The heart to single vertebra ratio: A new objective method for radiographic assessment of cardiac silhouette size in dogs.

Vertebral heart size (VHS) is widely determined in clinical practice as an objective method to assess the cardiac silhouette dimensions. However, a key limitation is that it is difficult to determine VHS in dogs with vertebral alterations. This retrospective, method comparison, observer agreement study sought to overcome this limitation by using the heart-to-single vertebra ratio (HSVR), by evaluating the level of agreement between VHS and HSVR, as well as the intra- and inter-observer agreement for HSVR. Three independent observers retrospectively evaluated thoracic radiographs obtained over a set time period. Exclusion criteria were the presence of alterations of the thoracic spine and the inability to clearly outline the cardiac silhouette. The lengths of the vertebral bodies, from the fourth to eighth thoracic vertebra, and VHS were measured on each radiograph. The HSVR was calculated by dividing the sum of the cardiac long and short axes by the length of each vertebral body. Eighty dogs of different breeds were included in the final analysis. Lin's concordance correlation coefficients revealed strong correlations between VHS and HSVR (0.91-0.96), and the Bland-Altman plots showed low bias (0.01-0.2) between the methods. The mean absolute errors indicated low average magnitudes of error (0.11-0.28). The intraclass correlation coefficients showed good to excellent inter-observer (0.87-0.92; P = 0.000) and intra-observer (0.87-0.99; P < .001) agreement. In the authors' opinion, this new method, which is less time consuming and more objective, could offer a valuable alternative to VHS.

Description of a low-cost picture archiving and communication system based on network-attached storage.

High costs for installing, maintaining, and updating a standard picture archiving and communication system (PACS) can be prohibitive for small/medium-sized veterinary facilities. The aims of this prospective, exploratory study were to describe the design, implementation, and author experiences for 1 year's use of a low-cost PACS based on network-attached storage. The system described here was easily installed and resiliently stored redundant copies of data. It excellently balanced data recovery, system speed, security, and available memory for storage. A virtual private network also allowed off-site data review. This system can also be used for future off-site backup of data in the cloud.

An ultrasound-guided subparaneural approach to the sciatic nerve in the dog: a cadaver study.

OBJECTIVE: To describe the gross and microscopic anatomy of the sciatic nerve paraneural sheath and to report an ultrasound (US)-guided subparaneural approach to the sciatic nerve in dogs, comparing two different volumes of injectate. STUDY DESIGN: Prospective, randomized, anatomical study. ANIMALS: A group of nine middle-sized adult Mongrel canine cadavers (18 limbs). METHODS: The sciatic nerves of three pelvic limbs of two canine cadavers were identified, exposed and isolated between the greater trochanter and the popliteal fossa for gross anatomical and microscopic examination. An additional three pelvic limbs were surgically dissected on the lateral surface of the limb; the sciatic nerves were isolated, and a 26 gauge over-the-needle catheter was inserted through the paraneural sheath under direct visualization. A methylene blue solution was then slowly injected into the subparaneural compartment through the catheter under US visualization using an 8-13 MHz linear-array transducer. Subsequently, 12 pelvic limbs (six cadavers) were randomly allocated to one of two groups; using US-guided percutaneous subparaneural approach, either 0.1 or 0.05 mL kg-1of a 1:1 solution of methylene blue and 0.5% bupivacaine was injected. The spread of the dye solution and the amount of nerve staining were macroscopically scored. The stained sciatic nerves with their sheaths were then harvested for microscopic examination. RESULTS: The paraneural sciatic nerve sheath was easily identified distinct from the nerve trunk both macroscopically and with US visualization, and microscopically. Complete staining was achieved in five of six (83.3%) sciatic nerves in each group; no difference was found in the amount of staining between the two groups. Microscopically, no signs of sciatic nerve intraneural injection were observed. CONCLUSIONS AND CLINICAL RELEVANCE: The US-guided subparaneural injection of 0.05 mL kg-1 of a dye injectate resulted in satisfactory nerve staining without evidence of sciatic nerve intraneural injection.

A computed tomography-based method for the assessment of canine retrobulbar cone volume for ophthalmic anaesthesia.

OBJECTIVE: To develop a comprehensive formula for calculating the volume of local anaesthetic solution used for retrobulbar anaesthesia in dogs with different skull morphologies. STUDY DESIGN: Retrospective cohort imaging study. ANIMALS: Skull computed tomography (CT) images of 188 dogs of different breeds collected between January 2009 and December 2017. METHODS: Anatomical integrity of the orbit and adjacent structures, presenting complaint, clinical signs and CT findings were verified to exclude ocular abnormalities. The volume of the retrobulbar cone of 376 eyes was calculated using CT scans of the dogs' skulls. Additional data recorded included morphology of the skull, body weight, sex and size of the dogs, all of which were matched for possible association to the retrobulbar cone volume through univariable and multivariable linear regression models. Results of linear regression models were expressed as estimated beta coefficients with the corresponding 95% confidence intervals (95% CIs). RESULTS: Using univariate analysis, the retrobulbar cone volume was positively associated with weight and male sex. In addition, brachycephalic and dolichocephalic dogs showed a larger retrobulbar cone volume than mesocephalic dogs, while sex was no longer significantly associated with the retrobulbar cone volume. In multivariate analysis, when considering all variables in the model, weight emerged as the strongest predictor (beta coefficient: 0.062 mL kg-1, 95% CI: 0.056-0.067 mL kg-1, p < 0.001). CONCLUSIONS: and clinical relevance In the veterinary literature, there is no agreement on the precise volume of local anaesthetic solution that should be used to achieve intraconal retrobulbar anaesthesia in dogs. Here we suggest a formula to calculate the retrobulbar cone volume and, accordingly, the injection volume of local anaesthetic solution for effective retrobulbar anaesthesia.

Ultrasonographic measurement of kidney-to-aorta parameters in Whippets.

In a previous study, an ultrasonographic method to assess kidney size in dogs as a ratio of kidney length to aortic luminal diameter (KL/AoD ratio) was proposed. The main limitation of this method was the wide range of normal values (5.5-9.1), which resulted in poor sensitivity and specificity. The aim of this prospective, observational, reference interval study was to determine whether the KL/AoD normal cut-off values in a single breed (Whippets) would have a narrower range than the previously reported normal reference ranges. The influence of sex, age, weight, and side on kidney length (KL) and of sex, age, weight, and scanning plane (longitudinal vs transversal) on aortic luminal diameter (AoD) were also investigated. Thirty-six clinically healthy Whippets (16 males, 20 females) without ultrasonographic renal lesions were included in this study. The 95% confidence interval of mean KL/AoD was found to be narrower than the previously reported range (ie, 6.3-6.9 versus 5.5-9.1). This was considered to be especially notable in that the KL in this breed exhibits marked sexual dimorphism. The KL/AoD ratio did not differ between right versus left sides or male versus female sexes in Whippets (P > .05). Findings from the current study provided KL/AoD ratio normal reference range cut-off values for future use in Whippets and supported the use of breed-specific KL/AoD ratio values for characterizing abnormal renal size in other canine breeds.

COMPARISON OF INTRAOCULAR PRESSURE MEASUREMENT USING REBOUND AND APPLANATION TONOMETRY IN LOGGERHEAD (CARETTA CARETTA) SEA TURTLES.

This study aimed to evaluate intraocular pressure (IOP) estimates in healthy eyes of Caretta caretta using rebound tonometry in comparison with applanation tonometry. Twenty-three healthy C. caretta (housed at the Marine Turtle Research Center) without preexisting ophthalmic disease were enrolled in the study. IOP measurements were obtained by the same ophthalmologist, with the turtle in ventral recumbency between 2:30 p.m. and 4:30 p.m., using a rebound tonometer (RT; TonoVet) in dog calibration mode, and after topical anesthesia, an applanation tonometer (AT; Tono-Pen) in both eyes. The average of three readings per instrument was used for analysis. The agreement between the two tonometers was assessed by Bland-Altman analysis and intraclass correlation coefficient (ICC). Moreover, differences in IOP between the two tonometers were analyzed using the Mann-Whitney test. Moderate agreement was found between the two tonometers (ICC, 0.663; 95% confidence interval, 0.206-0.857). The median, Q1, and Q3 IOP obtained with AT (6.2, 4.7, and 9.1 mm Hg) were significantly lower (P = 0.001) than that obtained with RT (9.7, 8.3, and 11.6 mm Hg). It was not possible to obtain an instrument automatically generated mean of four values with AT because of retraction of the globe by the animals, and IOP measurement was unsuccessful in 7 eyes. In conclusion, IOP readings from the RT were statistically higher than those from the AT. RT proved to be more feasible because of the light, short-lasting contact with the cornea.

Ultrasonographic assessment of normal jugular veins in Standardbred horses.

BACKGROUND: Ultrasonography (US) is the recommended imaging technique to evaluate jugular veins. This prospective randomized clinical study was designed to collect a series of B-mode US measurements of manually distended jugular veins in healthy Italian Standardbreds and to find possible correlations between ultrasound measurements and animal morphometric characteristics. Forty-two horses, eight males and 34 females (range 3-22 years; bodyweight 494.4 ± 41.7 kg), were included in the study. The diameters and wall thicknesses of both jugular veins were measured at three different sites of the neck. The differences in ultrasound measurements based on scans, age, gender, side, and site of the neck were evaluated by ANOVA or by the Kruskal-Wallis test. The effects of the morphometric measures on each ultrasound parameter were evaluated by MANOVA (P < 0.05). RESULTS: The ultrasound measurements did not differ significantly between the three different sites or between genders; hence, they were pooled together in the results. On the transverse scan, the mean dorsoventral and lateromedial diameters were 1.58 ± 0.23 and 2.20 ± 0.25 cm, respectively; the mean superficial and deep wall thicknesses (SWT and DWT) were 0.07 ± 0.01 and 0.08 ± 0.01 cm, respectively. On the longitudinal scan, the mean dorsoventral diameter was 1.59 ± 0.26 cm, and the SWT and DWT were both 0.08 ± 0.01 cm. Neck length, from the caudal edge of the mandible to the thoracic inlet, was related to the dorsoventral diameter in both longitudinal and transverse scan and to the SWT and DWT in transverse scan, whereas height at the withers (measured with tape) and estimated weight were related to the wall thickness. Dividing the subjects into groups by age in years ("young" 3-7, "mature" 8-14, "old" > 14), differences were found for the lateromedial diameter in the transverse scan and the SWT on the longitudinal scan. The main limitation of this study was that only one operator performed the measurements. CONCLUSION: The US measurements of the jugular veins and their relationship with morphometric measures reported in this manuscript might be considered as guidelines both for early diagnosis and monitoring jugular vein abnormalities in healthy Italian Standardbred horses.

Aeromonas induced polyostotic osteomyelitis in a juvenile loggerhead sea turtle Caretta caretta.

Bacterial bone infections have been occasionally reported in wild sea turtles. This study reports on a sub-adult Caretta caretta affected by Aeromonas hydrophila osteomyelitis, with extensive involvement of cranial and caudal flippers. The turtle was severely debilitated, had limited flipper mobility and showed signs of pain in reaction to manipulation. Radiographs and computed tomography revealed multiple lytic bone lesions. Since an infectious polyostotic osteomyelitis was suspected, the turtle was subjected to echo-assisted fine needle aspiration to characterize the etiology of the disease. Bacterial cultures and antibiotic susceptibility testing led to the isolation of Aeromonas hydrophila responsive to amikacin and doxycycline. Therefore, the turtle was treated with these antibiotics and monitored through repeat bacterial cultures and diagnostic imaging. The turtle was released 17 mo after admission, upon resolution of clinical signs. The documentation of this case provides a treatment approach that may improve the outcome of Aeromonas-associated osteomyelitis, especially in endangered wildlife species.

Oral Malignant Melanoma in a Ferret ( Mustela putorius furo).

Oral malignant melanomas are one of the most common oral malignant neoplasms in dogs but are rare in other domesticated species. This case report describes the clinical manifestations and histological appearance of oral melanoma in a ferret ( Mustela putorius furo). To the authors' knowledge, this is the first published description of a clinical case and histopathological findings of oral melanoma in this species.

Dacryocystography in a cat with orbital pneumatosis.

A 2-year-old neutered male European short-haired cat was presented for a persistent discharge from the scar of previous left eye enucleation, performed 6 months prior by the referring veterinarian. A surgical exploration of the orbit was performed and retained nictitating membrane glandular and conjunctival tissues were removed. Eleven days later, the cat developed an orbital pneumatosis caused by retrograde movement of air through a patent nasolacrimal system and diagnosed by survey radiographic examination of the skull. Nasolacrimal system patency was assessed by dacryocystography performed by injection of iodinated contrast medium under pressure into the orbital cavity. Computed tomography dacryocystography confirmed the radiographic findings. The condition resolved following dacryocystography, possibly as an inflammatory response to the contrast medium. To our knowledge, this is the first case of orbital pneumatosis reported in a cat.

Polyostotic Chondroblastic Osteosarcoma in a Kestrel ( Falco tinnunculus ).

We report a case of polyostotic chondroblastic osteosarcoma in a kestrel ( Falco tinnunculus ) admitted to the Wildlife Rehabilitation and Rescue Center (Naples, Italy). A consolidated fracture of the left tibiotarsus bone and a deviation of the limb were evident. After radiographic, cytologic, and histopathologic examinations, a diagnosis of polyostotic chondroblastic osteosarcoma was made. To our knowledge, this is the first report on polyostotic chondroblastic osteosarcoma in a kestrel.

Angiostrongylus vasorum: epidemiological, clinical and histopathological insights.

BACKGROUND: Canine angiostrongylosis is a nematode infection in domestic dogs and wild carnivores. The present report focuses on epidemiological, clinical and histopathological findings in a case of fatal disseminated angiostrongylosis in a dog living in southern Italy and provides data on the extent of the spread of Angiostrongylus vasorum in the same area. CASE PRESENTATION: A 4-year-old female English Setter from the Campania region of southern Italy was referred with a 2-week history of cough and severe respiratory distress that did not respond to antimicrobial therapy. Based on clinical, radiological, echographical and cytological findings (including the presence of larvae), a suspect diagnosis of lungworm infection was performed. After few days the dog died due to progressive clinical aggravation. Complete postmortem examination was conducted within 24 hours from death and samples from lungs, heart, liver, kidney, spleen, stomach and small intestine were fixed in 10% buffered formalin. Grossly, several hemorrhagic foci were observed mostly in the lungs, liver, kidney. Microscopically, the lungs contained numerous, multifocal to coalescing granulomas composed of epitheliod macrophages, multinucleated giant cells and some neutrophils, frequently associated with parasite eggs and larvae. The lungs contained many firm nodules, many adult nematodes approximately 1.5 to 2 cm in length were observed in cut sections and identified as A. vasorum. A subsequent parasitological survey performed with FLOTAC on stray dogs living in the same area showed the presence of A. vasorum larvae in 17 of 1639 stray dogs examined (1.04%). CONCLUSION: This survey provides new data on distribution of A. vasorum and underlines that canine angiostrongylosis should be considered as differential diagnosis in dogs.

Acepromazine-dexmedetomidine-ketamine for injectable anaesthesia in captive European brown hares (Lepus europaeus).

OBJECTIVE: To evaluate a combination of acepromazine, dexmedetomidine and ketamine (ADK) on induction and recovery from anaesthesia, and on physiological parameters in hares undergoing non-invasive procedures. STUDY DESIGN: Prospective clinical study. ANIMALS: Sixteen European hares (Lepus europaeus), seven males and nine females, aged (mean ± SD) 3.25 ± 0.9 months and weight 2.1 ± 0.6 kg. METHODS: Acepromazine 1% (A), dexmedetomidine 0.05% (D) and ketamine 5% (K) were mixed and given intramuscularly (IM) at 0.25 mL kg(-1), representing 10 mg kg(-1) K, 0.25 mg kg(-1) A, 12.5 µg kg(-1) D. If the righting reflex was present after four minutes, a second injection of 0.15 mL kg(-1) (6 mg kg(-1) K, 0.15 mg kg(-1) A, 7.5 µg kg(-1) D) was administered IM. Surgical anaesthesia was judged as present when righting, palpebral, ear-pinch and pedal withdrawal reflexes were absent. Anaesthetized hares were tagged, and underwent blood sampling and ocular ultrasound examination. Physiological parameters were recorded every ten minutes, and were compared by Kruskal-Wallis tests. RESULTS: A single dose induced loss of righting reflex in 11/16 (69%) hares within four minutes; the second dose was effective in the remaining hares. Ten minutes after the loss of the righting reflex, a surgical plane of anaesthesia was present in all hares. Sleep time to regaining righting reflex was 34 ± 11 (range 21-62) minutes and recovery was calm. Although there were some statistical differences over time, cardiovascular parameters remained within an acceptable range but there was respiratory depression and hares were hypoxemic. CONCLUSIONS AND CLINICAL RELEVANCE: The ADK mixture produced a smooth and rapid induction of anaesthesia, a low incidence of untoward side effects and full recovery after four hours. Supplementary oxygen might be advisable if a deeper plane of anaesthesia was required. Chemical restraint was adequate to perform non-invasive procedures.

Imaging techniques in veterinary medicine. Part II: Computed tomography, magnetic resonance imaging, nuclear medicine.

Radiography and ultrasonography are the most used techniques in veterinary clinical practice, due to organizational, managerial and, mostly, economic reasons. However, in the last decades, Computed tomography (CT), Magnetic Resonance Imaging (MRI) and, to a lesser extent, Nuclear Medicine (MN) are increasingly used. As we said in the previous article, all the Diagnostic Imaging techniques are actually "indispensable" in Veterinary Medicine, where many patients do not show any symptoms.This second part describes Computed Tomography (CT), Magnetic Resonance (MRI) and Nuclear Medicine techniques in Veterinary Medicine are described.

Computed Tomographic Assessment of Pituitary Gland Dimensions in Domestic Short-Haired Cats.

The detection of subtle changes in the pituitary dimensions has relevant clinical implications. In cats, a few studies have established the cut-off values of the pituitary gland's dimensions using small and inhomogeneous samples. The aims of this study were: to determine by computed tomography (CT) the pituitary linear dimensions and the pituitary-to-brain (P:B) ratio in a sample of domestic short-haired (DSH) cats; to assess the effects of sex, age, and weight on pituitary dimensions; and to evaluate the inter- and intra-observer agreement for such measurements. All skull CTs of DSH cats performed over four years using a multidetector CT and a standardized protocol were retrospectively reviewed. The exclusion criteria were: clinical, laboratory, or CT alterations of the pituitary gland, brain diseases, fractures of the neurocranium, and diabetes. The pituitary dimensions and brain area were assessed by two different observers using multiplanar reconstructions and automated segmentation tools. Fifty-one cats were included in the final sample. The intraclass correlation coefficients for intra- and inter-observer reliability were good/excellent, and moderate/good, respectively. No differences between sexes were detected, and negligible correlations were found between age and weight. According to this study, a pituitary gland with a height > 4 mm or a P:B ratio > 0.49 mm should be considered enlarged.

Efficacy of oral, topical and extended-release injectable formulations of moxidectin combined with doxycycline in Dirofilaria immitis naturally infected dogs.

BACKGROUND: Several studies in both experimentally and naturally infected dogs have reported the adulticide effect of a combination of macrocyclic lactones and doxycycline against Dirofilaria immitis, showing that these protocols can be used as an alternative to melarsomine. The present study evaluated the efficacy of oral, topical and extended-release injectable formulations of moxidectin when combined with doxycycline in dogs naturally infected with D. immitis from a shelter located in southern Italy. METHODS: Thirty dogs with naturally acquired D. immitis infection were divided in three groups (G) and treated with oral moxidectin (G1) once a month for 9 consecutive months, topical moxidectin (G2) once a month for 9 consecutive months or extended release moxidectin injectable (G3) at enrolment and again at 6 months (Day 180). All treatment groups received doxycycline for the first 30 days. Microfilarial concentrations in 1 ml (mff/ml) blood were determined monthly for 9 months with the modified Knott's test. A clinical scoring system was employed for each dog enrolled in the study based on thoracic radiography and cardiac ultrasound (CU) examinations performed at Day - 15 (before treatment) and at Day 180. RESULTS: Results from the present study suggest that the majority of dogs from all treatment groups became antigen negative, as evaluated at Day 270: 9/10 dogs (90.0%) from G1, 6/10 dogs (60.0%) from G2 and 8/10 dogs (80.0%) from G3. Improvement of radiographic alterations was observed in all treatment groups, and almost all dogs were cleared of pulmonary abnormalities by 6 months from the beginning of treatment (P = 0.000). Cardiac ultrasound examination showed a progressive improvement of cardiac function in a limited number of animals (4/30). CONCLUSIONS: The combination of doxycycline and three different formulations of moxidectin leads to antigen-negative status in naturally infected dogs.

Electroretinography, Ocular Ultrasonography, and Phacoemulsification of Bilateral Cataracts in Two Juvenile Loggerhead Sea Turtles (Caretta caretta) of the Mediterranean Region.

Bilateral cataracts were diagnosed in two rescued juvenile, immature loggerhead sea turtles (Caretta caretta), weighing 1.65 and 1.7 kg. Both animals showed vision impairment and difficulty in feeding without assistance. In fact, they did not notice the presence of the food in the tank unless it was brought close to touching the mouth. Ocular ultrasonography and electroretinography showed no lesions of the vitreal body and retinal layer, therefore, both animals were candidates for bilateral cataract surgery. Topical administration of tropicamide + phenylephrine alternating with rocuronium resulted in only minimal mydriasis. Administration of intracameral rocuronium did not improve mydriasis. Phacoemulsification using a one-handed technique was performed bilaterally with a phacoemulsification device (Sovereign, AMO (Abbott Medical Optics®). After surgery, the systemic anti-inflammatory drug (dexamethasone 0.2 mg/kg, IM daily for one week) and antibiotics (enrofloxacin 10 mg/kg IM q 72 h, for 4 weeks; ceftazidime 20 mg/kg IM q 72 h for 3 weeks) were administered. Topical ofloxacin, flurbiprofen and tobramycin/dexamethasone were instilled TID for 4 weeks. Both turtles regained vision in both eyes. Results at a 10-month follow-up were satisfactory. This is the first report of cataracts in turtles rescued in the Mediterranean Sea and the first description of surgical treatment of cataracts in loggerhead turtles so young.

Morphometrical and Immunohistochemical Evaluation of Kidney as an Indirect Parameter to Estimate Age in Puppies in Veterinary Forensic Pathology.

Estimation of age represents a central focus in the veterinary forensic pathology field. Currently, the visual examination of the dentition and the skeletal age are the main methods to estimate the age of puppies. Nevertheless, these methods are affected by a broad range of variables. In contrast, the kidney is characterized by a specific postnatal development. In human glomerulogenesis, fetal mesangial cells change their immunohistochemical phenotypes with maturation. Therefore, we hypothesized that histological and immunohistochemical examinations of the kidney can be used together as an indirect parameter for age determination in puppies' cadavers. Forty-five puppies' cadavers were divided into five groups defined by age (Group A= 0-15 days, Group B = 16-45 days, Group C = 46-85 days, Group D = 86-105 days, Group E= 105-365 days). For each case, kidney samples were collected and processed for histopathological (for morphometrical study of the glomerulus) and immunohistochemical (for the immunolocalization of the α-SMA protein) studies. Morphometrical study allowed us to observe statistical differences in the mean glomerulus numbers per field among assessed groups. Similarly, immunohistochemical examination showed differences in SMA expression among groups. Our findings suggest a potential use of kidney morphometrical and immunohistochemical examinations together as an indirect parameter to assess the age of illegally imported puppies.

Retrobulbar Filling for Enophthalmos Treatment in Dogs: Technique, Description and Computed-Tomographic Evaluation. Preliminary Cadaveric Study.

A new therapeutic approach for enophthalmos may be retrobulbar lipofilling. This study aims to standardize the intraconal filling technique and to evaluate the degree of eyeball displacement by computed tomography (CT). Skull CT was performed on six dog cadavers before and after intraconal injection of two 5% iodinated, viscoelastic solutions, one per eye, using an ultrasound-guided supratemporal approach. The volume to be injected was calculated using formulas for retrobulbar cone anesthesia. After CT, the dogs underwent necropsy and histopathology to evaluate damages that eventually occurred to retrobulbar structures. Eyeball displacement was estimated using two CT-based methods, named M1 and M2. The Wilcoxon signed-rank test revealed no significant difference between the two injected materials in both M1 (p > 0.99), and M2 (lateral p = 0.84 and rostral p = 0.84 displacement). A statistically significant difference was found between the pre- and post-injection group M1 (p = 0.002), M2 (p = 0.004) for the lateral and (p = 0.003) for rostral displacement. Although the slight eyeball displacement, the retrobulbar filling can lead to enophthalmos resolution. Compared to M1, the M2 method has better-defined anatomical landmarks. Further, preclinical in vivo studies are necessary to assess retrobulbar filling efficacy and safety.

Symblepharon, Ankyloblepharon, and Salt Gland Dysfunction in a Loggerhead Sea Turtle (Caretta caretta).

Adhesions involving the bulbar and the palpebral conjunctiva (Symblepharon) may interfere with tear drainage, cause chronic conjunctivitis, and reduce ocular motility. This condition may be associated with adhesion of the edges of the upper and lower eyelids (ankyloblepharon). The present case describes bilateral symblepharon, ankyloblepharon and salt gland dysfunction in a juvenile Caretta caretta. The loggerhead presented both eyelids swollen, ulcerated, and not separable when rescued. Eye examination was not possible, but ultrasonography showed right bulbar integrity, while the left eye was smaller, with a thicker cornea that had lost its normal doubled lined structure. Surgical dissection of the fibrous adhesions between the palpebral and bulbar conjunctiva, cornea, and third eyelid was performed, and large dacryoliths were removed. The microscopic findings were consistent with chronic keratoconjunctivitis. Ultrastructurally, no virus-like particles were observed. In addition, tissue samples were negative for herpesvirus by qualitative PCR. The eyelids of both eyes and the corneal epithelium of the right eye healed; moreover, the vision was restored in the right eye. There were no recurrences after 12 months of follow-up, and the turtle was released 16 months after the end of treatments on the southern Tyrrhenian coast in the western Mediterranean Sea. To the authors' knowledge, this is the first report of symblepharon with ankyloblepharon and salt gland dysfunction in Caretta caretta turtle. Ocular ultrasonography was helpful in the preliminary diagnostic work-up.