Protothecosis in four dogs in New Zealand.

CASE HISTORIES: Medical records of four dogs diagnosed with protothecosis in New Zealand were reviewed. The dogs were aged between 4 and 9 years and three of the four dogs were female. Breeds were one Labrador, one Miniature Schnauzer and two crossbreeds. The reasons for initial veterinary evaluation were a cough and opaque appearance of the right eye (Case 1), diarrhoea (Cases 2 and 3), and cutaneous disease (Case 4). CLINICAL FINDINGS: The ocular signs were characterised by panuveitis, retinal detachment and secondary glaucoma. Gastrointestinal signs included chronic haemorrhagic diarrhoea due to colitis. Three cases had disseminated infection and developed both bilateral, blinding, ocular disease and chronic gastrointestinal disease. Cutaneous signs consisted of draining fistulae over the olecranon, multifocal cutaneous nodules, and ulceration and tracts of the foot pads. Disseminated protothecosis was confirmed by histopathology of biopsied ocular tissues in Cases 1 and 2 and by gastrointestinal biopsies in Case 3. Prototheca spp. were also identified in cytological specimens from Cases 1 and 4 and recovered by culture in Cases 2 and 4. Cutaneous protothecosis was diagnosed in Case 4 initially by cytology and histopathology of skin lesions, and Prototheca zopfii was confirmed by PCR of cultured organisms. TREATMENT AND OUTCOME: Prior to diagnosis of protothecosis, a variety of treatments were prescribed to treat the gastrointestinal and ocular signs. After diagnosis, only Cases 2 and 4 received medication aimed at treating the protothecal infection, which was itraconazole in both cases. Following the progression of clinical signs and concerns about quality of life, all four dogs were euthanised. DIAGNOSIS: Disseminated protothecosis in three dogs, cutaneous protothecosis in one dog. CLINICAL RELEVANCE: Canine protothecosis is rarely reported, despite the ubiquity of the causal algae, and the disease usually carries an extremely grave prognosis when infection is generalised. In New Zealand, protothecosis should be considered as a differential diagnosis in dogs with panuveitis, chorioretinitis or retinal detachment, colitis, or nodular, ulcerative or fistulating cutaneous lesions.

An unusual case of eosinophilic uveitis in a cat.

An 8-year-old female spayed domestic short-haired cat was examined for recurrent unilateral anterior uveitis of 5 month's duration. No underlying cause was found on infectious disease screening. The cat also had a 4-year history of allergic or immune-mediated skin disease that was controlled with corticosteroid injections followed by long-term oral cyclosporine therapy. Medical management with frequent topical anti-inflammatory drugs (prednisolone acetate 1% suspension, diclofenac 0.1% solution) controlled the intraocular inflammation; however, the uveitis would relapse when therapy was discontinued. Eventually, secondary glaucoma developed OD and the eye was enucleated. At the time of surgery, a complete blood count showed a mild eosinophilia. Histopathology revealed a marked panuveitis characterized by an abundant accumulation of mixed inflammatory cells, with a predominantly eosinophilic infiltrate in the anterior chamber, iris, ciliary body, and choroid. No etiologic agents were found on serial sections, and there were no cellular criteria for malignancy noted. Nine months after enucleation, the chronic dermatitis appeared to be in remission despite no further medical management. This is the first known report of a primarily eosinophilic uveitis in a cat with chronic allergic skin disease and may be considered an ocular variant of feline eosinophilic granuloma complex.

Irreversible Ocular Lesions in a Dog With Angiostrongylus Vasorum Infection.

This report describes a 10-month-old dog with a sudden loss of vision and severe dyspnoea. The ocular examination revealed bilateral panuveitis, lens subluxation, secondary glaucoma, and retinal detachment. In addition, the ocular ultrasound showed in the vitreous body of the right eye, a small doubled-lined foreign body compatible with an intraocular parasite. Radiographs of the thorax revealed an increased opacity with mixed lung pattern (alveolar and bronchial) and thoracic ultrasonography showed several subpleural nodules. The presence of Angiostrongylus vasorum first stage larvae was confirmed with 324 larvae per gram of feces and an antigen test for the parasite (AngioDetect, IDEXX) also yielded a positive result. The severe and irreversible ocular lesions described in this case enhanced the complexity of the clinical picture of canine angiostrongylosis. Infection with the parasite should be included in the list of differential diagnoses for ocular uveitis to avoid potentially serious complications related to a missed or delayed diagnosis.

Supposed endogenous endophthalmitis caused by Serratia marcescens in a cat.

An 8-year-old male neutered domestic shorthair cat was presented for evaluation of acute respiratory distress. Respiratory auscultation revealed a diffuse and symmetric increase in bronchovesicular sounds. Thoracic radiographs showed a diffuse unstructured interstitial pulmonary pattern with multifocal alveolar foci. Despite an aggressive treatment with supportive care, including oxygenotherapy and systemic antibiotics, progressive respiratory distress increased. Three days after the presentation, acute anterior uveitis was noticed on left eye. Ophthalmic examination and ocular ultrasonography revealed unilateral panuveitis with ocular hypertension. The right eye examination was unremarkable. Cytological examination of aqueous humor revealed a suppurative inflammation. Serratia marcescens was identified from aqueous humor culture. Primary pulmonary infection was suspected but was not confirmed as owners declined bronchoalveolar lavage. Active uveitis resolved and cat's pulmonary status improved after appropriate systemic antibacterial therapy. Vision loss was permanent due to secondary mature cataract. To the best of authors' knowledge, this is the first report of endogenous bacterial endophthalmitis secondary to S. marcescens infection in a cat.

Canine panuveitis: a retrospective evaluation of 55 cases (2000-2015).

OBJECTIVE: To determine the most common etiologies of panuveitis in a group of dogs, patient response to therapy, and visual outcome. DESIGN: Retrospective study. MATERIALS AND METHODS: Medical records of 55 dogs diagnosed with panuveitis at the Purdue University Veterinary Teaching Hospital between December 2000 and December 2015 were reviewed. Data collected included signalment, season of diagnosis, descriptions of ocular lesions, diagnostic testing, treatment protocols, etiologic diagnoses (when determined), and visual outcome. RESULTS: The most common clinical sign in the anterior segment was aqueous flare and in the posterior segment was serous retinal detachment. The most common diagnosis was idiopathic/immune-mediated disease followed by systemic blastomycosis, lymphoma, and other causes (leptospirosis, aspergillosis, and histoplasmosis). Of the 43 dogs for which follow-up was available, 40% of dogs had resolution of visible inflammation and retinal reattachment, 32% of dogs had slight to moderate improvement, and 28% of dogs had no improvement or deterioration of lesions. Mean follow-up time was 11 months, and mean time to resolution of visible inflammation and retinal reattachment was 32 days. Sixty-five percent of dogs either retained or regained vision in one or both diseased eyes with initial medical therapy. CONCLUSIONS: Idiopathic/immune-mediated panuveitis was the most common diagnosis. Dogs with idiopathic/immune-mediated panuveitis tended to respond more favorably to medical therapy than dogs with infectious panuveitis. Visual outcome was favorable in those dogs that responded to initial medical therapy, but long-term therapy was required in many dogs to maintain vision and prevent recurrence of disease.

Positive immunolabelling for feline infectious peritonitis in an African lion (Panthera leo) with bilateral panuveitis.

A 15-year-old male African lion (Panthera leo) was presented with blindness due to bilateral panuveitis with retinal detachment. Feline coronavirus (FCoV) antigen was identified immunohistochemically in ocular macrophages, consistent with a diagnosis of feline infectious peritonitis (FIP) infection. This is the first report of FIP in an African lion and the first report of ocular FIP in a non-domestic felid.

Positive immunostaining for feline infectious peritonitis (FIP) in a Sphinx cat with cutaneous lesions and bilateral panuveitis.

Feline infectious peritonitis (FIP) is a common, fatal, systemic disease of cats. This case report describes the antemortem diagnosis of FIP in a 2-year-old spayed female Sphinx cat that presented with a bilateral panuveitis and multiple papular cutaneous lesions. Histopathologically, the skin lesions were characterized by perivascular infiltrates of macrophages, neutrophils, with fewer plasma cells, mast cells, and small lymphocytes in the mid- to deep dermis. Immunohistochemistry for intracellular feline coronavirus (FeCoV) antigen demonstrated positive staining in dermal macrophages providing an antemortem diagnosis of a moderate, nodular to diffuse, pyogranulomatous perivascular dermatitis due to FIP infection. Obtaining an antemortem diagnosis of FIP can be a challenge and cutaneous lesions are rare in the disease. Recognition and biopsy of any cutaneous lesions in cats with panuveitis and suspected FIP can help establish an antemortem diagnosis of the disease.

Management of bilateral uveitis in a Toxoplasma gondii-seropositive cat with histopathologic evidence of fungal panuveitis.

A 5-year-old, neutered male Domestic Short-haired cat was referred with a 5-month history of anterior uveitis and cataract in the right eye. Clinical examination confirmed anterior uveitis and immature cataract in the right eye and chorioretinitis in the left eye. Ocular ultrasound showed a retinal detachment in the right eye. Diagnostic testing revealed elevated serum titers for Toxoplasma gondii. Anterior uveitis in the right eye and chorioretinitis in the left eye progressed, resulting in blindness despite a 21-day course of clindamycin and aggressive topical medical management of uveitis. The right eye was enucleated and histopathologic evaluation of the globe revealed panuveitis and multiple organisms morphologically consistent with Histoplasma capsulatum. Systemic treatment with itraconazole was initiated. Vision returned after 3 months of treatment and complete resolution of the retinal hemorrhages with formation of a flat chorioretinal scar was noted after 6 months of therapy. Itraconazole was discontinued 7 months after starting therapy, at which time the funduscopic appearance of the chorioretinal scar had remained static for 1 month. The cat has remained visual without evidence of disease progression for 6 months following discontinuation of itraconazole.

A novel bioerodible deep scleral lamellar cyclosporine implant for uveitis.

PURPOSE: To determine the feasibility, safety, and effectiveness of an episcleral or deep scleral lamellar sustained release cyclosporine (CsA) device in a naturally occurring animal model of uveitis. METHODS: A two-compartment perfusion chamber was used to assess in vitro human and equine scleral permeability of fluorescein, dexamethasone-fluorescein, or CsA. A biodegradable, matrix-reservoir CsA implant was designed, and release rates of CsA were determined in vitro. Tissue CsA levels were measured in eyes with the implant. Horses with equine recurrent uveitis (ERU) received episcleral or deep scleral lamellar CsA implants and were monitored for up to 3 years. RESULTS: Dexamethasone-fluorescein and CsA penetrated the in vitro equine sclera poorly; however, low but detectable levels of CsA were detected intraocularly in vivo. The implant placed episclerally failed to control inflammatory episodes in ERU. CsA implants placed in the deep sclera adjacent to the suprachoroidal space resulted in high levels of CsA in most ocular tissues. In clinical equine patients with ERU, frequency of uveitic flare-ups was significantly decreased after implantation of a deep scleral lamellar CsA implant. CONCLUSIONS: Diffusion of CsA across the sclera from the episcleral space was not a feasible method of drug delivery to the equine eye. However, placing a deep scleral lamellar CsA implant adjacent to the suprachoroidal space was effective in achieving therapeutic ocular drug concentrations and controlling uveitis in horses with ERU.

Leptospirosis and panuveitis in a dog.

A case of panuveitis as a result of leptospiral infection in an 8-year-old Jack Russell Terrier is reported. Mild hyphema, aqueous flare, and partial serous retinal detachments were noted in both eyes on initial ophthalmic examination. The serum microscopic agglutination testing for Leptospira serovarieties revealed titers of 1 : 12 800 for Leptospira canicola and 1 : 200 for Leptospira icterohemorrhagiae. With medical therapy, the panuveitis resolved and functional vision was regained. Four weeks after the initial presentation, convalescent titers were 1 : 200 for L. canicola and 1 : 100 for L. icterohemorrhagiae. The incidence of leptospirosis, along with difficulties diagnosing, and current medical therapies for this disease are also discussed.

Inter- and intramolecular epitope spreading in equine recurrent uveitis.

PURPOSE: To test the hypothesis that inter- and intramolecular spreading to S-antigen (S-Ag) and interphotoreceptor retinoid binding protein (IRBP)-derived epitopes occurs in a spontaneous model of recurrent uveitis in the horse. METHODS: The immune response of eight horses with equine recurrent uveitis (ERU) was compared with that of five control horses with healthy eyes. Lymphocytes derived from peripheral blood (PBLs) were tested every 8 weeks for their reactivity against S-Ag and various S-Ag and IRBP-derived peptides for 12 to 39 months (median, 22 months). During uveitic episodes, additional blood samples were analyzed. RESULTS: Intermolecular epitope spreading was detectable in all ERU cases during the study. Intramolecular spreading occurred in seven (of eight) horses with ERU. Fourteen relapses were analyzed during the observation period. Ten uveitic episodes were accompanied by neoreactivity to S-Ag or IRBP-derived peptides during the relapse. Shifts in the immune response profile were also detectable without any clinical signs of inflammation. Eye-healthy control horses were negative at all time points in the in vitro proliferation assays. CONCLUSIONS: Inter- and intramolecular spreading was detectable in a spontaneous model of recurrent uveitis. The shifts in immunoreactivity could account for the remitting-relapsing character of the disease.