Edição N. 81
julho/agosto - Ano XIV, 2009
Autor(es): Mônica Vicky Bahr Arias
Dicas essenciais para o controle da epilepsia em cães e gatosA epilepsia é uma das alterações neurológicas mais frequentes na clínica de pequenos animais. As causas de convulsão no cão e no gato são variadas e o êxito do tratamento das desordens convulsivas se baseia no diagnóstico correto da síndrome neurológica quanto à sua origem idiopática, sintomática ou criptogênica. Aproximadamente 80% dos pacientes epilépticos tratados com anticonvulsivantes ficam livres das crises de forma permanente ou apresentam quadros de menor intensidade e frequência. As causas de falha terapêutica incluem doença progressiva, orientação inadequada do proprietário, seleção indevida de um anticonvulsivante, intolerância aos efeitos do medicamento e epilepsia resistente ao tratamento. Este artigo aborda a avaliação correta do paciente e os princípios da terapia farmacológica, com ênfase na monoterapia, para reduzir as interações e os efeitos colaterais.
Unitermos: sistema nervoso, terapêutica, convulsões
Essential tips for epilepsy control in dogs and cats
Epilepsy, one of the most common neurological disorders found in small animal practice, is characterized by the recurrence of seizures. The causes of convulsions in dogs and cats are varied and successful treatment of convulsive disorders depends on correct diagnosis. It is important to determine whether a seizure has occurred and to distinguish it from a syncopal episode, narcolepsy/cataplexy or episodic weakness. Epilepsy classification is based on its underlying etiology, including idiopathic epilepsy, symptomatic epilepsy, and probable symptomatic epilepsy. Seizures may be caused by extracranial and intracranial factors. Reactive epileptic seizures are not true epilepsy and result from an extracranial disease. Intracranial causes include neoplasia, infectious/inflammatory diseases, hydrocephalus, trauma, vascular disease, and primary epilepsy; extracranial causes include metabolic problems and toxicity. Seizure activity in young animals suggests congenital anomalies such as hepatic encephalopathy, infectious diseases, traumatic or metabolic disorders. Animals which are older than five years of age are more likely to have infectious diseases, neoplasia, degenerative diseases, trauma, metabolic disorders and acquired epilepsy. Idiopathic epilepsy may occur at any age, but it occurs most frequently in dogs or cats between six months and five years of age. Although idiopathic epilepsy in cats is an important cause of seizures, brain tumors and inflammatory diseases are more likely to cause seizures. A physical and complete neurological examination is very important in all animals with a seizure disorder. Animals with idiopathic epilepsy are expected to be neurologically normal during the inter-ictal period whereas animals with seizures from toxic, metabolic, congenital, neoplastic, and inflammatorydisorders may have neurological abnormalities between seizures. A description of an animal s seizures, their frequency and duration, and the animal s behavior between seizures may be helpful in determining the cause of a seizure disorder. Data on the environment, the nutritional status, immunizations, previous illnesses or injuries, age at onset of seizures, type and frequency of seizures provide important diagnostic information. A complete blood count, serum chemistry profile, including fasting blood glucose, calcium, BUN, albumin, total protein, cholesterol, triglycerides, urinalysis and radiographs of the thorax or abdomen should all be done for animals that have had one or more seizures. Cerebral spinal fluid analysis, electroencephalography, neuroradiography, and serum titres for infectious diseases may be helpful in determining etiology. The decision to start anti-epileptic drug therapy should be based on each individual case. Use of anti-epileptic drugs is indicated when a diagnosis of primary epilepsy is made, or when treatment of the underlying cause of the seizures in secondary epilepsy does not control seizures. General recommendations for initiating therapy include a single seizure occurring more than once every 4-6 weeks, cluster seizure activity or status epilepticus regardless of frequency. The primary goal of therapy is to balance adequate seizure control with acceptable drug adverse effects. Monotherapy is the initial goal of treating any seizuring dog or cat in order to reduce possible drug interactions and adverse effects. The most common drug used to treat seizures in veterinary medicine is phenobarbital, a relatively inexpensive, well-tolerated drug that can be administered two times per day to prevent seizures in dogs and cats. The appropriate starting dose of phenobarbital for dogs is 2.5 to 5mg/kg orally q12h. It is also the recommended first-line anticonvulsant drug in epileptic cats. Most cats can be treated with 1-2mg/kg/day. Monitoring of serum phenobarbital concentrations is important in the management of epileptic dogs treated with this drug, because seizure control in dogs and cats correlates best with serum phenobarbital concentration, not with the administered dose. The therapeutic range for serum phenobarbital concentration in dogs has been established at 15 to 45µg/mL, although concentrations above 35µg/mL are associated with an increased risk of hepatotoxicity. Dogs treated with phenobarbital should be monitored every 4-12 months with a physical examination, measurement of phenobarbital blood levels and a chemistry panel to check for signs of hepatotoxicity. Potassium bromide is used most commonly as a second anticonvulsant in dogs refractory to phenobarbital alone, or it can be used alone. As it is not metabolized in the liver, it is an ideal anticonvulsant for patients with liver disease. It is not recommended in cats due to the high prevalence of adverse respiratory problems. Diazepam, a very effective anticonvulsant; must be used primarily in emergency situations, due to its short duration of action and the fact that dogs develop tolerance to it. In refractory epileptic canine patients, other new antiepileptic drugs can be added to the standard treatment. However, pharmacokinetics and efficacy of many of these new drugs are not well known. The causes of treatment failure include the presence of progressive disease, inadequate guidance to the owner, inappropriate selection of an anticonvulsant, intolerance to effects of the drug and epilepsy resistant to treatment 4,16. This article discusses the correct assessment of the patient and the principles of pharmacological therapy, with emphasis on monotherapy to reduce interactions and side effects.
Keywords: Keywords: nervous system, therapeutics, seizures
Consejos básicos para el control de la epilepsia en perros y gatos
La epilepsia es uno de los trastornos neurológicos más frecuentes en la clínica de pequeños animales. Las causas de las convulsiones en el perro y el gato son variadas y el éxito o el fracaso del tratamiento de los desórdenes convulsivos se basa en el correcto diagnóstico del síndrome epiléptico, en cuanto a su naturaleza idiopática, sintomática o criptogenética. Aproximadamente 80% de los pacientes epilépticos tratados con anticonvulsivantes quedan libres de crisis en forma permanente o presentan crisis en menor intensidad o frecuencia. Las causas de fallas terapéuticas incluyen la presencia de desórdenes subyacentes, deficiente educación al cliente, inapropiada selección del medicamento, intolerancia a los efectos del medicamento y a ataques que no responden al medicamento. En este artículo se revisan la evaluación adecuada del paciente, los principios de la farmacología antiepiléptica, con énfasis en la monoterapia para reducir las posibles interacciones farmacológicas y los efectos secundarios.
Palavras clave: Palabras clave: sistema nervioso, terapéutica, convulsiones
Autor(es): Marcelo Monte Mór Rangel ; Bruno Cogliati, Rodrigo Ubukata, Thaís Andrade Costa-Casagrande, Andréa Alves, Krishna Duro de Oliveira, Maria Lúcia Zaidan Dagli
Aspectos clínico-patológicos em casos de meningoencefalite necrosante caninaCom o aprimoramento das técnicas de investigação na medicina veterinária, as neoplasias em cães e gatos são cada vez mais diagnosticadas e representam um amplo campo de atuação do médico veterinário como oncologista. Atualmente, os protocolos antineoplásicos adotados são baseados nos conhecimentos sobre a biologia tumoral, aliados às características individuais de cada paciente, além da experiência do oncologista na clínica veterinária e na interpretação dos trabalhos publicados na literatura. Nesse contexto, o conhecimento dos principais aspectos da utilização de antineoplásicos é fundamental tanto para a melhor eficiência terapêutica quanto para um manejo mais seguro. Assim, o presente trabalho se propõe a abordar os mecanismos de ação, metabolismo, excreção, efeitos colaterais, diluição, manipulação e armazenamento dos principais antineoplásicos utilizados na clínica veterinária.
Unitermos: quimioterapia, câncer, oncologia, biossegurança, tratamento.
General aspects of the main chemotherapy agents used for dogs and cats in small animal clinics: review
With the improvement of investigative techniques in veterinary medicine, feline and canine neoplasms have been more frequently diagnosed, widening the field of work for veterinarians as oncologists. Knowledge on the use of antineoplastic drugs is fundamental for therapeutical efficacy and safe management. This paper covers mechanisms of actions, metabolism, excretion and side effects of the main antineoplastic agents, as well as practical issues related to the their manipulation, such as dilution, storage, conservation period and temperature, and handling precautions. Cyclophosphamide is an alkylating agent developed from nitrogen mustards between World War I and II. It is a cycle-dependent agent which requires biotransformation to become active. Its main target within the cell is DNA. Immunosupression and hemorrhagic cystitis are the main toxic effects of this drug. Another important alkylating antineoplastic agent employed in veterinary medicine is lomustine, classified among the nitrosureas group. This drug has the important characteristic of crossing the blood-brain barrier, so it is able to target neoplasms in the central nervous system. It is administered orally, having bone marrow suppression and liver toxicity as its main side effects, although nephrotoxicity, gastrointestinal symptoms, thrombocytopenia, late and cumulative leucopenia can also be related to this drug. Chlorambucil is another alkylating agent. Its mechanism of action is similar to that of other drugs within the same class, and it can be employed in protocols to treat lymphomas, leukemias, myelomas and mast cell tumors. It also substitutes cyclophosphamide after sterile hemorrhagic cystitis. It is considered of intermediary action because its results are inferior to cyclophosphamide. Vincristine and vinblastine belong to the group of vinca alkaloids, which target microtubules. As phase-dependent agents acting on the M phase, its mains adverse reactions are gastrointestinal disturbances, bone marrow suppression, alopecia, peripheral neuropathy and constipation. Because they are considered vesicant drugs, intravenous administration with a catheter is required. Vinblastine is considered to present higher bone marrow suppression than vincristine. Vincristine is employed in lymphoma and TVT protocols, while vinblastine is widely used against mast cell tumors and in substitution to vincristine in lymphoma protocols in cases of peripheral neuropathy. Doxorubicin, which belongs to the antracycline group, is the most employed agent in antineoplastic therapy. Among its mechanisms of action are the generation of free radicals, lipid peroxidation, direct effects on the cell membrane, stabilization of DNA-topoisomerase II complex and DNA intercalations. Canine cardiotoxicity, feline nephrotoxicity and hematologic toxicity for both are the main side effects. Gastrointestinal toxicity and alopecia can also be observed. It is a cycle-dependent agent, but since DNA activity takes place mainly during S phase, this is when this drug has its utmost cytotoxic effect. Doxorubicin is employed in lymphoma, carcinoma, sarcoma and TVT protocols. Metothrexate is an antimetabolite agent used mostly for treating lymphomas in polychemotherapy protocols. It is classified as a specific cell cycle agent. The main toxic effects of methotrexate are diarrhea, nausea, vomiting, anorexia, leukopenia, thrombocytopenia, fever, temporary hair loss, skin rash, lesions of oral mucous membranes, among several other clinical signs. Nephrotoxicity, liver toxicity and nonspecific pneumonia can also be observed. Cisplatin and carboplatin are platin derivates widely employed in veterinary medicine, indicated for the treatment of mesenchymal neoplasms as fibrosarcomas and osteosarcomas. The target of these agents is DNA. Nausea, vomiting, neurotoxicity and nephrotoxicity are less severe with carboplatin when compared to cisplatin. Cisplatin is prohibited for feline use, in which case carboplatin is employed. Cisplatin and carboplatin also suppress the bone marrow. 5-FU is another antimetabolite antineoplastic agent, used mostly for the treatment of malignant neoplasms of the breast, head and neck. It is no longer employed in France due to its neurologic toxicity, which has random presentation in canine and is frequently fatal in feline. Among the associated clinical signs are ataxy, seizures, hyperexcitability, loss of consciousness, nystagmus, sleepiness and visual alterations. L-asparaginase is an enzyme employed as antineoplastic agent in lymphoma protocols. Hypersensitivity reactions to this drug are responsible for most of its toxic effects, which are significantly reduced in subcutaneous administration. Paclitaxel belongs to the taxane group and targets microtubules, although in a different manner when compared to vinca alkaloids. Taxanes cause hypersensitivity reactions and bone marrow suppression as their main side effects. Because of the high incidence of hypersensitivity reactions, its use in veterinary medicine remains under investigation. A specific section is destined to matters regarding storage and manipulation of the studied drugs. This review is not aimed as a chemotherapy manual with doses and protocols, but as an update on general aspects for daily practice of veterinary clinicians.
Keywords: Keywords: chemotherapy, cancer, oncology, biosafety, treatment
Aspectos generales sobre los principales antineoplásicos utilizados en la clínica veterinaria de perros y gatos: revisión de literatura
Con el perfeccionamiento de las técnicas de investigación en medicina veterinaria, las neoplasias en perros y gatos son cada vez más diagnosticadas y representan un amplio campo de actuación del médico veterinario en el manejo de pacientes oncológicos. Hoy en día, los protocolos antineoplásicos adoptados tienen su base en los conocimientos sobre la biología tumoral aliados a las características individuales de cada paciente, además de la experiencia del oncólogo en la clínica veterinaria y en la interpretación de los trabajos publicados en la literatura. En este contexto, el conocimiento sobre los principales aspectos acerca de la utilización de antineoplásicos es fundamental para una mejor eficácia terapéutica y también para una manipulación más segura. Entonces, este trabajo se propone a tratar de los mecanismos de acción, metabolismo, excreción, efectos colaterales, dilución, manipulación y almacenaje de los principales antineoplásicos utilizados en clínica veterinaria.
Palavras clave: Palabras clave: quimioterapia, cáncer, oncología, bioseguridad, tratamiento
Autor(es): Márcia Marques Jericó ; Jane Mary Albinati, Fernanda Bueno Fusco
Estudo sobre os hábitos alimentares e as atividades físicas de cães obesos da cidade de São Paulo e seus reflexos no balanço metabólicoA obesidade, doença metabólica de origem multifatorial, acarreta prejuízos à saúde e à longevidade do indivíduo. Objetivou-se avaliar o comportamento de cães obesos na cidade de São Paulo em relação à ingestão alimentar e à prática de atividades motoras e suas consequências no balanço metabólico desses animais. Foram pesquisados 50 animais obesos de faixas etárias variadas e diferentes raças. Verificou-se que 22% dos animais pesquisados não realizam nenhuma atividade física, 46% deles são considerados moderadamente preguiçosos e 56% têm um comportamento alimentar voraz ou guloso. Também 78% desses cães consomem o mesmo tipo de alimento que seu proprietário e todos apresentam um balanço metabólico positivo. Concluiu-se que os cães obesos estudados apresentam comportamento alimentar e de atividade motora que resultam num balanço metabólico positivo, com consequente perpetuação e progressão da condição de obesidade.
Unitermos: obesidade, atividade motora, comportamento alimentar
Study on the eating habits and level of physical activity of obese dogs in São Paulo and their effect on the metabolic balance
Obesity, a metabolic disease of multifactorial origin resulting in hazards to the individual s health and longevity, is defined as the excessive accumulation of body fat caused by a chronic imbalance between energy intake and energy expenditure. The aim of this study was to assess the behavior of obese dogs in São Paulo city, regarding to their feeding habits and practice of physical activity, and the resulting metabolic balance of these animals. Fifty owners of obese dogs were interviewed by means of a closed questionnaire used to identify and characterize the animal s behavior and to report on their food consumption, performed physical activities and management habits. Obesity was determined through the Body Condition Score (BCS >3), and body fat percentage (BF%) was determined through morphometric measurements. Among the 50 dogs studied, there were 5 mongrel dogs (10%). Breeds observed included labrador (22%), dachshund and beagle (8% each), poodle, cocker, bulldog, golden retriever (6% each), in addition to doberman (4%), basset hound, bernese, bichon frisé, cane corso, kuvasz, lhasa apso, pincher, pit bull, siberian husky, schnauzer and whippet (1%). Age groups ranged from 1 to 3 years of age (36%), 4 to 7 years of age (38%) and > 8 years of age (26%), and 54% of the animals were males. Reproductive condition was reported for 38 animals, 45% of which had been neutered. BF% mean was 35% (SD=±14%), with a weight range of 3.6 to 60kg. Regarding the eating habits of the 50 obese dogs, 56% of them presented a voracious and gluttonous appetite, 18% were selective or fussy eaters and none presented poor appetite. As to the type of food offered by the owner, results showed that 44% of them offered dog food, homemade food as well as treats and snacks, whereas 26% offered dog food, treats and snacks and 16% offered dog food, exclusively. None of the owners offered homemade food, exclusively. It was also observed that 70% of these dogs were fed once to twice a day and 78% of the owners shared the same types of foods with their dogs. Considering a classification scale from 0 to 10 for each animal s behavior while performing its favorite activities, 90% slept a lot or moderately, 65% of them enjoyed eating, 43% were considered moderately active and a minority (26%) was highly active. When evaluating the animals motivation towards physical exercises, it was observed that 46% were moderately lazy, 30% were active and 24% were very active, whereas none was considered apathetic. As to the type of physical activity performed, 68% walked and 22% did not perform any physical activity. Among those practicing physical activities, 32% presented a daily exercise frequency of once a day, 43% of twice a day and 25% of 3 times a day. Analysis of walked distance/minutes showed that of the 39 obese dogs that exercised, 57% walked a total of 20 to 40 minutes and 28% walked for around one hour. When proportions were compared (Fisher s test), there was a significant association (p=0.018) between physical activity and the dog s age, in which the moderately lazy group presented a higher percentage of cases aged older than 4 and the active and very active groups presented a higher percentage of individuals between 1 and 3 years of age. When comparing age groups as to their BF%, the group aged 1 to 3 years of age significantly differed from the group aged > 8 years (Kruskal-Wallis; p< 0.05), presenting significantly lower BF% values. Physical activity levels also differed in relation to BF% (p<0.001), with the very active group presenting significantly lower BF% values in contrast with the moderately lazy group. On the other hand, eating habits did not differ regarding BF% (p=0.7355). Spearman s coefficient showed a negative and significant correlation between playing and BF% - i.e., the higher the BF%, the lower the motivation to play and vice-versa (r =-0.31952; p= 0.0237); between age and playing (r= -0.28606; p=0.0440) and between age and exercising (r= - 0.51474; p = 0.0001). As to food consumption, McNemar s non-parametric test showed no significant correspondence between the owner s and the dog s food, except for the item fruit (p=0.180). Of the assessed animals, the mean daily energy gain through food was 2,921 kcal (SD=±1637kcal); the median caloric expenditure through exercises was 95 kcal (%5 and %95 = 0 to 560 kcal). These values resulted in a mean positive energy balance of 2,709 kcal (SD=±1599kcal), and consequently in a median daily excess caloric intake of 1,631 kcal (%5 and %95 =454 to 4814 kcal), for an ideal estimated weight. It was concluded that among the obese dogs studied, there was a significantly negative correlation between age and BF% and the practice of physical activities. Additionally, the positive metabolic balance related to high energy intake and low intensity of physical activity is considered the main cause of weight gain in these animals, pointing towards the perpetuation and progression of obesity.
Keywords: Keywords: obesity, physical exercise, eating behavior
Estudio sobre los hábitos alimentarios y actividad física de perros obesos en la ciudad de Sao Paulo y su efecto sobre el balance metabólico
La obesidad, enfermedad metabólica de origen multifactorial, causa daños a la salud y disminuye la longevidad del individuo. El objetivo fue evaluar el comportamiento de perros obesos en São Paulo en relación a la ingestión de alimentos y a la práctica de la actividad física y sus consecuencias sobre el equilibrio metabólico. Se estudiaron 50 animales obesos de diferentes edades y diferentes razas. Se observó que 22% de los animales evaluados no realizaban ninguna actividad física, 46% eran considerados moderadamente perezosos y 56% tenían comportamiento alimentar voraz o goloso. Además, 78% de los perros consumían el mismo tipo de alimento que su propietario y todos tenían un equilibrio metabólico positivo. Se constató que los perros obesos presentan comportamiento alimentario y nivel de la actividad motora que resultan en equilibrio metabólico positivo, con la consiguiente perpetuación y progresión de la obesidad.
Palavras clave: Palabras clave: obesidad, actividad motora, conducta de alimentación
Autor(es): Fernando Yutaka Moniwa Hosomi ; Adriano Tony Ramos, Eduardo Kenji Masuda, Maria Elisa Trost, Dominguita Lühers Graça, Paulo César Maiorka
Aspectos clínico-patológicos em casos de meningoencefalite necrosante caninaA meningoencefalite necrosante canina (MNC) é uma doença inflamatória idiopática que afeta principalmente os hemisférios cerebrais de cães de raças pequenas. A sintomatologia apresentada pelos animais é progressiva, sendo as crises convulsivas o principal sinal clínico. A etiologia da MNC ainda é pouco conhecida, sendo possivelmente multifatorial e influenciada por fatores genéticos e ambientais. Até o momento, os tratamentos têm sido paliativos, com uso de anti-inflamatórios corticoides em dosagens imunossupressoras e anticonvulsivos. Nesta revisão são descritos seis casos recentes de MNC no Brasil, ocorridos nas raças pug (dois casos), Yorkshire (dois casos) e maltês (dois casos). Deste total, três casos foram provenientes da Faculdade de Medicina Veterinária e Zootecnia - Universidade de São Paulo - SP e três do Laboratório de Patologia Veterinária - Universidade Federal de Santa Maria - RS.
Unitermos: cães, encefalopatias, neurologia
Clinical and pathological aspects of canine necrotizing meningoencephalitis
The canine necrotizing meningoencephalitis complex (CNM) is an inflammatory disease characterized by multifocal nonsuppurative idiopathic meningoencephalitis, which mainly affects the cerebral hemispheres of small and miniatute breed dogs. This paper presents clinical and pathological data regarding cases registered in Brazil, compared with cases in literature. The disease has been reported in pug, maltese, papillon, Shih tzu, chihuahua and pekingese dogs. More recent reports describe the occurrence of CNM in greyhound, West Highland white terrier and French bulldog. In Brazil, there have been cases of this disease in pug, maltese and Yorkshire dogs (Figure 3). Although the etiology of CNM is much still unknown; it is most likely a multifactorial disease, influenced by genetic and environmental factors. The viral etiology of meningoencephalitis was suggested by some authors in the first case reports. However, several studies have shown negative results to testing (PCR and serological tests) for viruses such as canine distemper, as well as protozoa and agents of dirofilariasis, ehrlichiosis and borreliosis in the cases presented. Still, etiologic agents are not discarded as possible factors triggering a secondary autoimmune response to a prior exposition. An epidemiological study with 60 affected pug dogs indicated higher frequency (though not statistically significant) in females (40 affected individuals). This evidence is supported by the fact that autoimmune encephalitis tend to affect more females than males in different species. The most likely pathogenesis of CNM is the autoimmune hypothesis reinforced by signs of autoantibodies against astrocytic glial fibrillary acidic protein (GFAP) in cerebrospinal fluid (CSF) of dogs affected by this disease. Determination of autoantibodies in CSF or serum of affected dogs has provided relevant data on the etiology of the disease, besides assisting diagnosis. The autoimmune hypothesis is also supported by the occurrence of glomerulonephritis in recent cases, with the presence of autoantibodies and its complexes in serum. The symptoms onset in cases of CNM is variable, and dog owners often fail to perceive the neurological signs of the disease, which are rather subtle in the beginning. With Chihuahuas, clinical service was sought after a period of time that varied from 5 days to 2.5 years. With pugs, clinical signs may appear from one to six months before death. Seizures are the most consistent clinical manifestations in CNM, and the neurological syndrome develops progressively. Other clinical signs include nystagmus, ataxia, head tilt, ipsilateral circling, incoordination, paralysis, changes in behavior and consciousness, depression and coma. Neurological examination may reveal changes / loss / decrease of sight, but in most cases the pupillary reflexes remain unalterared. Computerized tomography, magnetic resonance imaging and ultrasound examinations may provide evidence of tissue lesion, cystic areas, malacia and dilation of ventricles. Examination of CSF may indicate important changes such as increased protein, red blood cells or presence of occult blood and predominantly mononuclear pleocytosis. Definitive diagnosis, nevertheless, is still based on histopathological examinations done through brain biopsy or post-mortem. Alterations occur primarily in the cerebral hemispheres, but there may be morphological differences and varying location according to the dog s breed. Macroscopic alterations in CNM are relatively common, and were observed in most cases in São Paulo and Santa Maria, with lateral ventricular dilatation (4 / 6) (Figure 4), areas of change in color, and malacia in the cerebral cortex (5 / 6) (Figure 5). Kidney alterations may occur, such as proliferative membranous glomerulonephritis, characterized by a diffuse lesion in the cortical area, with thickening of Bowman s capsule, lymphoplasmacytic interstitial infiltrates and proteinaceous cylinders, as described in West Highland white terrier breeds 10 and pugs dogs. Prognosis for dogs affected by CNM is unfavorable. To present date, patients have received palliative care, with the use of steroidal anti-inflammatories such as prednisone, employed in immunosuppressive dosages, associated to anticonvulsants. This treatment may help extend the survival period, which has varied from less than 60 days to four months. Reports of combined treatment with prednisone and cyclosporine suggest greater efficacy in the treatment of clinical signs and increased survival periods, exceeding 300 days. Anticonvulsant drugs and steroid therapy usually show little eficacy. The study of neurological disorders in small animals has gained increased attention from veterinary practitioners in the past years. The information exchange among professionals (breeders, practitioners and pathologists) is of vital importance and will certainly prompt reporting of CNM cases. At present, the disease is probably under diagnosed in Brazil, since the definitive diagnosis still depends on histopathological examinations, usually post-mortem. The occurrence of seizures in affected animals is the symptom that usually leads them to the veterinary clinic. Thus, when CNM is considered for diagnosis, it is usually late. Practitioners are advised to inform the owners of predisposed breeds so that they are aware of the more subtle neurological symptoms of the disease, as listed in figures 1 and 2. They should also consider CNM as a possibility in differential diagnoses.
Keywords: Keywords: dogs, brain diseases, neurology
Aspectos clínico-patológicos en casos de meningoencefalitis necrosante canina
La meningoencefalitis necrosante canina (MNC) es una enfermedad inflamatoria idiopática que afecta los hemisferios cerebrales de perros de razas pequeñas. Crisis convulsivas son la señal clínica más característica de un proceso progresivo que puede durar días o años. La etiología de este complejo no es conocida mas se cree que factores genéticos y ambientales puedan estar implicados. La terapia usada actualmente es paliativa y se usan corticosteroides inmunosupresores y anticonvulsivos. En esta revisión son descritos seis casos de MNC en Brasil, en las razas Pug (dos casos), Yorkshire (dos casos) y Maltés (dos casos). Tres casos fueron procedentes de la Faculdade de Medicina Veterinária e Zootecnia de la Universidade de São Paulo, SP, y tres del Laboratório de Patologia Veterinária de la Universidade Federal de Santa Maria, RS.
Palavras clave: Palabras clave: perros, encefalopatías, neurología
Autor(es): Bruno Martins Araújo ; Mônica Vicky Bahr Arias, Eduardo Alberto Tudury
Paraplegia aguda com perda da percepção de dor profunda em cães: revisão de literaturaA paraplegia aguda com perda da percepção de dor profunda indica lesão medular grave, capaz de lesionar fibras bastante resistentes à lesão e localizadas profundamente na medula espinhal. Várias enfermidades são consideradas no diagnóstico diferencial de cães com essa alteração, em que na maioria dos casos, a lesão ocorre por extrusão de disco intervertebral, fraturas/luxações vertebrais e embolismo fibrocartilaginoso. O diagnóstico baseia-se na resenha clínica, na anamnese, na evolução aguda dos sinais clínicos e nos resultados do exame neurológico e de exames complementares, como imagens da coluna vertebral e da medula espinhal. O tratamento deve ser direcionado na prevenção da destruição neuronal bioquímica, na descompressão da medula espinhal e/ou na estabilização da coluna vertebral. O prognóstico varia de reservado a desfavorável, dependendo da etiologia da lesão e das opções de tratamento disponíveis.
Unitermos: sistema nervoso, afecções da medula espinhal, analgesia
Acute paraplegia with loss of deep pain perception in dogs: literature review
Acute paraplegia with loss of deep pain perception (DPP) indicates severe spinal injury, capable of damaging resistant fibers that are deeply situated in the spinal cord. Several conditions are considered for the differential diagnosis of dogs with this alteration. In most cases, the lesion occurs by intervertebral disk extrusion, vertebral fractures/luxations and fibrocartilaginous embolism. The initial mechanisms of acute spinal lesion correspond to the primary injury. They occur at the moment of injury, with the partial or complete rupture of nervous tissue and the loss of medullary tissue, which are considered untreatable lesions. Afterwards, a series of vascular and metabolic alterations take place, which constitute the events referred to as secondary lesions. The diagnosis is based on patient signalment, history, on the acute evolution of clinical signs and on the results of the neurological exam and complementary exams, such as imaging of the vertebral column and the spinal cord. The treatment must be directed towards preventing biochemical neuronal destruction, with the use of neuroprotectors (substances which prevent or limit the mechanisms of secondary injury to the spinal cord). Corticosteroids have been the most frequently employed drugs in trauma and decompression of the spinal cord, both in animals and human beings. They are frequently associated with gastrointestinal complications like hemorrhage, pancreatitis, ulcers and/or gastric perforations. The medical management of the intervertebral disk disease (IVDD) with loss of DPP still consists, for some authors, in the administration of methylprednisolone sodium succinate (MPSS) during the eight hours following trauma, and in the referral for emergency decompression. Surgical treatment of these animals must be readily arranged, as it is considered a neurological emergency, and must entail: decompression of the spinal cord (hemilaminectomy or laminectomy), removal of the disk material extruded into the vertebral canal, decrease of medullary edema and ischemia, macroscopic evaluation and intraoperatory irrigation of the spinal cord. Animals that present with spinal trauma and suspected vertebral instability must be placed in a firm surface to avoid movement and additional injury to the spinal cord, while proper treatment is initiated. Hypotension must be controlled through the use of fluids, and followed by treatment with MPSS as soon as possible, within the first eight hours after trauma. Surgery is indicated for cases presenting with vertebral instability, in which animals must be evaluated through mielography or magnetic ressonance to detect evidence of spinal cord transection or extensive necrosis. If none of these alterations are present, the surgeon may perform a hemilaminectomy, to decompress (in cases where there is extradural compression) and identify a possible progressive hemorrhagic myelomalacia (PHM). If the spinal cord is intact, surgical fixation takes place. There is no specific treatment for FCE, nor is there evidence that any treatment possesses more value than the general nursing care for patients that remain recumbent. The prognosis varies from guarded to unfavorable, depending on the etiology of the lesion and on the available treatment options. In IVDD, the main factor to be considered is the presence or absence of DPP. Among dogs without DPP, the main parameters to be evaluated are speed of occurrence and duration of analgesia, and the recovery time frame to pain perception. Animals which have lost deep pain perception after suffering exogenous vertebral trauma usually present an unfavorable prognosis for recovery, because in this type of injury, the lack of nociception is frequently associated with the transection of the spinal cord or to the rapid onset of PHM. For dogs suffering medullary infarction due to FCE, prognosis in terms of recovery of function is very unpredictable, reflecting the varying severity of the characteristic lesion of this disease. It is important to point out that some animals manage to regain the ability to walk without recovering DPP. In these animals, the occurrence of involuntary motor activity may indicate the development of spinal cord reflex walk, which originates from the mechanism of neural plasticity and the formation of local circuits 53. Paraplegic animals need intensive nursing care during their recovery period or during their entire life (in cases where there isirreparable spinal cord injury). Attention must be given to the emptying of the bladder and intestines, by means of abdominal massage or urinary catheter, and the use of an appropriate diet; to the prevention of skin sores and decubitus ulcers, by constantly cleaning the skin of urine and feces and changing position every four hours; to the treatment of trauma related wounds (usually in case of car accidents) and to the use of passive and active physical therapy, to avoid muscle atrophy and contracture and loss of articular and neuromuscular function.
Keywords: Keywords: nervous system, spinal cord diseases, analgesia
Paraplejia aguda con pérdida de la percepción del dolor profundo en perros:revisión de literatura
La paraplejia aguda con pérdida de la percepción del dolor profundo indica lesión medular severa, capaz de lesionar fibras muy resistentes a lesiones y situadas profundamente en la médula espinal. Varias enfermedades deben ser consideradas en el diagnóstico diferencial de esta alteración, que en la mayoría de los casos, tienen lesiones por extrusión del disco intervertebral, fracturas / dislocaciones vertebrales o embolismo fibrocartilaginoso. El diagnóstico se basa en la reseña, la anamnesis, los signos clínicos agudos, los resultados del examen neurológico y pruebas adicionales como la obtención de imágenes de la columna vertebral y médula espinal. El tratamiento debe ser dirigido a la prevención de la destrucción neuronal bioquímica, la descompresión de la médula espinal y/o en la estabilización de la columna vertebral. El pronóstico varía de reservado a desfavorable, dependiendo de la etiología de las lesiones y las opciones de los tratamientos disponibles.
Palavras clave: Palabras clave: sistema nervioso, enfermedades de la médula espinal, analgesia
- Animais silvestres
Autor(es): Silvia Neri Godoy ; Zalmir Silvino Cubas
Principais doenças bacterianas e fúngicas em Psittaciformes - revisãoO Brasil é considerado o país mais rico do mundo em representantes da ordem Psittaciformes, cujas espécies são popularmente conhecidas como psitacídeos. Muitas espécies estão ameaçadas de extinção devido à contínua destruição de hábitats e à captura de exemplares na natureza. Portanto, a manutenção legalizada desses animais em cativeiro é extremamente importante para a conservação de diversas espécies. Os psitacídeos são sensíveis a diversas doenças causadas por diferentes vírus, bactérias, fungos e parasitas, porém ainda são necessários muitos estudos tanto das aves mantidas em cativeiro como nas de vida livre. Tanto fungos como bacterias podem apresentar-se como agentes primários ou oportunistas em animais com imunodepressão ou desnutridos. Este trabalho apresenta uma revisão das principais doenças bacterianas e fúngicas que acometem os psitacídeos mantidos em cativeiro, visando subsidiar clínicos no diagnóstico e na conduta terapêutica dessas infecções.
Unitermos: animais selvagens, aves silvestres, zoonoses, clínica de aves, psitaciformes
Main bacterial and fungal diseases in Psittaciformes - literature review
Brazil is considered the richest country in representatives of the Psittaciformes order, with the occurrence of about 80 species. Many species are threatened due to the destruction of habitats and illegal trade; therefore, the legalized maintenance of these animals in captivity is extremely important for their conservatio. Many diseases affect psittacines, but there are still few studies on these birds in captive settings and in the wild. Bacterial and fungal infections may be caused by opportunistic or primary agents. The degree of exposure to the agent, age, immunosupression, nutrition deficiency, overuse of antibiotics, diets with high levels of carbohydrates, senility, concomitant diseases, inadequate hygiene of facilities and stress are important factors that determine the onset and severity of the disease. This article describes some fungal and bacterial diseases that affect psittacines kept in captivity, their diagnosis, treatment and prophylaxis. Escherichia coli, Salmonella sp, Klebsiella sp, Proteus sp, Bordetella sp, Citrobacter freundiie and Pseudomonas sp, Staphylococcus sp, Streptococcus sp, Enterococcus sp, Mycobacterium sp, Chlamydophila psittaci and Mycoplasma sp are the most significant agents in psittacine infections. On immunosupressed birds, Escherichia coli is usually involved in infectious processes, generally associated to other agents. Nevertheless, some strains of E. coli are considered primary agents of pseudomembranous or ulcerative enteritis, causing affected birds to die acutely or develop symptoms associated to the digestive tract. Salmonelosis is a highly contagious zoonosis which usually develops into septicemia. In psittacines, the most frequent species are Salmonella typhimurium and S. enteritidis. Strains isolated from pets are not important pathogenic agents for humans, but they may cause gastroenteritis in children, elderly people and immunosupressed individuals. Bordetella avium, Klebsiella pneumoniae and K. oxytoca are respiratory pathogens which are usually associated to cases of sinusitis, aerosaculitis and caseous pneumonia. Enteritis, hepatitis, alterations on the central nervous system and septicemia have been occasionally observed. The Proteus genera usually present low pathogenicity, but they can lead to septicemia in young psittacine birds and aerosaculitis and caseous pneumonia in adults. Citrobacter freundii is a high pathogenicity agent that has been associated to cases of septicemia and hepatitis, especially in young and immunosupressed individuals. Pseudomonas sp is considered a primary agent of infections in psittacines. P. aeruginosa is the most common species, associated to cases of aerosaculitis, pneumonia and bronchopneumonia caseous. Staphylococcus aureus is the most common agent involved in folliculitis and pododermatitis in birds. Streptococcus sp can be associated to respiratory diseases and septicemia in psittacines. Enterococcus sp is part of the normal bacterial fauna of birds and usually acts as an opportunistic agent in immunosupressed animals. Enterococcus faecalis and E. hirae are associated to septicemic processes or subchronical diseases. Out of the digestive tract, some species of Enterococcus sp can cause necrotic inflammation of the affected organs, and others are associated to respiratory problems including pneumonia and caseous aerosaculitis. Mycobacterium avium and Chlamydophila psittaci are the most prominent bacteria in terms of zoonotic potential, mainly in immunosupressed humans. The parrots of Amazona genera are highly susceptible to Micobacterium, which leads to chronic disease, affecting mostly the digestive tract. Chlamydophila psittaci are intracellular bacteria which affect the liver and the digestive and respiratory tracts. Micoplasmosis in psittacines is usually related to Mycoplasma gallisepticum and M. synoviae. The main clinical signals and injuries are related to the superior respiratory tract. The most common fungal and yeast agents in psittacines are Candida albicans, Macrorhabdus ornithogaster and Cryptococcus neoformans, which affect the digestive tract, and Aspergillus sp, affecting the respiratory tract. They act as opportunistic agents mainly in immunosupressed and young birds. These infections are very common in birds seized from illegal trade. Small concentrations of Candida sp are common in the enteric microbiota of birds; however, extreme growth of these agents can determine necrotic whitish plaques pseudomembranosis in the oral cavity and digestive tract, hindering deglutition and breath. Cryptococcus is an encapsulated basidiomycete yeast-like fungus with a predilection for the respiratory and nervous system of humans and animals. Cryptococcus neoformans affect mainly the respiratory tract, causing necrotic granulomatosis whitish lesions and gelatinous exudates. Megabacteriosis is a gastric yeast infection caused by Macrorhabdus ornithogaster affecting several species of birds worldwide. This agent colonizes the proventriculus and gizzard mucosas, causing ulcerations, milky secretion and hemorrhages. Affected birds usually have a typically chronic course and die with severe cachexia. The most common agent of aspergilosis is Aspergilus fumigates. This fungus can occur as a saprophyte, but it also leads to a devastating respiratory disease, particularly in animals that are immunosupressed or that have been exposed to high levels of the agent. The agent penetrates the mucous wall of the respiratory tract, forming micelia from the inhalated hyphae and spores, which causes intense scaling and epithelial necrosis, extensive plaques and microabscesses in lungs and air sacs.
Keywords: Keywords: wildlife, birds, zoonosis, avian medicine, psittaciforms
Principales enfermedades bacterianas y fúngicas en Psittaciformes - revisión de literatura
Brasil es considerado el país más rico del mundo de representantes del orden Psittaciformes. Muchas especies están amenazadas de extinción debido a la continua destrucción de habitats y captura de ejemplares en la naturaleza. Por lo tanto la manutención legalizada de estos animales en cautiverio es extremadamente importante para la conservación de diversas especies. Los psitácidos son sensibles a diversas enfermedades causadas por diferentes virus, bacterias, hongos y parásitos, aunque son necesarios muchos estudios en las aves mantenidas en cautiverio y vida libre. Tanto hongos como bacterias, pueden presentarse como agentes primarios y oportunistas en animales inmunosuprimidos o desnutridos. Este trabajo presenta una revisión de las principales enfermedades bacterianas y fúngicas que acometen psitácidos mantenidos en cautiverio, con el objetivo de dar un subsidio a los clinicos en el diagnóstico y en la conducta terapéutica de estas infecciones.
Palavras clave: Palabras clave: animales salvajes, aves silvestres, zoonoses, clínica de aves, psittaciformes
- Animais silvestres
Autor(es): Ana Carolina Holanda Maluenda ; Renata Assis Casagrande, Viviane Cristhiane Nemer, Cristina Takami Kanamura, Danilo Kluyber, Rodrigo H. F. Teixeira, Eliana Reiko Matushima
Infecção aguda fatal por Toxoplasma gondii em macaco-barrigudo (Lagothrix lagotricha) - relato de casoA infecção por Toxoplasma gondii é um problema para a manutenção de primatas não humanos em cativeiro, sendo as espécies do Novo Mundo altamente suscetíveis à doença. O objetivo deste trabalho é relatar um caso de toxoplasmose aguda em um macaco-barrigudo (Lagothrix lagotricha) adulto, proveniente de vida livre, que morreu e foi encaminhado para necropsia. Os principais achados anatomopatológicos estavam no pulmão, baço, fígado e linfonodos, com a visualização de estruturas compatíveis com T. gondii no exame citológico, histopatológico e na imunomarcação positiva com anticorpo policlonal anti-T. gondii - achados esses que condizem com os casos encontrados na literatura. Como os primatas neotropicais normalmente desenvolvem infecção aguda e fatal, ressalta-se a importância do manejo preventivo e suas possíveis vias de transmissão em cativeiro.
Unitermos: animais silvestres, primatas, patologia, protozoários, toxoplasmose
Toxoplasma gondii acute fatal infection in a woolly monkey (Lagothrix lagotricha) - case report
The protozoan Toxoplasma gondii is one of the most common parasitic infections of man and other warm-blooded animals. Toxoplasma gondii is a coccidian obligate intracellular parasite, with a sexual cycle (enteroepithelial cycle) in the definitive host (domestic cats and other member of the Felidae family) and an asexual cycle (extraintestinal cycle) in intermediate hosts (man, many mammals and birds). There are three infections stages of T. gondii for all animals: tachyzoites (individually and in groups), bradyzoites (in tissue cysts), and sporozoites (in oocysts). This protozoan represents a problem for the maintenance of non-human primates in captivity, especially the New World primates that are highly susceptible to this infection. The objective of the present study is to report an acute toxoplasmosis case in an adult free-living woolly monkey (Lagothrix lagotricha) that was sent by IBAMA from Roraima State to Criadouro Conservacionista Toca da Raposa in São Paulo State. This monkey was lethargic, anorexic, and it died two days later. This dead animal was sent to the Animal Pathology Laboratory at University of São Paulo for post-mortem examination. Necropsy revealed cachexia, pale mucous membrane, heterogeneous red-colored and consolidated lungs, severe splenomegaly, mild hepatomegaly and enlarged and red-colored lymph nodes, mainly mesenteric. The cytology exam by imprint of the lungs, liver, spleen and mesenteric lymph nodes showed compatible T. gondii tachyzoites free or in macrophages (individually or in small groups). Sections of all tissues were collected, fixed in 10% buffered neutral formalin for 48 hours, embedded in paraffin, sectioned at 4µm, stained with hematoxylin and eosin, and submitted to a light microscopy examination. Histopathologically, exams revealed nonsuppurative, acute, diffuse, severe pneumonia; nonsuppurative, multifocal, mild myocarditis; nonsuppurative, moderate hepatitis with severe, multifocal necrosis; interstitial, nonsuppurative, multifocal, moderate nephritis. The spleen presented lymphoid depletion and moderate necrosis with haemorrhage and histiocitic splenitis. In the lymph nodes, which were mainly mesenteric, multifocal to coalescing severe necrosis with haemorrhage was observed, as well as moderate diffuse histiocitic lymphadenitis. Intralesion, individual or in small groups, T. gondii tachyzoites were visualized free or within macrophages in the lungs, liver, spleen and lymph nodes. Paraffin-embedded tissue blocks were sent to the Immunohystochemistry Laboratory at Adolfo Lutz Institute. Immunohystochemistry (IHC) was performed with the streptavidin-biotin peroxidase technique and the use of polyclonal antibodies against T. gondii. IHC showed a specific antigen-antibody reaction which was very intense in the lungs, liver, spleen, lymph nodes, moderate in the kidneys, and mild in the central nervous system, heart, and adrenal glands. These findings were in accordance with the lesions reported in literature. Toxoplasmosis is considered to be a fatal parasitic disease in some animals, such as New World primates. This disease is one of the main diseases in New World primates, and there are many outbreaks in zoos and private breeders in Brazil and in other countries. According to literature, free-living New World primates (Cebus spp and Alouatta spp) have had antibodies against T. gondii. They are much more susceptible than Old World primates, rarely surviving the disease. The reasons for such high susceptibility are not clear; however, data suggested that, due to their arboreal habits, these primates were isolated, during their evolution, from both felids and T. gondii oocysts; as a result, they failed to develop a resistance to toxoplasmosis. Moreover, data suggest that vertebrates of this type do not develop an effective cellular immune response to T. gondii. Normally, New World primates die without premonitory signs having been observed, indicating the acute nature of the disease. If the clinical signs are present, they are not specific, such as lethargy, malaise, anorexia, and the animals die in few days In previous reports and in the present study, the gross and microscopic lesions were similar. These lesions were characterized by necrosis in the lungs, liver, spleen, mesenteric lymph nodes, and absent or variable lesions in the gastroenteric system. The presence of the tachyzoites or cysts of bradyzoites was detected in the histology, mainly in the lesion or associated with inflammatory cell infiltration. Toxoplasma gondii may be transmitted by the consumption of infected meat, by the oral-faecal route, or congenitally. Experimental studies indicated the possibility of aerosol transmission of T. gondii to squirrel monkeys (Saimiri sciureus) 6. In many cases described in literature, the route of T. gondii transmission to New World primates was not identified. It was then assumed that transmission had occurred by ingestion of infected raw meat or food or drink contaminated with sporulated oocysts. As New World primates usually develop acute and fatal infection, this fact militates against the use of therapeutic measures, and it is important to emphasize the need for rigorous prophylactic procedures to prevent the occurrence of these parasites in captive colonies.
Keywords: Keywords: wildlife animals, primates, pathology, protozoans, toxoplasmosis
Infección aguda fatal por Toxoplasma gondii en un mono lanudo (Lagothrix lagotricha) - relato de caso
La infección por Toxoplasma gondii representa un problema en el mantenimiento en cautiverio de los primatas no humanos, siendo que las especies del nuevo mundo son muy susceptibles a la enfermedad. El objetivo de este trabajo es relatar un caso de toxoplasmosis aguda en un mono lanudo (Lagothrix lagotricha) adulto, originario de vida libre, enviado para necropsia despues de haber muerto en un periodo de dos dias. Los principales hallazgos anatomopatologicos fueron encontrados en el pulmón, bazo, hígado y ganglios linfáticos, con visualización de extructuras compatibles con T. gondii por la citología, histopatología y imunomarcación positiva con anticuerpo policlonal anti-T. gondii; estos hallazgos son iguales a los descriptos en la literatura. Como los primates neotropicales normalmente desenvueven infección aguda y fatal, se destaca la importancia del manejo
preventivo y sus posibles vías de transmisión.
Palavras clave: Palabras clave: animales silvestres, primatas, patología, protozoários, toxoplasmose
Autor(es): Luiz Henrique de Araújo Machado ; Mauro José Lahm Cardoso, Viciany Erique Fabris, Mariana Isa Poci Palumbo
Dermatomiosite canina familiar - relato de casoA dermatomiosite canina familiar é uma dermatose incomum, de caráter hereditário, inflamatório e idiopático de pele, músculos e algumas vezes dos vasos sanguíneos, mais frequente em collies e pastores de Shetland. As lesões cutâneas se desenvolvem entre sete semanas e seis meses de idade, apresentando maior comprometimento muscular nos collies. As lesões dérmicas são mais comuns em locais de maior traumatismo mecânico, como regiões perioculares, facial e labial, pina, ponta da cauda e proeminências ósseas, caracterizando-se por eritema, descamação, alopecia, crostas e distúrbios de pigmentação. A miosite caracteriza-se por atrofia dos músculos mastigatórios e dos membros. O diagnóstico se dá pela história clínica, pela raça e pela idade do animal, com o auxílio dos exames dermatológico e osteomuscular, e coadjuvado pelas alterações histológicas da pele e dos músculos reveladas em biopsias respectivas, imunofluorescência da pele e eletromiografia. Este artigo visa relatar um caso de dermatomiosite canina familiar em collies, bem como revisar seus diversos aspectos descritos na literatura.
Unitermos: cães, collies, dermatoses
Canine familial dermatomyositis
Canine familial dermatomyositis (CFD) is an uncommon hereditary inflammatory and idiopathic condition of skin, muscles and sometimes blood vessels found mainly in collies and Shetland sheepdogs. This disease was first described in collies in 1984 and in Shetland dogs in 1985, and it has also been reported in their related crossbreeds. In Brazil, the disease was first described in 1993, and in another study it appears as 1.5% of the myositis cases. Cutaneous lesions develop between seven weeks and six months of age, affecting mainly the muscles in collies. Skin lesions are more common in most frequently traumatized regions, such as the periocular, facial and labial areas, the tip of the tail and bone protuberances, being characterized by erythema, desquamation, alopecia, crusts and pigmentation disorders. Myositis is characterized by atrophy of masticatory and limb muscles. Diagnosis is based on patient s signalment, anamnesis, physical examination and specially by detailed dermatological and musculoskeletal examinations. Diagnosis is confirmed by skin and muscle biopsy, electromyography and negative direct immunofluorescence of affected skin. Correlation between dermatomyositis stage and abnormalities in electromyography have not been established. The aim of the present study is to report on a case of canine familial dermatomyositis in a collie dog and to review the different aspects described in the literature. An eleven-month-old male collie dog was admitted to the Dermatology Service of HV-FMVZ-Unesp, in Botucatu. With no morbid history, the animal had presented with alopecic, erythematous, itchy, crusty lesions for about two weeks, beginning at nasal mirror and bridge and gradually evoluting to dorsal regions of forelimbs and labial comissure. Anamnesis revealed lameness, locomotion difficulty, muscle weakness, emaciation, apathy, sialorrhea and hyporexia. At physical examination, the animal presented with hyperthermia, normal hydration, hypocolored mucosae, lymphadenomegaly, splenomegaly, atrophied testicles, blepharitis and enophthalmos. At the dermatological examination, nasal depigmentation, erythematous, erosive-ulcerative dermatosis at the transition from nasal bridge to nasal mirror (Figure 1), labial comissure (Figure 2) and nail bed (Figure 3) were observed. The animal also presented with hypotrichosis at limbs and gluteus, scapular and cranium muscle atrophy. Parasitologic skin examination and hair fungal culture were both negative; complete blood countrevealed neutrophilic leucopenia, lymphopenia, eosinophilia and regenerative anemia; serum biochemistry was normal. Skin fragments from labial comissure, nasal bridge and extensor carpal surface were obtained for histopathology and presented similar alterations. Fibrotic perifollicular collagen was condensed with focal atrophy of pylosebaceous apparatus and there was a discreet perivascular and annexial lymphocytic infiltrate in deep dermis (Figure 4a). Skin biopsy revealed discreet laminated hyperkeratosis, discreet hypergranulosis, regular acanthosis, spongiosis, vacuoles in basal epidermis and rare apoptotic keratinocytes. Superficial dermis presented incontinence of melanic pigment and sparse infiltrate of mononuclear cells (Figure 4b). Once the anatomo-clinical diagnosis of CFD was established, therapy with vitamin E, prednisone and pentoxyfilin was initiated. After 30 days, there was mild improvement of dermatological condition and evident recovery of pain and muscle atrophy. For another 30-day period, the administration of corticosteroid was gradually reduced while vitamin E and fatty acids were maintained. One year after the beginning of the treatment, there was no recurrence of clinical signs. The clinical data related to patient s evolution, age, breed and clinical signs observed during examination, combined with histological findings, led to the CFD diagnosis. The animal s age when lesions occurred was coincident to that commonly reported. Dermatological findings, characterized by the type and distribution of skin lesions, as well as muscle alterations, were in agreement with the cases previously described. Hematological findings, however, did not correspond to those found in literature cases. Electromyography was not employed because alterations are seldom observed, and abnormalities occasionally found do not correlate to the stage of the disease. Histopathological findings corresponded to those in literature reports and were useful to confirm the diagnosis. This disease is characterized by typical histopathological alterations, which were all present in the skin samples examined (Figures 3a and 3b). After the prescription of recommended therapy with prednisone, vitamin E and pentoxyfilin, the animal recovered significantly and did not present any recurrence of clinical signs, even though this is likely to occur, according to the literature. Canine familial dermatomyositis is a progressive condition and, in some cases, euthanasia may be considered 4. Because of its hereditary and cureless nature, the animals affected by this disease should not be allowed to breed.
Keywords: Keywords: dogs, collies, dermatosis
Dermatomiositis canina familiar
La dermatomiositis canina familiar es una dermatosis poco frecuente, de carácter hereditario, inflamatorio e idiopático de piel, músculos y algunas veces de los vasos sanguíneos. Es más frecuente en Collies y pastores de Shetland, con las lesiones cutáneas desarrollándose entre las siete semanas y los seis meses de edad y presentando mayor compromiso muscular en los Collies. Las lesiones dérmicas son más comunes en locales de mayor traumatismo mecánico, como regiones perioculares, faciales y labiales, pabellón auricular, punta de cola y prominencias óseas, caracterizándose por eritema, descamación, alopecia, costras y disturbios de pigmentación. La miositis se caracteriza por atrofia de los músculos de masticación y de los miembros. El diagnóstico se obtiene por la historia clínica, raza y edad del animal, examen dermatológico y osteomuscular y complementado por las alteraciones histológicas de la piel y músculos en biopsias respectivas, inmunofluorescencia de la piel y electromiografía. Esto artículo procura relatar un caso de dermatomiositis canina familiar en Collie, así como revisar sus diversos aspectos descritos en la literatura.
Palavras clave: Palabras clave: perros, collies, dermatosis