Reconstruction of a Complicated Orbital Depression Fracture with Medial Wall and Globe Repositioning in a Horse: A Collaboration Across Disciplines and Specialties.

OBJECTIVE: To report the surgical reconstruction of a complicated orbital depression fracture in a horse with emphasis on medial wall and globe repositioning. STUDY DESIGN: Clinical report. ANIMALS: A 6 year old Irish Sport Horse gelding. METHODS: The eventer presented with acute, severe orbital trauma and globe displacement. After initial elevation of the depression fractures of the facial bones and reconstruction of the orbit, the globe was recessed secondary to displacement of the medial wall and floor of the orbit within the conchofrontal sinus. A three-dimensional model of the fracture configuration was used for presurgical planning to reposition the globe. During a subsequent surgical procedure, a resorbable plate was placed in the floor of the orbit and the medial orbital wall and globe were repositioned using a sinoscopic approach and stabilized with the placement of tissue expanders within the conchofrontal sinus. The tissue expanders were subsequently removed after 3 weeks under standing sedation. RESULTS: The right globe was successfully repositioned in a more correct anatomical orientation and the horse resumed work 3 months postoperatively, and successfully competed at its previous level 5 months postoperatively. No visual deficits have been reported by the owners. CONCLUSION: Efforts to restore the medial wall and/or floor of the orbit with concurrent globe repositioning should be considered in horses with severe orbital depression fractures that result in abnormal globe position.

Suspected hypothyroid-associated neuropathy in a female rottweiler dog.

A 7-year-old, 46-kg spayed female rottweiler dog was presented with sudden onset of disorientation, bilateral convergent strabismus, and enophthalmos. Diagnostic workup revealed hypothyroid-associated cranial neuropathy. Symptoms abated considerably upon treatment with levothyroxine-sodium (T4) at an initial dose of 800 µg/kg body weight (BW), PO, q12h, which was reduced 3 days later to 600 µg/kg BW, q12h due to severe agitation and panting. Two weeks later the dosage of the levothyroxine-sodium (T4) was reduced to 400 µg/kg BW in the morning and 600 µg/kg BW in the evening. Eight weeks after the initial presentation, the dog had recovered with only mild convergent strabismus in the right eye. This is the first case report of suspected hypothyroid-associated neuropathy resulting in these symptoms.

Neuropathie hypothyroïdienne chez une chienne rottweiler. Une chienne rottweiler de 7 ans, pesant 46 kilogrammes, est présentée pour désorientation, strabisme convergent et enophtalmie d'apparition brutale. Les examens complémentaires révèlent une neuropathie hypothyroïdienne affectant les nerfs crâniens. Le traitement, levothyroxine sodium initialment à la dose 800 µg per os, deux fois par jour, reduit à 600 µg deux fois par jour en raison de apgitation et haleter, permet considerablement l'amélioration des symptômes. Le propriétaire ait conjeillié à diminuer la dose à 400 µg le matin et 600 µg dans la soirée. La chienne recupérait avec solement daix strabisme convergent dans l'oeil drait 8 semaines après la presentation initiale. Ceci est le premier cas rapporté de suppose neuropathie thyroïdienne présentant cette association de symptômes.(Traduit par les auteurs).

Surgical correction of severe strabismus and enophthalmos secondary to zygomatic arch fracture in a dog.

A grossly displaced segmental zygomatic arch fracture with marked ventro-lateral deviation of the left globe was diagnosed in a 3-month-old male German Shepherd dog following a bite injury. The fracture was approached via a modified lateral orbitotomy and a fragment of the lacrimal bone removed. The rostral portion of the fracture was stabilized with a 5-hole 2.0 dynamic compression plate bone plate. The surgical correction achieved sufficient skeletal fixation for proper anatomical reduction of the globe and excellent cosmetic and functional outcomes.

Orbital neoplasia with enophthalmos in a cat.

A 9-year-old cat was evaluated for left-sided enophthalmos and protrusion of the third eyelid. A primary orbital fibrosarcoma was diagnosed. During the orbital exploration, normal periorbital fascia could not be identified in the lateral and ventral region, thus accounting for the enophthalmos.

Clinical and laboratory assessment of hydration status of neonatal calves with diarrhea.

OBJECTIVE: To develop accurate, objective guidelines for assessing hydration status of neonatal calves with diarrhea. DESIGN: Prospective study. ANIMALS: 15 male dairy calves 3 to 10 days old. PROCEDURE: Dehydration and diarrhea were induced by administration of diuretic agents (i.e., furosemide, spironolactone, hydrochlorothiazide) and sucrose solution. Linear regression was used to examine the relationship between potentially useful factors for evaluating hydration status (extent of enophthalmos; skin-tent duration on neck, thorax, and upper and lower eyelids; heart rate; mean central venous pressure; peripheral [extremity] and core [rectal] temperatures; core-peripheral [rectal-extremity] temperature difference; PCV; and hemoglobin and plasma protein concentrations) and degree of dehydration, as determined by change in body weight. RESULTS: Best predictors of degree of dehydration were extent of enophthalmos, skin elasticity on neck and thorax, and plasma protein concentration. CLINICAL IMPLICATIONS: These experimentally determined guidelines provide practitioners with a simple, inexpensive, and practical method for evaluating hydration status of neonatal calves with diarrhea.

Sino-orbital aspergillosis in a dog.

Fungal rhinitis-sinusitis with orbital involvement was diagnosed in a dog with profuse unilateral ocular and bilateral nasal discharge, enophthalmos, and a corneal descemetocele. The descemetocele was treated with a conjunctival pedicle graft. Frontal sinusotomy was performed, and clotrimazole was infused through catheters placed in the frontal sinuses and nasal cavities to saturate the tissues for 1 hour. Successful resolution of orbital infection may have been aided by a fistula between the frontal sinus and orbit that allowed delivery of clotrimazole to the orbit. The dog retained sight in the affected eye, and clinical signs of infection were not detected 14 months later, although enophthalmos and medial strabismus may have been caused by persistent postinflammatory fibrosis.

Horner's syndrome in the horse: a clinical, experimental and morphological study.

A clinical case of Horner's syndrome is described in a Standardbred horse, and the various symptoms of cranial sympathetic denervation are studied in two ponies after experimental transection of the left cervical sympathetic trunk and vagosympathetic trunk, respectively. The most prominent symptoms of equine Horner's syndrome were ptosis, local sweating and increased cutaneous temperature in the denervated area. Enophthalmos, miosis and increased lacrimation were also observed but these symptoms were mild, variable and difficult to ascertain. Prolapse of the third eyelid was not noticed. Concomitant laryngeal hemiplegia was present in the clinical case and was provoked experimentally in one pony by transection of the left vagosympathetic trunk. The aetiology of each of these symptoms is discussed by comparing the results of pharmacological tests and histological findings in the three horses with the data from the literature.