Long-term vision outcomes and breed differences of Ahmed Glaucoma Valve implantation in 132 eyes of 122 dogs.

OBJECTIVE: To evaluate the long-term vision outcomes of Ahmed glaucoma valve (AGV) implantation in dogs. PROCEDURES: The medical records of dogs that underwent AGV implantation from January 2010 to December 2019 were reviewed to assess the duration of post-surgical vision preservation (PVP). The relationship between PVP and the underlying cause of glaucoma, implant placement, and preoperative intraocular pressure was evaluated. RESULTS: One hundred and thirty-two eyes of 122 dogs (mean age, 8.3 ± 2.6 years) were included. The mean ± standard error of PVP for all eyes was 57.5 ± 3.9 months. PVP in the dogs with primary acute glaucoma and prior history of cataract surgery was 56.4 ± 4.7 and 59.3 ± 5.9 months, respectively (p = .712). The PVP of the Shiba Inu, American Cocker Spaniel, and other breeds was 63.1 ± 5.5, 33.7 ± 5.3, and 59.1 ± 6.3 months, respectively (p < .05). The PVP in dogs with medial implantation was 61.9 ± 4.7 months, and in those with lateral implantation was 45.4 ± 6.4 months (p = .034). Among the 132 eyes investigated, 48 (36.4%) lost vision by the last follow-up, and 18 eyes retained vision for more than 5 years. Two of the total number of eyes retained their vision for more than 8 years. CONCLUSIONS: The vision outcomes regarding the use of AGV for the management of canine glaucoma were favorable in dogs.

Comprehensive Prospective Analysis of the Factors Contributing to Aspiration Pneumonia Following Endoscopic Submucosal Dissection in Patients with Early Gastric Neoplasms.

Endoscopic submucosal dissection (ESD) has become the first-line treatment for early gastric neoplasms; however, a subset of patients treated by this method develop aspiration pneumonia. We conducted a comprehensive prospective analysis of the factors contributing to post-ESD aspiration pneumonia in early gastric neoplasms in this study, with special focus on whether pre-treatment oral care can prevent aspiration pneumonia. Sixty-one patients who underwent ESD for gastric neoplasms were randomly assigned to the oral care or control groups. ESD was performed under deep sedation. Of 60 patients whose data were available for analysis, 5 (8.3%) experienced pneumonia confirmed either by chest radiography or computed tomography. Although no difference in the rate of pneumonia was found between the control and oral care groups, the post-oral care bacteria count was significantly higher in the saliva of patients who developed pneumonia compared to those without pneumonia. In addition, the presence of vascular brain diseases and the dose of meperidine were also significantly associated with the occurrence of pneumonia. These results suggest that the number of oral bacteria as well as pre-existing vascular brain diseases and high-dose narcotics can affect the incidence of post-ESD pneumonia.

Clinical features of cats with aqueous tear deficiency: a retrospective case series of 10 patients (17 eyes).

OBJECTIVES: The aim of this study was to describe the clinical findings, diagnostic test results and response to therapy of cats with Schirmer tear test 1 (STT-1) values below the reference interval. METHODS: The medical records of three institutions were searched for cats with ocular surface disease and STT-1 values <9 mm/min, confirmed at two or more separate visits. RESULTS: Ten cats (17 eyes) were included. The mean ± SD (range) age and STT-1 values in affected eye(s) were 6.1 ± 5.7 (0.2-16) years and 2.4 ± 3.1 (0-8) mm/min, respectively. Concurrent ocular surface disease was bilateral in 5/10 cats. Clinical signs included conjunctivitis (14/17 eyes), corneal ulceration (6/17 eyes), non-ulcerative keratitis (4/17 eyes), symblepharon (4/17 eyes), eosinophilic keratitis (3/17 eyes), corneal sequestrum (3/17 eyes), corneal fibrosis (2/17 eyes) and meibomitis (2/17 eyes). Management included: topically applied lacrimomimetics, antiviral drugs, corticosteroids or immunomodulatory drugs; orally administered famciclovir; or surgical procedures, in various combinations. Response to therapy (defined as an increase in STT-1 value of ⩾5 mm/min) was transient (seen at a single reassessment) in 65% of eyes and sustained (seen at ⩾2 consecutive reassessments) in 18% of eyes. CONCLUSIONS AND RELEVANCE: Clinical features seen in cats with low STT-1 values are described, although the association between aqueous deficiency and the reported ocular changes is unknown at this time. We encourage clinicians to assess the tear film in cats with ocular surface disease, and initiate therapy with lacrimomimetics if STT-1 values are repeatedly below normal. Such information will further define aqueous tear deficiency in cats, providing a better understanding of disease prevalence, pathogenesis and treatment.