of the technique and minimization of possible complications.Materials, Methods & Results: Seven canine corpses (CCs) from non-traumatic death, weighing between 2 and 7 kg, were used. A ventral cervical approach to the trachea was associated with blunt mediastinal dissection. Trans cervical pneumatic mediastinoscopy was used for evaluation of the dissection and location of the implant. These were compared with the necropsy findings by the exact Wilcoxon two-sample test, with P < 0.05. The results of necropsy and mediastinoscopy did not present significant differences at P < 0.05. During the examinations, the presence of some mediastinal visceral lesions caused by the prosthesis, the integrity of the mediastinum and possible lesions to RLN and blood vessels (BV) were analyzed. We also investigated the location of the distal part of the prosthesis in the thoracic segment of the trachea and its dissection. To evaluate the technique, statistical comparison was made between mediastinoscopy and necropsy findings. The data were compared by the Wilcoxon test at 5% probability. The tracheas of all CCs were efficiently dissected, but in some cases problems that can happen during the procedure were noticed. This was checked by mediastinoscopy and confirmed by necropsy. The median of the scores was 1 (good dissection and visualization), with variance of zero for mediastinoscopy and 0.14 for necropsy. In the mediastinoscopy of one CC, the prosthesis crossed the tracheal bifurcation, involving the posterior vessels of this region, which was confirmed by necropsy. However, the dissection showed no vascular lesions. The integrity of the mediastinum was assessed only by mediastinoscopy. There was no impairment caused by any of the procedures performed. This resulted in a median score of 1 (integrity) with zero variance. When the positioning of the prosthesis was evaluated in relation to the tracheal bifurcation, identical values were obtained by both methods. The median score was 1, with variance of 0.62. No statistical differences were found between the two evaluation methods for the analyzed variables. This demonstrates the strong potential of the proposed evaluation techniques.Discussion: Our results show that the execution of the technique is possible, but some complications may occur. Mediastinoscopy as an evaluation procedure can pose some complications, these considerations are important, but by using technique proposed in this study, these factors are minimized due to the ease of technical implantation of the extraluminal tracheal stent, without the need for several instruments competing in the inflated mediastinal space. We concluded that the technique is viable and a safe method with minimal invasion for investigation and treatment of mediastinal diseases, presenting low impairment of the paratracheal structures, and that mediastinoscopy can be used as a transoperative evaluation method to minimize complications.
No abstract
O megaesôfago é uma dilatação esofágica, resultante de uma doença primária ou secundária, determinando distúrbio motor da deglutição. Dos vários procedimentos terapêuticos preconizados, o tratamento cirúrgico representa uma opção, por proporcionar alívio dos sinais clínicos e melhorar o estado nutricional. Entretanto, contestações surgem quanto à melhor técnica cirúrgica em animais com megaesôfago após tratamento conservador prévio. O presente trabalho teve como objetivo descrever a técnica cirúrgica denominada cardioplastia esôfago diafragmática em filhote de cão com megaesôfago congênito generalizado. Nesse relato, um filhote canino foi levado ao atendimento médico veterinário devido a regurgitações cada vez mais frequentes. Na radiografia contrastada, foi observado que o esôfago torácico se encontrava acentuadamente dilatado, sendo a imagem sugestiva de megaesôfago generalizado. Devido ao agravo dos episódios de regurgitação e perda de peso progressiva após duas semanas de tratamento dietético conservador, foi decidido à realização da cirurgia pela técnica de cardioplastia esôfago diafragmático. Essa técnica consiste em reduzir artificialmente a paralisia da porção torácica final do esôfago e da cardia, através da atividade contrátil do diafragma durante os ciclos respiratórios. No primeiro retorno, o tutor relatou que a cadela ainda regurgitava esporadicamente, mas com uma diminuição significante da frequência que os mesmos ocorriam.
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