Chemical ciliary body ablation in dogs with chronic glaucoma and anterior lens luxation: A retrospective review from 2017 to 2022.

OBJECTIVES: To evaluate the clinical outcomes of chemical ciliary body ablation (CBA) in dogs with chronic glaucoma and concurrent anterior lens luxation and to investigate adverse ocular effects of this procedure. PROCEDURES: Retrospective review of 17 dogs (18 eyes) with chronic glaucoma and concurrent anterior lens luxation treated with intravitreal gentamicin with or without dexamethasone sodium phosphate or triamcinolone acetonide. Data collected included signalment, concurrent ocular disease, topical medications prescribed, follow-up duration, and intraocular pressure (IOP) pretreatment, posttreatment, and at the last follow-up visit. Success was defined as an IOP <25 mmHg with no additional procedures or ocular hypotensive medications at the last examination to date. RESULTS: The success rate for CBA in dogs with chronic glaucoma and concurrent anterior lens luxation was 88.9% without the need of additional surgical or ocular hypotensive therapies. Glaucoma was suspected to be secondary to lens luxation in 72.2% of cases. The most common postoperative complications were phthisis bulbi (50.0%), keratoconjunctivitis sicca (27.8%), and uveitis (27.8%). Long-term management with topical nonsteroidal anti-inflammatories, corticosteroids, and/or immunomodulators was needed in 70.6% of cases. CONCLUSIONS: CBA with intravitreal injection of gentamicin is effective at maintaining an IOP <25 mmHg in dogs with chronic glaucoma and concurrent anterior lens luxation. Management of postoperative sequelae commonly requires continued use of topical medications.

Prevalence and type of ocular disease in a population of aged captive nondomestic felids.

OBJECTIVES: Report of prevalence and type of ocular disease in a captive population of nondomestic felids. METHODS: Medical records of 202 cats from 1993 to 2018 were reviewed. Species, age at diagnosis, sex, ocular examination abnormalities, systemic/physical examination abnormalities, type of examination (visual, sedated, or anesthetized), ocular structures affected, other diagnostics, therapy, and resolution of ocular disease were recorded. RESULTS: A total of 202 nondomestic felids including 18 different species (bobcat, caracal, cougar, Fishing cat, Geoffroy's cat, jaguar, jungle cat, leopard, leopard cat, liger, lion, lynx, ocelot, Sand cat, Savannah cat, serval, snow leopard, and tiger) from a rescue facility were evaluated. Forty-six ocular lesions were diagnosed in 33 (16.3%) cats from 8 different species (bobcat, caracal, cougar, leopard, lion, ocelot, serval, and tiger) with a mean age of 16 ± 5.9 years at time of diagnosis. Ocular lesions included corneal disease (37%) (ulcerations, perforations, keratitis, corneal scars), cataracts (23.9%), hyphema (8.7%), lens luxation (6.5%), retinal detachment (6.5%), uveitis (4.3%), conjunctival disease (4.3%), retinal degeneration (2.1%), glaucoma (2.1%), and optic neuritis (2.1%). Therapies included medical (topical antibiotics, anti-inflammatories, serum, etc.) and/or surgical management (enucleation, intracapsular lens extraction, corneoconjunctival transposition, and corneal burr debridement). CONCLUSIONS: To the authors' knowledge, this is the first report of the prevalence of ocular disease in a population of captive nondomestic felids. It is difficult to diagnose and treat ocular disease in nondomestic cats due to challenges related to handling, diagnostics, and therapeutics in nondomestic species. Ocular disease seen in this population is similar to that found in domestic cat populations.

Pharmacologic ciliary body ablation for chronic glaucoma in dogs: A retrospective review of 108 eyes from 2013 to 2018.

OBJECTIVE: To evaluate the long-term outcome and efficacy of intravitreal injection of gentamicin and dexamethasone sodium phosphate (IVGD) or triamcinolone in end-stage glaucoma patients and determine pre-procedure prognostic indicators of success and post-operative complications. PROCEDURE: Medical records were reviewed for 108 dogs (108 eyes) treated with intravitreal gentamicin with or without dexamethasone sodium phosphate or triamcinolone for glaucoma between 2013 and 2018 with 3 months of minimum follow-up. Signalment and clinical findings, including type of glaucoma, pre-procedure intraocular pressure (IOP), chronicity, procedure protocol, and outcome were recorded. Success was defined as an intraocular pressure of ≤25 mm Hg at the time of last re-examination or no ocular hypotensive medications at 3 months or longer post-injection. RESULTS: The overall success rate for pharmacologic ablation was 95%. The success rate for dogs receiving no ocular hypotensive medications was 86%. Seventy-six eyes (70.4%) had primary glaucoma, and 32 eyes (29.6%) had secondary glaucoma. Age at the time of injection had no effect on initial success but did in final success (P =-.03) for dogs requiring repeat injections. Cocker Spaniels required the most repeat 2nd and 3rd injections (3/12 dogs) and (2/4 dogs), respectively. No preoperative variable significantly affected the success rate. The most common complications were phthisis bulbi (59.2%), corneal edema (25.9%), and ulcerative keratitis (22.3%). Uncontrolled IOP resulted in enucleation in two dogs (1.8%). CONCLUSIONS: Pharmacologic ablation has a high overall success rate in lowering IOP to ≤25 mm Hg short-term in blind, glaucomatous canine eyes. Type of glaucoma, pre-procedure IOP, chronicity, and protocol did not affect success.

A retrospective analysis of lipid-laden aqueous humor in dogs: Thirty cases.

OBJECTIVE: To describe the clinical presentation and outcome of canine patients that present with lipid-laden aqueous humor (LLA) and to evaluate its association with other ocular and systemic disorders. METHODS: Medical records were identified and reviewed of 30 dogs presenting with clinical signs of LLA between 2013 and 2017 and compared to the canine referral population during the same time period. The percentage of dogs affected by LLA and potential risk factors were compared between groups. RESULTS: There were 40 eyes in 30 dogs with LLA out of 8011 (0.4%) referrals. The mean age of dogs with LLA was significantly younger than dogs without LLA (P = .0334). Sex was not associated with LLA. Miniature Schnauzers were more likely to have LLA than mixed breeds (P < .0001). Incidence of LLA was significantly higher in eyes also affected by corneal ulceration (P = .0018) or phacoemulsification (P = .0001). Sixty-two percent and 51% of dogs with LLA had concurrent diabetes mellitus and hypertriglyceridemia, respectively. Average triglyceride level of dogs with LLA was 1087 mg/dL (±544) (reference 50-150 mg/dL) and average cholesterol level was 575 mg/dL (±232) (reference 125-300 mg/dL). Complete resolution of LLA was achieved in all dogs re-examined with an average of 20.2 days (range 4-175 days) after diagnosis. There were 6/30 dogs lost to follow-up. Recurrence of LLA occurred at least once in 4/24 dogs (16.7%) after resolution. CONCLUSIONS: Lipid-laden aqueous humor occurs more frequently in Miniature Schnauzers. Corneal ulceration and phacoemulsification are risk factors. Complete resolution was seen in all cases with a low incidence of recurrence.

Retrospective analysis of ocular neuropathies in diabetic dogs following cataract surgery.

OBJECTIVES: To describe and compare the cumulative incidence and clinical progression of ocular neuropathies in diabetic dogs vs nondiabetic dogs following cataract surgery. METHODS: Medical records of 196 diabetic and 442 nondiabetic dogs who underwent cataract surgery between 2004 and 2015 were reviewed. The percentage of patients affected by neuropathy and potential risk factors were compared between groups. RESULTS: Patients with diabetes mellitus (DM) were 20.4 times more likely to develop an ocular neuropathy than patients without DM (12.24% vs 0.68%). Twenty-four diabetic patients were affected by mononeuropathies or polyneuropathies including Horner's syndrome (n = 20), facial neuropathy (n = 5), and neurogenic keratoconjunctivitis sicca (NKCS) (n = 5). The odds of a diabetic patient developing Horner's syndrome and NKCS were 86.3 and 20.7 times higher than a nondiabetic patient, respectively. The average duration of DM prior to diagnosis of neuropathy was 659 days (range 110-2390 days; median 559 days). Complete resolution was achieved in 10 of 22 neuropathies (45%) within an average of 248 days (range 21-638 days; median 187 days) after diagnosis. CONCLUSIONS: The odds of developing an ocular neuropathy, specifically Horner's syndrome and NKCS, are statistically higher in diabetic patients compared to nondiabetic patients. Neuropathies were observed as a long-term complication in this group of diabetic patients, and complete resolution of the neuropathy was observed in less than half of the affected population.

Hemangiosarcoma in a Dog: Unusual Presentation and Increased Survival Using a Complementary/Holistic Approach Combined with Metronomic Chemotherapy.

This case report documents the clinical and pathologic findings in a 12-year-old terrier mix with intraocular and splenic hemangiosarcoma. Pathologic findings in both the spleen and globe were consistent with hemangiosarcoma with a low mitotic count. Initial treatment consisted of enucleation and then splenectomy followed by one cycle of conventional doxorubicin chemotherapy. Due to poor tolerance, a subsequent treatment regimen consisted of metronomic chemotherapy with chlorambucil combined with an alternative/complementary regimen of I'm-Yunity (polysaccharopeptide) and Yunnan Baiyao. Follow-up thoracic radiographs and abdominal ultrasounds over a period of 24 months showed no evidence of pulmonary, hepatic, or right atrial metastases, during which time the patient had an excellent quality of life. However, shortly after achieving two-year survival, the patient developed new onset seizures unresponsive to anticonvulsant therapy. Therefore, a decision was made to euthanize the dog given that the most likely etiology of the seizures was a brain tumor. Overall, this is an exceptional treatment response given the poor survival statistics of hemangiosarcoma even with conventional chemotherapy. However, additional clinical pharmacology and clinical trial data are needed to further support the use of a complementary/holistic approach in combination with metronomic chemotherapy.

Retinal detachment and glaucoma in the Boston Terrier and Shih Tzu following phacoemulsification (135 patients): 2000-2014.

OBJECTIVES: To report the cumulative incidence of retinal detachment (RD) and glaucoma following phacoemulsification in Boston Terriers and Shih Tzu in the southeastern United States over a 14-year period and investigate the potential predisposing risk factors. METHODS: Medical records of 83 Shih Tzu and 52 Boston Terriers that underwent phacoemulsification between 2000 and 2014, with or without intraocular lens placement, were reviewed. For a comparison population, phacoemulsification data from 45 Labrador Retrievers, 73 Schnauzers, and 159 Bichon Frises were evaluated. Information collected included signalment, concurrent systemic diseases, preoperative findings, surgical details, postoperative complications, and duration of follow-up. Percentages of patients to develop RD and glaucoma were assessed, as well as potential risk factors. Minimum of 3 months of follow-up after surgery was required for inclusion. RESULTS: Retinal detachment occurred in 7.7% (7/91 eyes) and 8.9% (11/123 eyes) and glaucoma occurred in 38.0% (35/91 eyes) and 29.3% (36/123 eyes) of Boston Terriers and Shih Tzu, respectively. Mean follow-up time was 804 days. Neither Boston Terriers nor Shih Tzu were at increased risk for RD or glaucoma when compared to the other breeds, and no significant risk factors for either breed were identified in the final multivariate analysis. CONCLUSIONS: The cumulative incidence of RD in Boston Terrier and Shih Tzu reported here was in agreement with previously reported nonbreed specific percentages (2.7-8.4%). The cumulative incidence of glaucoma in this population of Boston Terriers and Shih Tzu was higher than previously reported nonbreed specific percentages (5.1-18.8%).

Measurement of corneal sensitivity in 20 ophthalmologically normal alpacas.

OBJECTIVE: To determine corneal sensitivity in 20 healthy adult alpacas (40 eyes) in order to establish reference values. DESIGN: Prospective study. ANIMALS: Twenty healthy, adult alpacas. PROCEDURES: Corneal sensitivity was determined by the corneal touch threshold (CTT) using a Cochet-Bonnet esthesiometer. Five different regions of the cornea were evaluated (nasal, ventral, lateral, dorsal, and central). RESULTS: Corneal touch threshold values (in mm filament length) obtained from five corneal regions demonstrated varying corneal sensitivities. The central region (34.5 ± 7.1 mm) was the most sensitive, followed by the ventral (29.5 ± 7.2 mm), medial (29.3 ± 7.3 mm), dorsal (25.6 ± 6.3 mm), and lateral (21.8 ± 5.7 mm) regions. All pairwise comparisons of regional differences were statistically significant (P < 0.05), except for the comparison between the ventral and medial regions (P = 0.88). Evaluation of the CCT while controlling for age (2-5 years vs. 6-10 years) demonstrated an increased CTT with an increasing age for the central, ventral, medial and lateral regions. A decrease in the CTT of the dorsal region was noted with increasing age. CONCLUSION AND CLINICAL RELEVANCE: Corneal touch threshold values in 40 eyes of 20 healthy adult alpacas were determined using a Cochet-Bonnet esthesiometer. This study demonstrated the central corneal region to be most sensitive. Values obtained may serve as reference values in subsequent studies.

Scleral and suprachoroidal foreign body in a dog--a case report.

A 2-year-old male castrated Springer Spaniel with a 3-week history of waxing and waning right sided exophthalmos, periorbital swelling, chemosis, and fundic changes was examined. Ophthalmic examination of the right eye revealed slight chemosis and nictitating membrane protrusion. Indirect ophthalmoscopy showed an approximately 8 mm peripapillary hyporeflective tapetal lesion with subretinal edema consistent with a bulbar/retrobulbar disease process. Inflammatory or neoplastic diseases were the main differential diagnoses. Ancillary diagnostics (ocular ultrasound and computed tomography) showed a focal, poorly defined dense tissue involving the caudomedial aspect of the right globe, adjacent to the optic nerve head without apparent orbital involvement. Considering the duration, location, and severity of the clinical findings, enucleation of the right globe was performed. Histopathology revealed focal thickening of the posterior wall with severe pyogranulomatous inflammation, surrounding a foreign body most consistent with plant material embedded between the sclera and the choroid (suprachoroidal). This report describes a rare case of a scleral/suprachoroidal foreign body (plant material), and outlines the difficulty of establishing an etiological diagnosis using standard ocular imaging.

Intervertebral biomechanics of locking compression plate monocortical fixation of the canine cervical spine.

OBJECTIVE: To evaluate the use of a locking compression plate (LCP) with monocortical screw purchase for stabilization of the canine cervical spine. STUDY DESIGN: Experimental study. ANIMALS: Cadaveric canine cervical spine specimens (n = 7). METHODS: Flexion and extension bending moments were applied to canine cadaveric specimens (C3-C6) in 4-point bending, before and after creation of a ventral slot at C4-C5, and after fixation with a 5 hole, 3.5 mm LCP with monocortical screw placement. Screw placement and penetration into the vertebral canal were determined by radiography. Range of motion, stiffness, and energy for passive physiologic loads were determined for the C3-C4, C4-C5, and C5-C6 vertebral motion units (VMU). Monotonic failure properties were determined for cervical extension. Effects of treatments on biomechanical variables were assessed using repeated measures analysis of variance and least square means (P ≤ .05). RESULTS: The ventral slot procedure increased range of motion at the treated VMU. Plate fixation decreased range of motion, increased stiffness, and decreased energy at the treated VMU. No changes were observed at adjacent VMUs. None of the screws penetrated the vertebral canal. Mean (± SD) yield bending moment of plate stabilized, slotted spines was 15.6 ± 4.6 N m. CONCLUSION: LCP fixation with monocortical screws stabilized the canine cervical spine.