• 1. Grahn BH, Sandmeyer LS. Diseases and surgery of the canine nasolacrimal system. In: Gelatt KN, Gilger BC, Kern TJ, eds. Veterinary ophthalmology. 5th ed. Ames, Iowa: Wiley-Blackwell, 2013;894911.

    • Search Google Scholar
    • Export Citation
  • 2. Giuliano EA. Diseases and surgery of the canine lacrimal secretory system. In: Gelatt KN, Gilger BC, Kern TJ, eds. Veterinary ophthalmology. 5th ed. Ames, Iowa: Wiley-Blackwell, 2013;912944.

    • Search Google Scholar
    • Export Citation
  • 3. Lavach JD. The lacrimal system. In: Slatter D, ed. Textbook of small animal surgery. 2nd ed. Toronto: WB Saunders Co, 1993;225245.

    • Search Google Scholar
    • Export Citation
  • 4. Severin GA. Severin's veterinary ophthalmology notes. 3rd ed. Fort Collins, Colo: DesignPointe Communications Inc, 1995;226.

  • 5. Michel G. Beitrag zur Anatomie der Tränenorgane von Hund und Katze. Dtsch Tierarztl Wochenschr 1955;62:347349.

  • 6. Pope ER, Champagne ES, Fox D. Intraosseous approach to the nasolacrimal duct for removal of a foreign body in a dog. J Am Vet Med Assoc 2001;218:541542.

    • Search Google Scholar
    • Export Citation
  • 7. Zhang MQ, Zou T, Huang YC, et al. Braided thin-walled biodegradable ureteral stent: preliminary evaluation in a canine model. Int J Urol 2014;21:401407.

    • Search Google Scholar
    • Export Citation
  • 8. Holmes ES, Weisse C, Berent AC. Use of fluoroscopically guided percutaneous antegrade urethral catheterization for the treatment of urethral obstruction in male cats: 9 cases (2000–2009). J Am Vet Med Assoc 2012;241:603607.

    • Search Google Scholar
    • Export Citation
  • 9. Weisse C, Berent AC, Todd K, et al. Endovascular evaluation and treatment of intrahepatic portosystemic shunts in dogs: 100 cases (2001–2011). J Am Vet Med Assoc 2014;244:7894.

    • Search Google Scholar
    • Export Citation
  • 10. Berent AC, Weisse CW, Todd K, et al. Technical and clinical outcomes of ureteral stenting in cats with benign ureteral obstruction: 69 cases (2006–2010). J Am Vet Med Assoc 2014;244:559576.

    • Search Google Scholar
    • Export Citation
  • 11. Hill TL, Berent AC, Weisse CW. Evaluation of urethral stent placement for benign urethral obstructions in dogs. J Vet Intern Med 2014;28:13841390.

    • Search Google Scholar
    • Export Citation
  • 12. Kuntz JA, Berent AC, Weisse CW, et al. Double pigtail ureteral stenting and renal pelvic lavage for renal-sparing treatment of obstructive pyonephrosis in dogs: 13 cases (2008–2012). J Am Vet Med Assoc 2015;246:216225.

    • Search Google Scholar
    • Export Citation
  • 13. Balsa IM, Culp WT, Johnson EG, et al. Efficacy of two radiologic-assisted prophylactic gastropexy techniques. Vet Surg 2016;45:464470.

    • Search Google Scholar
    • Export Citation
  • 14. Spadari A, Spinella G, Grandis A, et al. Endoscopic examination of the nasolacrimal duct in ten horses. Equine Vet J 2011;43:159162.

    • Search Google Scholar
    • Export Citation
  • 15. Müllner K, Bodner E, Mannor GE. Endoscopy of the lacrimal system. Br J Ophthalmol 1999;83:949952.

  • 16. Alañón-Fernández , Alañón-Fernández FJ, Martínez-Fernández A, et al. Comparative study of primary intention lacrimal probing with and without nasal endoscopy. Acta Otorrinolaringol Esp 2014;65:297301.

    • Search Google Scholar
    • Export Citation
  • 17. University of California-Davis School of Veterinary Medicine. The ophthalmology clinical trials page. Available at: www.vetmed.ucdavis.edu/clinicaltrials/current_trials/by_service/ophthalmology.cfm. Accessed Sep 29, 2016.

    • Search Google Scholar
    • Export Citation
  • 18. Jones LT. The cure of epiphora due to canalicular disorders, trauma and surgical failures on the lacrimal passages. Trans Am Acad Ophthalmol Otolaryngol 1962;66:506524.

    • Search Google Scholar
    • Export Citation
  • 19. Lester T, Jones MD, Linn MD. The diagnosis of the causes of epiphora. Am J Ophthalmol 1969;67:751754.

  • 20. Kong YT, Kim TI, Kong BW. A report of 131 cases of endoscopic laser lacrimal surgery. Ophthalmology 1994;101:17931800.

  • 21. Plaza G, Beteré F, Nogueira A. Transcanalicular dacryocystorhinostomy with diode laser: long-term results. Ophthal Plast Reconstr Surg 2007;23:179182.

    • Search Google Scholar
    • Export Citation
  • 22. Lennon GM, Thornhill JA, Grainger R, et al. Double pigtail ureteric stent versus percutaneous nephrostomy: effects on stone transit and ureteric motility. Eur Urol 1997;31:2429.

    • Search Google Scholar
    • Export Citation
  • 23. Ali MJ, Baig F, Lakshman M, et al. Scanning electron microscopic features of the external and internal surfaces of normal adult lacrimal drainage system. Ophthal Plast Reconstr Surg 2015;31:414417.

    • Search Google Scholar
    • Export Citation

Advertisement

A multidisciplinary, minimally invasive approach combining lacrimoscopy and fluoroscopically guided stenting for management of nasolacrimal apparatus obstruction in dogs

View More View Less
  • 1 Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 2 Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 3 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 4 Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 5 Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 6 Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 7 Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Abstract

OBJECTIVE To describe and evaluate outcomes of a multidisciplinary, minimally invasive approach combining lacrimoscopy and fluoroscopically guided stenting for management of nasolacrimal apparatus (NLA) obstruction in dogs.

DESIGN Prospective, nonrandomized clinical trial.

ANIMALS 16 client-owned dogs with confirmed NLA obstruction.

PROCEDURES Dogs underwent CT contrast dacryocystorhinography, rhinoscopy, and lacrimoscopy. Whenever possible, the NLA was stented, typically with fluoroscopic guidance.

RESULTS Median duration of clinical signs prior to treatment was 3.2 months (range, 0.2 to 14 months). Causes of NLA obstruction were a foreign body (n = 5), dacryocystitis (4), stenosis secondary to fibrosis (3), granulation tissue (1), or granulation tissue in association with a small foreign body (1); a cause was not identified in 2 dogs. Stents were placed in 14 of 16 (88%) dogs for a median duration of 5.6 weeks (range, 1.3 to 9.4 weeks). Stenting was not possible in 2 dogs with stenosis of the NLA secondary to granulation tissue or fibrosis. Owners of all 16 dogs reported at least 60% clinical improvement with median improvement rated as 95%, and owners of 8 dogs reporting complete resolution of signs. Two dogs required antimicrobial administration because of dacryocystitis that persisted after stent removal; a foreign body was not found in either dog.

CONCLUSIONS AND CLINICAL RELEVANCE Overall clinical response and owner-rated improvement for dogs with NLA obstruction that underwent lacrimoscopy and fluoroscopically guided stenting were high, especially given that these dogs had failed to respond to conventional treatment.

Contributor Notes

Dr. Strom's present address is Evidensia Animal Hospital, Cypressvägen 11, 213 63 Malmö, Sweden.

Address correspondence to Dr. Maggs (djmaggs@ucdavis.edu).