Treatment of mammary gland tumors in bitches: effects of sodium dichloroacetate as neoadjuvant therapy

Mastectomy is the standard treatment for mammary gland tumors in dogs. In addition to traditional therapy, sodium dichloroacetate (DCA) can act as target therapy, as it may promote autophagy, reduce metastatic potential, and tumor proliferation in mammary tumor cell lines. This study aimed to analyze the effects of DCA as preoperative therapy for mammary tumors in bitches. Nineteen animals were selected, and they received DCA at a dose of 10 mg/kg orally every 12 hr, for 15 days. The periodic evaluation included hematological analysis (complete blood count and biochemical markers), evaluation of gastrointestinal adverse effects, evaluation of tumor volume, histopathological analysis, and immunohistochemical evaluation (Ki67 and cyclooxygenase-2/COX-2 markers). After treatment, there was a significant reduction in hematocrit (P=0.02) and leukocyte (P=0.04) means. Despite the variations for these two hematological parameters, the means remained within the reference range for the species. There were two cases of vomiting and one case of diarrhea. Most cases were classified as carcinoma in mixed tumor (n=7, 36.8%), followed by solid carcinoma (n=6, 31.6%). Nine cases (47.4%) showed reduced tumor volume, nine (47.4%) had stable disease, and one showed progressive disease. While there was no sample with a COX-2 score higher than 6, tumor samples with COX-2 scores 3 and 4 were significantly associated with stable disease or progression. DCA preoperative treatment for bitches with mammary gland tumors showed safety and potential cytoreduction in some cases.

Angiofibroma of the Nasal Cavity in a Dog: Case Report

Nasopharyngeal angiofibroma is a histologic benign but locally aggressive vascular tumor described in humans. The description of this disease in dogs is limited. A mixed-breed female dog was presented with a history of epistaxis and nasal discharge. Rhinoscopy and computed tomography revealed a soft-tissue mass obstructing the entire nasal cavity, choana, maxillary recess, and right frontal sinus, but there was no bone or lymph node involvement. Histopathologic evaluation revealed irregular groups of blood vessels within a stroma of connective tissue, with secondary inflammation. Immunohistochemistry showed strong vimentin staining, mild factor VIII-related antigen staining, and negative staining for S100. The patient underwent tumor resection with fenestration surgery through the right maxillary bone, and there was tumor recurrence one year after surgery. This case report describes new findings regarding the immunohistochemical evaluation of nasopharyngeal angiofibroma in a dog. The laboratory and imaging findings, associated with a long-term follow-up, reinforce similar features between human and canine angiofibroma and may serve as a basis for immunohistochemical evaluation of this tumor in dogs.

Clitoridectomy and Urethrostomy in a Pseudohermaphrodite Dog

Background: Hermaphroditism is a rare congenital disease that causes ambiguous sexual features. True hermaphrodites have testicular and ovarian tissue, whereas pseudohermaphrodites have only one type of gonadal tissue, genitalia, but secondary characteristics of the opposite sex. Pseudohermaphrodites are classified as male or female according to their gonads. Treatment of pseudohermaphroditism consists of surgical removal of the gonads including reconstruction of abnormal genitalia, especially if the urethra is involved. Therefore, the objective of this report is to describe a case of a male pseudohermaphrodite in a dog treated with clitoridectomy with urethrostomy.Case: A 7-month-old, mixed-breed dog was referred due to the presence of a flaccid structure similar to a small penis, containing an os clitoris, bulbourethral glands, and urethra protruding from the vulva. Physical examination, complete blood count and serum biochemistry were within normal ranges. Hormonal levels of estradiol, testosterone, and progesterone were 56.39 pg/mL, 127.9 ng/mL, and 0.892 ng/mL, respectively. The abdominal ultrasound and posteriorly the exploratory celiotomy found a normal size prostate and two round organs resembling testicles connected to a uterus-like tubular structure. The patient underwent surgical abdominal exploration that confirmed the ultrasonographic findings and led to gonadohysterectomy. Also, clitoridectomy and urethrostomy were performed to excise the protruded structure and maintain normal urethral patency. The histopathological examination of the clitoris and penis confirmed it was a male genital organ, however, the abdominal structures were compatible with the testicles, epididymis, uterus, and even a broad ligament. These organs are normally found in cases of male pseudohermaphroditism. The testicles were histologically composed of regular seminiferous tubules, single layer Sertoli cells but there were no spermatogenic cells. After ten months of follow-up, the patient was alive, without urination impairment or any other clinical signs.Discussion: The animal presented the protrusion of the penile structure as the sole clinical sign. The reproductive system had a female origin, been possible its masculinization due to high testosterone concentration that induced the development of Wolff ducts, resulting in the formation of the epididymis, deferent ducts, and seminal vesicles. In these cases, it led to an enlarged clitoris. The patient described had hormonal levels compatible with a neutered male/female or a female in anestrus. The clinical signs become evident as the clitoris gets hypertrophied increasing the sensibility, resulting in constant licking of the mucosa, chronic inflammation, and mucopurulent discharge. This patient was diagnosed with male pseudohermaphroditism as it had cryptorchid male gonads along with the uterus and external genitalia of a female dog but containing traces of male genitals such as the os clitoris. Surgery is indicated when there are clinical signs or when the clitoris had an os clitoris or urethra due to an intersex abnormality. The surgical resection of the external male genitalia associated with the excision of the internal reproductive tract treated while preserving the urethra in this animal. Clitorectomy is a simple technique and creates a normal female anatomy ending the clinical signs of the exposed clitoris and improving the quality of life.Clitoridectomy and Urethrostomy in a Pseudohermaphrodite Dog

Island Skin Graft Associated with Non-Adherent Mesh in a Dog’s Pelvic Limb

Background: Large skin defects are caused by tumor excision, making appropriate reconstruction and complete healing of the lesion a challenge for surgeons. There are some difficulties in reaching these goals, especially in cases of surgical wound in the limbs, due to the scarce amount of skin and its reduced elasticity, which limit the possibility of flaps when compared to the head, neck, and trunk. This study reports a case of wound closure on the lateral skin in the femoral region of a dog’s pelvic limb via island skin graft associated with the implantation of a nonadherent cellulose acetate mesh and intensive postoperative care.Case: An 8-year-old Rottweiler female dog was attended at Pontifical Catholic University of Paraná’s Veterinary Clinic (CVE), in Curitiba, Paraná, presenting a tumor located laterocaudally to the right stifle joint. After preoperative examinations, the patient underwent tumor surgery; however, two more surgical procedures were required due to suture dehiscence in the region, which resulted in increased wound size. At first, the wound was treated for granulation tissue to be formed. Subsequently, the island skin grafting technique was chosen to close the wound, associated with the implantation of a nonadherent cellulose acetate mesh imbibed with petrolatum emulsion to keep the grafted fragments in place. The mesh was fixed in a simple interrupted suture pattern using 2-0 nylon thread. The lateral regions of the chest and abdomen were chosen as donor skin beds due to their large dimensions, skin elasticity, and ease in defect reconstruction. The fragments were obtained using a 10-mm biopsy punch and scalpel, and the defects were sutured in a simple interrupted pattern using 2-0 nylon thread. The patient remained hospitalized for movement restriction and postoperative monitoring for 72 h, and the bandage remained untouched during this time interval. Thereafter, the patient was discharged and it was recommended to clean the wound with jets of 0.9% saline using a 40 × 12 needle attached to a 20 mL syringe, from a distance of 10 cm from the wound. The dressings were changed every 48 h to maintain minimum contact with the wound; however, still keeping it clean to optimize healing. Fourteen days postoperatively, the sutures as well as the non adherent mesh were removed from the donor beds. The dressing was changed and the lesion was cleaned every 24 h because the fixation between the receptor bed and the implanted tissue was considered good. After approximately 80 days, complete epithelialization of the wound was observed.Discussion: Closing of large skin defects in the limbs is challenging due to the impossibility of using other reconstructive surgery techniques, which have limited use because of the extension of the lesion. However, island skin grafting can be considered despite its slower skin healing process than that of skin flaps. Specific management is required for the successful execution of this technique, and in the present case, the application of the non adherent mesh after island skin grafting helped in the immobilization and better adhesion of the fragments to the receiving bed. Thus, it was demonstrated that in-depth knowledge of reconstructive surgery and the surgeon’s expertise favor the emergence of ideas and more effective techniques that ensure success of the surgical procedure by avoiding complications and improving the patients’ quality of life.

Use of the Angularis Oris Axial Pattern Buccal Flap for the Correction of Facial Defects in Six Dogs

Background: Reconstructive surgery is an important area of veterinary surgery because it allows the reconstruction of large cutaneous defects in areas where a primary approach is not possible. Axial patterns flaps are composed by one direct cutaneous artery and vein, leading to a better blood supply with a good survival outcome. The angularis oris axial pattern buccal flap was introduced for correction of facial defects, but its versatility is not really explored in the existing literature. This article reports the use and complications of the angularis oris axial pattern buccal flap in six dogs, to treat defects in mandibular, temporal or labial regions.Cases: Five mixed breed dogs and one Labrador, with age between 4 and 9 years’ old were submitted for surgery and the angularis oris axial pattern buccal flap was used to close the different defects. Causes of defect included a lesion caused by myiasis in three of the dogs, and tumoral removal in the other three, where two were mast cell tumors and one a keratinizing basal cell carcinoma. The regions affected included rostral mandible with oral mucosa, intermandibular region, temporal region and upper lip. Before flap confection the tissue was cleaned, resected and prepared properly, according to each cause of lesion. The flap was made with two parallel incisions, wich center was usually the labial commissure, with the dorsal limits at the ventral aspect of the zygomatic arch, and the ventral incision on the ventral aspect of the mandibular ramus. Caudal extension was based on the length needed for surgical closure, but stained between the vertical auditory canal or up to atlas wing. Suture size and pattern depend the region and patient size. Patients were observed closely for any complication in the surgical site. From the six dogs presented here, five got some complications in the surgical site, including: lymphedema (2), suture dehiscence (4) and hematoma (1); however, regardless the complication, all patients had successful wound healing in 15 to 21 days after surgery. Also in two of the four suture dehiscence episodes, the cause of dehiscence was secondary to trauma and not the surgery.Discussion: The reconstruction of facial defects is noteworthy due the limited availability of flaps that can reach the region without excessive tension or healing complications. The angularis oris axial buccal flap pattern is the nearest flap to close defect in the intermandibular, temporal or labial regions. In the cases reported, it is possible to observe that the most frequent complication was suture dehiscence, but it occurred mostly in a small proportion of the flap, allowing healing in the expected time.The surgical planning is an important factor for reconstructive surgeries, so that there is enough tissue for the closure of the recipient and donor site, without tension over the flap or interference with tissue function and aesthetics. Despite the suture dehiscence in some of the cases, all patients showed adequate final recovery, since they returned to normal function with satisfactory cosmetic appearance.The angularis oris axial pattern buccal flap was applied in the correction of defects easily and all patients returned to normal function with satisfactory cosmetic appearance.

Open Surgical Thrombectomy and Coronary Stent Placement for Treatment of Aortic Thrombotic Disease in a Bitch

Background: The thrombotic aortic disease in dogs and cats is characterized by the pathological formation of blood clots that can rupture and obstruct the blood flow. Abdominal ultrasonography can identify the location and extension of thrombus in the main vasculature and using the doppler it is possible to observe the blood flow around the thrombus. Stents are expandable tube-shaped endoprosthesis characterized as a metal mesh and used to prevent or repair stenoses, allowing liquid, gas, or solids to flow. This report aims to describe the surgical and medical treatment of aortic thrombotic disease followed by coronary stents placement in a bitch.Case: An 8-year-old Shih Tzu bitch, presented for evaluation of a 1-month progressive hind limbs paresis. Nociception was present in both limbs, but the patient presented discomfort and vocalization when manipulating the pelvic limbs. A complete blood count demonstrated anemia, mild neutrophilia, and lymphopenia. Serum biochemistry found an increase in ALT, ALP, blood urea nitrogen, and CK. Abdominal ultrasonography detected mild bulging of the caudal aorta and trifurcation of the iliac arteries. Increased intraluminal echogenicity and absence of blood flow were also detected using duplex doppler. The initial medical treatment was ineffective in improving clinical signs, therefore surgical repair was performed. The aorta was isolated and clamped with Satinsky forceps and incised. The thrombus fragmented during removal. A non-compliant high-pressure balloon was used to dilated and remove small fragments of blood clots from the right and left external iliac arteries. Coronary stents of 32 mm length by 2.75 mm diameter were placed to keep both iliac arteries free. Immediately after the procedure, there was a detectable distal pulse in both hind limbs. Despite intensive medical treatment, the patient evolved to respiratory distress and died on the sixth day after surgery. At necropsy, there were thrombi in the lumen of the arteries and several organs in addition to a large hyaline thrombus occluding 80-90% of the aortic lumen and left femoral artery. In the trifurcation region, clots were present, and stents placed in the iliac arteries were also occluded.Discussion: The occurrence of aortic and iliac thrombosis is associated with several conditions, including neoplasia, chronic kidney disease, heart failure, gastric dilatation-volvulus, hypothyroidism, and hyperadrenocorticism (HAC). In this case, the underlying cause of thromboembolism was supposed to be related to an endocrine condition, since the patient had clinical signs compatible with HAC; however, the low-dose dexamethasone suppression test was borderline and further examination could not be afforded. The diagnosis of thrombosis at the iliac trifurcation was obtained through ultrasonographic examination. Computed tomographic and nuclear resonance imaging could have been applied as well. The medical management of the thromboembolic disease was based on anticoagulant therapy with both heparin and clopidogrel in association with surgical thrombectomy and coronary stents placement. Despite the efforts, the patient died shortly after the surgical procedure, which was expected since high rates of mortality and morbidity is often related to the thromboembolic ischemia. The necroscopic examination of the animal found thrombi at the stents, cranial aorta, and microscopically in several tissues. The failure to directly treat the cause of the thrombus, which could not be diagnosed in time, may negatively interfered in patient survival time. The thrombectomy and coronary stents placement reestablished the femoral pulse immediately after surgery, which has been reported in other studies. The surgical resolution of aortic thrombus should be addressed in further studies.

Comparison of Two Different Vinblastine Dosages for Treatment of Cutaneous Mast Cell Tumor in Dogs

Background: Mast cell tumors (MCT) are among the most common malignant cutaneous neoplasm in dogs with variable biologic behavior and remain a therapeutic challenge in high-grade cases. Surgery remains the primary treatment for canine MCT; however, chemotherapy and radiation therapy are commonly used to treat aggressive cases. The combination of vinblastine (VBL) at a dose of 2 mg/m² and prednisone is the classically described protocol for MCT treatment. Studies have shown the safety of higher VBL doses for dogs with MCT, but there is a lack of information regarding dose intensity and outcome as a goal after chemotherapy.   This study aimed to evaluate the impact of a higher dose of VBL on MCT treatment outcome.Materials, Methods & Results: This was an observational and comparative study conducted in two different Veterinary Teaching Hospitals. Client-owned dogs with histopathological diagnosis of grade II or III MCT were selected and underwent at least four chemotherapy sessions with VBL and prednisone. The experimental group (EG) consisted of 18 dogs that received a dose of 3 mg/m² VBL treated in one institution. The control group (CG) included 31 dogs that received a dose of 2 mg/m² VBL treated at the other institution. All dogs treated in both groups had a clinical and complete blood count (CBC) evaluation performed previous the start of chemotherapy (T0) and before each weekly treatment (T1, T2, T3, and T4). After treatment, dogs in both groups were followed-up for the recurrence rate and overall survival time after diagnosis. There was no significant difference in clinical variables between EG and CG. During treatment, dogs of EG showed a significant reduction in erythrocyte, hemoglobin, and hematocrit values between T0 and T1, T2, T3, and T4 (P < 0.001). Comparatively, the CG showed significant reduction in hemoglobin (P = 0.02) and total leucocytes (P = 0.001) values in the same period. Despite these findings, these hematological parameters did not exceed the lower limit for the species in both groups. There was a higher-grade neutropenia one week after the first VBL application (T2) in both groups, with no statistical difference in neutrophil counts at T2 or during the whole treatment. There were discrete and self-limited episodes of anorexia, vomiting, and diarrhea in both groups. After chemotherapy, dogs in EG showed a significantly lower rate of recurrence than dogs in CG (P = 0.02). There was no significant difference in the overall survival time between groups.Discussion: The absence of significant differences in clinical variables (e.g. sex, age, histological grading, and tumor location) between EG and CG suggests that the groups may be similar regarding these parameters. All dogs included in this study had a recommendation for MCT post-operative chemotherapy treatment. VBL action is non-selective and anemia is not a commonly described adverse effect associated with its administration. Despite that, EG dogs exhibited a reduction in erythrocytes, hematocrit, and hemoglobin, and CG dogs in hemoglobin throughout T0 to T4. The highest number of neutropenia episodes occurred during T2, after the first VBL application in both groups with a trend of stabilization after T2, which is compatible with findings described in the literature. Any dog of EG or CG had to interrupt the treatment due to hematological or gastrointestinal toxicity or died during treatment. The role of VBL dose intensity in outcome is still debatable for dogs with MCT, once it is a multifactorial disease with variable presentation. In this study, there was no difference in overall survival time after diagnosis between groups, and EG dogs treated with a higher VBL dose showed significantly less tumor recurrence than CG.

Use of Monopolar Cauterization for Ectopic Intramural Ureter Correction by Cystoscopy in Bitch

Background: The ectopic ureter (EU) is considered a congenital anomaly in which the ureteral aperture opens in a position other than the bladder neck. The diagnosis involves the use of different methods or combination of image exams, including excretory urography, pneumocystography, ultrasonography, cystoscopy and computed tomography. The technics for surgical repair should be considered evaluating the number and functionality of the EU, the location of the ureteral opening, functional condition of ipsilateral kidney and the presence of other abnormalities. The case reports aims to show the surgical repair of an intramural EU in an English Bulldog bitch by cystoscopy-guides monopolar cautery.Case: A 1-year-old English Bulldog bitch received medical care due to a history of urinary incontinence since a few months of life. The animal had laboratory abnormalities compatible with lower urinary tract infection, followed by a profound growth of Klebsiella sp in urine culture, and received antibiotic treatment for 21 days based on antibiogram results. Due to a suspect EU, a urinary tract tomography was performed and indicated a congenital kidney malformation (renal dysplasia), enlargement and distal insertion of the left ureter (in comparison with the contralateral one), rising suspiciously of its intramural progression. We choose to proceed to cystoscopy examination, in which both right and left ureteral ostium could be seen in the urethral region. A guide of a pigtail catheter was inserted through both ureteral ostia in order to orient the ureteral incision. The monopolar cautery was inserted in cystoscopy working channel to section the mucosa of EU channel on urethra region, separating the lumen of EU from the urethra and extending the incision cranially inside the urinary bladder lumen. After a complete section of the ectopic tissue, a pigtail urinary catheter was correctly placed in both ureters. After bilateral repair of EU, the bitch showed a significative decrease of urinary incontinence, although completer resolution could not be obtained.Discussion:Studies showing the treatment of EU using the ablation of the tissue separating the ureteral and urethral or bladder lumen using cystoscopy-guided laser showed lower post-operative pain and hospitalization time, besides being a minimally invasive technique in comparison with traditional surgery. The limiting factor is the specialized equipment required for the procedure. In our surgical routine, there is a cystoscope, however, we do not own a diode laser or radiofrequency equipment. The adaptation of a monopolar cautery with the objective of correct an intramural EU proved to be feasible in practice since we achieved satisfactory recovery of the patient, similar than what is seen with lasers. Even after surgical repair of both EU, the patient sustained urinary incontinence, although lesser than before surgery. The remaining of the clinical sign, in this case, is compatible with the low rate of postoperative urinary continence in bitches, irrespective of the surgical technique, varying between 25% and 58% with or without medical treatment. To our knowledge, there was no published report on the use of monopolar cautery to treat EU. The monopolar cautery can be used as a less invasive and alternative technique to traditional surgery in the treatment of intramural EU through cystoscopy in bitches.

Acrochordonous plaque in a Doberman Pinscher dog

An 8-yr old, neutered female Doberman Pinscher was presented for dermatological evaluation due to numerous pruritic, non-pigmented nodules that created a plaque in the lumbo-sacral region. This report is the first published photographic record of an acrochordonous plaque in a dolichocephalic dog and is the first reported case in Brazil.

Intermuscular Lipoma in Dogs

Background: Lipoma is a benign tumor composed of mature adipose tissue commonly found in subcutaneous tissues. However, eventually, lipomas may be located between the muscle fasciae being classifed as intermuscular lipomas. Complete surgical resection of the tumor mass is indicated as a treatment of affected patients.This report describes fve cases of intermuscular lipoma in dogs, due to the scarcity of data in the literature and lipoma relative importance in the clinical and surgical routine.Case: Five dogs were presented with a history of a large volume in the limbs with progressive growth, suggesting the presence of neoplasia. The frst step was to conduct anamnesis, when the owner reported slow growth, absence of pain, limping and licking of site. No other change was observed upon physical examination. Complete blood count (CBC) as well as liver assessment (FA) and renal (creatinine) were performed in all patients, and the results showed no changes. Fine needle aspiration cytology (FNAC) was performed and showed cells from adipose tissue, followed by histopathological examination of the lesions. Histopathological examination after incisional biopsy of the tumors showed malignancy-freetissue, composed of adipocytes without atypia, interspersed with fbrovascular stroma, confrming the lipoma diagnosis.Intermuscular lipomas were diagnosed in fve dogs with a history of a large volume in the limbs with progressive growth; all of them underwent bloc resection of the tumors. In all cases, the intermuscular lipomatous tumors were well-circumscribed and easily isolated from the tissues.Discussion: Although lipomas are relatively common in older dogs, especially in the subcutaneous tissue, intermuscular subtype is rare in veterinary medicine, which justifes the report of these cases. Intermuscular lipomas account for only 0.3% of the occurrences in human medicine. Morphologically described as tumors of slow and progressive evolution, typically reaching sizes up to 2 cm in humans, the particular cases of tumor masses greater than 5 cm are called giant lipomas. Theslow development of intermuscular lipomas has also been described in domestic animals by, thus corroborating the clini cal history in this work. The intermuscular septum is considered as the origin of intermuscular lipoma, with subsequent development of the adipose tissue between adjacent muscle bundles, thus, resulting usually in well-circumscribed mass of easy surgical divulsion. The morphological characteristics of the resected lipomas, as well as the simple surgical technique corroborate descriptions in the literature. Intermuscular lipomas consist of a challenging diagnosis despite attracting little attention from surgeons. The possibility of the mass being malignant, such as liposarcoma, should also be consideredsince the clinical symptoms consist of swelling of the deep soft tissues. The diagnosis for all these patients was obtained by histopathological examination, since the simple observation of the clinical fndings alone does not support the tumor diagnosis. Lipoma and liposarcoma should be differentiated by cytological and histopathological evaluations of the neoplasia, whereas infltrative lipomas can be diagnosed based on diagnostic imaging methods or even on the fndings during surgery. In this report, specifcally, the fndings during surgery contributed to the differentiation between infltrative and intermuscular lipoma, while for malignancy rating all patients underwent cytological and histopathological evaluations asindicated in the literature. In conclusion, this study demonstrated that complete resection of intermuscular lipoma proved to be an effective treatment to cure the patients.Keywords: benign neoplasm, surgery, resection of intermuscular, canine.

Mixed Epigastric Axial Pattern Flap Following Cutaneous Hemangiosarcoma Excision in a Male Dog

Background: Axial pattern flaps use direct cutaneous arteries to enable closure of a skin defect using a large skin segment. Caudal epigastric axial pattern flaps are highly versatile owing to their wide arc of rotation, which includes the preputial area. The presence of abundant loose and elastic skin allows wider flaps. Hemangiosarcoma (HSA) is a malignant neoplasm of endothelial cells with aggressive local behavior and high metastatic rate; the lungs are the most common site of metastasis. This case report aims to describe the use of a caudal epigastric artery-based flap, with preservation of some cranial epigastric artery branches for penis sparing, following resection of a hemangiosarcoma in the right inguinal region of a male dog.Case: An eight-year-old male Pitt Bull dog was referred with a 15 cm, ulcerated hemangiosarcoma in the right inguinal region, near the prepuce. A similar tumor had been removed from the same location two years before. Previous treatment with oral prednisone did not provide satisfactory results. The patient was suffering from intense chronic blood loss andbacterial infection of the tumor tissue. Thoracic radiographs revealed multiple metastatic nodules. Only mild regenerative anemia was found in blood tests. Considerable reductions in tumor size and in the ulcerated surface, decrease in bleeding, and recovery of appetite were observed after 7 days of administration of piroxicam and cephalexin. Surgical resectionof the tumor was performed as a palliative treatment with a minimal safety margin of 2 cm, which spared the penis. An epigastric skin flap incorporating the second mammary gland was performed preserving branches of cranial epigastric arteries, and was rotated 160° to cover the defect created in the right inguinal region and on the body of the penis. A small suture dehiscence, necrosis of the distal border of the flap, seroma, and multidrug-resistant Escherichia coli infection were observed in the postoperative period. Administration of penicillin V and topical collagenase, placement of a passive drain, and a second surgical procedure to correct the dehiscence were necessary to solve postoperative complications. Piroxicam based metronomic chemotherapy was maintained continuously, as the patient would exhibit worsening of overall condition upon discontinuation of medication. One hundred days after the initial presentation, the animal was euthanized owing to the presence of an osteolytic lesion on the vertebral bodies of L3-L4 and L5-L6, which were suggestive of discosponlylitis or axial bone metastasis.Discussion: Since lung metastases were present, penectomy and uretrostomy were not considered an option, and a pallia tive surgical treatment was performed. In this case report, cranial and caudal epigastric flap presented few complications. Caudal epigastric blood vessels are robust and abundant. Distal necrosis was considered a minor complication and was in accordance with others reports. The multidrug resistant infection was considered a nosocomial infection that arised from a long hospital stay. By inhibiting cyclooxygenase, piroxicam decreases angiogenesis, increases apoptosis, and prolongs disease-free intervals with mild toxicity. An excellent response to preoperative administration of piroxicam was crucial when choosing the postoperative protocol. A signifcant tumor size reduction and a decrease in chronic bleeding associated to improvement in general health were observed with the piroxicam-based treatment. To our knowledge, this is the frst report of a mixed (cranial and caudal) epigastric artery skin flap. This type of flap was considered a good option for correction of large defects in the inguinal region and for preservation of the prepuce and penis.Keywords: hemangiosarcoma, cranial, caudal, penis, sparing.

Determining the Optimal Time of Gastric Emptying in Cats Using Dry or Wet Food

Background: Pulmonary aspiration of gastric content can result in intraoperative and postoperative complications, such as regurgitation, gastro-esophageal reflux and esophagitis. There are variations among authors about the ideal period of solid and liquid fasting. Determination of the appropriate amount of food abstinence in surgical patients is important, because of the metabolic disorders that interfere in response to anesthetic protocol or surgical intervention. Thereby, this research aimed to evaluate the appropriate period of fasting for elective anesthesia and surgical procedures in cats, by analysis of gastric emptying time based on the daily energy requirement.Materials, Methods & Results: Seven cats of mixed breed, health and with an average weight of 2.857 ± 0.3780 were evaluated by gastroscopy for the presence of food and obtaining tissue samples. To evaluate the gastric emptying time, dry and moist food were offered at two different times, 8 h and 4 h before each evaluation, with an interval of seven days between each food treatment (dry and moist). There was no significant difference in all biochemical parameters evaluated (cholesterol, glucose, and lactate) in both fasting times and food types (P > 0.05). All animals underwent gastric biopsy for histological evaluation and urease test, to discard morphological changes. After 4 h it was observed dry food in all cat’s stomach, however just five cats presented food in their stomach after eight hours. In other hand all the animals, which ate moist food, did not present any gastric content after four hours and eight hours of feeding. Gastric mucosa were considered normal in all cats with moderate amount of Helicobacter sp.Discussion: The difficulty of a consensus on the fast time in cats, and the great variability of the emptying time according to the feeding type, makes this study useful as basis for future studies on fasting with wet food, as well as providing immediate clinical application in surgical routine. Only a moderate gastritis related to helicobacter sp. was detected, but even healthy animals can carry Helicobacter sp.  Four h of fasting time if feed the patient with 80% humidity ration improve anesthetic security of the patient with typical biochemical values. As shown, the appropriate preoperative fasting directly implies on decrease in the number of complications related to full stomach. Thus, always should take into account the possibility to perform fast in an appropriate period to prevent vomiting and aspiration, without the risk of hypoglycemia benefiting the patient and reassuring the anesthesiologist, especially in situations requiring urgent or emergency intervention. As observed through endoscopy, even eight hours of fasting with dry feed is inappropriate due to significant gastric volume of food in almost all cats. This suggests that prolonged preoperative fasting is no guarantee of low stomach volume. Wet feed can be an option for elderly and debilitated patients requiring surgical intervention within a short period of fasting. The time varies with type and volume of food that is variable according patients and different species and digestive conditions. The research were conducted with none complications. By means, this experiment it was concluded that the fasting time of 4 h with 80% humidity moist food allows complete gastric emptying without any complication.

Reconstructive Surgical Repair of a Forth Degree Iatrogenic Burn in a Dog

Background: Burns are uncommon in small animal surgery routine and represents a real therapeutic challenge. Skin can be affect in different degrees of deepness as superfcial, partial thickness, full thickness and full thickness affecting underlying tissues. Each degree has individual features. Progression through degrees can occur in the frst 24 h or if treatment is inadequate. This paper aims to describe therapeutic approach and surgical technique to treat a huge dorsal iatrogenic thermal burn injury. Case: A 4-year-old female German Shepard was referred to veterinary hospital after 11 days of elective ovariosalpingohisterectomy. The patient presented a severe skin injury with crusts, eschars, purulent discharge and myiasis on dorsal cervical, thoracic and lumbar region. Beside severity of the wound, animal present good general status and normal vital signs. Complete blood count and biochemical analysis were within normal ranges. Histopathologic analysis of a wound tissue sample revealed the presence of coagulation necrosis and inflammatory response. The absence of traumatic events, histopathologic result and wound features increased suspicious of an iatrogenic burn injury from a poorly regulated thermal mattress used during surgical intervention. “Rule of Nines” was estimated as 25% of total body surface area. Systemic antibiotics and topical treatment with 0.05% chlorhexidine digluconate and 2.5% silver sulfadiazine ointment followed by wet-wet bandage was performed after initial surgical debridement. Muscle and vertebral bone explosion were evident. Topical treatment with Silver Sulfadiazine and chlorhexidine persisted twice daily until granulation tissue formation. Pain killers and sedation were often necessary during bandage changes. At 65th day proceeded to en bloc excision of scar tissue and surgical reconstruction with skin advancement and recruitment technique. Tie-over dressing was applied to cover the fnal wound. After 14 days animal received hospital discharge, and was assessed bi-weekly for 60 days. Discussion: Besides great extension of the burn injury, patient’s age, absence of systemic involvement and fluid therapy or critical care the prognosis was good. Modifed “rule of nine” are used to estimate wound size in dogs. The wound was classifed as forth degree or full thickness injury due to exposed muscular layer and bone. Early debridement, standard topical and systemic treatment protocol applied granted good recovery of wound bed. Due to be uncommon in small animal routine, main diagnosis and therapeutic recommendations for veterinary patients are based on human data. Systemic antimicrobial drugs are usually not recommended due to low concentration in burned tissues, however, prophylactic use was necessary due to highly infected tissues and possible bacterial absorption from devitalized tissues. Delayed primary closure technique was necessary due to highly infection site and extension, which turns surgical approach hard to perform. After formation of a granulation tissue bed for wound reconstruction, surgical treatment was performed. Surgical reconstruction is indicated in large full thickness defects and for better cosmetic appearance. The correct use and regulation of thermal mattress can avoid burns that can be life threatening. This case report rises the important concept that even low contact temperatures when persistent for long time can cause burn injuries. Keywords: thermal, mattress, injury, dogs, plastic.

Idiopathic Diffuse Lipomatosis in Dogs

Background: Idiopathic diffuse lipomatosis is a rare disease in veterinary medicine. It is characterized by excessive proliferation of adipocytes, which results in the formation of fatty tumours throughout the body. In humans, this disease is also known as Madelung’s disease or multiple symmetric lipomatosis and is classifed as type I and II. The aim of this study was to investigate two cases of dogs diagnosed with idiopathic diffuse lipomatosis and compare their characteristics with those found in humans.Cases: Case 1 - A 3-year-old standard poodle female was taken for veterinary evaluation for a slow-growing tumoural lesion over the neck and trunk. The tumours measured >30 cm in diameter that caused irregular and protruding folds resulting in a signifcant loss of body architecture. No clinical signs of adjacent systemic disease were observed. Elliptical excisions of the skin revealed diffuse mature adipocytes and hyperplastic and dysplastic lipoblast hypertrophy of the panniculus, which was associated with epidermodermal hypotrophy and skin appendages. The combination of these fndings supported a diagnosis of idiopathic diffuse lipomatosis. The animal underwent surgical therapy. However, the clinical symptoms recurred within two months. Owing to the continuous recurrence of tumours and history of three other surgeries, it was decided to euthanize the animal. Case 2 - An 11-year-old female cocker spaniel preenting tumoural lesions of insidious evolution and widespread distribution. Clinical examination revealed the presence of multiple subcutaneous tumours in the lateral, lumbosacral, and abdominal regions of the pelvic limb. No clinical signs of adjacent systemic disease were observed. Biopsies of tumoural lesions also supported the diagnosis of idiopathic diffuse lipomatosis. The animal was fed a low-calorie diet, after which its body weight decreased without inducing any changes in tumour size. In addition, the animal underwent surgical treatment for removal of the largest tumours. After surgery, the animal was monitored for 1year and showed no tumour recurrence.Discussion: In veterinary medicine, lipomatosis is an extremely rare disease. Therefore, before diagnosing a case, it is necessary to exclude other proliferative disorders of the adipose tissue, among which, the most common are lipomas and liposarcomas. There are no genetic studies related to lipolytic activity or adipocyte proliferation in animals. However, it is believed that the aetiology of idiopathic diffuse lipomatosis is similar to the pathophysiology of the human form of multiple symmetrical lipomatosis, and could be associated with a primary lipid metabolism disorder. In this study, the two cases described showed a distinct distribution in the type of tumours. In case 1, the tumours were well defned and focused in the cervical and thoracic region, a pattern similar to human type I lipomatosis. However, in case 2, the fat accumulationswere diffuse and mainly located in the posterior region of the animal’s body similar to type II lipomatosis. No animals presented intra-abdominal or intrathoracic fat infltration, diagnosed by ultrasound or radiography. There is no description of any treatment capable of being effective. However, surgical procedures are recommended to minimize the occurrence of tumours and improve the quality of life of the affected animals. In the two cases described in this study, it was diffcult to completely resect the tumours. In the frst case, the recurrence of fatty deposits and performance of multiple interventions resulted in a poor quality of life of the animal, which was fnally euthanized to avoid further suffering. Therefore, frequentrecurrences might correlate with a poor prognosis in dogs.Keywords: fat, subcutaneous, tumour, skin.