Dacryops with dacryolithiasis in a dog.

BACKGROUND: A 10-year-old castrated male Maltese dog was presented with chronic swelling that had been present for at least 5 years in the medial canthus of the right eye (OD). OBJECTIVES: To describe the treatment outcome of dacryops with dacryolithiasis. METHODS: Bilateral patency of the nasolacrimal system was confirmed by flushing of both upper and lower puncta. Ocular ultrasonography revealed a well-defined, oval-shaped, heterogeneous mass with several hyperechoic foci. Dacryocystorhinography revealed no connection between the mass and lacrimal canaliculus. Gentle blunt dissection of the fibrous connective tissue around the cystic mass was performed. The mass was removed, which intraluminally contained multiple calculi. RESULTS: Histopathologically, the cystic structure was lined by simple cuboidal epithelium and surrounded by smooth muscle actin positive myoepithelial cells consistent with dacryops derived from the lacrimal glandular ductal system. In addition, several spherical basophilic minerals were observed in the lumen, which were identified as dacryoliths. CONCLUSION: Surgical removal of this dacryops with dacryolithiasis was curative without recurrence after four months.

Conjunctival dacryops in a domestic shorthair cat.

A 1-year-old spayed female domestic shorthair cat with a 1-week history of a conjunctival mass located in the dorsolateral quadrant of the right eye was presented to a referral hospital. Ophthalmic examination revealed a pink, fluctuant, and non-painful cystic swelling of the upper right palpebral conjunctiva. An ocular ultrasound confirmed the presence of a fluid-filled cystic structure that extended into the temporal orbit. The histopathology of the excisional biopsy revealed multiple cysts lined by ductal epithelium along with dilated lacrimal gland ducts and lymphocytic nodules adjacent to the dorsal lacrimal gland; consistent with a diagnosis of dacryops.

Dacryops conjonctivale chez un chat domestique à poil court. Une chatte domestique stérilisée de 1 an à poils courts avec une histoire d'une semaine d'une masse conjonctivale située dans le quadrant dorsolatéral de l'oeil droit a été présentée à un hôpital de référence. L'examen ophtalmologique a révélé une tuméfaction kystique rose, fluctuante et non douloureuse de la conjonctive palpébrale supérieure droite. Une échographie oculaire a confirmé la présence d'une structure kystique remplie de liquide qui s'est étendue dans l'orbite temporale. L'histopathologie de la biopsie excisée a révélé de multiples kystes bordés d'épithélium canalaire ainsi que des canaux glandulaires lacrymaux dilatés et des nodules lymphocytaires adjacents à la glande lacrymale dorsale; compatible avec un diagnostic de dacryops.(Traduit par Dr Serge Messier).

Dacryops with extensive lacrimal and maxillary bone defects in four dogs.

OBJECTIVE: To describe and discuss ventromedial orbital lacrimal gland or duct cysts (dacryops) in dogs with extensive bone defects based on their symptoms, results of diagnostic imaging and histopathological examination, and therapy and discuss their potential origin based on the morphology. ANIMALS STUDIED: Four dogs of different breeds, age, and sex were presented with a unilateral round, slow growing, indolent, and non-tender process ventromedial to the nasal canthus of the eye. PROCEDURES: Transverse computed tomography showed a low-density, non-contrast-enhancing cystic process ventromedial to the globe with extensive defects in the lacrimal and maxillary bones in all cases. The cystic character of the structure was confirmed by the aspiration of the brownish fluid without cellular and microbiological contents. For treatment, the cystic fluid was aspirated, and the sclerosing agent polidocanol was injected in three cases. Cystorhinostomy (nasal marsupialisation) was performed in one case as the first choice and in another case following failure of sclerotherapy. Histopathological examination of the cyst walls was performed in two cases and confirmed the diagnosis of dacryops. RESULTS: Follow-up between 2 and 18 months showed no recurrence and very good to excellent cosmetic results. CONCLUSIONS: Aberrant lacrimal gland or duct tissue with secondary development of dacryops should be included in the differential diagnoses of ventromedial orbital cysts. Large cysts near the lacrimal drainage system with extensive bone defects in dogs should be treated by nasal marsupialization. Treatments such as evacuation of the cyst and inducing sclerosis (sclerotherapy) should be reserved for exceptional cases.

Bilateral temporal dacryops in a cat.

A 1-year-old Maine Coon female spayed cat was presented for a 7-week history of bilateral pinkish masses located over the dorsotemporal conjunctival quadrants. Ophthalmic examination revealed the presence of bilateral temporal, slightly hyperemic, subconjunctival masses, fluctuant, and nonpainful. The remainder of the ocular examination was unremarkable. Ultrasound biomicroscopy and B-scan ultrasonography confirmed the presence of a bilateral cavitated and tubular structure, extending within the temporal orbit, with anechoic fluid-like content. Surgical removal was performed. Histopathology described the lesions as lacrimal gland tissue, markedly infiltrated by inflammatory cells, associated with cavitated structures filled with proteinaceous debris, and lined by flattened bilayered cuboidal epithelial cells. Bilateral adenitis of unknown origin and dacryops of the temporal lacrimal glands were diagnosed. Both surgical sites healed uneventfully, and no recurrence was reported on either eye during a 12-month follow-up period.

Intrasinus bolstering of traumatic maxillary sinus fractures by using Foley catheter balloons in two foals.

OBJECTIVE: To describe the repair of unstable facial fractures by using Foley catheter balloons as intrasinus bolsters. STUDY DESIGN: Case report ANIMALS: Two weanling foals with unilateral fractures of the sinus and orbit secondary to kick injuries. Preoperative imaging that included positive contrast dacrocystorhinography and computed tomography confirmed severe comminution of facial fractures and nasolacrimal duct disruption in both foals. METHODS: Small bone fragments were surgically removed, and large fragments were retained even when denuded of periosteum. Repair procedures included nasolacrimal canaliculosinusotomy and suturing fracture fragments together with polydioxanone sutures. After fixation, the fracture fragments could be depressed into the sinus with manual pressure, so two intrasinus Foley catheters were placed to bolster the sinus wall, with the tubing exiting through a frontal sinus trephine. The skin was completely closed over the fractures. Catheters and nasolacrimal stenting were maintained in place during fracture healing. RESULTS: One foal prematurely dislodged catheters and nasolacrimal stent 11 days after fixation. The catheters and stenting were removed as planned 4 weeks after surgery in the second foal. Wound, fracture healing, and overall cosmesis was good in both foals, and epiphora resolved. Surgical site infection, sinusitis, and sequestration did not occur. Both foals became high-level performance horses with acceptable cosmetic outcome and good bilateral nasal airflow. CONCLUSION: Foley catheter balloons supported sinus fracture repair and maintained stability of the surgical reconstruction during convalescence. CLINICAL SIGNIFICANCE: Suture repair of comminuted sinus fractures can be supported by using Foley catheters, which are readily available.

Alleviation of Epiphora by Canaliculosinostomy into the Caudal Maxillary Sinus in the Horse.

OBJECTIVE: To describe a technique of canaliculosinostomy into the caudal maxillary sinus to alleviate epiphora secondary to nasolacrimal duct obstruction and to report the long-term outcome in 5 horses. STUDY DESIGN: Case series. ANIMALS: Five client-owned horses. METHODS: Case records of all horses presented for chronic epiphora to a single equine hospital that underwent surgical treatment were reviewed. All included horses had a Jones test or dacryocystography to confirm nasolacrimal duct obstruction. All horses were anesthetized and canaliculosinostomy was created from the medial canthus of the eye into the caudal maxillary sinus using a Steinmann pin and Jacob's chuck. A Foley catheter was placed normograde through the stoma. The inflated bulb held the Foley in place in the sinus, while the proximal end was pulled through the upper eyelid and sutured to the skin on the head. The Foley catheter was maintained in place for 3 weeks and then removed under sedation. RESULTS: Five horses were included. There were no intraoperative difficulties or complications. One horse dislodged the Foley catheter 3 days postoperatively. No other postoperative complications occurred. Followup was available for all horses. One horse was euthanatized for unrelated reasons 10 weeks postoperative at which time epiphora was resolved. The remaining 4 horses had resolution of epiphora at followup (24-46 months postoperative). CONCLUSION: This report describes a simple technique for canaliculosinostomy into the caudal maxillary sinus and long-term outcome in 4 of 5 horses, all of which had resolution of epiphora. This technique can be used to resolve epiphora of various etiologies.

Differential diagnoses, investigation, and management of a periocular swelling close to the nasolacrimal duct in a horse - A case report of Dacryops.

To describe the differential diagnoses, investigation, and management of a periocular swelling close to the nasolacrimal duct in a horse that was consistent with a nasolacrimal duct dacryops (lacrimal cyst). A 16-year-old gelding, Connemara cross presented with a history of a periocular swelling rostroventral medial to the right eye that had been sampled by the referring veterinary surgeon. A cystic lesion was diagnosed following standing computed tomography. Surgical removal of the cystic lesion was performed, and the tissue was submitted for histopathologic and immunohistochemical examination. Surgical removal of the cyst was curative, and there was no recurrence of clinical signs 7 months later. There was a small amount of mineralized material in the center of the cyst. Histopathologic and immunohistochemical examination confirmed a nasolacrimal duct cyst. Dacryops can form in horses as well as other species and appears to have a favorable outcome if surgically removed.

Avaliação da epífora de cães usando dacriocistografia e tomografia computadorizada / Epiphora assessment of dogs with dacryocystography and computed tomography

A avaliação da epífora pode ser feita por exames clínicos, testes de excreção lacrimal, exames contrastados, como avaliação radiológica e estudo tomográfico; estes dois últimos permitem análise minuciosa das estruturas. O presente estudo teve como objetivo avaliar a via lacrimal excretora com uso de radiografia e tomografia computadorizada contrastadas, feitas em animais com epífora, comparando-se com animais sadios, sem essa afecção. Foram utilizados 20 cães, de raças e pelagens variadas, machos e fêmeas, com peso de 1 a 20 kg, com 0,7 a 8 anos de idade, apresentando epífora (grupo epífora - GE). Como grupo de controle (GC), foram utilizados 15 cães, sem alterações clínicas de drenagem do sistema lacrimonasal de raças e pelagens variadas, machos e fêmeas, pesando 1 a 20 kg, com 0,7 a 8 anos. Foi proposta a divisão do sistema de drenagem lacrimal em quatro regiões. Na região 1, o GE teve 29 (76,3%) animais com dilatação visibilizada pelo R-X e 32 (84,2%) pela TC; no GC, 4 (12,5%) no R-X e 1 (3,1%) na TC demonstraram dilatação. Na região 3, 13 (34,2%) cães evidenciaram dilatação do DLN no R-X e 14 (36,8%) na TC; e 21 (55,3%) comunicação do ducto lacrimonasal com o seio nasal pelo R-X e 28 (73,7%) pela TC. Já no GC, 15 (46,9%) pelo R-X e 22 (68,7%) pela TC possuíam comunicação do ducto lacrimonasal com o seio nasal. Concluiu-se que: dilatações também podem ser observadas em alguns cães sem sinal clínico da afecção; comunicação do ducto lacrimonasal com o seio nasal não indica alteração causadora de epífora, pois está presente em animais com e sem afecção; os dados do presente estudo confirmam que o exame DCG por si pode dar importantes informações, de forma semelhante à TC, devendo-se recorrer à ela apenas quando houver dúvidas sobre lesões ósseas, fraturas e corpos estranhos não detectados pelo primeiro...

Epiphora evaluation can be done through clinical exams, lachrymal excretion tests, contrasted exams, like radiologic evaluation and tomography studies; those last two allow a detailed analysis of the structures. The present study had as the objective to evaluate the lacrimal drainage system through radiography and contrasted computed tomography, which were made with animals presenting epiphora, comparing them to healthy animals, without the mentioned condition. Twenty dogs were used for tests, from a variety of breeds and coatings, males and females, weight varying from 1kg to 20kg, ages varying from 0.7 to 8 years old, presenting epiphora (epiphora group - GE*). As a control group (GC*) 15 dogs were used, with no clinical alterations of naso-lachrymal drainage system, from different breeds and coatings, males and females, weighing from 1kg to 20kg and ages varying from 0.7 to 8 years old. It was propoused the division of the lacrimal drainage system in four regions. On region 1, the GE had 29 (76.3%) animals with dilation visualized by the RX and 32 (84.2%) by CT, the GC, 4 (12.5%) in the RX and 1 (3.1% ) CT showed dilation. In region 3, 13 (34.2%) dogs showed dilatation of the DLN in RX and 14 (36.8%) on CT, and 21 (55.3%) nasolacrimal duct communication with the sinus and the X-ray 28 (73.7%) by CT. For the CG, 15 (46.9%) the X-ray and 22 (68.7%) by CT had nasolacrimal duct communication with the nasal sinus. It has been concluded that dilations can also be observed in some dogs with no clinical signs of disease; nasolacrimal duct communication to sinus does not indicate epiphora causing alteration, as it is present in animals with and without affection; the present study data confirm that DCG itself can provide important informations, in a similar manner to CT, and should resort to it just in case of doubts about bone lesions, fractures and foreign bodies undetected at first...

Dacryocystography in a cat with orbital pneumatosis.

A 2-year-old neutered male European short-haired cat was presented for a persistent discharge from the scar of previous left eye enucleation, performed 6 months prior by the referring veterinarian. A surgical exploration of the orbit was performed and retained nictitating membrane glandular and conjunctival tissues were removed. Eleven days later, the cat developed an orbital pneumatosis caused by retrograde movement of air through a patent nasolacrimal system and diagnosed by survey radiographic examination of the skull. Nasolacrimal system patency was assessed by dacryocystography performed by injection of iodinated contrast medium under pressure into the orbital cavity. Computed tomography dacryocystography confirmed the radiographic findings. The condition resolved following dacryocystography, possibly as an inflammatory response to the contrast medium. To our knowledge, this is the first case of orbital pneumatosis reported in a cat.

Canine dacryolithiasis: a case description and mineral analysis.

A 4-year-old, female, spayed, Labrador retriever was presented with a painless swelling of the left ventromedial eyelid and epiphora of 3 months duration. Bilateral patency of the nasolacrimal system was confirmed by the appearance of fluorescein dye at both nares. Ultrasonography revealed a well-demarcated fluid-filled structure containing echogenic ill-defined material in close proximity to the nasolacrimal system. A transconjunctival surgical approach confirmed the close anatomical proximity of the cyst and the absence of a communication with the inferior canaliculus. The cyst contained multiple intraluminal calculi (dacryoliths). Following surgical excision of the cyst, the epiphora resolved and no recurrence was noted over a 12-month follow-up period. On histopathology, the cystic structure was lined by stratified squamous epithelium, consistent with lacrimal canaliculus epithelium. Presumed progression of a canalicular diverticulum to a cyst with the formation of intraluminal dacryoliths was suspected. Mineral analysis of the dacryoliths revealed a calcium carbonate composition.

Conjunctival dacryops in two golden retrievers.

Two 5-month-old golden retriever dogs were referred for the evaluation of a mass arising from the left ventrolateral conjunctiva of the lower eyelid. The masses were externally located, deemed to be cystic in nature, and were surgically removed, and in one case, 0.15 mL of clear fluid was collected. Cytological examination of the aspirated fluid revealed proteinaceous, basophilic amorphous material, and few epithelial cells with foamy cytoplasm and small nuclei. No micro-organisms were detected. Histological examination of the cysts showed a wall composed of single to double cell layers. The cells were cuboidal to flattened, nonciliated, lined with mild submucosal connective tissues and slight inflammation composed of lymphocytes, plasma cells, and rare macrophages. In some areas, lobules of acinar glandular tissue were observed. To the authors' knowledge, this is the first case report of conjunctival dacryops in dogs. The complete surgical removal of the cysts was curative in both cases.

Transplante de glândulas salivares menores no tratamento da ceratoconjuntivite seca em cães / Transplantation of the minor salivary gland in dogs with keratoconjunctivitis sicca

Relatou-se o efeito do transplante de glândulas salivares menores (TGSM) em cães portadores de ceratoconjuntivite seca (CCS) e estudaram-se os efeitos da secreção dessas glândulas usadas como alternativa de lubrificação ocular. A aplicação da técnica foi satisfatória, uma vez que resultou em melhora no quadro clínico oftalmológico sem que houvesse mínimas intercorrências pós-operatórias.

The effect of the transplant of minor salivary gland (TGSM) in carrying dogs of dry ceratoconjuntivite (CCS) and the effect of these used glands as alternative for ocular lubrication have been studied. The transplantation of the salivary gland in dogs with keratoconjunctivitis sicca (KCS) was reported and clinical effects of the salivary secretion as ocular lubricant for the relief of the disease were studied. Based on these results, it was concluded that the application of the TMSG technique in dogs with KCS is satisfactory, as demonstrated by improvement in the clinical ophthalmology and appreciated by the landlord regardin the results of the surgery and minimal postoperative complications.

Radiotherapy for canine chronic superficial keratitis using soft X-rays (15 kV).

OBJECTIVE: To evaluate the effect of soft X-ray therapy in the treatment of refractory chronic superficial keratitis (CSK). ANIMALS STUDIED: Thirteen dogs with severe CSK, that had been refractory to prior medical and/or surgical therapy were treated with soft X-ray therapy. PROCEDURES: Both corneas of each dog were irradiated with soft X-rays (15 kV), to a total dose of 30 Gy, administered as two fractions over 48-96 h. Treatment was carried out under deep sedation in all dogs. Three dogs were treated by superficial lamellar keratectomy 48 h prior to radiotherapy. Changes in the extent of corneal pigmentation, pigment density and corneal vascularization were documented using a semi-quantitative grading scheme, schematic drawings and clinical photographs. RESULTS: Only minor, transient adverse effects of treatment, such as photophobia, epiphora and blepharitis were noted. Overall the effect of soft X-rays on the course of the keratitis was superior when compared to the effect of Sr-90 irradiation that had been determined in a previous study. CONCLUSION: Soft X-ray irradiation combined with keratectomy is a safe and effective new treatment option for severe and advanced CSK with significant visual impairment due to corneal pathology.

Suture exostosis causing obstruction in the nasolacrimal duct in three horses.

CASE HISTORY: Three horses were presented with facial swelling and epiphora. CLINICAL FINDINGS: All horses had facial swellings and radiographic findings consistent with exostosis at the lacrimomaxillary suture, and ipsilateral epiphora. Positive contrast dacryocystorhinography demonstrated that the site of obstruction of the nasolacrimal duct was located where the duct traverses the lacrimomaxillary suture. DIAGNOSIS: Lacrimomaxillary suture exostosis. CLINICAL RELEVANCE: Lacrimomaxillary suture exostosis should be considered as a differential diagnosis in cases of epiphora in horses. Dacryocystorhinography, preferably retrograde and normograde, may be used as an aid to diagnosis.

Dacryops (lacrimal cyst) in three young labrador retrievers.

This case series constitutes a report of dacryops in multiple Labrador retrievers and the use of smooth-muscle actin immunostaining to confirm the lacrimal duct origins of the cyst wall. Three Labrador retrievers were presented with a history of a slowly enlarging mass adjacent to the left medial canthus. Ultrasonography of the masses revealed they were each spherical, thin-walled cystic structures. Aspiration cytology was performed in two cases revealing mixed inflammation and absence of detectable microorganisms. Dacryocystorhinography of the left nasolacrimal system performed in two cases revealed a normal nasolacrimal system that was closely associated, but not communicating with, the cystic mass in both cases. Surgical excision of all cysts was curative. Histopathology and positive immunohistochemical staining for smooth-muscle actin confirmed a diagnosis of dacryops in all cases.

Lacrimal cystadenoma in a Chinese box turtle (Cuora flavomarginata).

An adult male Chinese box turtle (Cuora flavomarginata) presented to the Avian and Exotic Pet Service of the Animal Medical Center for periorbital swelling of the right eye. The swelling had failed to respond to nutritional supplementation and parenteral administration of vitamin A. What had initially presented as periorbital swelling developed into a growth ventral to the globe that impeded vision and was frequently traumatized by forelimb movements of the turtle. Twenty-six months after initial presentation, the turtle was anesthetized and the bulk of the mass was surgically removed. Histopathologic examination determined the mass to be a benign lacrimal cystadenoma.

A new surgical method for the control of the epiphora in dogs: modified parotid duct transposition.

A five-year-old, female, spayed beagle with a history of unilateral epiphora of several months' duration as a result of inadequacy of the lacrimal drainage system was treated successfully with a new surgical method of parotid duct transposition. Data from complete preoperative ophthalmological examination, surgical technique, postoperative treatment, contrast radiography and histological examination were recorded. Absence of complications and complete patency of the stoma at 30 days after surgery confirmed the validity of this new technique. The use of an anatomic duct may be advantageous compared with the current techniques of conjunctivorhinostomy, conjuntivobuccostomy and conjunctival maxillary sinusostomy for the treatment of epiphora in the dogs caused by inadequacy of the lacrimal drainage system.

Generalized osteosclerosis in a cat.

A 12-year-old, neutered male, domestic long-hair cat was evaluated for a 6-month history of inspiratory stertor and epiphora. In computed tomography of the skull and pelvis, and radiographs of the thorax, right femur and stifle there was generalized osteosclerosis, with obliteration of the nasal turbinates and nasolacrimal duct obstruction. The cat also had a large fibrosarcoma involving the right pelvic limb. Osteosclerosis is a rare disorder that is poorly understood but has been described in several species. Various manifestations, potential causes, and radiologic findings of osteosclerosis are discussed.

Lacrimal gland myoepithelioma in a rhesus macaque (Macaca mulatta).

An 18-year-old rhesus macaque (Macaca mulatta) developed ptosis of the left upper eyelid due to a mass that had first been observed 10 years previously. The 11 x 7 x 7-mm mass was surgically excised, and the ptosis resolved after 5 days. Histologic examination of the mass revealed two confluent cell populations. Most cells were spindle-shaped and were arranged in loose fascicles. Smaller numbers of cells had squamous differentiation. The spindle-shaped cells expressed smooth muscle actin. Cells with squamous differentiation did not express smooth muscle actin, but did, along with around half of the spindle-shaped cells, express pan-cytokeratin. On the basis of histologic and immunohistochemical findings, the mass was diagnosed as myoepithelioma. The neoplasm most likely originated from the palpebral lobe of the lacrimal gland, although accessory lacrimal gland origin could not be excluded. Recurrence of the neoplasm has not been observed 6 months after surgery.

Surgical treatment of recurrent dacryocystitis secondary to cystic dilatation of the nasolacrimal duct in a dog.

A 3-year-old, castrated male golden retriever was presented for evaluation of recurrent ocular discharge of 4 months' duration from the left eye. Dacryocystorhinography was performed and demarcated a cystic dilatation of the left nasolacrimal duct with obstruction of the duct distal to the cystic cavity. Surgical exploration of the left maxillary sinus was performed to confirm the diagnosis and reestablish drainage into the nasal cavity. Recovery was uneventful, and the dog has been asymptomatic for >36 months postoperatively. This report documents the third published case of surgical treatment for cystic dilatation of the nasolacrimal duct.