Manifestations of hypertensive encephalopathy in cats.

OBJECTIVES: Hypertensive encephalopathy in cats is an important entity but is underestimated in clinical practice. This could be explained, in part, by non-specific clinical signs. The objective of this study was to characterise the clinical manifestations of hypertensive encephalopathy in cats. METHODS: Cats with systemic hypertension (SHT) recognised by routine screening, associated with underlying predisposing disease or a clinical presentation suggestive of SHT (neurological or non-neurological), were prospectively enrolled over a 2-year period. Confirmation of SHT was based on at least two sets of measurements of systolic blood pressure >160 mmHg by Doppler sphygmomanometry. RESULTS: Fifty-six hypertensive cats with a median age of 16.5 years were identified; 31 had neurological signs. In 16/31 cats, neurological abnormalities were the primary complaint. The other 15 cats were first presented to the medicine or ophthalmology service, and neurological disease was recognised based on the cat's history. The most common neurological signs were ataxia, various manifestations of seizures and altered behaviour. Individual cats also showed paresis, pleurothotonus, cervical ventroflexion, stupor and facial nerve paralysis. In 28/30 cats, retinal lesions were detected. Of these 28 cats, six presented with a primary complaint of visual deficits, and neurological signs were not the primary complaint; nine presented with non-specific medical issues, without suspicion of SHT-induced organ damage; in 13 cats, neurological issues were the primary complaint and fundic abnormalities were detected subsequently. CONCLUSIONS AND RELEVANCE: SHT is common in older cats and the brain is an important target organ; however, neurological deficits are commonly ignored in cats with SHT. Gait abnormalities, (partial) seizures and even mild behavioural changes should prompt clinicians to consider the presence of SHT. A fundic examination in cats with suspected hypertensive encephalopathy is a sensitive test to support the diagnosis.

3T high-resolution magnetic resonance imaging, conventional ultrasonography and ultrasound biomicroscopy of the normal canine eye.

BACKGROUND: Advances in MRI coil technology and increased availability of high-field MRI in veterinary medicine enable the acquisition of images of increasingly high spatial resolution while preserving signal-to-noise ratio.The purpose of the present study was to compare 3T high-resolution magnetic resonance imaging (HR-MRI) with ultrasound (US) and ultrasound biomicroscopy (UBM) in the normal canine eye, to assess its potential to depict normal ocular anatomy. RESULTS: HR-MRI was compared with US and UBM in 10 eyes from 10 healthy beagle dogs. Ocular structures (cornea, anterior chamber, iridocorneal angle, iris, lens, ciliary body, choroid, vitreous body, posterior wall of the eye, optic nerve and optic nerve sheath, extraocular muscles) were assessed subjectively and central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AQD), anteroposterior, mediolateral and dorsoventral lens diameter (APLD, MLLD, DVLD), anteroposterior diameter of the globe including and excluding the scleroretinal rim (APDSRR, APD), vitreous chamber depth (VCD) and optic nerve sheath diameter (ONSD) were measured in HR-MRI and in US. Optic nerve diameter (OND) was measured in HR-MRI. HR-MRI and UBM appearance of the anterior segment were subjectively compared. Detailed reference high-resolution MRI images of normal eyes of Beagle dogs are provided. CONCLUSIONS: HR-MRI allowed assessment of all structures identified with US and UBM. The MRI examinations were performed under general anesthesia with the addition of a neuromuscular blocking agent, while US and UBM examinations were performed in conscious animals. Visibility of the entire ocular wall, the lens, the structures caudal to the ciliary body and the optic nerve and its sheath was superior with HR-MRI. HR-MRI allowed the distinction of retina, choroid and sclera, and the delineation of structures not previously identified in canine eyes with MRI, including Tenon's capsule and the sub-Tenon's space.Plane selection was more accurate with HR-MRI compared to US. In general, the range of measurements was narrower for MRI than for US. CCT, AQD, APLD, MLLD, APD, APDSRR and ONSD differed significantly between HR-MRI and US, respectively (p = 0.005-0.027).Micro-MRI may be useful for the assessment of ocular pathologies in the future.

Occurrence of Chlamydiaceae and Chlamydia felis pmp9 Typing in Conjunctival and Rectal Samples of Swiss Stray and Pet Cats.

Chlamydia (C.) felis primarily replicates in feline conjunctival epithelial cells and is an important cause of conjunctivitis in cats. Data on C. felis infection rates in stray cats in Switzerland has been missing so far. We performed a qPCR-based Chlamydiaceae-screening on 565 conjunctival and 387 rectal samples from 309 stray and 86 pet cats followed by Chlamydia species identification and C. felis typing using the gene pmp9, which encodes a polymorphic membrane protein. Overall, 19.1% of the stray and 11.6% of the pet cats were Chlamydiaceae-positive with significantly higher rates in cats displaying signs of conjunctivitis (37.1%) compared to healthy animals (6.9%). Rectal shedding of Chlamydiaceae occurred in 25.0% of infected cats and was mostly associated with concurrent ocular positivity (87.5%). In 92.2% of positive conjunctival and rectal samples, the Chlamydia species was identified as C. felis and in 2.6% as C. abortus. The C. felis pmp9 gene was very conserved in the sampled population with only one single-nucleotide polymorphism (SNP) in one conjunctival sample. In conclusion, C. felis strains are circulating in Swiss cats, are associated with conjunctivitis, have a low pmp9 genetic variability, and are rectally shed in about 16% of positive cases.

Penetrating Keratoplasty in Dogs using Acellular Porcine Corneal Stroma (BioCorneaVet™): A prospective pilot study of five cases.

OBJECTIVE: This prospective pilot study was conducted to evaluate the outcome of a commercially available corneal stroma substitute, Acellular Porcine Corneal Stroma (APCS), in dogs undergoing penetrating keratoplasty (PK) to restore corneal integrity after having deep ulcers. METHOD: Five dogs (1 eye in each dog) underwent a PK using APCS (BioCorneaVet™) as a graft. The surgical procedure and peri- and postoperative treatment were standardized. All cases required a minimum 6 months follow-up. Ease of keratoprosthetic tissue handling, graft survival, anterior chamber stability, corneal opacity, neovascularization and re-epithelialization were noted. Presence of secondary uveitis was investigated. RESULTS: BioCorneaVet™ was easy to handle and, at all-time points, provided adequate tectonic support. Graft survival was achieved in all 5 cases. A minimum follow-up period of 10 months was available for the five eyes (22 months maximum). Degree and area of corneal graft opacity progressively improved resulting in minimal to moderate loss of transparency in all cases but one, where it was severe. Neovascularization degree was most severe 0.5-1 month after surgery and fully resolved 4-6 months post-surgery. Re-epithelialization was complete in the majority of grafts in 1 month. Secondary uveitis was not detected at any time in 4 of 5 dogs. CONCLUSION: BioCorneaVet™ seems to be an effective graft for PK in the dog. In this case series, APCS was convenient to handle during surgery and provided excellent tectonic support. The material showed good tissue biocompatibility and resulted in the majority of cases in minimal to moderate graft opacity, that ameliorates with time.

The effects of soft cryotherapy on conjunctiva and cornea in isolated pig eyes and comparison with standard liquid nitrogen: A pilot ex vivo study.

PURPOSE: To evaluate the immediate effects on cornea and conjunctiva of a cryosurgical method based on the application of a dimethyl ether, propane and isobutene solution (DMEPI, Histofreezer® ), and of Liquid Nitrogen (LN2 ; Cry-Ac Cryogun® ). METHODS: A total of 52 isolated pig eyes were obtained at the slaughterhouse, preserved for less than one hour in Ringer Lactate and divided into four groups. The first group included eyes treated with two applications of DMEPI in the center of the cornea, the second group eyes treated with DMEPI on the third eyelid's conjunctiva, the third group eyes treated with LN2 on the third eyelid's conjunctiva and the fourth group included eyes treated with LN2 on the central cornea. Each cryogen application (0.8 cm area) lasted 40 seconds. Each group included one (untreated) control eye. The eyes were submitted for routine histopathological evaluation. Histological alterations were recorded and scored with a semiquantitative scoring system. RESULTS: No tissue alteration was detected on the conjunctiva, in any of the groups. Treated corneas showed mild to moderate cytoplasmic vacuolization of epithelial cells, shrinkage and hypereosinophilia of small groups of basal epithelial cells and stromal cleft formation. CONCLUSIONS: Soft cryosurgery caused no severe acute histologically detectable damage to cornea and conjunctiva in isolated pig eyes, and no significant difference was observed when LN2 and DMEPI treatments were compared. Further in vivo studies should be performed in order to verify possible delayed effects and the clinical efficacy of DMEPI cryosurgery in specific corneal and/or conjunctival diseases.

Use of four-layer porcine small intestinal submucosa alone as a scaffold for the treatment of deep corneal defects in dogs and cats: preliminary results.

BACKGROUND: To describe the efficacy of four-layer porcine small intestinal submucosa (Vetrix BioSIS plus+) as single scaffold for the treatment of deep corneal lesions in dogs and cats. METHODS: 10 dogs and 3 cats with deep or full thickness corneal defects were treated surgically with BioSIS plus graft. Corneal transparency scores and vision were evaluated. RESULTS: Lesions in dogs were four perforations, three descemetoceles, two limbal melanocytomas and one deep corneal ulcer. In cats, there were one limbal melanocytoma and two perforations. The average length of the follow-up was 86 days. In all, 12 out of 13 eyes treated were visual at last recheck (92.3 per cent). The scars were mild eight cases (66.7 per cent), but denser in four cases (33.4 per cent). Complication were partial collagenolysis in three cases (25 per cent), which resolved with medical therapy, mild corneal pigmentation in one case (8.4 per cent) and anterior synechia in one case (8.4 per cent). One case experienced severe collagenolysis and was enucleated 21 days postoperatively. CONCLUSIONS: Four-layer porcine SIS graft was successfully used for surgical treatment of deep corneal lesions in selected corneal diseases in a small series of dogs and cats, with good results in terms of mechanic support and corneal transparency.

Use of episcleral cyclosporine implants in dogs with keratoconjunctivitis sicca: pilot study.

PURPOSE: To describe the use, tolerability, and efficacy of episcleral silicone matrix cyclosporine (ESMC) implants in dogs with keratoconjunctivitis sicca (KCS). METHODS: Retrospective study. ESMC implants (1.9 cm length, 30% wt/wt CsA in silicone; with approximately 12 mg of CsA loaded into them) were used in dogs with KCS responsive to topical CsA (good candidate, GC) or not responsive (poor candidate, PC). Ocular surface inflammation scores, Schirmer tear test (STT) values, and ocular discharge quantity were evaluated and compared. RESULTS: Twenty-seven eyes (15 dogs) received an ESMC implant for KCS; 15 eyes were considered GC, and 12 were considered PC. Both GC eyes and PC eyes showed a significant increase in STT values (increase of 7.7 and 8.5 mm/min; P = 0.023 and P = 0.003, respectively) after placement of ESMC implants (mean follow-up 18 ± 2 and 10.4 ± 15 months, respectively). Clinical signs improved significantly in both groups during the same follow-up, with reduction in conjunctival hyperemia (P < 0.001), corneal neovascularization (P = 0.004), corneal opacity (P = 0.003), and ocular discharge (P = 0.002). ESMC implants were well tolerated by all dogs, but two eyes lost the device at 12-months and 1-week follow-up, respectively. CONCLUSIONS: Results from this study suggest that the EMSC implants were well tolerated and efficacious in dogs with KCS responsive to topical CsA as well as dogs with poor response to topical therapy. Further study is needed to determine the duration of efficacy and optimal dose of CsA.

Hormographiella aspergillata keratomycosis in a dog.

A 4-year-old, female, Border Collie was presented to the University of Bern Veterinary Teaching Hospital, because of a corneal lesion of 10 days duration. The axial cornea presented a whitish fluorescein-positive plaque with irregular margins. A diagnosis of keratomycosis was made based on cytology. Medical therapy with local broad-spectrum antibiotic and fluconazole was instituted. After 1 week of treatment, the improvement was deemed unsatisfactory. Therefore, a lamellar keratectomy and conjunctival pedicle flap were performed. After surgery, the cornea healed uneventfully. Histology confirmed the diagnosis of keratomycosis. The fungus could not be grown in culture and a precise etiological diagnosis could only be obtained with genetic identification of the fungus. A PCR technique was used to amplify the fungal genome from the cornea. Hormographiella aspergillata, the asexual reproductive form of the basidiomycete Coprinopsis cinerea, was identified. As advised in human medicine, we encourage the use of this molecular technique to obtain an early species diagnosis, allowing targeted medical therapy.

Evaluation of the presence of selected viral and bacterial nucleic acids in pericardial samples from dogs with or without idiopathic pericardial effusion.

Many viruses have been identified in pericardial fluid and in tissue samples from humans with pericarditis by means of molecular diagnostics. In canine idiopathic pericardial effusion there is as yet no conclusive evidence to support the involvement of an infectious agent. This study was designed to investigate a possible relationship between idiopathic pericardial effusion in dogs and viruses most commonly encountered in humans affected with viral pericarditis. Coxsackievirus B3 RNA, influenza virus type A RNA, human adenovirus type 2 DNA, human cytomegalovirus DNA, and parvovirus B19 DNA were investigated using PCR on pericardial effusion samples and pericardial tissue specimens collected from 14 dogs with idiopathic pericardial effusion. PCR was also used to test for two bacteria, Borrelia burgdorferi and Chlamydia pneumoniae. The same microorganisms were also looked for in pericardial effusions or pericardial washes from 10 dogs with neoplastic pericardial effusion, and in samples collected from 10 dogs which died of a non-cardiac disease. One pericardial effusion sample from a dog with the idiopathic form of the disease tested positive for influenza virus type A and sequencing of the amplicon confirmed the PCR result. In another dog from the same group a cytomegalovirus was detected by PCR in the effusion, but sequencing showed this to be a false-positive result. The genomes of the microorganisms investigated were not detected in neoplastic effusions or pericardial washes. The results indicate that viral and bacterial DNA/RNA of relevance for human pericarditis is rare in pericardial samples from dogs with idiopathic pericardial effusion. The finding of influenza type A viral RNA in pericardial fluid from one dog with the idiopathic form of the disease warrants further investigation.

Effect of anabolics on bovine granulosa-luteal cell primary cultures.

Granulosa cell tumours are observed with increased frequency among calves slaughtered in Northern Italy. The use of illegal anabolics in breeding was taken into account as a cause of this pathology. An in vitro approach was used to detect the possible alterations of cell proliferation induced by anabolics on primary cultures of bovine granulosa-luteal cells. Cultures were treated with different concentrations of substances illegally used in cattle (17beta-estradiol, clenbuterol and boldione). Cytotoxicity was determined by means of MTT test, to exclude toxic effects induced by anabolics and to determine the highest concentration to be tested. Morphological changes were evaluated by means of routine cytology, while PCNA expression was quantified in order to estimate cell proliferation. Cytotoxic effects were revealed at the highest concentrations. The only stimulating effect on cell proliferation was detected in boldione treated cultures: after 48 h treated cells, compared to controls, showed a doubled expression of PCNA. In clenbuterol and 17beta-estradiol treated cells PCNA expression was similar to controls or even decreased. As the data suggest an alteration in cell proliferation, boldione could have a role in the early stage of pathogenesis of granulosa cell tumour in cattle.

Scleral rupture in dogs, cats, and horses.

OBJECTIVES: The aim of this retrospective study was to summarize the most frequent clinical signs, ultrasonographic, and histological findings accompanying scleral rupture as a result of blunt trauma in dogs, cats, and horses. ANIMALS STUDIED AND PROCEDURES: Thirty small animals and three horses diagnosed with scleral rupture resulting from blunt trauma. B-mode ultrasonography was performed on 20 animals. Histopathology was carried out on 18 enucleated globes. RESULTS: In small animals, 80% presented hyphema, 60% subconjunctival hemorrhage, and 53% eyelid and conjunctival swelling. In horses, 100% presented eyelid and conjunctival swelling, 67% hyphema, subconjunctival hemorrhage, and collapsed anterior chamber. Ultrasonographic findings were an area with ill-defined scleral margins (90%), echoic/hyperechoic contents in the anterior and posterior chamber (55%) and in the vitreous (80%). In small animals, scleral rupture location noted on gross examination was: at the posterior pole (4), close to the optic nerve (3), near the limbus (2), and in the dorsal aspect of the globe (1). In horses, the lesion was located at the limbus (3). In small animals, histopathology showed presence of hemorrhage in the anterior, posterior chamber, and vitreous (94%), retinal detachment (94%), choroidal edema and hemorrhages (88%), and choroidal detachment as a result of suprachoroidal hemorrhage (88%). The same lesions were found in the globes of two horses. In small animals, rupture location noted on histopathology was: at the posterior pole (8), close to the optic nerve (4), near the limbus (1), near the ciliary body (1). CONCLUSIONS: The most frequent clinical signs observed were hyphema, subconjunctival hemorrhage, and eyelid and conjunctival swelling. Ultrasonographic findings suggestive for scleral rupture were ill-defined scleral borders and/or echoic/hyperechoic material in the cavities of the globe. On histopathology, lesions severely altering the anatomy of the eye structures were: hemorrhage into the chambers of the globe, subretinal and suprachoroidal hemorrhage leading to retinal and choroidal detachment, respectively. In small animals, the most frequent locations for scleral rupture were the posterior pole and close to the optic nerve, whereas in horses it was the limbus.

Collie eye anomaly in a mixed-breed dog.

A 5-year-old, mixed-breed dog was presented for tetraparesis. Neurologic alterations included a decreased menace response in both eyes. Therefore, an ophthalmic examination was requested. The dog was visual, but menace response, dazzle and pupillary light reflexes were reduced bilaterally. Indirect ophthalmoscopy revealed bilateral optic nerve coloboma and severe choroidal hypoplasia. These lesions closely resembled the ophthalmoscopic features of Collie eye anomaly (CEA). In spite of treatment, the dog's condition worsened and the animal was therefore euthanized. Histology of the globes confirmed severe choroidal hypoplasia and optic disc coloboma in both eyes. The dog was diagnosed to have a lymphoma involving the spinal cord. The two entities were considered not related. As only moderate sight impairment was caused by the posterior segment anomalies, it is by chance that these lesions resembling CEA were found in this mixed-breed dog.