Lateral canthal reconstruction for the treatment of macroblepharon/diamond eye conformation in dogs.

PURPOSE: To introduce a novel surgical technique for treatment of macroblepharon and diamond eye conformation in dogs. METHODS: Lateral canthal reconstruction was used in dogs with prominent eyelid malformations resulting in ocular surface disease. Lateral canthus was resected and new lateral canthus was created using a two-layer closure. This technique was performed either alone or in combination with additional procedure(s). Additionally, this technique was used to resect lateral canthal dermoid. RESULTS: One hundred and fifty-three eyes of 85 dogs were included in the study. Procedure was done for macroblepharon and/or lateral canthal entropion (149 eyes of 81 dogs) or for lateral canthal dermoid (four eyes of four dogs). Procedure was done either alone (n = 68 eyes) or in combination with additional procedure (n = 85 eyes). Favorable cosmetic outcome and client satisfaction was achieved in all dogs. Good to excellent functional outcome was recorded in all but 6 eyes of 4 dogs, which required additional surgery. Most common complications included slight undercorrection or overcorrection. CONCLUSIONS: Lateral canthal reconstruction is a simple yet effective surgical procedure for macroblepharon and/or lateral canthal entropion. If done early, it prevents development of secondary eyelid malformation ("pagoda defect") in giant breed dogs. If done after severe eyelid malformation has developed, combining this technique with concurrent pagoda resection is recommended to achieve ideal eyelid conformation. None.

Clinical therapeutic efficacy of mycophenolate mofetil in the treatment of SARDS in dogs-a prospective open-label pilot study.

OBJECTIVE: Sudden acquired retinal degeneration syndrome (SARDS) is a leading cause of irreversible blindness in dogs, yet no treatment has been objectively evaluated, or proven to be effective. Consensus of opinion is that SARDS is immune-mediated, although corticosteroid medications may exacerbate associated systemic signs. We examined the effect of sole-agent treatment with mycophenolate mofetil (MMF), a potent immunosuppressive medication unlikely to exacerbate associated systemic signs. ANIMALS STUDIED: Ten client-owned dogs with SARDS prospectively recruited within 6 weeks of vision loss. PROCEDURES: Clinical history, findings of systemic and ophthalmic examinations, blood parameters, visual navigation ability, electroretinography, and optical coherence tomography (OCT) were collected at baseline and at recheck after approximately 6 weeks of treatment with 10 mg/kg q 12 h of oral MMF. RESULTS: Twenty percent of dogs (2/10) experienced side effects (diarrhea, vomiting, lethargy), which resolved with reduction in dose to 8 mg/kg q12 h. No significant changes in systemic signs, physical examination findings, or laboratory test results were detected at the recheck examination. Compared with baseline, visual ability significantly declined at the recheck examination, and the amplitude of a slow-onset negative waveform noted on dark-adapted electroretinography was reduced at the recheck examination. The outer retinal layers were significantly thinner at the recheck examination as measured by OCT. CONCLUSIONS: Mycophenolate mofetil as a sole agent has no measureable positive effect on physical health, vision, or retinal structure following a 6-week trial period. Further studies are needed to evaluate other treatment options for SARDS.

Development and validation of the canine visual function instrument.

OBJECTIVE: In this study, we created the Canine Visual Function Instrument (CVFI) and tested its validity and reliability for assessing the quality of vision of dogs. METHODS: We used Cronbach's alpha to test the strength of the consistency of the questions in the instrument and factor analysis to assess whether the questions achieved unidimensionality in the measurement of dogs' vision quality. RESULTS: Our analysis shows that the CVFI is a valid and reliable tool to seek self-reported observations about dogs' vision quality from owners. Our results also show that the vision quality scale has high empirical validity and therefore can be used to determine whether a dog has normal vision or moderate or serious visual impairments. CONCLUSION: The CVFI might have important practical applications in the field of veterinary ophthalmology in two important ways. First, it can be used to determine whether the treatment of dogs with visual impairment improves vision quality. Second, it can be used as a warning system to alert owners about their dogs' quality of vision.

Corneal edema in four horses treated with a superficial keratectomy and Gundersen inlay flap.

OBJECTIVE: To describe the clinical presentation, treatment, and outcome of four horses with severe corneal edema caused by suspected endothelial disease treated with a superficial keratectomy and Gundersen inlay flap and to determine whether this procedure (i) reduces corneal edema, (ii) reduces ocular pain, (iii) eliminates recurrent corneal ulceration, and (iv) improves vision in these horses. ANIMALS STUDIED: Four horses met inclusion criterion of (i) diagnosis with endothelial disease by a board-certified veterinary ophthalmologist and (ii) surgical treatment with a superficial keratectomy and Gundersen inlay flap. PROCEDURE: Retrospective medical record review of included horses was used to determine breed, age and sex of included horses, as well as details of medical and surgical therapy, and visual outcome. RESULTS: Four horses were presented with a complaint of focal corneal edema that progressed to diffuse corneal edema. Epithelial bullae and ulceration were present in all cases. The disease process was unresponsive to standard medical treatment with a hyperosmotic agent and topical and systemic anti-inflammatories. However, treatment with a superficial keratectomy and Gundersen inlay flap performed under general anesthesia was associated with (i) a significant decrease in corneal edema, (ii) increased comfort, (iii) elimination of corneal ulceration, and (iv) retention of vision postoperatively with little to no need for medical therapy. Follow-up time was 15, 12, 6, and 3 months. CONCLUSIONS: The superficial keratectomy and Gundersen inlay flap may provide a surgical alternative to chronic medical treatment of severe corneal edema in horses.

Quantification and comparison of baseline cortisol levels between aqueous and plasma from healthy anesthetized hound dogs utilizing mass spectrometry.

OBJECTIVE: The purpose of this study is to quantify and compare the resting cortisol levels between aqueous (Aq) and plasma of anesthetized hound dogs utilizing mass spectrometry. ANIMALS: Nine hound breed dogs weighing between 20.8 and 29.2 kg (x = 26.3 kg, SD ± 2.6 kg) were utilized from a previous project. PROCEDURES: All dogs underwent two anesthesia sessions to harvest Aq from each eye respectively. A paired blood sample was taken immediately after aqueous centesis. The Aq and plasma were analyzed for cortisol levels using mass spectrometry. Correlation of cortisol levels in dog serum and ocular fluid was determined with Sigma Stat using Pearson's correlation analysis. The level of significance for correlation analysis was set at P < 0.05. RESULTS: The plasma resting cortisol levels in the dog ranged from 3.59 to 89.35 nm (x = 31.68 nm, SD ± 28.53 nm), while the Aq cortisol levels ranged from 0.82 to 5.62 nm (x = 2.73 nm, SD ± 1.94 nm). The correlation of cortisol levels in Aq compared to plasma was significant (P = 0.008) with a correlation coefficient of r = 0.779. Based on these results, 61% (r = 0.779(2) ) of the variation in Aq cortisol levels is explained by the variations in plasma cortisol levels. CONCLUSION AND CLINICAL RELEVANCE: This study identified significant levels of cortisol in the Aq of the canine eye and positively correlated them with plasma cortisol levels. The dog may offer a representative model for further studies to help clarify the overall role of cortisol in the anterior chamber.

Use of a sclerosing agent (1% polidocanol) to treat an orbital mucocele in a dog.

A case of a salivary gland mucocele in a dog causing nonpainful exopthalmos with dorsolateral deviation of the globe and protrusion of the third eyelid. Diagnosis was made via ultrasound and confirmed with computed tomography. Aspiration of the cystic material along with injection of a sclerosing agent, 1% polidocanol (Aethoxysklerol), was used to destroy the mucocele. Follow-up monthly examination post injection confirmed resolution of clinical signs to date, namely abnormal globe position, with no complications observed.

Ocular findings in Quarter Horses with hereditary equine regional dermal asthenia.

OBJECTIVE: To compare ocular structures of Quarter Horses homozygous for hereditary equine regional dermal asthenia (HERDA) with those of Quarter Horses not affected by HERDA (control horses) and to determine the frequency of new corneal ulcers for horses with and without HERDA during a 4-year period. DESIGN: Cohort study of ocular structures and retrospective case series of horses with and without HERDA. ANIMALS: The cohort portion of the study involved 10 Quarter Horses with HERDA and 10 Quarter Horses without HERDA; the retrospective case series involved 28 horses with HERDA and 291 horses without HERDA. PROCEDURES: Ophthalmic examinations, Schirmer tear tests, tonometry, corneal pachymetry, histologic examinations, and scanning electron microscopy (SEM) were performed in cohorts of Quarter Horses with and without HERDA. Records were reviewed to determine the incidence of corneal ulcers in horses with and without HERDA during a 4-year period. RESULTS: Corneal thickness of horses with HERDA was significantly less than that of control horses, but tear production of horses with HERDA was significantly greater than that of control horses. Results of SEM revealed zones of disorganized, haphazardly arranged collagen fibrils in corneas of horses with HERDA that were not evident in corneas of control horses. The incidence of corneal ulcers was significantly greater for horses with HERDA than for horses without HERDA during the 4-year period. CONCLUSIONS AND CLINICAL RELEVANCE: Alterations in corneal thickness, arrangement of collagen fibers, and incidence of corneal ulcers indicated that abnormalities in horses with HERDA were not limited to the skin.

Histologic comparison of canine skin biopsies collected using monopolar electrosurgery, CO2 laser, radiowave radiosurgery, skin biopsy punch, and scalpel.

OBJECTIVE: To compare the histologic appearance of canine skin biopsies collected by use of a scalpel, skin biopsy punch, monopolar electrosurgery, CO2 laser, and radio wave radiosurgery in fully rectified wave form (RWRS). STUDY DESIGN: Experimental, randomized design. ANIMALS: Healthy adult grayhounds (n=4). METHODS: Skin biopsies were collected using 5 techniques. Cut margins of biopsy specimens and adjacent peripheral skin were evaluated using light microscopy to compare penetration of the dermis by tissue carbonization (char). RESULTS: No char occurred in skin specimens collected by biopsy punch and scalpel. Char penetration occurred in all specimens collected by electrosurgery, CO2 laser, and RWRS. Mean char penetration in skin biopsies collected by RWRS (0.158 mm) was significantly less than for monopolar electrosurgery (0.223 mm) and CO2 laser (0.215 mm). Mean char penetration in adjacent peripheral skin surrounding biopsies collected by RWRS (0.171 mm) was significantly less than monopolar electrosurgery (0.255 mm) but not less than CO2 laser (0.215 mm, P<.07). CONCLUSIONS: RWRS (blended waves in cut-coagulate mode) caused less lateral thermal damage to canine skin biopsies than monopolar electrosurgery and CO2 laser and less lateral thermal injury to peripheral skin than monopolar electrosurgery. CLINICAL RELEVANCE: Excision of canine skin biopsies with heat-generating devices may not allow reliable histologic interpretation, particularly when assessing margins of small biopsy specimens. RWRS may be less traumatic to canine skin than monopolar electrosurgery and CO2 laser when used to make incisions.