Úlcera de córnea em bugio-ruivo (Alouatta guariba clamitans) - tratamento com soro heterólogo / Corneal ulcer in a Southern brown howler monkey (Alouatta guariba clamitans) - treatment with heterologous serum

Background: In the routine care of non-human primates, ocular trauma is frequent, however, unlike the small animal clinic, the prevalence of corneal ulcers is not documented. Among the numerous therapeutic options available in dogs, blood serum is being increasingly used as an adjuvant treatment in these conditions, due to its tear-like properties. Based on this, the present study aims to describe a case of corneal ulcer in a southern brown howler monkey (Alouatta guariba clamitans) attacked by a porcupine, and the use of heterologous serum obtained from an equine as an adjuvant treatment. Case: A southern brown howler monkey (Alouatta guariba clamitans), which had been attacked by porcupine quills, was treated at a University Veterinary Hospital. During the clinical examination, the presence of blepharospasm and secretion in the right eye was noticed. The ophthalmological examination, through the fluorescein test, detected the presence of an extensive superficial corneal ulcer in the right eye. After removing the spines, the corneal ulcer was treated with tobramycin-based eye drops, 1% atropine sulfate eye drops, and serum from equine blood in the form of eye drops, as an adjuvant therapy. After 5 days of treatment, the fluorescein test was repeated, which was negative in both eyes due to complete healing of the lesion, and thus the treatment was concluded. Discussion: The scarcity of scientific literature on wild animals is one of the factors responsible for the difficulty in advancing clinical and surgical procedures in non-human primates. Corneal ulcers are characterized by the loss of corneal epithelium with exposure of the stroma. The main clinical treatments adopted include antimicrobial therapy, analgesics, lubricating agents, and antiprotease drugs. Widely used as an adjuvant therapy in corneal ulcers in small animals, blood serum presents some advantages, as it is rich in growth factors, vitamins, immunoglobulins, and anti-collagenolytic substances, in addition to being obtained for a low cost. Considering the aforementioned, in the case reported, it was decided to use blood serum obtained from an equine as an adjuvant treatment of the corneal ulcer in a southern brown howler monkey. Complete healing of the corneal ulcer was confirmed in just five days, contributing to the well-being of this animal and contributing to the evolution of ophthalmology in this species that is still poorly studied.

Uso de soro autólogo no tratamento de úlcera ocular em cães: uma revisão bibliográfica / Use of autologus serum in the treatment of ocular ulcers in dogs: a bibliographic review / Uso de suero autólogo em el tratamiento de úlceras oculares em perro: una revisión bibliográfica

Sendo considerada uma doença de alto acometimento na oftalmologia veterinária de cães, a úlcera de córnea é um distúrbio caracterizado por uma ferida exposta na região corneal do olho. Os sinais são variados conforme o grau de agressividade da lesão, acarretando em perda da visão caso a intervenção não seja iniciada imediatamente. Devido a estes fatores e ao elevado nível de importância da doença, torna-se necessário o uso de terapêuticas que auxiliem o processo de reparo ocular, como a utilização do soro autólogo. Essa substância realiza uma função de evitar degradação da córnea e diminuir os sinais inflamatórios, o que torna essa prática um apoio eficaz para a finalização do tratamento, além de ser barato e de fácil acesso. Levando essas informações em consideração, o presente artigo realiza uma revisão com base em publicações apresentando o soro autólogo como um elemento adicional para o paciente poder concluir o tratamento de úlcera de córnea em menor tempo e com maior qualidade, retomando-o ao seu estado saudável.(AU)

Being considered a disease of high involvement in the veterinary ophthalmology of dogs, the corneal ulcer is a disorder characterized by an exposed wound in the corneal region of the eye. The signs vary according to the degree of aggressiveness of the lesion, leading to loss of vision if intervention is not started immediately. Due to these factors and the high level of importance of the disease, it becomes necessary to use therapies that help in the process of ocular repair, such as the use of autologous serum. This substance performs a function of preventing corneal degradation and reducing inflammatory signs, which makes this practice an effective support for the completion of treatment, besides being cheap and easily accessible. Taking this information into consideration, the present article performs a review based on publications presenting the autologous serum as an additional element for the patient to finish the corneal ulcer treatment in less time and with higher quality, returning him to his healthy state.(AU)

Siendo considerada una enfermedad de alto ataque en la oftalmología veterinaria de perros, la úlcera de córnea es una alteración caracterizada por una herida expuesta en la región corneal del ojo. Los signos son variados según el grado de agresividad de la lesión, acarreando en pérdida de la visión en caso de que la intervención no sea iniciada inmediatamente. Debido a estos factores y al alto nivel de importancia de la enfermedad, es necesario utilizar terapias que ayuden al proceso de reparación ocular, como el uso de suero autólogo. Esta sustancia cumple una función de evitar la degradación corneal y disminuir los signos inflamatorios, lo que hace de esta práctica un apoyo eficaz para el final del tratamiento, además de ser barata y de fácil acceso. Teniendo en cuenta esta información, el presente artículo realiza una revisión basada en publicaciones que presentan el suero autólogo como un elemento adicional para que el paciente finalice el tratamiento de la úlcera corneal en menor tiempo y con mayor calidad, devolviéndolo a su estado saludable.(AU)

Induced corneal ulcers in cats - effects of 2% dorzolamide on epithelization time and on the expression of matrix metalloproteinase-9

Background: Topically administered 2% dorzolamide is among the most commonly used agents to lower IOP. As a complication of glaucoma, blind patients may develop corneal ulcers secondary to trauma. Nonetheless, in patients with a hypertensive or glaucomatous eye, in which the cornea has also been ulcerated, medical hypotensive therapy should not be discontinued. Therefore, the present study aimed to determine whether the instillation of a benzalkonium chloride (BAK)-preserved 2% dorzolamide alters corneal wound healing time and the levels of matrix metalloproteinases (MMP-9) in the tears of cats with experimentally induced corneal ulcers. Materials, Methods & Results: Sixteen cats (8/group) were randomly assigned to receive 40 µL of 2% dorzolamide (TG) or saline (CG) 3 times daily until corneal re-epithelialization. Experimental keratectomies were performed under general and topical anesthesia using an operating microscope. For this purpose, a millimitred trephine was calibrated and used to create a temporal paraxial corneal ulcer with a diameter of 6 mm and a depth of 200 µm. After corneal wounding, the ulcerated area, the healing time, blepharospasm, conjunctival hyperemia, and aqueous flare were compared between groups. Tears were collected at baseline and 24 and 48 h after keratectomy, and the total MMP-9 was quantified by ELISA. Data were assessed statistically using unpaired Student's t test, one-way, and two-way ANOVA followed by a Bonferroni post hoc test. Statistical significance was set at P < 0.05 for all analyses. The average time to achieve corneal wound healing did not differ between groups (P = 0.36) and was 65.50 ± 3.62 h in the CG and 71.00 ± 4.58 h in the TG. Twenty-four h after keratectomy, the ulcerated area in the CG was 3.34 mm2 larger than that observed in the TG (P = 0.04); the rest of the comparisons did not reach statistical significance at any time point between groups (P > 0.05). Higher blepharospasm scores were observed in cats of TG (P = 0.04). When compared with baseline of both groups, the levels of MMP-9 increased significantly at 24 and 48 h post-keratectomy (P < 0.001), but differences between groups were not observed at 24 and 48 h post-keratectomy (P > 0.05). Discussion: In cats, 9 mm axial corneal ulcers created by superficial debridement re-epithelize approximately 48 h postwounding. In the present study, re-epithelialization post keratectomy occurred within an average time of 68.25 h in most cats and in a delayed manner in one cat of the TG after 96 h. In the current study, the lesions in both groups healed without corneal scarring, pigmentation, or vascularization. Although BAC was present in all topical medications used in the present study, the authors attribute the higher scores of blepharospasm in the TG to the rheological characteristics and the pH of the dorzolamide ophthalmic solution. Indeed, the pH value of dorzolamide (5.58) may cause signs of irritation, as the tear film has an approximate pH of 7.6. Previous studies showed that ulcerated corneas presented significantly higher levels of MMP-9 in tears at the early stages (8 to 36 h) post-wounding. In the current study, the levels of this enzyme after wounding did not change significantly in the tears of cats treated with 2% dorzolamide when compared to the eyes in the control group. This study showed that the instillation of a BAC-preserved 2% dorzolamide ophthalmic solution did not impair the corneal wound healing time or the early expression of MMP-9 in the tears of cats with experimentally induced corneal ulcers. However, our results warrant further investigation in patients with ocular hypertension or glaucoma presenting concomitant naturally occurring corneal ulcers to certify our findings.

Hydrodissection in the construction of conjunctival flaps in dogs

Background: Hydrodissection is a minimally invasive procedure that consists of injecting fluid into an anatomical space to facilitate dissection during surgery. Although this procedure is employed in several areas of veterinary medicine, including ophthalmology, there are no reports of the use of this maneuver in conjunctival procedures in dogs. The use of this technique can facilitate the construction of conjunctival pedicle flaps, thereby improving the results. The purpose of this work was to evaluate the use of hydrodissection in the construction of conjunctival pedicle flaps in dogs. Materials, Methods & Results: The sample consisted of 20 eyes from 10 healthy dogs that had been subjected to elective surgical procedures of ovariohysterectomy and orchiectomy. The dogs were divided into 2 groups; the 1st group of 10 eyes underwent hydrodissection and the 2nd group of 10 eyes did not. All the patients underwent a complete ophthalmic examination and assessment of their systemic conditions. The patients were then anesthetized and the procedures were performed under a surgical microscope. In the group subjected to hydrodissection, the conjunctival flap was prepared by means of a previous subconjunctival injection of 0.7 mL of 0.9% sodium chloride, followed by preparation of the flap. In the group without hydrodissection, the flap was prepared by means of conventional divulsion using iris scissors. After producing the conjunctival flaps, a conjunctival fragment was collected from both groups for histological analysis and evaluation of the presence of the Tenon capsule. The operating time, degree of hemorrhage and ease of handling the conjunctiva in the intraoperative period were evaluated. Postoperative evaluations were performed at 1, 7 and 14 days after surgery and included: blepharospasm, conjunctival hyperemia and edema, which were classified as absent, mild, moderate or severe; tear production was evaluated using the Schirmer test, and the appearance of the conjunctival scar was assessed based on photographs taken in the postoperative period, and by a visual analogue scale, with healing classified as fair, good or excellent. The 2 groups showed no statistical difference in terms of operating time, bleeding, ease of handling and conjunctival divulsion. A volume of 0.48 ± 0.12 mL of 0.9% sodium chloride was administered to the conjunctiva. Postoperative assessments of hyperemia, blepharospasm, conjunctival edema, and tear production also did not differ statistically. Conjunctival scarring was considered optimal until the 14th postoperative day, with no statistically significant difference between the 2 groups. These results demonstrate that both maneuvers are effective in creating conjunctival flaps. The Tenon capsule could not be identified in histological stains. Discussion: The literature offers numerous descriptions of the use of hydrodissection in surgical procedures in humans in order to facilitate dissection and reduce surgical duration and handling, thereby improving the clinical recovery of patients. Conversely, this technique has not been described frequently in veterinary medicine, notably with respect to conjunctival procedures. In this study, we demonstrated that conjunctival hydrodissection was perfectly feasible, contributing to the divulsion and preparation of conjunctival flaps, thus proving to be a viable option for this type of procedure. The absence of the Tenon capsule in the evaluated samples demonstrates that, in both groups, the techniques were effective in separating them from the conjunctiva. It was therefore concluded that the hydrodissection technique is a feasible maneuver in the construction of conjunctival flaps, providing a new option for surgeons, especially for novice ophthalmologists.

Abscesso estromal em córnea de cão / Corneal stromal abscess in a dog

Background: The eye is an important sense organ responsible for sight. The cornea is the outermost of many eye layers,being predisposed to several lesions, some of them being frequent in small animal clinics meanwhile others are unusualand seldom reported in specialized literature. The stroma abscess is a common condition in horses, but atypical in dogs,it’s a condition in which a microperforation in the corneal epithelium allows microorganisms or a foreign body to penetratethe corneal stroma, and those become inside the cornea after a re-epithelialization, producing an intense inflammatoryresponse. Therefore, this case reports a case of deep stromal abscess in a Shih Tzu dog.Case: A 4-year-old female Shih Tzu, weighing 4.6 kg, was submitted to ophthalmic examination in which the left eyepresented an opaque yellowish-white protruding structure located on the right side, in the center of the cornea (3 o´clockposition), bulbar and palpebral conjunctival hyperemia and congestion, chemosis, blepharospasm, and a moderate amountof mucous discharge. The clinical diagnosis was stromal abscess with reflex uveitis. A differential diagnosis should includeconditions affecting the anterior part of the cornea, such as an epithelial inclusion cyst and a corneal ulcer. The inclusioncyst, contrarily to the corneal abscess, doesn’t cause pain, meanwhile, the corneal ulcer was ruled out by the FluoresceinStaining Test. The recommended treatment was surgical, through lamellar keratectomy, followed by overlapping pedicledconjunctival graft and third eyelid flap. In association with the surgical treatment, oral antibiotics, anti-inflammatory,and opioids, plus topical antibiotics and autologous serum eye drop. Seventy days post-surgery, the previously observedinflammatory signs were no longer present. In the conjunctival graft insertion site perpetuated a scar leucoma with few...

Abscesso estromal em córnea de cão / Corneal stromal abscess in a dog

Background: The eye is an important sense organ responsible for sight. The cornea is the outermost of many eye layers,being predisposed to several lesions, some of them being frequent in small animal clinics meanwhile others are unusualand seldom reported in specialized literature. The stroma abscess is a common condition in horses, but atypical in dogs,its a condition in which a microperforation in the corneal epithelium allows microorganisms or a foreign body to penetratethe corneal stroma, and those become inside the cornea after a re-epithelialization, producing an intense inflammatoryresponse. Therefore, this case reports a case of deep stromal abscess in a Shih Tzu dog.Case: A 4-year-old female Shih Tzu, weighing 4.6 kg, was submitted to ophthalmic examination in which the left eyepresented an opaque yellowish-white protruding structure located on the right side, in the center of the cornea (3 o´clockposition), bulbar and palpebral conjunctival hyperemia and congestion, chemosis, blepharospasm, and a moderate amountof mucous discharge. The clinical diagnosis was stromal abscess with reflex uveitis. A differential diagnosis should includeconditions affecting the anterior part of the cornea, such as an epithelial inclusion cyst and a corneal ulcer. The inclusioncyst, contrarily to the corneal abscess, doesnt cause pain, meanwhile, the corneal ulcer was ruled out by the FluoresceinStaining Test. The recommended treatment was surgical, through lamellar keratectomy, followed by overlapping pedicledconjunctival graft and third eyelid flap. In association with the surgical treatment, oral antibiotics, anti-inflammatory,and opioids, plus topical antibiotics and autologous serum eye drop. Seventy days post-surgery, the previously observedinflammatory signs were no longer present. In the conjunctival graft insertion site perpetuated a scar leucoma with few...(AU)

Corneal ulcer in a sheep - treatment with third eyelid flap

Background: Corneal ulcers are frequently reported in the literature in several species, however, the treatment of traumaticlesions on the corneal surface of ruminants is still poorly described. The use of the third eyelid flap is questioned whenapplied to deep ulcers, since the technique prevents the evolutionary follow-up of corneal healing and compromises care.However, several authors report its successful use for the treatment of superficial and deep corneal ulcers. This techniqueprotects the ocular surface and prevents the occurrence of new lesions or their aggravation. The aim of this study was toreport the treatment of corneal ulcers in sheep through the third eyelid flap associated with the use of topical antibiotics.Case: A 2-year-old male Dorper sheep, with ocular discomfort, conjunctival hyperemia and mucopurulent secretion in theleft eye, was assisted in a private rural property in the West region of Bahia, Brazil. The owner reported that before seeking veterinary help he used a spray based on oxytetracycline and hydrocortisone, which worsened the animal’s condition.Upon inspection, it was observed eyelid asymmetry, slight lateralization of the head to the left, periorbital alopecia onthe left face, intense blepharospasm in the left eye, with projection of the third eyelid occurring at times. The ophthalmicexamination was performed after application of anesthetic eye drops based on proxymetacaine to reduce eye discomfort.A corneal stromal lesion, edema and fibrovascular tissue in the left eye were identified, but the cause of the lesion was notdefined, with lagophthalmia, entropion, dystychiasis or ectopic cilia being ruled out. So, it was suggested that the lesionhad occurred by a foreign body, such as dust...

Corneal ulcer in a sheep - treatment with third eyelid flap

Background: Corneal ulcers are frequently reported in the literature in several species, however, the treatment of traumaticlesions on the corneal surface of ruminants is still poorly described. The use of the third eyelid flap is questioned whenapplied to deep ulcers, since the technique prevents the evolutionary follow-up of corneal healing and compromises care.However, several authors report its successful use for the treatment of superficial and deep corneal ulcers. This techniqueprotects the ocular surface and prevents the occurrence of new lesions or their aggravation. The aim of this study was toreport the treatment of corneal ulcers in sheep through the third eyelid flap associated with the use of topical antibiotics.Case: A 2-year-old male Dorper sheep, with ocular discomfort, conjunctival hyperemia and mucopurulent secretion in theleft eye, was assisted in a private rural property in the West region of Bahia, Brazil. The owner reported that before seeking veterinary help he used a spray based on oxytetracycline and hydrocortisone, which worsened the animals condition.Upon inspection, it was observed eyelid asymmetry, slight lateralization of the head to the left, periorbital alopecia onthe left face, intense blepharospasm in the left eye, with projection of the third eyelid occurring at times. The ophthalmicexamination was performed after application of anesthetic eye drops based on proxymetacaine to reduce eye discomfort.A corneal stromal lesion, edema and fibrovascular tissue in the left eye were identified, but the cause of the lesion was notdefined, with lagophthalmia, entropion, dystychiasis or ectopic cilia being ruled out. So, it was suggested that the lesionhad occurred by a foreign body, such as dust...(AU)

Fluconazol intra-estromal - eficácia na cirurgia de abscesso estromal em equino / Intrastromal fluconazole - effectiveness in the surgery of stromal abscess in a horse

Background: Due to its ocular microflora, the equine species is predisposed to develop mycotic ulcers which, when notproperly treated, can lead to the formation of a stromal abscess. A stromal abscess occurs through the introduction ofmicroorganisms into the corneal stroma. During re-epithelialization, the foreign body is encapsulated, thus creating abarrier that protects bacteria or fungi from treatment with antimicrobial medication. This framework can end up resultingin blindness due to chronic iridocyclitis, putting the animal’s vision at risk. The current work aims to report a case of corrective surgery for stromal abscess in a mare with the administration of intraoperative intrastromal fluconazole, in orderto corroborate the effectiveness of the technique.Case: A 9-year-old mare was evaluated, with the complaint that her right eye was closed and “yellowish” and that she hadalready been treated with intramuscular injectable anti-inflammatory drugs based on flunexin meglumine (Banamine® -50 mg) for 15 days, referring to a possible ulcer in the right eye. Ophthalmic screening resulted in a negative direct reflexand no threat response in the right eye. Examination of the conjunctiva showed congestion and chemosis. Examination ofthe cornea of the right eye was negative for Fluorescein and Green Lissamine tests, and opacity and corneal neovascularization were noted. The final diagnosis was a corneal abscess of probable fungal origin secondary to a keratomycosis. Afterthe consultation, complementary blood and biochemical tests were performed, which showed normal results for the speciesin question, and treatment was started with eye drops based on atropine 1% (Fagra® - 20 mL), ciprofloxacin antimicrobialeye drops (Ciprovet Colirio® - 5 mL), and antifungal eye drops based on ketoconazole...

Necrose tissular em equino associada ao uso de fenilbutazona / Tissue necrosis in equine associated with use of phenylbutazone

Background: Wounds that occur with tissue necrosis and that result from the application of medications through the most diverse accesses are described as drug skin medical embolism or Nicholas syndrome in human medicine, with wide description. In veterinary medicine, this subject has not yet been described extensively and specifically in veterinary medicine, especially regarding to wounds that occurred after the application of non-intravenous medications in horses, even though these lesions are recurrent in the clinical routine. This report aims to describe a case of skin necrosis in a horse, due to phenylbutazone infection. Case: A 7 year-old Mangalarga Marchador horse, weighing 400 kg, was admitted to the Veterinary Hospital for Large Animals of the Universiade Federal Rural do Rio de Janeiro (UFRRJ), with a history of phenylbutazone injection to the left side of the neck. The animal had an extensive wound on the neck and face on the left side and was characterized by the presence of cold and devitalized skin, with a hardened and parched appearance and that easily detached. During the anamnesis, a single administration of 10 mL of a non-steroidal anti-inflammatory drug based on phenylbutazone was reported intramuscularly for about 10 days to control the pain resulting from the claudication present for 14 days. The medication was administered in the region of the lateral border of the neck, on the left side. After drug administration, the animal presented an increase in volume at the application site. After 24 h, the lesion spread from the inoculation region, extending to the head and chest of the animal. During debridement, it was found that the lesion did not reach the underlying muscle tissue. In addition to the wound, the animal had upper eyelid palsy, lower lip, and auricular ptosis. Treatment with surgical debridement of devitalized tissue, topical application of ozonated sunflower oil, ketanserin, and a free skin graft was instituted. During hospitalization, the animal had a corneal ulcer in the left eye with an unfavorable prognosis due to paralysis of the upper eyelid, with enucleation of the affected eyeball. The animal was under veterinary care for 180 days and was discharged when his wound was already in an advanced stage of healing. Discussion: The history of the application of phenylbutazone intramuscularly and the location and characteristics of the lesion presented by the patient in the present report suggest that this animal presented aseptic tissue necrosis resulting from the administration of non-steroidal anti-inflammatory drugs, phenylbutazone. Although aseptic tissue necrosis, better known as Nicolau's syndrome or drug embolism cutis, is widely characterized and described in this species, there are studies in the literature that reproduce the syndrome in pigs and rabbits. Phenylbutazone was able to cause arterial damage, mainly in the tunica intima of the artery in which the medication was administered, with perivascular inflammatory infiltrate and subsequent skin necrosis at the site of administration. In addition to the skin lesion, the animal started to show signs compatible with the left facial nerve lesion, evidenced by the immobility of the upper eyelid and labial and ear ptosis. This resulted in corneal ulceration and subsequent enucleation. The animal also developed chewing difficulty in the first months of hospitalization. This dysfunction may be due to a lesion of the mandibular nerve, responsible for innervating the masticatory muscles and the oral mucosa. However, the animal showed improvement in this aspect, no longer showing this condition after 90 days of hospitalization. The treatment used was successful in healing the wound.

Uso da hidrodissecção para remoção de flap conjuntival em 360° em cão – relato de caso / Use of hydrodissection to removal 360° conjunctival flap in dog case report

O objetivo desse trabalho foi relatar um caso onde foi usado a hidrodissecção para auxiliar na remoção da aderência de flap conjuntival em 360° em córnea, em um cão. Foi atendido um cão da raça buldogue francês, macho, 2 anos, 18 kg, apresentando olho esquerdo com presença de um flap conjuntival em 360°, em decorrência de tratamento prévio de uma úlcera em melting extensa há 40 dias. Após a realização de exames pré-operatórios de rotina, o paciente foi submetido a um novo procedimento cirúrgico para remoção do flap. Para isso foi realizada a técnica de hidrodissecção, que consistiu na injeção de 2 mL cloreto de sódio a 0,9% sob flap o conjuntival, seguida pela divulsão com tesoura de íris, removendo a aderência entre conjuntiva e córnea. O paciente apresentou excelente recuperação pós-operatória, com diminuição da cicatriz na córnea e ausência de inflamação da conjuntiva ao longo de três meses de avaliações seriadas. Concluiu-se que a técnica de hidrodissecção facilitou a remoção do flap conjuntival de 360° no paciente do presente caso, tornando-se uma manobra em potencial para utilização em outros procedimentos semelhantes.

The aim of this case report is to present a case where it was used hydrodissection to remove a 360° conjunctival flap° from a dog. A 2 year old, male french bulldog weighting 18 kg was taken to a veterinary service with a 360° conjunctival flap in its left eye due to a previous treatment of an extensive melting ulcer for the past 40 days. After performing routine preoperative exams, a new surgical procedure was performed to remove the flap. The technique of choice was hydrodissection, which consisted of injecting 2 mL of 0.9% sodium chloride under conjunctival flap, followed by the divulsion, releasing the conjunctiva from its corneal bed with the use of iris scissors until complete removal of the tissue. The patient showed excellent postoperative recovery, with decreased corneal scarring and no inflammation of the conjunctiva over 3 months of post op evaluation. The hydrodissection technique has facilitated the removal of the 360° conjunctival flap in this present case, making it a potential technique of choice in other similar procedures.

Uso da hidrodissecção para remoção de flap conjuntival em 360° em cão relato de caso / Use of hydrodissection to removal 360° conjunctival flap in dog case report

O objetivo desse trabalho foi relatar um caso onde foi usado a hidrodissecção para auxiliar na remoção da aderência de flap conjuntival em 360° em córnea, em um cão. Foi atendido um cão da raça buldogue francês, macho, 2 anos, 18 kg, apresentando olho esquerdo com presença de um flap conjuntival em 360°, em decorrência de tratamento prévio de uma úlcera em melting extensa há 40 dias. Após a realização de exames pré-operatórios de rotina, o paciente foi submetido a um novo procedimento cirúrgico para remoção do flap. Para isso foi realizada a técnica de hidrodissecção, que consistiu na injeção de 2 mL cloreto de sódio a 0,9% sob flap o conjuntival, seguida pela divulsão com tesoura de íris, removendo a aderência entre conjuntiva e córnea. O paciente apresentou excelente recuperação pós-operatória, com diminuição da cicatriz na córnea e ausência de inflamação da conjuntiva ao longo de três meses de avaliações seriadas. Concluiu-se que a técnica de hidrodissecção facilitou a remoção do flap conjuntival de 360° no paciente do presente caso, tornando-se uma manobra em potencial para utilização em outros procedimentos semelhantes.(AU)

The aim of this case report is to present a case where it was used hydrodissection to remove a 360° conjunctival flap° from a dog. A 2 year old, male french bulldog weighting 18 kg was taken to a veterinary service with a 360° conjunctival flap in its left eye due to a previous treatment of an extensive melting ulcer for the past 40 days. After performing routine preoperative exams, a new surgical procedure was performed to remove the flap. The technique of choice was hydrodissection, which consisted of injecting 2 mL of 0.9% sodium chloride under conjunctival flap, followed by the divulsion, releasing the conjunctiva from its corneal bed with the use of iris scissors until complete removal of the tissue. The patient showed excellent postoperative recovery, with decreased corneal scarring and no inflammation of the conjunctiva over 3 months of post op evaluation. The hydrodissection technique has facilitated the removal of the 360° conjunctival flap in this present case, making it a potential technique of choice in other similar procedures.(AU)

Allogenic platelet-rich plasma in induced ulcers in rat's cornea / [Plasma rico em plaquetas alogênico em úlceras de córnea induzidas em ratos]

The objective in this study was to evaluate the clinic effect of applying allogenic platelet-rich plasma (PRP) heated or not, for treating cornea ulcers, including the dosage of PDGF-BB in the cornea. The ulcers were induced, standardizing the left eye from 81 rats (Ratus norvegicus, albinus variety), assigned randomly into three groups (N=27): control group (CG) which did not receive any topic treatment; heated PRP group (GA) and PRP group (GP), which received topical treatment every eight hours for five days. Each group underwent evaluation at 24 hours (M1), three days (M3) and five days (M5). The clinical exam evaluated the opacity, vascularization and corneal repair. The corneal PDGF-BB was dosed through the ELISA method. The corneal opacity was decreased in PRP-treated animals (GA and GP) and corneal repair time reduced when compared to CG at M1 and M5. Furthermore, GP showed greater vascularization at M3 compared to M1. Applied allogenic PRP eye drops, heated or not, speed up corneal healing, and reduce corneal repair time. However, the corneal PDGF concentration was not altered in any of the treatments.(AU)

Objetivou-se avaliar o efeito clínico da aplicação de plasma rico em plaquetas alogênico (PRP) aquecido ou não, no tratamento de úlceras de córnea, como a dosagem de PDGF-BB na córnea. As úlceras foram induzidas, padronizando-se o olho esquerdo de 81 ratos (Rattus norvegicus, variedade albinus), aleatoriamente, nos três grupos (N = 27): grupo controle (CG), que não recebeu nenhum tratamento tópico; grupo PRP aquecido (GA) e grupo PRP (GP), que receberam tratamento tópico a cada oito horas, durante cinco dias. Cada grupo foi subdividido em 24 horas (M1), três dias (M3) e cinco dias (M5). O exame clínico avaliou a opacidade, a vascularização e o reparo corneano. O PDGF-BB corneano foi dosado pelo método Elisa. Houve diminuição da opacidade da córnea nos animais tratados com PRP (GA e GP) e diminuição do tempo de reparo da córnea em comparação com CG, M1 e M5. Além disso, foi observada maior vascularização no GP no momento M3 em relação ao M1. A aplicação de colírios de PRP alogênico, aquecidos ou não, acelera a cicatrização da córnea, além de reduzir o tempo de reparo da córnea. No entanto, a concentração de PDGF na córnea não se alterou em nenhum dos tratamentos.(AU)

Outcome of a ceratohyiodectomy in a criollo mare with temporohyoid osteoarthropathy

Background: Temporohyoid osteoarthropathy (THO) is a progressive disease that causes acute onset of peripheral vestibular signs with or without facial paralysis. Ankylosis of temporhyoid joint occurs which predispose to fractures of theinvolved bones and consequently causes the commonly neurological signs observed. Clinical signs vary depending on thestage of the disease and the nerves affected. Surgical treatment is advised to improve survival rates in which the ceratohyoidectomy is currently known as the most advantageous. The aim of the present study is to report a case and outcome ofa ceratohyoidectomy procedure in a Criollo mare presenting THO of the right temporohyoid joint.Case: A 17-year-old Criollo mare was referred to the Equine Clinical Hospital of the Federal University of Pelotas witha 5-day history of facial paralysis on the right side, head tilt and difficulty to chew and swallow. Auricular, palpebraland labial ptosis along with deviation of the lip and nostril to the left were observed. A corneal ulcer was also identifiedin the right eye. Complementary imaging exams (endoscopy of the guttural pouches and radiography of the head) wereperformed and showed thickening of the right stylohyoid bone confirming a diagnosis of THO. Anti-inflammatory andantibiotic therapy were administered and the corneal ulcer was treated with topical antibiotics and autologous serum. Dueto rapid deterioration of clinical signs, the mare was referred to surgery. A ceratohyoidectomty procedure was performedunder general anesthesia. In this procedure, the ceratohyoid bone was disarticulated from the ceratohyoid-basihyoid jointand removed. During the procedure, a branch of the linguofacial vein was accidentally incised causing hemorrhage, thebranch was identified and successfully ligated. Recovery was uneventful. Supportive treatment with anti-inflammatory andantibiotics was continued after surgery and ...

Outcome of a ceratohyiodectomy in a criollo mare with temporohyoid osteoarthropathy

Background: Temporohyoid osteoarthropathy (THO) is a progressive disease that causes acute onset of peripheral vestibular signs with or without facial paralysis. Ankylosis of temporhyoid joint occurs which predispose to fractures of theinvolved bones and consequently causes the commonly neurological signs observed. Clinical signs vary depending on thestage of the disease and the nerves affected. Surgical treatment is advised to improve survival rates in which the ceratohyoidectomy is currently known as the most advantageous. The aim of the present study is to report a case and outcome ofa ceratohyoidectomy procedure in a Criollo mare presenting THO of the right temporohyoid joint.Case: A 17-year-old Criollo mare was referred to the Equine Clinical Hospital of the Federal University of Pelotas witha 5-day history of facial paralysis on the right side, head tilt and difficulty to chew and swallow. Auricular, palpebraland labial ptosis along with deviation of the lip and nostril to the left were observed. A corneal ulcer was also identifiedin the right eye. Complementary imaging exams (endoscopy of the guttural pouches and radiography of the head) wereperformed and showed thickening of the right stylohyoid bone confirming a diagnosis of THO. Anti-inflammatory andantibiotic therapy were administered and the corneal ulcer was treated with topical antibiotics and autologous serum. Dueto rapid deterioration of clinical signs, the mare was referred to surgery. A ceratohyoidectomty procedure was performedunder general anesthesia. In this procedure, the ceratohyoid bone was disarticulated from the ceratohyoid-basihyoid jointand removed. During the procedure, a branch of the linguofacial vein was accidentally incised causing hemorrhage, thebranch was identified and successfully ligated. Recovery was uneventful. Supportive treatment with anti-inflammatory andantibiotics was continued after surgery and ...(AU)

Modified eye evisceration in a tropical screech owl (Megascops choliba)

Background: An adult owl was presented with an injury to the right eye that rendered it blind in that eye. The left eye was normal. Removal of the right eye was recommended and a modified eye evisceration was performed. No complications were observed during or after surgery. The objective of this paper is to describe the modified eye evisceration technique that was successfully used in a tropical screech owl (Megascops choliba). Case: An adult owl was presented with an injury to the right eye that rendered it blind in that eye. Two previous surgical treatments have been carried out but have not been successful. Using a portable slit-lamp (Kowa SL-15®), both eyes were examined. The left eye was normal. Upon ophthalmic examination of the right eye, the owl demonstrated blepharospasm and large central corneal ulcer. Removal of the right eye was recommended. The bird received midazolam hydrochloride [Dormire® - 1 mg/kg, IM] and ketamine hydrochloride [Ketamina® - 5 mg/kg IM] as pre-anesthetic medications. Subsequently, the bird was anesthetized with isoflurane (Isoforine®) by facemask for induction, and then maintained with isoflurane vaporized in 100% oxygen through an endotracheal tube. With the aid of a surgical microscope and microsurgery materials, a modified eye evisceration was performed. Post-operatively, the owl received meloxicam [Maxicam® - 0.5 mg/kg, IM] and tramadol hydrochloride [Cronidor® - 15 mg/kg, orally for 4 days]. The day after surgery, the owl was comfortable and its usual appetite was regained. The patient remained hospitalized for 3 weeks and was evaluated daily. The skin sutures were removed 10 days after the surgical procedure and the surgical wound had healed normally. The patient was reintroduced into the wild after 2 months. During the 6 months post-release, the bird was evaluated once a month, and no complications were observed. Discussion: Severe eye trauma and complicated corneal ulcers are common causes of eyeball removal in birds. In birds, there is a high risk of complications during enucleation. The fragility of the orbital bones makes them susceptible to trauma during the surgery. Evisceration involves the removal of the inner contents of the eye while leaving the cornea and the sclera intact. In the current case, evisceration was chosen because the eye was blind, and maintaining a blind eye would be a source of pain and infection. In the modified evisceration technique, the risk of complications is minimal compared to enucleation, mainly because surgical manipulation is minimal. In our case, the total surgery time was 20 min. Another complication reported after enucleation in birds is the possibility of disfiguring the bird because the removal of the globe disturbs the natural head balance. To avoid these complications, the use of an intraocular prosthesis after evisceration in birds has been performed. However, owls have a tubular-shaped globe with scleral ossicles. These factors could hinder or even prevent the accommodation of a cylindrical silicone prosthesis. In the present case, an intraocular prosthesis implant was never considered due to the unavailability of the prosthesis and to avoid the risk of postoperative complications that have been reported from the literature in dogs. In this case, the owl recovered well from anesthesia without complications, and no postoperative hemorrhage was observed. No signs of pain were observed during the postoperative period and the owl had already shown an appetite and fed on the first postoperative day. The previously published reports using the modified evisceration technique also demonstrated an absence of pain signs during the postoperative period.(AU)

Otite média e interna com extensão para tronco encefálico em buldogue francês / Otitis media and internal with brainstem extension in a French bulldog

Background: Otitis is a frequent condition in dogs, with a multifactorial etiology covering primary causes, predisposing and perpetuating factors. It is characterized by an inflammatory process of structures that make up the auditory system, with prevalence data ranging from 15 to 20%, which can occur in any age group and without sex predisposition. According to the location, it can be classified as uni or bilateral, affecting the outer, middle and / or inner ear, the latter two being associated with neurological changes such as vestibulopathy, facial nerve paresis and Horner's syndrome. The morbidity and mortality of otitis media and internal may increase with delay in diagnosis, resulting in delay in the correct treatment, and the extension to brainstem is described in felines and considered rare in dogs. The present study aims to report an atypical case of otitis media and internal, with extension to the brain parenchyma in a brachycephalic dog. Case: A 3-year-old bitch French Bulldog was seen, weighing 12 kg, with a history of vomiting, apathy, nystagmus, ataxia and acute evolution hemiparesis. As a result of adoption, it was not known about the animal's morbid past. On special physical and clinical examination, depressed mental status, changes in postural reactions, nostril stenosis with unilateral mucopurulent nasal discharge, corneal ulcer, palpebral and labial ptosis, absence of eyelid reflex and spontaneous strabismus were observed, all of these findings observed on the left side of the face. No signs of otitis external to otoscopy were found. The clinical signs found characterize left facial nerve paresis and peripheral and central vestibulopathy. Otitis media / internal and meningoencephalitis were suspected. Hemogram, serum biochemistry (glucose, urea, creatinine, alanine aminotransferase, total proteins, albumin, globulin, alkaline phosphatase, gamma glutamyltransferase, phosphorus, total bilirubin, cholesterol and total calcium), urinalysis, rapid tests for erlichiosis, anaplasms , borreliosis, heartworm, distemper and leishmaniasis, CSF analysis, neurological panel performed by PCR (Polymerase Chain Reaction) that tested the animal for Bartonellosis, Lyme Disease (Borrelia burgdorferi), Blastomyces dermatitidis, Cryptococcus sp., Virus West Nile, Distemper, Toxoplasmosis, Neosporose and Coccidioides sp. using conjunctival swab, whole blood, urine and CSF samples. The samples were negative for all of these tests. As an image exam, brain magnetic resonance was performed. In the latter, otitis media and left internal was observed with extension of the lesion to the brain parenchyma. CSF analysis showed cytological changes compatible with a non-suppurative inflammatory process, mild pleocytosis with predominantly mononuclear leukocyte infiltrate. As a form of treatment, antibiotic therapy and total ablation of the auditory canal with lateral bulectomy were performed, showing good results with reduced clinical symptoms. Discussion: It is concluded that although the diagnosis of otitis media and internal with extension to brainstem is more common in cats, it should be included as a differential for central vestibular disorders in dogs, and that the diagnosis together with early and effective treatment are important, since that the evolution of the infection to the central nervous system represents a risk to the patient.

Uso do plasma rico em plaquetas associado a colírios no tratamento de ceratite ulcerativa em equino / Use of rich plasma on platters associated with collieries in the treatment of ulcerative caeratitis in equine

A córnea é a primeira estrutura do olho a receber luz, sendo localizada na parte mais externado bulbo ocular. Devido a sua localização está sujeita, com maior frequência, a processos lesivos, como a úlcera de córnea, também chamada de ceratite ulcerativa. É a patologia com maior ocorrência dentre as afecções oftalmológicas em equinos, e caso não tenha o tratamento adequado, pode levar a perda da visão do animal. Diante desse contexto, objetivo do estudo foi relatar um caso clínico de ceratite ulcerativa em equino tratado com plasma rico em plaquetas (PRP) associado a colírios. Um equino, macho, de 3 anos de idade, raça Quarto de Milha, pelagem alazã foi encaminhado para atendimento veterinário por ter sofrido uma pancada em um caibro. Durante o exame clínico foi constatado que o cavalo apresentava quemose, epífora, blefaroespasmo e perda temporária da capacidade visual. Baseado nos sinais clínicos e histórico a suspeita clínica foi de ceratite ulcerativa. O tratamento indicado foi instilação de Ocucan® colírio, Ciprovet® e PRP, duas gotas de cada, duas vezes ao dia, além de lavagem com solução fisiológica. O animal apresentou evolução significativa ao tratamento e com 30 dias foi liberado para retornar a propriedade e as atividades físicas gradativamente. Dessa forma, podemos concluir que o uso de plasma rico em plaquetas constitui uma ferramenta importante e acessível no tratamento de ceratite ulcerativa em equinos, inclusive demonstrando bons resultados na caraterística da cicatrização e no tempo da mesma.

The cornea is the first structure of the eye receiving light, being located at the outermost part of the ocular bulb. Due to its location is subject, more often, the harmful processes such as corneal ulcer, also called keratitis Ulcerative. It is the disease with higher incidence among ophthalmologic diseases in horses, and if no proper treatment, can lead to the animal vision loss. In this context, objective of the study was to report a case of keratitis Ulcerative equinus treated with platelet-rich plasma (PRP) associated with eye drops. A horse, male, 3 years old, Quarter Horses, sorrel coat was referred to veterinary care after suffering a stroke on a rafter. During the clinical examination revealed that the horse had chemosis, epiphora blepharospasm and temporary loss of vision. Based on clinical signs and history clinical suspicion was keratitis Ulcerative. The treatment was Ocucan® instillation of eye drops, Ciprovet® PRP and two drops each, twice a day, and washing with saline solution. The animal showed evolution significant treatment and was released 30 days to return the property and physical activity gradually. Thus, we conclude that the use of platelet rich plasma is an important tool and accessible in the treatment of ulcerative keratitis in horses, including demonstrating good results in healing characteristic and time thereof.

Uso do plasma rico em plaquetas associado a colírios no tratamento de ceratite ulcerativa em equino / Use of rich plasma on platters associated with collieries in the treatment of ulcerative caeratitis in equine

A córnea é a primeira estrutura do olho a receber luz, sendo localizada na parte mais externado bulbo ocular. Devido a sua localização está sujeita, com maior frequência, a processos lesivos, como a úlcera de córnea, também chamada de ceratite ulcerativa. É a patologia com maior ocorrência dentre as afecções oftalmológicas em equinos, e caso não tenha o tratamento adequado, pode levar a perda da visão do animal. Diante desse contexto, objetivo do estudo foi relatar um caso clínico de ceratite ulcerativa em equino tratado com plasma rico em plaquetas (PRP) associado a colírios. Um equino, macho, de 3 anos de idade, raça Quarto de Milha, pelagem alazã foi encaminhado para atendimento veterinário por ter sofrido uma pancada em um caibro. Durante o exame clínico foi constatado que o cavalo apresentava quemose, epífora, blefaroespasmo e perda temporária da capacidade visual. Baseado nos sinais clínicos e histórico a suspeita clínica foi de ceratite ulcerativa. O tratamento indicado foi instilação de Ocucan® colírio, Ciprovet® e PRP, duas gotas de cada, duas vezes ao dia, além de lavagem com solução fisiológica. O animal apresentou evolução significativa ao tratamento e com 30 dias foi liberado para retornar a propriedade e as atividades físicas gradativamente. Dessa forma, podemos concluir que o uso de plasma rico em plaquetas constitui uma ferramenta importante e acessível no tratamento de ceratite ulcerativa em equinos, inclusive demonstrando bons resultados na caraterística da cicatrização e no tempo da mesma.(AU)

The cornea is the first structure of the eye receiving light, being located at the outermost part of the ocular bulb. Due to its location is subject, more often, the harmful processes such as corneal ulcer, also called keratitis Ulcerative. It is the disease with higher incidence among ophthalmologic diseases in horses, and if no proper treatment, can lead to the animal vision loss. In this context, objective of the study was to report a case of keratitis Ulcerative equinus treated with platelet-rich plasma (PRP) associated with eye drops. A horse, male, 3 years old, Quarter Horses, sorrel coat was referred to veterinary care after suffering a stroke on a rafter. During the clinical examination revealed that the horse had chemosis, epiphora blepharospasm and temporary loss of vision. Based on clinical signs and history clinical suspicion was keratitis Ulcerative. The treatment was Ocucan® instillation of eye drops, Ciprovet® PRP and two drops each, twice a day, and washing with saline solution. The animal showed evolution significant treatment and was released 30 days to return the property and physical activity gradually. Thus, we conclude that the use of platelet rich plasma is an important tool and accessible in the treatment of ulcerative keratitis in horses, including demonstrating good results in healing characteristic and time thereof.(AU)

Deep anterior lamellar keratoplasty (DALK) as a treatment of a deep stromal ulcer in a dog: case report / Ceratoplastia lamelar anterior profunda(DALK) como tratamento de úlcera estromal profunda em cão: relato de caso

Characterized by the rupture of the corneal epithelium, corneal ulcers threaten ocular integrity, with multifactorial development, such as decreased protection and excessive abrasion applied to the corneal surface. Keratoplasty restores the corneal anatomy, removing the inflamed or infected tissues, in order to promote visual acuity. The technique of deep anterior lamellar keratoplasty (DALK) selectively removes the diseased layers of the cornea, keeping the Descemet membrane and endothelium healthy, reducing the risk of rejection, aimed at tissue recovery. In the present report, a canine, from the Shih Tzu breed, a female, that has not been castrated, 2 years and 6 months old, was treated, she had a history of ocular discomfort and mucous secretion in both eyes. In the ophthalmic examination, keratoconjunctivitis sicca was found in the left eye and ectopic cilia was found in both eyes. With the aid of a fluorescein test, the presence of a deep stromal ulcer affecting the right eye was confirmed. The patient underwent ectopic cilia removal using the wedge resection technique and an allogeneic corneal transplantation using DALK, with only the diseased epithelium and stroma being replaced, reducing the risk of rejection and failures related to surgery. 90 days after the procedure, there was no reaction to the graft, there was complete epithelial repair and maintenance of

Caracterizada pela ruptura do epitélio corneano, as úlceras de córnea ameaçam a integridade ocular, tendo desenvolvimento multifatorial, como a diminuição da proteção e o excesso de abrasão aplicado na superfície da córnea. A ceratoplastia restaura a anatomia corneana, removendo tecidos inflamados ou infectados, com objetivo de promover acuidade visual. A técnica de ceratoplastia lamelar anterior profunda (DALK -deep anterior lamelar keratoplasty) remove seletivamente as camadas doentes da córnea, mantendoa membrana de Descemet e endotélio saudáveis, reduzindo o risco de rejeição, visando recuperação tecidual. No presente relato, um canino, raça Shih Tzu, fêmea não castrada, 2 anos e 6 meses de idade, foi atendido com histórico de desconforto ocular e secreção mucosa em ambos os olhos. No exame oftálmico constatou-se ceratoconjuntivite seca no olho esquerdo e cílios ectópicos em ambos os olhos. Com auxílio do teste de fluoresceína, confirmou-se a presença de úlcera estromal profunda acometendo o olho direito. O paciente foi submetido a remoção dos cílios ectópicos pela técnica de secção em cunha e ao transplante de córnea alógena utilizando a DALK, sendo substituído apenas o epitélio e estroma doentes, reduzindo o risco de rejeição e falhas relacionadas a cirurgia. Após 90 dias do procedimento, constatou-se ausência de reação ao enxerto, completa reparação epitelial e manutenção da função visual com discreta opacidade corneana.