Intraocular Parafilaria bovicola infection and surgical removal in a mixed breed heifer.

An approximately 1.5-year-old mixed breed heifer was presented for evaluation and treatment due to ocular pain affecting the right eye secondary to a live nematode within the anterior chamber. Ophthalmic examination revealed marked blepharospasm, evidence of chronic keratitis, uveitis, and a single, white, approximately 2.5 cm long, 0.5 mm thick, living parasite. The heifer underwent general anesthesia, and the parasite was removed using passive aqueous humor outflow following a stab incision into the anterior chamber. Twenty-four hours after removal of the intraocular parasite, the heifer displayed a significant improvement in ocular comfort, corneal edema, and uveitis. The nematode was identified via genetic analyses as Parafilaria bovicola, a filarial parasite of cattle. The heifer was discharged 5 days following nematode removal with a marked improvement in all ocular signs and apparently normal vision. To the authors' knowledge, there are no previous reports of confirmed intraocular filariosis caused by P. bovicola in the veterinary literature, nor are there reports detailing surgical removal of intraocular parasites in bovids.

Evaluation of risk factors for treatment failure in canine patients undergoing photoactivated chromophore for keratitis - corneal cross-linking (PACK-CXL): a retrospective study using additive bayesian network analysis.

BACKGROUND: Infectious keratitis is a common ophthalmic condition in canine patients. Sequelae can include keratomalacia and corneal perforation, a vision threatening outcome. Photoactivated chromophore for keratitis - corneal cross-linking (PACK-CXL) is a non-surgical, adjunctive treatment method for infectious keratitis. The goal of this retrospective, multicenter study was to determine risk factors for treatment failure following PACK-CXL in canine patients suffering from suspected infectious keratitis. Medical records from four veterinary ophthalmology services were reviewed, and information related to patient demographics, ophthalmic findings, the PACK-CXL protocol used, and epithelialization time was collected and analyzed. Due to the potential for intervariable relationships, an additive Bayesian network (ABN) analysis was performed to evaluate these complex relationships. RESULTS: Records for 671 eyes (668 dogs) were included in the analysis. Based on the ABN, in the population included here, patients who underwent an accelerated PACK-CXL protocol were less likely to experience treatment failure versus patients treated with a slow protocol. Mutual dependencies between exposure variables were identified by ABN, which would have been overlooked using classical regression. Corneal re-epithelialization time was shortened following PACK-CXL combined with topical medical therapy compared to PACK-CXL alone. CONCLUSIONS: No risk factors associated with treatment failure were identified in the population included in the present study. Canine patients may benefit from the use of accelerated PACK-CXL protocols, especially when combined with topical antibiotics and anti-collagenolytic therapy. The reasons for this apparent positive impact on treatment outcome remain unclear.

A prospective pilot study on early toxicity from a simultaneously integrated boost technique for canine sinonasal tumours using image-guided intensity-modulated radiation therapy.

In order to overcome the common local treatment failure of canine sinonasal tumours, integrated boost techniques were tried in the cobalt/orthovoltage era, but dismissed because of unacceptable early (acute) toxicity. Intriguingly, a recent calculation study of a simultaneously integrated boost (SIB) technique for sinonasal irradiation using intensity-modulated radiation therapy (IMRT) predicted theoretical feasibility. In this prospective pilot study we applied a commonly used protocol of 10 × 4.2 Gy to the planning target volume (PTV) with a 20%-SIB dose to the gross tumour volume (GTV). Our hypothesis expected this dose escalation to be clinically tolerable if applied with image-guided IMRT. We included 9 dogs diagnosed with sinonasal tumours without local/distant metastases. For treatment planning, organs at risk were contoured according to strict anatomical guidelines. Planning volume extensions (GTV/CTV/PTV) were standardized to minimize interplanner variability. Treatments were applied with rigid patient positioning and verified daily with image guidance. After radiation therapy, we set focus on early ophthalmologic complications as well as mucosal and cutaneous toxicity. Early toxicity was evaluated at week 1, 2, 3, 8 and 12 after radiotherapy. Only mild ophthalmologic complications were found. Three patients (33%) had self-limiting moderate to severe early toxicity (grade 3 mucositis) which was managed medically. No patient developed ulcerations/haemorrhage/necrosis of skin/mucosa. The SIB protocol applied with image-guided IMRT to treat canine sinonasal tumours led to clinically acceptable side effects. The suspected increased tumour control probability and the risk of late toxicity with the used dose escalation of 20% has to be further investigated.

Equine keratomycosis in Switzerland: a retrospective evaluation of 35 horses (January 2000-August 2011).

REASON FOR PERFORMING STUDY: Keratomycosis is a severe disease in horses. Geographical differences in fungi causing keratomycosis and susceptibility of the organisms to antifungal drugs exist but few previous publications on this disease originate from Europe. OBJECTIVE: To retrospectively compare the clinical data of 36 eyes with keratomycosis, diagnosed in 35 horses between January 2000 and August 2011 at the Vetsuisse Faculty of Switzerland. Case history, season, prior treatment, clinical appearance, surgical and medical treatment, treatment duration, and globe survival were evaluated. STUDY DESIGN: Retrospective case series. METHODS: Medical records of horses with a definitive cytological or histological diagnosis of keratomycosis were reviewed. RESULTS: Thirty-one of 36 eyes (86.1%) presented with ulcerative keratitis, 2/36 (5.55%) had diffuse corneal infiltration, 2/36 (5.55%) had superficial punctate keratitis and 1/36 (2.8%) had a fluorescein-negative fungal plaque. Two of 6 fungal cultures produced Aspergillus spp. Thirty eyes received medical and surgical treatment, while 3 eyes were treated medically only. In 3 horses the globe was removed at the time of first presentation. Sex, age, prior treatment with antimicrobials or steroids, or type of surgical approach did not significantly influence the outcome. Twenty-three of 36 eyes (63.9%) were at least partially visual, 11/36 eyes (30.5%) were enucleated and 2 horses (2/36 eyes, 5.6%) were subjected to euthanasia. Treatment protocols were compared in the 31 eyes with ulcerative keratitis. In this group, 3/31 globes were immediately enucleated, 16/31 eyes were treated topically with voriconazole or voriconazole/fluconazole and 12/31 with other antifungal drug combinations. The different medication protocols did not significantly affect the outcome. CONCLUSIONS: There were no significant differences in outcome between different medical treatment protocols or types of surgical approach. POTENTIAL RELEVANCE: Future studies in central Europe should focus on the identification of fungal pathogens, susceptibility patterns and the efficacy of antifungal drug therapies.

A comparative study between carbohydrate-deficient transferrin and gamma-glutamyltransferase for the diagnosis of excessive drinking in a liver unit.

AIM: To compare the efficacy of carbohydrate-deficient transferrin and gamma-glutamyltransferase for the diagnosis of excessive alcohol intake in patients admitted in a liver unit. METHODS: The 346 patients were divided into three groups of alcoholics: 57 patients (31 men, 26 women) with a normal liver, 77 patients (51 men, 26 women) with non-cirrhotic alcoholic liver disease, and 61 patients (43 men, 18 women) with alcoholic cirrhosis; and three groups of non-alcoholics: 35 abstainers (21 men, 14 women), and 58 healthy blood donors (26 men, 32 women), and 58 patients (32 men, 26 women) who had a non-alcoholic liver disease. Carbohydrate-deficient transferrin and gamma-glutamyltransferase were measured at admission using commercially available kits. RESULTS: Carbohydrate-deficient transferrin was more sensitive than gamma-glutamyltransferase in patients without alcoholic liver disease, in both men (85 vs 54%) and women (64 vs 36%). Carbohydrate-deficient transferrin sensitivity decreased slightly but not significantly according to the severity of the liver disease in men and women. The sensitivity of gamma-glutamyltransferase which was low in men and women without alcoholic liver disease, improved in groups with moderate or severe alcoholic liver disease: not less than 80% in men and up to 100% in women. The specificity of carbohydrate-deficient transferrin in patients with non-alcoholic liver disease was consistently higher than that of gamma-glutamyltransferase (80% vs 60%). CONCLUSIONS: In liver units, carbohydrate-deficient transferrin can help to identify excessive drinkers without liver disease with a higher efficacy than that of gamma-glutamyltransferase; carbohydrate-deficient transferrin can also be used to distinguish between alcoholics with moderate liver disease and patients with non-alcoholic liver diseases.

Photosynthetic rates in relation to leaf phosphorus content in pioneer versus climax tropical rainforest trees.

In Guyana dense rainforest occurs on intensely weathered acid soils, low in soil phosphorus. To investigate whether low P availability limits photosynthesis of trees growing on these soils more than N does, leaf P and N content, and their relationship with the photosynthetic capacity (A sat, µmol CO2 m-2 s-1) were studied for nine pioneer and climax tree species in a range of light climates. Light environment was described using hemispherical photographs. For both pioneer and climax species, leaf P content (r 2=0.71 and 0.23, respectively) is a more important determinant of A sat than leaf N content (r 2=0.54 and 0.12, respectively). Pioneer species have a higher leaf P and N content than climax species. At similar P or N content, pioneers have a higher A sat than climax species. The saplings studied had a relatively high A sat, considering their low P concentration (15-30 µmol P g-1). All species studied had a constant leaf P and N concentration and photosynthetic capacity across light climates, because specific leaf mass (g m-2) increased similarly with light availability. This acclimation to a change in light environment makes a possible limitation of A sat by P or N independent of light environment.