RESUMO

Background: Portosystemic shunt (PSS), an alteration commonly found in toy dogs, is caused by an anastomosis between the systemic and portal circulation, interfering with the metabolism of several toxins. It can be of congenital or acquired origin and is classified as intra- or extrahepatic. Clinical signs include the gastrointestinal tract, nervous system, and urinary system according to the fraction of the shunt. It is diagnosed by several imaging tests and exploratory laparotomy. Therapy involves drug therapy and/or surgical correction of the anomalous vessels. Thus, the aim is to present an unusual case of extrahepatic cPSS originating from the left gastric vein and insertion into the azygos vein. Case: A 2-year-old female toy poodle, spayed, weighing 2.7 kg was treated with a history of recurrent cystitis and neurological signs such as focal seizures, ataxia, tremors, blindness, lethargy, head pressing, and compulsive gait. Complementary tests revealed normochromic microcytic anemia, neutrophilia-induced leukocytosis, monocytosis, and lymphopenia. Biochemical analysis revealed hypoproteinemia due to hypoglobulinemia, an increase in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase, and a decrease in urea. In the urinalysis, ammonium biurate crystals were detected, and Doppler ultrasound revealed microhepathy and the presence of an anomalous gastrosplenic vein inserted into the azygos vein, a finding compatible with the congenital extrahepatic PSS. Abdominal tomography confirmed vascular deviation with a sinuous path originating from the left gastric and splenic veins, inserting into the azygos vein, measuring approximately 5.95 cm in length. Cranial tomography revealed changes consistent with hepatic encephalopathy. Drug therapy was performed with hydration, liver chow, lactulose, probiotics, metronidazole, S-adenosyl-L-methionine, and ursodeoxycholic acid, and after 15 days, surgery was performed to place a 3.5 mm ameroid constrictor ring for gradual occlusion of the anomalous vessel. The animal recovered well, and a control abdominal ultrasound was repeated 30 days after the procedure, noting that the constrictor had not yet fully occluded the deviation. Doppler imaging revealed a favorable evolution with an increase in the diameter of the portal vein in the hepatopetal direction. The patient was followed-up for a year and had a normal and healthy life. Discussion: Extrahepatic PSS is frequently diagnosed in purebred and toy dogs, commonly occurring between the portal vein and one of its tributaries, with a lower frequency of anomalous vessels between the azygos veins, as in the present report. The patient's age and clinical signs were compatible with the disease, in addition to ammonia biurate crystals and hematological and biochemical alterations. The neurological clinical signs observed were compatible with hepatic encephalopathy secondary to congenital PSS. The imaging examinations facilitated the identification of the extrahepatic vascular anomaly, with the tomography being more accurate and helping in proper surgical planning. Clinical treatment should be performed for presurgical stabilization, and occlusion can be performed by placing cellophane bands or an ameroid constrictor, which is the technique of choice for congenital PSS, as it allows for slow constriction to avoid acute portal hypertension, as in this case, emphasizing that anesthesia in animals with portosystemic shunts must be performed with care.

Assuntos

RESUMO

Pancreatic cysts are rare in both humans and animals. They are defined as an enclosed structure externally surrounded by a capsule, internally coated with a cuboidal epithelium and filled with liquid or semi-solid content. This case described the clinical and pathological characteristics of a pancreatic cyst in a feline. A mixed breed cat with a history of recurrent vomiting was attended. Physical examination revealed pain on abdominal palpation. Abdominal ultrasonography showed a cystic, anechoic structure with well-defined edges located in the left cranial abdomen and in close contact with the duodenum and pancreas. Partial pancreatectomy was performed. Microscopically, the structure was surrounded by fibrous material, coated with cuboidal to columnar epithelium, and containing eosinophilic material. Although, pancreatic cyst is rare in animals, they should be included in the differential diagnosis of causes of vomiting in young cats.(AU)

Os cistos epiteliais pancreáticos são raros em humanos e animais, e são definidos como estruturas encapsuladas rodeadas por epitélio cuboidal, preenchido por substância líquida. O objetivo desse estudo foi descrever as características clínico-patológicas de um cisto pancreático verdadeiro em um felino. Foi atendido uma gata sem raça definida com histórico de vômitos recorrentes. No exame físico o animal apresentou dor à palpação abdominal. Na ultrassonografia abdominal, evidenciou-se a presença de uma estrutura cística, anecóica e com bordos bem definidos localizado no abdome cranial esquerdo, em contato com o duodeno e o pâncreas. Foi realizada pancreatectomia parcial. No exame microscópico observou-se estrutura encapsulada, circundado por material fibroso, revestido por epitélio cuboidal a colunar, contendo material eosinofílico. Embora os cistos pancreáticos verdadeiros sejam raros nos animais, eles devem ser incluídos no diagnóstico diferencial de doenças que cursam com vômitos nos gatos.(AU)

Assuntos

RESUMO

Pancreatic cysts are rare in both humans and animals. They are defined as an enclosed structure externally surrounded by a capsule, internally coated with a cuboidal epithelium and filled with liquid or semi-solid content. This case described the clinical and pathological characteristics of a pancreatic cyst in a feline. A mixed breed cat with a history of recurrent vomiting was attended. Physical examination revealed pain on abdominal palpation. Abdominal ultrasonography showed a cystic, anechoic structure with well-defined edges located in the left cranial abdomen and in close contact with the duodenum and pancreas. Partial pancreatectomy was performed. Microscopically, the structure was surrounded by fibrous material, coated with cuboidal to columnar epithelium, and containing eosinophilic material. Although, pancreatic cyst is rare in animals, they should be included in the differential diagnosis of causes of vomiting in young cats.

Os cistos epiteliais pancreáticos são raros em humanos e animais, e são definidos como estruturas encapsuladas rodeadas por epitélio cuboidal, preenchido por substância líquida. O objetivo desse estudo foi descrever as características clínico-patológicas de um cisto pancreático verdadeiro em um felino. Foi atendido uma gata sem raça definida com histórico de vômitos recorrentes. No exame físico o animal apresentou dor à palpação abdominal. Na ultrassonografia abdominal, evidenciou-se a presença de uma estrutura cística, anecóica e com bordos bem definidos localizado no abdome cranial esquerdo, em contato com o duodeno e o pâncreas. Foi realizada pancreatectomia parcial. No exame microscópico observou-se estrutura encapsulada, circundado por material fibroso, revestido por epitélio cuboidal a colunar, contendo material eosinofílico. Embora os cistos pancreáticos verdadeiros sejam raros nos animais, eles devem ser incluídos no diagnóstico diferencial de doenças que cursam com vômitos nos gatos.

Assuntos

RESUMO

ABSTRACT: Pancreatic cysts are rare in both humans and animals. They are defined as an enclosed structure externally surrounded by a capsule, internally coated with a cuboidal epithelium and filled with liquid or semi-solid content. This case described the clinical and pathological characteristics of a pancreatic cyst in a feline. A mixed breed cat with a history of recurrent vomiting was attended. Physical examination revealed pain on abdominal palpation. Abdominal ultrasonography showed a cystic, anechoic structure with well-defined edges located in the left cranial abdomen and in close contact with the duodenum and pancreas. Partial pancreatectomy was performed. Microscopically, the structure was surrounded by fibrous material, coated with cuboidal to columnar epithelium, and containing eosinophilic material. Although, pancreatic cyst is rare in animals, they should be included in the differential diagnosis of causes of vomiting in young cats.

RESUMO: Os cistos epiteliais pancreáticos são raros em humanos e animais, e são definidos como estruturas encapsuladas rodeadas por epitélio cuboidal, preenchido por substância líquida. O objetivo desse estudo foi descrever as características clínico-patológicas de um cisto pancreático verdadeiro em um felino. Foi atendido uma gata sem raça definida com histórico de vômitos recorrentes. No exame físico o animal apresentou dor à palpação abdominal. Na ultrassonografia abdominal, evidenciou-se a presença de uma estrutura cística, anecóica e com bordos bem definidos localizado no abdome cranial esquerdo, em contato com o duodeno e o pâncreas. Foi realizada pancreatectomia parcial. No exame microscópico observou-se estrutura encapsulada, circundado por material fibroso, revestido por epitélio cuboidal a colunar, contendo material eosinofílico. Embora os cistos pancreáticos verdadeiros sejam raros nos animais, eles devem ser incluídos no diagnóstico diferencial de doenças que cursam com vômitos nos gatos.

RESUMO

Background: Portosystemic deviation (PSD) is a congenital or acquired vascular anomaly that allows an abnormal bloodflow from the portal vein directly to the systemic circulation. This liver by-pass avoids hepatic metabolism of severaltoxins. Congenital PSDs are usually solitary and extra-hepatic, with a high incidence in pure-breed dogs. Acquired PSDsare usually multiple and occur as a consequence of portal hypertension. Surgery is the definitive treatment. Cliniciansand surgeons may present difficulties in the propaedeutic of animals with PSD. This paper aims at reporting a successfulsurgical treatment of a solitary extra-hepatic congenital PSD in a mixed-breed dog.Case: A 7-month-old mixed-breed dog, female, spayed, weighing 8 kg, was presented with a history of sudden syncopeafter feeding. Complementary exams revealed normocytic hypochromic anaemia, hypoalbuminemia and increased alanineaminotransferase and alkaline phosphatase. Abdominal ultrasound revealed an anomalous vessel inserted in the caudalcava vein, compatible with a congenital extra-hepatic PSD. Computed tomography revealed the anomalous vessel, with1,1 cm of diameter, originated from the cranial mesenteric vein and it inserted in the cranial margin of the caudal cavavein. A medical support was started with hydration, metronidazole, lactulose, probiotic and Hepatic diet. After 15 days thedog was submitted to surgery and a 5 mm ameroid constrictor ring was placed to gradually close the anomalous vessel.The dog recovered well and an abdominal ultrasound was repeated after 30 days, showing the ameroid constrictor ringring in the left cranial abdominal region, occluding the PSD close to its insertion in the caudal cava vein...(AU)

Assuntos

RESUMO

Background: Portosystemic deviation (PSD) is a congenital or acquired vascular anomaly that allows an abnormal bloodflow from the portal vein directly to the systemic circulation. This liver by-pass avoids hepatic metabolism of severaltoxins. Congenital PSDs are usually solitary and extra-hepatic, with a high incidence in pure-breed dogs. Acquired PSDsare usually multiple and occur as a consequence of portal hypertension. Surgery is the definitive treatment. Cliniciansand surgeons may present difficulties in the propaedeutic of animals with PSD. This paper aims at reporting a successfulsurgical treatment of a solitary extra-hepatic congenital PSD in a mixed-breed dog.Case: A 7-month-old mixed-breed dog, female, spayed, weighing 8 kg, was presented with a history of sudden syncopeafter feeding. Complementary exams revealed normocytic hypochromic anaemia, hypoalbuminemia and increased alanineaminotransferase and alkaline phosphatase. Abdominal ultrasound revealed an anomalous vessel inserted in the caudalcava vein, compatible with a congenital extra-hepatic PSD. Computed tomography revealed the anomalous vessel, with1,1 cm of diameter, originated from the cranial mesenteric vein and it inserted in the cranial margin of the caudal cavavein. A medical support was started with hydration, metronidazole, lactulose, probiotic and Hepatic diet. After 15 days thedog was submitted to surgery and a 5 mm ameroid constrictor ring was placed to gradually close the anomalous vessel.The dog recovered well and an abdominal ultrasound was repeated after 30 days, showing the ameroid constrictor ringring in the left cranial abdominal region, occluding the PSD close to its insertion in the caudal cava vein...

Assuntos