Topical ropivacaine hydrochloride 0.5% and lidocaine hydrochloride 2% significantly reduce corneal sensitivity without short-term negative side effects in horses.

OBJECTIVE: To evaluate corneal sensitivity and acute side effects following application of ropivacaine hydrochloride 0.5% and lidocaine hydrochloride 2% on the healthy equine cornea. ANIMALS STUDIED: Eight healthy adult horses. PROCEDURE: A randomized, masked, crossover study design was utilized. Baseline Semiquantitative Preclinical Ocular Toxicology (SPOT) scores and corneal touch thresholds (CTT) using a Cochet-Bonnet esthesiometer were recorded and measured, respectively, for eight healthy adult horses before medication application. Commercially available eyewash was used as a negative control. Ropivacaine hydrochloride 0.5% or lidocaine hydrochloride 2% solution was sprayed on a randomly selected eye, and the contralateral eye received eyewash. CTT was measured in both eyes at 1, 5, 15, 25, 35, 45, 55, 65, and 75 min post-application. Post-application SPOT scores were recorded immediately following the trial. Linear mixed model statistical analyses (mean ± standard error) were performed (p < .05). RESULTS: Mean eyewash CTT (3.41 cm ± 0.464) was significantly different from ropivacaine-treated (1.44 cm ± 0.562) (p = .008) and lidocaine-treated eyes (1.75 cm ± 0.562) (p = .024); CTT was not significantly different between drug groups (p = .88). Time to maximum anesthesia was not significantly different between ropivacaine (13.25 min ± 3.353) and lidocaine (16.25 min ± 3.353) (p = .40). No side effects were appreciated as confirmed by SPOT. CONCLUSIONS: Ropivacaine and lidocaine similarly decreased corneal sensitivity when applied topically without clinically evident short-term ocular side effects. Lidocaine may be preferable in clinical settings due to its large, multi-use vials and similar effects to ropivacaine.

In vitro antibacterial efficacy of autologous conditioned plasma and amniotic membrane eye drops.

OBJECTIVE: To determine the in vitro antibacterial efficacy of equine and canine autologous conditioned plasma (ACP) and amniotic membrane extract eye drops (AMEED) against aerobic bacteria common to the corneal surface. PROCEDURES: Canine (n = 4) and equine (n = 4) anticoagulated whole blood samples were sterilely collected, pooled for each species, and processed using the Arthrex ACP® Double-Syringe System. Platelet counts were performed on ACP and pooled blood. AMEED were obtained from a commercial source. An electronic medical records search (2013-2022) identified aerobic bacteria cultured from canine and equine corneal ulcers at Mississippi State University College of Veterinary Medicine (MSU-CVM). Ten commonly isolated bacteria for each species were collected from cultures submitted to the MSU-CVM Microbiology Diagnostic Service and frozen at -80°C. The Kirby-Bauer disk diffusion method was used to determine the sensitivities of these isolates to ACP and AMEED. Bacterial isolates were plated onto Mueller-Hinton +5% sheep blood agar and blank sterile discs saturated with 20 µL of ACP or AMEED were tested in duplicate. Imipenem discs served as positive controls and blank discs as negative controls. Zones of inhibition were measured at 18 h. RESULTS: ACP platelet counts were 1.06 and 1.65 times higher than blood for equine and canine samples, respectively. Growth of a multi-drug resistant Enterococcus faecalis was partially inhibited by canine and equine ACP. AMEED did not inhibit growth of any examined bacteria. CONCLUSIONS: Canine and equine ACP partially inhibited E. faecalis growth in vitro. Further studies using varying concentrations of ACP against bacterial isolates from corneal ulcers are warranted.

Dorsally placed commercially available subpalpebral lavage systems have low complication rates in horses.

OBJECTIVE: To retrospectively evaluate the complication rate following dorsal placement of a commercially available 1-hole subpalpebral lavage system (SPL) at a veterinary teaching hospital. ANIMALS: 102 client-owned horses with ophthalmic disease. PROCEDURES: Medical records of horses (2010 to 2020) with ophthalmic disease were reviewed to determine whether a commercially available SPL system was dorsally placed. Data collected from the medical record included signalment, presenting complaint(s), diagnosis, ophthalmic procedures performed, SPL laterality, hospital service that placed the SPL, anesthetic technique for placement (general anesthesia or sedation with local nerve blocks), duration of SPL management while hospitalized or at home, type of enclosure for the horse, use of eye protection, duration of time the SPL was in place, location of SPL management (home vs hospital), types and numbers of medications administered, recorded complications, and outcome of the globe. Complications experienced during treatment were categorized as either ocular or nonocular. The χ2 test for independence test and Fisher exact test were performed to examine the relationship between the department that placed the SPL, method of anesthesia, antimicrobial administration, type of facial protection used, and complication type and rate. RESULTS: Overall complication rate for SPL systems was 29.1% (37/127), with 21.2% (27/127) being ocular complications and 7.9% (10/127) being nonocular complications. SPL complication rate was not affected by any variable that was examined. CLINICAL RELEVANCE: Commercially available SPL systems placed dorsally have a low ocular complication rate. These SPL systems may be placed by veterinarians with varied training backgrounds and managed at home without significantly increasing complication rate.

Investigation of fluorescein stain-based tear film breakup time test reliability in dogs in a clinical setting.

OBJECTIVE: To determine intra- and interobserver reliability of a fluorescein stain-based tear film breakup time (TFBUT) test as performed in a clinical environment with and without administration of a topical anesthetic. ANIMALS: 21 privately owned dogs. PROCEDURES: A randomized study design was used. Two independent observers that commonly perform the TFBUT test in clinical practice read the same description of TFBUT. Observers performed TFBUT testing for each dog before and after topical administration of 0.5% proparacaine solution in 4 testing periods with a 1-hour interval between periods. Intraclass correlation coefficient (ICC) analysis was used to assess inter- and intraobserver test reliability. Linear mixed models were used to assess the main effects of testing period, observer, eye, and presence of ophthalmic disorders and their interactions on TFBUT. RESULTS: Mean TFBUT measurements performed by observer 1 and observer 2 were 5.9 seconds and 8.6 seconds, respectively, when adjusted for other effects in the model. Intraobserver ICC was poor for one observer and moderate for the other. Interobserver ICC was poor without use of topical anesthetic and slightly lower when anesthetic was used. Observer and testing period were each significantly associated with TFBUT; the measurements decreased and were more variable after multiple applications of fluorescein stain and proparacaine. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested tear film stability is negatively affected by topical administration of 0.5% proparacaine solution and repeated applications of fluorescein stain. The TFBUT test as performed in this study had poor to moderate reliability.

Surgical Correction of cicatricial Entropion in cattle: Two cases.

Utilization of the Hotz-Celsus technique with standing sedation and local nerve blocks in cattle provides adequate correction of cicatricial entropion.

Subconjunctival enucleation with orbital implant placement in standing horses: 20 cases (2014-2017).

OBJECTIVE: To develop a protocol for subconjunctival enucleation and orbital implant placement in standing horses and to document short- and long-term complications, cosmesis, and client satisfaction. ANIMALS: 20 horses with nonneoplastic ocular disease requiring enucleation. PROCEDURES: A standardized protocol of surgical suite cleaning, patient preparation, sedation, local nerve blocks, surgical procedure, and postoperative care was performed. Owners were required to provide follow-up information at 1 year after surgery during a phone questionnaire. Additionally, some owners provided follow-up information at 1.8 to 4 years postoperatively. RESULTS: 11 mares, 6 geldings, and 3 stallions with a mean age of 9 years (range, 0.5 to 25 years) were included in this study. Reasons for enucleation included corneal lacerations (n = 3), perforated ulcers (4), end-stage uveitis (7), fungal keratitis (3), endophthalmitis (1), glaucoma (1), and stromal abscess (1). The mean surgery time was 64 minutes (range, 50 to 83 minutes). The most common implant size used was 45-mm diameter (range, 43- to 47-mm diameter). Complications included mild postoperative colic (n = 4), incisional swelling (1), and drainage from the surgical site (1) that resolved without implant removal. One-year follow-up information was available for 19 of 20 horses. Fourteen owners were very satisfied and 5 owners were satisfied with the cosmetic appearance. One horse was lost to follow-up. CONCLUSIONS AND CLINICAL RELEVANCE: Subconjunctival enucleation and orbital implant placement in standing horses was a safe and efficient alternative to general anesthesia when a standardized perioperative protocol was used. No horse developed clinically relevant complications, and owner satisfaction and cosmesis were good.

Enucleation or exenteration in two dogs with previous parotid duct transposition: parotid duct ligation versus reverse parotid duct transposition.

Two dogs with previous parotid duct transpositions presented with unrelated ocular disease. In both cases, ophthalmic examination revealed the need for enucleation or exenteration. In case 1, systemic coccidioidomycosis was diagnosed with panuveitis and secondary glaucoma of the left eye. In this case, the parotid duct was ligated at the time of enucleation to stop salivary secretions. This dog encountered morbidity in the form of a sialocele that did not resolve for 11 months. In case 2, ultrasound and computed tomography revealed a discrete mass within the left medial orbit that was suspected to arise from the nictitating membrane. A combination of exenteration and parotid duct transposition reversal was performed to avoid morbidity associated with ligation of the parotid duct. The dog encountered no complications from this novel procedure. This case report represents the first report of re-routing a transposed parotid duct from the ventral conjunctival sac back to the mouth at the time of enucleation or exenteration in the dog.

The effects of subconjunctival bupivacaine, lidocaine, and mepivacaine on corneal sensitivity in healthy horses.

OBJECTIVE: To compare the efficacy and duration of effect of three local anesthetics on corneal sensitivity when administered subconjunctivally in horses. ANIMALS STUDIED: Eight healthy adult horses. PROCEDURE: A randomized, masked, crossover study design was used, with a two-week washout period between trials. The subconjunctival space of the randomly selected eye was injected with 0.2 mLs of bupivacaine (0.5%), lidocaine (2%), mepivacaine (2%), or saline. All horses received each medication once. The contralateral eye served as a control. The corneal touch threshold (CTT) was measured in both eyes with a Cochet-Bonnet esthesiometer prior to sedation with xylazine, after sedation, and at 10-min intervals after subconjunctival injection until corneal sensitivity returned to baseline. The total time of decreased CTT and the maximum decrease in CTT were compared for each medication using a general linear mixed model (P < 0.05). RESULTS: Total time of decreased CTT was 105.0 min for bupivacaine, 103.8 min for lidocaine, 138.8 min for mepivacaine, and 7.5 min for saline. All local anesthetics decreased CTT longer than saline (P < 0.001) and mepivacaine decreased CTT longer than lidocaine (P = 0.04). The mean minimum CTT was 1.67 cm for bupivacaine, 1.42 cm for lidocaine, and 0.73 cm for mepivacaine, which were all significantly less (P < 0.001) than saline (4.73 cm). No evidence of corneal toxicity was noted with any treatment. CONCLUSION: Subconjunctival injections of lidocaine, bupivacaine, and mepivacaine effectively and safely reduce corneal sensitivity in eyes of healthy horses for 1.5-2 h, and may be useful for providing perioperative analgesia for equine corneal procedures.

Assessment of bacterial contamination of three multidose ophthalmic solutions.

OBJECTIVE: To investigate the frequency of bacterial contamination of multidose proparacaine hydrochloride, tropicamide, and eyewash bottles used in veterinary ophthalmology examination rooms during normal operating procedures. METHODS: Three representative bottles each of proparacaine hydrochloride, tropicamide, and purified water eye wash were opened at the same time, numbered, and placed into small animal examination rooms. Doctors, students and technicians who were using the solutions were blinded to the study. Aerobic cultures were obtained at the time of opening (time 0), at 1 week (time 1), and at 2 weeks after opening (time 2) the bottles. The sites cultured included a drop of each solution, the inside of the bottle cap, the tip of the bottle, and the bottle threads and medication residue found in these threads. RESULTS: Aerobic cultures of tropicamide and proparacaine had no growth of bacteria from any of the evaluated sites. Staphylococcus epidermidis was cultured from the tip of one bottle of eye wash after 1 week. CONCLUSIONS: We conclude that proparacaine, tropicamide, and eyewash solutions used in veterinary examination rooms are adequately preserved for use in ophthalmic examination. They have a low level of bacterial contamination 1 or 2 weeks after opening when used and stored according to the recommendations of the product manufacturers and previous studies.

In vitro fungistatic and fungicidal activities of silver sulfadiazine and natamycin on pathogenic fungi isolated from horses with keratomycosis.

OBJECTIVE: To evaluate the in vitro antifungal properties of silver sulfadiazine (SSD) and natamycin against filamentous fungi isolated from eyes of horses with keratomycosis. SAMPLE POPULATION: Filamentous fungal isolates obtained from eyes of keratomycosis-affected horses. PROCEDURES: Fungal culture of ocular samples yielded 6 Fusarium spp; 7 Aspergillus spp; and 1 isolate each of Curvularia, Scopulariopsis, Penicillium, and Chrysosporium. For each fungal isolate, minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of SSD and natamycin were determined. RESULTS: For all 17 fungal isolates, SSD MIC distribution ranged from < or = 1 to > 64 microg/mL; MIC50 and MIC90 (MICs at which 50% and 90% of organisms were inhibited) were 4 and 32 microg/mL, respectively. The SSD MFC distribution for all isolates was < or = 1 to > 64 microg/mL; MFC50 and MFC90 (MFCs at which 50% and 90% of organisms were killed) were 8 and > 64 microg/mL, respectively. For all fungal isolates, natamycin MIC distribution ranged from 256 to > 1,000 microg/mL; MIC50 and MIC90 were 512 and > 1,000 microg/mL, respectively. The natamycin MFC distribution for all isolates ranged from 512 to > 1,000 microg/mL; MFC(50) and MFC(90) were each > 1,000 microg/mL. CONCLUSIONS AND CLINICAL RELEVANCE: These in vitro data suggest that SSD is fungicidal against the fungal isolates that were obtained from eyes of horses with keratomycosis and that natamycin is fungicidal against some of the isolates at the drug concentrations evaluated. Silver sulfadiazine may be a therapeutic option for equine keratomycosis.