Chemical ciliary body ablation in dogs with chronic glaucoma and anterior lens luxation: A retrospective review from 2017 to 2022.

OBJECTIVES: To evaluate the clinical outcomes of chemical ciliary body ablation (CBA) in dogs with chronic glaucoma and concurrent anterior lens luxation and to investigate adverse ocular effects of this procedure. PROCEDURES: Retrospective review of 17 dogs (18 eyes) with chronic glaucoma and concurrent anterior lens luxation treated with intravitreal gentamicin with or without dexamethasone sodium phosphate or triamcinolone acetonide. Data collected included signalment, concurrent ocular disease, topical medications prescribed, follow-up duration, and intraocular pressure (IOP) pretreatment, posttreatment, and at the last follow-up visit. Success was defined as an IOP <25 mmHg with no additional procedures or ocular hypotensive medications at the last examination to date. RESULTS: The success rate for CBA in dogs with chronic glaucoma and concurrent anterior lens luxation was 88.9% without the need of additional surgical or ocular hypotensive therapies. Glaucoma was suspected to be secondary to lens luxation in 72.2% of cases. The most common postoperative complications were phthisis bulbi (50.0%), keratoconjunctivitis sicca (27.8%), and uveitis (27.8%). Long-term management with topical nonsteroidal anti-inflammatories, corticosteroids, and/or immunomodulators was needed in 70.6% of cases. CONCLUSIONS: CBA with intravitreal injection of gentamicin is effective at maintaining an IOP <25 mmHg in dogs with chronic glaucoma and concurrent anterior lens luxation. Management of postoperative sequelae commonly requires continued use of topical medications.

Prevalence and type of ocular disease in a population of aged captive nondomestic felids.

OBJECTIVES: Report of prevalence and type of ocular disease in a captive population of nondomestic felids. METHODS: Medical records of 202 cats from 1993 to 2018 were reviewed. Species, age at diagnosis, sex, ocular examination abnormalities, systemic/physical examination abnormalities, type of examination (visual, sedated, or anesthetized), ocular structures affected, other diagnostics, therapy, and resolution of ocular disease were recorded. RESULTS: A total of 202 nondomestic felids including 18 different species (bobcat, caracal, cougar, Fishing cat, Geoffroy's cat, jaguar, jungle cat, leopard, leopard cat, liger, lion, lynx, ocelot, Sand cat, Savannah cat, serval, snow leopard, and tiger) from a rescue facility were evaluated. Forty-six ocular lesions were diagnosed in 33 (16.3%) cats from 8 different species (bobcat, caracal, cougar, leopard, lion, ocelot, serval, and tiger) with a mean age of 16 ± 5.9 years at time of diagnosis. Ocular lesions included corneal disease (37%) (ulcerations, perforations, keratitis, corneal scars), cataracts (23.9%), hyphema (8.7%), lens luxation (6.5%), retinal detachment (6.5%), uveitis (4.3%), conjunctival disease (4.3%), retinal degeneration (2.1%), glaucoma (2.1%), and optic neuritis (2.1%). Therapies included medical (topical antibiotics, anti-inflammatories, serum, etc.) and/or surgical management (enucleation, intracapsular lens extraction, corneoconjunctival transposition, and corneal burr debridement). CONCLUSIONS: To the authors' knowledge, this is the first report of the prevalence of ocular disease in a population of captive nondomestic felids. It is difficult to diagnose and treat ocular disease in nondomestic cats due to challenges related to handling, diagnostics, and therapeutics in nondomestic species. Ocular disease seen in this population is similar to that found in domestic cat populations.

Pharmacologic ciliary body ablation for chronic glaucoma in dogs: A retrospective review of 108 eyes from 2013 to 2018.

OBJECTIVE: To evaluate the long-term outcome and efficacy of intravitreal injection of gentamicin and dexamethasone sodium phosphate (IVGD) or triamcinolone in end-stage glaucoma patients and determine pre-procedure prognostic indicators of success and post-operative complications. PROCEDURE: Medical records were reviewed for 108 dogs (108 eyes) treated with intravitreal gentamicin with or without dexamethasone sodium phosphate or triamcinolone for glaucoma between 2013 and 2018 with 3 months of minimum follow-up. Signalment and clinical findings, including type of glaucoma, pre-procedure intraocular pressure (IOP), chronicity, procedure protocol, and outcome were recorded. Success was defined as an intraocular pressure of ≤25 mm Hg at the time of last re-examination or no ocular hypotensive medications at 3 months or longer post-injection. RESULTS: The overall success rate for pharmacologic ablation was 95%. The success rate for dogs receiving no ocular hypotensive medications was 86%. Seventy-six eyes (70.4%) had primary glaucoma, and 32 eyes (29.6%) had secondary glaucoma. Age at the time of injection had no effect on initial success but did in final success (P =-.03) for dogs requiring repeat injections. Cocker Spaniels required the most repeat 2nd and 3rd injections (3/12 dogs) and (2/4 dogs), respectively. No preoperative variable significantly affected the success rate. The most common complications were phthisis bulbi (59.2%), corneal edema (25.9%), and ulcerative keratitis (22.3%). Uncontrolled IOP resulted in enucleation in two dogs (1.8%). CONCLUSIONS: Pharmacologic ablation has a high overall success rate in lowering IOP to ≤25 mm Hg short-term in blind, glaucomatous canine eyes. Type of glaucoma, pre-procedure IOP, chronicity, and protocol did not affect success.

Neuromuscular electrical stimulation and exercise for reducing trapezius muscle dysfunction in survivors of head and neck cancer: a case-series report.

PURPOSE: Damage to the spinal accessory nerve (SAN) can result in denervation of the trapezius muscle in patients undergoing surgery for head and neck cancer. Trapezius denervation leads to muscle weakness and dysfunction that, for some patients, persists despite the return of conduction along the SAN. This prospective case series describes an intervention involving a combination of a novel type of neuromuscular electrical stimulation (NMES) with bilateral exercise. METHODS: Three survivors of head and neck cancer participated in the 6-week program. NMES was applied over the region of the SAN on the affected side while subjects performed bilateral voluntary scapular retraction and elevation exercises against resistance. The NMES was delivered using relatively wide pulse widths and high frequencies to enhance the electrically evoked sensory volley and was triggered by the onset of trapezius muscle activity on the non-affected side. Shoulder range of motion (ROM) assessments and patient-rated outcomes were administered at baseline and 6 weeks. RESULTS: All patients showed improvements in shoulder flexion and abduction ROM and reported reductions in pain and disability. CONCLUSIONS: This combination of NMES and bilateral exercise may prove to be an effective component of a comprehensive shoulder rehabilitation program for patients with persistent trapezius muscle dysfunction as a result of SAN damage.

Objectif : Des dommages au nerf spinal accessoire (NSA) peuvent donner lieu à une dénervation du muscle trapèze chez les patients qui subissent une intervention chirurgicale pour un cancer au cou ou à la tête. La dénervation du trapèze provoque une faiblesse musculaire et une dysfonction qui, chez certains patients, persistent malgré le retour d'une conduction du NSA. Cette série de cas prospectifs décrit une intervention qui met à contribution une nouvelle technique de stimulation neuromusculaire électrique (NMES), associée à des exercices bilatéraux. Méthode : Trois personnes ayant survécu à des cancers au cou ou à la tête ont pris part à un programme de six semaines. La NMES a été utilisée sur toute la région du NSA, sur le côté touché, pendant que les sujets exécutaient des mouvements de rétraction bilatérale scapulaire volontaires et des exercices d'élévation avec résistance. La NMES a été administrée en utilisant des durées d'impulsions relativement longues et des fréquences élevées pour évoquer, sous forme électrique, un élan (volée) sensoriel; la NMES était activée dès le début de l'activité musculaire du trapèze du côté non affecté. Les évaluations de l'amplitude du mouvement (ADM) et l'évaluation des résultats par les patients ont eu lieu au départ, puis six semaines plus tard. Résultats : Tous les patients ont démontré des améliorations dans l'ADM en flexion et abduction de l'épaule, et tous ont fait part de diminutions de la douleur et de l'incapacité. Conclusions : La combinaison de NMES et d'exercices bilatéraux pourrait s'avérer efficace dans le cadre d'un programme complet de réadaptation de l'épaule pour les patients aux prises avec une dysfonction persistante du muscle trapèze à la suite de dommages subis au NSA.