Equine infectious keratitis in Finland: Associated microbial isolates and susceptibility profiles.

OBJECTIVE: To retrospectively describe laboratory findings, treatment, and outcome associated with equine infectious keratitis in Finland. ANIMALS AND PROCEDURES: Medical records of horses diagnosed with infectious keratitis in University of Helsinki Equine Hospital from January 2007 to June 2018 were reviewed. RESULTS: Forty-seven cases were included. Keratomycosis was diagnosed in 27 eyes and bacterial keratitis in 20 eyes. Aspergillus flavus was the most frequent fungal isolate (9/17, 53%), followed by Cylindrocarpon sp. (3/17, 18%) and Aspergillus fumigatus (2/17, 12%). Susceptibility was tested for 10/11 Aspergillus sp. isolates; all were susceptible to voriconazole while only two were susceptible to amphotericin B. Cylindrocarpon sp. isolates were resistant to both agents. Streptococcus equi subsp. zooepidemicus was the most frequent bacterial isolate (9/19, 47%), followed by other streptococci (4/19, 21%). All 13 Streptococcus sp. isolates were susceptible to penicillin, and all tested isolates (n = 11) were also susceptible to chloramphenicol. Mean duration of medical treatment was longer in fungal keratitis (38 days) than in bacterial keratitis (25 days) (P < .001). Twenty-six of the eyes underwent globe-sparing surgery in addition to medical therapy. Recovery was achieved in 66% (31/47) of all cases and in 59% (16/27) and 75% (15/20) (P = .264) of cases with keratomycosis and bacterial keratitis, respectively. CONCLUSIONS: Although Aspergillus sp. and S zooepidemicus were the most frequently encountered isolates, cytology, culture, and susceptibility testing are essential to differentiate bacterial and fungal keratitis and guide the clinician to choose the most efficient treatment.

Comparison of two rebound tonometers in healthy horses.

OBJECTIVE: To obtain a reference range for evaluation of intraocular pressure (IOP) in horses using Tonovet Plus® , to compare the IOP readings obtained with Tonovet® and Tonovet Plus® , and to evaluate the repeatability of readings. ANIMALS STUDIED AND PROCEDURES: Intraocular pressure of 30 client-owned horses (60 eyes) with no signs of illness or ocular disease was evaluated using Tonovet® and Tonovet Plus® rebound tonometers. Horses' mean age was 10.7 (range 6-17) years. Triplicate measurements were performed without using sedatives or local anesthetics, with minimal restraint. RESULTS: Calculated reference intervals (the CLSI robust method) were 14.4-27.2 mmHg for Tonovet® and 16.0-26.1 mmHg for Tonovet Plus® . Mean values (± standard deviation, SD [± coefficient of variation, CV]) obtained with Tonovet Plus® (21.6 ± 2.45 mmHg [11.3%]) were on average 0.6 mmHg higher than with Tonovet® (21.0 ± 3.14 mmHg [15.0%]), and a negligible statistical difference between the devices was found using the paired sample t test (P = .049). The correlation coefficient for the averaged triplicate measurements was 0.73. The average CV was 4.6% and 4.4% for Tonovet® and Tonovet Plus® , respectively. CONCLUSIONS: The repeatability of measurements was very good with both devices. The readings between the two devices differed statistically significantly, but the correlation was considered good and the variation was numerically small, and thus, the difference was considered clinically irrelevant. When monitoring disease process or treatment response in an individual patient, repeated readings are best performed using a similar device to avoid false interpretation of results.

Clinical features and outcomes of horses presenting with presumed equine immune mediated keratitis to two veterinary hospitals in the United Kingdom and Finland: 94 cases (2009-2021).

BACKGROUND: There is limited literature regarding equine immune mediated keratitis (IMMK) in Europe. North America-based publications describe minimal blepharospasm, rare corneal ulceration and no uveitis; clinical impression suggests these are seen in Europe. OBJECTIVES: Assess the prevalence of blepharospasm, corneal ulceration and uveitis and their impact on outcome in horses diagnosed with IMMK in Europe (UK and Finland). STUDY DESIGN: Retrospective case series. METHODS: Clinical records of 94 horses with IMMK were evaluated. The UK and Finland populations were comparable; therefore, descriptive statistics were performed on combined data on subtypes of IMMK and clinical features. Odds ratios (OR) and confidence intervals (CI) were calculated for impact of blepharospasm, ulceration or presence of uveitis on the outcome of enucleation and treatment duration. RESULTS: IMMK subtype was classified as 10/94 (10.6%) epithelial, 50/94 (53.2%) anterior stromal, 14/94 (14.9%) mid-stromal, 4/94 (4.25%) endothelial and 16/94 (17.0%) unrecorded. After excluding three horses with incidental corneal ulceration, blepharospasm was documented in 34/91 (37.4%), corneal ulceration in 26/91 (28.6%), and signs of uveitis in 23/91 (25.3%) horses. Increased odds of enucleation were significantly associated with the presence of blepharospasm (OR 5.5, 95% CI 1.6-19.4, p = 0.008) and signs of uveitis (OR 8.9, 95% CI 2.6-30.8, p < 0.001), but not corneal ulceration. The presence of blepharospasm, corneal ulceration or uveitis did not significantly alter the odds of ongoing medication. MAIN LIMITATIONS: Data were collected over a wide timeframe; the diagnosis was mainly made without histopathology; a broad definition of uveitis was used and there was a bias towards complicated cases being retained for follow-up. CONCLUSIONS: The clinical features of IMMK were similar between two European countries but differed to USA descriptions. Blepharospasm, corneal ulceration and signs of uveitis can occur with IMMK; presence of blepharospasm and uveitis increase the odds of enucleation.

Breed and conformational predispositions for prolapsed nictitating membrane gland (PNMG) in dogs in the UK: A VetCompass study.

BACKGROUND: Prolapsed nictitating membrane gland (PNMG) is the most common disorder of the third eyelid in dogs. However, the epidemiology of PNMG in the wider dog population remains understudied. METHODS: Using de-identified clinical data from the VetCompass Programme, this cohort study aimed to report the prevalence, demographic and breed-related risk factors of PNMG in dogs attending UK primary care veterinary practices in 2016. RESULTS: There were 1,802 PNMG cases identified from 905,543 dogs, yielding an annual prevalence of 0.20% (95% confidence interval (CI) 0.19-0.21). The median age at first diagnosis was 0.63 years (IQR 0.33-1.98, range 0.11-18.00). Dogs aged under 1 year had 10.82 times the odds (95% CI 9.17-12.76) compared with dogs aged from 2 to under 4 years. Neutered animals had higher odds than entire animals within both sexes. Breeds with the highest odds of PNMG compared with crossbred dogs included Neapolitan Mastiff (odds ratio (OR) 34.26, 95%CI 15.92-73.75), English Bulldog (OR 24.08, 95% CI 20.62-28.13), Cane Corso (OR 14.66, 95% CI 8.18-26.28), Lhasa Apso (OR 12.37, 95% CI 10.26-14.92) and American Cocker Spaniel (OR 11.57, 95% CI 5.59-23.96). Purebred dogs had 1.43 times the odds (95% CI 1.26-1.63) of PNMG compared with crossbreed dogs. Breeds with brachycephalic skull conformation had 6.71 times the odds (95%CI 5.89-7.64) compared with breeds with mesocephalic skull conformation. Insured dogs had 1.89 times the odds (95% CI 1.65-2.16) compared with uninsured dogs. CONCLUSIONS: This study reports the largest cohort of primary-care PNMG cases assembled to date. The results showing young age at diagnosis along with the breed, purebred and brachycephalic skull conformation predispositions suggest a hereditary involvement in PNMG development. These results may help to guide breeding strategies to reduce the prevalence of PNMG and improve welfare in predisposed individuals.