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.
20 horses with nonneoplastic ocular disease requiring enucleation.
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.
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.
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.
21 privately owned dogs.
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.
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.
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 ≤ 1 to > 64 μg/mL; MIC50 and MIC90 (MICs at which 50% and 90% of organisms were inhibited) were 4 and 32 μg/mL, respectively. The SSD MFC distribution for all isolates was ≤ 1 to > 64 μg/mL; MFC50 and MFC90 (MFCs at which 50% and 90% of organisms were killed) were 8 and > 64 μg/mL, respectively. For all fungal isolates, natamycin MIC distribution ranged from 256 to > 1,000 μg/mL; MIC50 and MIC90 were 512 and > 1,000 μg/mL, respectively. The natamycin MFC distribution for all isolates ranged from 512 to > 1,000 μg/mL; MFC50 and MFC90 were each > 1,000 μg/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.
To retrospectively evaluate the complication rate following dorsal placement of a commercially available 1-hole subpalpebral lavage system (SPL) at a veterinary teaching hospital.
102 client-owned horses with ophthalmic disease.
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.
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.
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.