Autohemotherapy at acupuncture points post orchiectomy surgery in cart horses--eight cases report/Autohemoterapia en puntos de acupuntura en el postoperatorio de orquiectomias en equinos de traccion de carroza--reporte de ocho casos/Auto-hemoterapia em pontos de acupuntura nos posoperatorios de orquiectomias de equinos carroceiros--relato de oito casos.
The Alagoas State, Northeastern of Brazil, has one of the lowest indexes of human development in Brazil. So, the cart horses used by people in that area are the financial source for many families, reaching in some municipalities 5 % of the economically active population (1).
The orchiectomies of those animals are indicated to improve the behavior, to avoid transmission of genetic characteristics not desirable to the descendants and to limit some infect-contagious disease progression (2, 3). Due to financial and cultural problems, many owners avoid the surgical procedure done by certified veterinarians. So, many of these surgical procedures are done by lay people, without antisepsis and post surgical therapy, with high hates of mortality and suffering to the animals.
In order to demonstrate and teach the technique of orchiectomy in standing position in equine cart horses from Alagoas State in practical classes for the discipline of Veterinary Surgical Technique and enable the surgery at a low coast for the poor community, this paper proposed the evaluation of the use of the postoperative technique of autohemotherapy at acupuncture points as a substitute medical therapy for the use of analgesics and antibiotics, leading to exemption of the surgical cost and promoting welfare in places were such medical drugs are not available.
This paper report the cases of eight cart horses, without specific breed, with age ranging from 3 to 10 years, and weigh from 190 to 358kg, which after clinical exam were submitted to orchiectomy using emasculator in standing position, under neuroleptic analgesia with acepromazine (0,05 mg/kg) and after fifteen minutes xylazine (0,5 mg/kg), both intravenously (IV), and local analgesia (lidocaine), as described by Finger et al. (2) and Lopes, Escobro and Silva (3). The only treatment done post surgery was autohemotherapy at acupuncture points immediately after the surgical procedure, followed by local dressings at surgical site. The volume used was 30ml of whole blood, collected from the left jugular vein, with puncture done with a 40 mm x 1,2 mm needle and immediately administered with a 30 mm x 0,8 mm needle in four points: 10ml intramuscular, caudal to triceps brachial muscle, at an acupuncture point nominated as Immunity Point (IP); 5ml at 5cm lateral to the 2nd and 3th lumbar vertebra, at an acupuncture point nominated Bladder 23 (Bl23); 5ml in between the Achilles tendon and the external tibial malleolus, at an acupuncture point nominated Bladder 60 (Bl60) and 10ml in a depression between the anus and the tail, at an acupuncture point nominated Governador Vessel 01 (GV01). The points were chosen due to its properties on immunological system, genitourinary disturbance, lombossacral pain, edema, genital function and anti-inflammatory effects, according to Chinese Traditional Medicine theory (4-9).
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All patients were admitted at the vet school bam for the first 72h and been evaluated at every 8h in relationship to vital signs, appetite and surgical wound aspect. The vital signs evaluated were: heart rate (bpm), respiratory rate (breaths/ min), temperature (T[degrees]C), color of the oral mucosa and capillary refill time (CRT). Appetite was monitored through the ingestion of 1 kg of commercial feed every 8h, being: A--excellent appetite (ingestion of the total quantity offered); B--good (ingestion of 50 to 90%); C--moderate (intake of 20 to 50%) and D--inhibited appetite (intakes below 20%). Surgical wound aspect was classified as follows: I--normal healing; II--healing with edema; III--healing with edema and mucus secretion and IV--healing with edema and purulent discharge. The surgical dressing was changed and checked every 12h through douche, povidone iodine and repellent spray. After this, all animals were evaluated every 7 days for 4 weeks.
Analyzing the signs it was observed that eight horses remained with normal color of the oral mucosa throughout the evaluated period; in relation of the appetite all remained in the A classification. Evaluating the surgical wound aspect, all animals showed the I or II classification, which is expected in post-operatives of horses orchiectomies. Only one horse was presented grade III with forty-eight hours post-procedure, possibly associated with difficulty of carrying out the dressing by aggressive behavior, returning to grade I in seven days.
The CRT of all the animals was between one and two seconds, which is considered normal for the species. The parametric parameters (bpm, hearth/min and T[degrees]C) were recorded and the distribution of response variables was analyzed and a descriptive statistic was produced. Linear Models for repeated measures (10) were used to compare the average of the parameters between the periods studied. Tukey's method was used to adjust the P-value resulting from the multiple comparisons between moments and the statistical significance was defined as P < 0.05. There was a difference between the averages, but there was no significant change (P > 0.05), identifying that no animal had tachycardia, tachypnea or hyperthermia related to the lack of post-surgical therapy such as pain killers or antibiotics.
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DISCUSSION AND CONCLUSION
The orchiectomies in standing position under neuroleptoanalgesy and local anesthesia did not present any complications during surgery, being considered a satisfactory procedure for submission of the animals for such approach.
Autohemotherapy at acupuncture points in the postoperative of equine orchiectomies showed to be effective, without any complication or sign of interference in the welfare of animals, though there is a necessity of more studies comparing the physiological response of equines submitted to autohemotherapy at acupuncture points in relationship to others submitted to conventional antibiotics and anti-inflammatory after post surgical procedure, validating this protocol in equine postoperative routine on communities with poor veterinary medical approach.
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(2.) Finger MA, Dornbusch PT, Bonfa AF, Dornbusch LPTC, Deconto I, Barros Filho IR. Comparison of two techniques in equine orchiectomy, employed in the instruction of the veterinary surgical technique. Arch Vet Sci. 2011;6:53-9.
(3.) Lopes PFR, Escodro PB, Silva RH. Estudo retrospectivo de orquiectomia em estacao com uso do emasculador em 52 cavalos: 2002-2008. In: Anais do 4 Simposio Internacional do Cavalo Atleta; 2009, Belo Horizonte. Belo Horizonte: Universidade Federal de Minas Gerais; 2009. p.26-8.
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Recebido em: 06/07/12
Aceito em: 17/09/12
Pierre Barnabe Escodro 
Jean G. Fernandes Joaquim 
Tobyas M. de Albuquerque Mariz 
Aline Saraiva de Oliveira 
Lucineia Oliveira Escodro 
Elvan Nascimento Santos Filho 
Jose Valmir Tenorio Ferreira Junior 
Juliana Oliveira Bernardo 
 Professor Adjunto do Curso de Medicina Veterinaria- Universidade Federal de Alagoas (UFAL)
 Professor Dr. do Instituto Bioethicus-Botucatu-SP
 Professor Adjunto de Equinocultura e Anatomia dos Animais Domesticos- Curso de Zootecnia-UFAL
 Graduanda Curso de Medicina Veterinaria e Bolsista de Desenvolvimento Institucional-UFAL
 Tecnica em Enfermagem e Biomedica Pesquisadora do GRUPEQUI-UFAL
 Medico Veterinario do Curso de Medicina Veterinaria-UFAL
 Graduando Curso de Medicina Veterinaria e Bolsista Permanencia Institucional-UFAL
 Graduando Curso de Medicina Veterinaria e Bolsista de Iniciacao em Inovacao Tecnologica CNPq