Use of subdermal hyaluronic acid injections and a free labial mucocutaneous graft for the repair of feline eyelid agenesis.

OBJECTIVE: To describe a technique to repair feline eyelid agenesis using a hyaluronic acid (HA) subdermal filler injection to allow for acute soft tissue expansion, followed by a free labial mucocutaneous graft. MATERIALS AND METHODS: Thirty-nine colobomatous eyelids in 24 feline patients with secondary keratitis were recruited to the study group. RESULTS: Keratitis and trichiasis were markedly resolved in 27/39 (69.2%) eyelids after a single procedure. Post-operative HA subdermal filler injections were required to resolve 5/39 (12.8%) eyelids that had mild post-operative trichiasis, and 1/39 (2.5%) eyelids that had post-operative lateral canthal collapse. Complications occurred in 6/39 (15.4%) cases, consisting of distal graft necrosis (n = 2 eyes), suture rubbing the cornea (n = 2 eyes), moderate trichiasis (n = 1 eye) and graft adherence to the episclera (n = 1 eye). CONCLUSION: The technique was successful in enhancing corneal protection, cosmesis and eyelid function and should be considered as a surgical option for any degree of eyelid agenesis in feline patients.

Recurrent corneal hemangiosarcoma in a cat with subsequent extension into the orbit.

A 7-year-old neutered female Domestic Short-haired cat was presented for evaluation of ulceration and severe vascularization of the left cornea. Ophthalmic examination revealed a large red irregular mass over the whole cornea in the left eye. A lamellar keratectomy was performed. Histopathology revealed a chronic lymphoplasmacytic, histocytic, neutrophilic ulcerative keratitis with fibrosis and vascularization. The tumor recurred within 3 months, and another lamellar keratectomy and sclerotomy were performed. The lesion was diagnosed histopathologically as a hemangiosarcoma with incomplete margins. The mass recurred locally 6 weeks later, and an enucleation was performed. Histopathology revealed infiltration of the limbus and connective tissue beyond the sclera. Seven weeks later, a fluctuant swelling was found in the left orbit. Computed tomography confirmed a soft tissue attenuating mass measuring 33 x 24 mm diameter in the orbit. There was no sign of metastasis. Clinical remission was achieved with combined chemotherapy with doxorubicin and radiation therapy. The patient remained in clinical remission 20 months post-chemotherapy.

Early postoperative results of Descemet's stripping endothelial keratoplasty in six dogs with corneal endothelial dystrophy.

OBJECTIVE: To describe and assess the clinical outcome and intraoperative and postoperative complications of Descemet's stripping endothelial keratoplasty (DSEK) in the treatment of canine corneal endothelial dystrophy. ANIMALS STUDIED: Six dogs (six eyes) diagnosed with progressive corneal edema resulting from abnormal dystrophic endothelial cells underwent Descemet's stripping endothelial keratoplasty. PROCEDURES: Six patients underwent Descemet's stripping endothelial keratoplasty (DSEK). The patients were examined preoperatively and postoperatively at 24 hours, 7 days, 1, 2, and 3 months after surgery. Corneal edema and ultrasonic pachymetry were evaluated preoperatively and postoperatively. The positions of DSEK grafts were evaluated 3 months after surgery using optical coherence tomography. Intraoperative and postoperative complications were noted. RESULTS: The degree of corneal edema and corneal thickness improved postoperatively in all the patients (n = 6). Fibrin was encountered intraoperatively in one out of the six eyes (1/6) and postoperatively in two out of the six eyes (2/6). One out of the six DSEK grafts was partially scrolled (1/6). Secondary ocular hypertension was observed in one out of the six eyes (1/6). Corneal vascularization was encountered in four out of six patients (4/6). CONCLUSIONS: Descemet's stripping endothelial keratoplasty is an effective surgical treatment option for corneal endothelial dystrophy in dogs. Corneal edema resolved and corneal thickness reduced significantly. The early postoperative results are encouraging. Further investigation is warranted to document any long-term complications and to study the longevity of the transplanted grafts.

A retrospective multi-center study of treatment, outcome, and prognostic factors in 34 dogs with disseminated aspergillosis in Australia.

BACKGROUND: Disseminated aspergillosis (DA) in dogs has a guarded prognosis and there is a lack of a gold standard treatment protocol. OBJECTIVE: To retrospectively assess survival times and factors influencing survival times. ANIMALS: Dogs diagnosed with DA from January 2007 to June 2017. METHODS: Disseminated aspergillosis case data were retrieved from 13 Australian veterinary referral centers, with a diagnosis confirmed with culture or PCR. Factors influencing survival time after diagnosis were quantified using a Cox proportional hazards regression model. RESULTS: Thirty-four dogs met the study inclusion criteria. Twenty-two dogs were treated with antifungal treatment and 12 dogs received no antifungal treatment. Accounting for censoring of dogs that were either still alive on the date of data collection or were loss to follow-up, dogs treated with itraconazole alone (n = 8) had a median survival time (MST) of 63 (95% CI: 20-272) days compared to 830 (95% CI: 267-1259) days for the n = 14 dogs that received multimodal antifungal therapy ( χ 2 test statistic 8.6; df = 1; P < .01). The daily hazard of death (DHOD) for dogs with abnormally high serum creatinine concentration at the time of diagnosis was 7.4 (95% CI: 1.9-29) times that of dogs with serum creatinine within the reference interval. CONCLUSION AND CLINICAL IMPORTANCE: Serum creatinine concentration at the time of diagnosis is a useful prognostic indicator for survival after a diagnosis of DA. The MST for dogs treated with multimodal antifungal therapy is longer than itraconazole alone and warrant further investigation (P < .01).