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- Author or Editor: Ellison Bentley x
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Abstract
Objective—To characterize ocular findings in hypertensive dogs, determine prevalence of hypertension in dogs with ocular disease suggestive of hypertension, and examine possible relationships between degree of hypertension and ocular disease.
Design—Retrospective case series.
Animals—65 dogs initially referred for blood pressure measurement (n = 22), ophthalmic examination (25), or both (18).
Procedures—Medical records were reviewed to identify dogs examined at the teaching hospital that underwent a complete ophthalmic examination and blood pressure measurement within a 24-hour period between January 1, 2005, and December 31, 2007. Signalment, history, blood pressure measurements, ophthalmic examination findings, and any vasoactive drug treatments were recorded. Ocular lesions considered likely to be associated with systemic hypertension included retinal hemorrhage, retinal detachment, hyphema, tortuous vessels, and subretinal edema.
Results—Of the 65 dogs, 42 were hypertensive (systolic blood pressure ≥ 160 mm Hg) and 23 were normotensive. Sixty-two percent (26/42) of hypertensive dogs had ≥ 1 type of ocular lesion identified. Retinal hemorrhage was the most common ocular lesion in hypertensive dogs (17/42 [40%]). The presence of ≥ 1 type of ocular lesion had moderate sensitivity and specificity of 62% and 61 %, respectively, for identification of hypertension. Fifteen of the 25 (60%) dogs referred for blood pressure measurement after initial ophthalmic examination were found to be hypertensive.
Conclusions and Clinical Relevance—Ocular lesions are common in dogs with systemic hypertension. Dogs with hypertension or diseases associated with hypertension should be monitored carefully for evidence of ocular target organ damage, and hypertension should be systematically ruled out in dogs with characteristic ocular lesions.
Abstract
Objective—To assess the efficacy of a retrobulbar bupivacaine nerve block for postoperative analgesia following eye enucleation in dogs.
Design—Randomized controlled trial.
Animals—22 dogs.
Procedures—Client-owned dogs admitted to the hospital for routine eye enucleation were enrolled with owner consent and randomly assigned to a treatment (bupivacaine hydrochloride) or control (saline [0.9% NaCl] solution) group. Baseline subjective pain scores were recorded. Anesthesia consisted of hydromorphone and midazolam preoperatively, thiopental or propofol for induction, and isoflurane in oxygen for maintenance. An inferior-temporal palpebral retrobulbar injection of either saline solution or bupivacaine was administered. Transpalpebral eye enucleation was performed. Pain scores were recorded at 0.25, 0.5, 1, 2, 4, 6, 8, and 24 hours after extubation (time 0) by observers masked to treatment groups. Dogs were given hydromorphone (0.2 mg/kg [0.09 mg/lb], IM or IV) as a rescue analgesic if the subjective pain score totaled ≥ 9 (out of a maximum total score of 18) or ≥ 3 in any 1 category.
Results—9 of 11 control dogs required a rescue dose of hydromorphone, but only 2 of 11 dogs in the bupivacaine treatment group required rescue analgesia. Mean time to treatment failure (ie, administration of rescue analgesia following extubation) was 0.56 hours (95% confidence interval, 0.029 to 1.095 hours) for the 11 dogs that received hydromorphone.
Conclusions and Clinical Relevance—Retrobulbar administration of bupivacaine in dogs in conjunction with traditional premedication prior to eye enucleation was an effective form of adjunctive analgesia and reduced the need for additional postoperative analgesics.
Abstract
Objective—To compare analgesia provided by carprofen and tramadol in dogs after enucleation.
Design—Randomized, masked clinical trial.
Animals—43 dogs.
Procedures—Client-owned dogs admitted for routine enucleation were randomly assigned to receive either carprofen or tramadol orally 2 hours prior to surgery and 12 hours after the first dose. Dogs were scored for signs of pain at baseline (ie, before carprofen or tramadol administration) and at 0.25, 0.5, 1, 2, 4, 6, 8, 24, and 30 hours after extubation. Dogs received identical premedication and inhalation anesthesia regimens, including premedication with hydromorphone. If the total pain score was ≥ 9 (maximum possible score of 20), there was a score ≥ 3 in any of 5 behavioral categories (highest score possible per category was 3 or 4), or the visual analog scale (VAS) score was ≥ 35 (maximum possible score of 100) combined with a palpation score > 0, rescue analgesia (hydromorphone) was administered and treatment failure was recorded.
Results—No differences were found in age, sex, or baseline pain scores between groups. Significantly more dogs receiving tramadol required rescue analgesia (6/21), compared with dogs receiving carprofen (1/22). Pain and VAS scores decreased linearly over time. No significant differences were found in pain or VAS scores between groups at any time point (dogs were excluded from analysis after rescue).
Conclusions and Clinical Relevance—Results of this study suggested that carprofen, with opioid premedication, may provide more effective postoperative analgesia than tramadol in dogs undergoing enucleation.
Abstract
Objective—To evaluate the usefulness of high-resolution ultrasonography (HRUS) for measurements of anterior segment structures in canine eyes.
Animals—4 clinically normal Beagles.
Procedure—Images were obtained from 8 eyes with a handheld 20-MHz transducer. Eleven anterior segment structures on each image were measured 5 times by 2 independent observers. Coefficients of variation (CVs) for measurements were used to assess intraobserver reliability. Interobserver reliability was assessed by comparing measurements obtained by the 2 observers from the same images. Five images were sequentially obtained from 2 locations (ie, superior and temporal) to evaluate image reproducibility. Anterior segment structures were measured once on each image; image reproducibility was assessed by use of the CV for each parameter measured. Imaging location was assessed by comparison of CV for measurements from each location.
Results—CVs were < 10% for observer A for all measurements except the ciliary cleft area (11.63%). The CVs were > 10% for observer B for measurements of the angle recess area (18.51%) and ciliary cleft width (17.44%) and area (16.01%). Significant differences in measurements between observers were found for 5 of 11 anterior segment structures. Imaging the superior aspect of the globe provided the most reproducible images, although image reproducibility was still somewhat variable, with the highest and lowest CVs for measurements of 33.01% and 11.32%, respectively, in the superior position.
Conclusions and Clinical Relevance—High-resolution ultrasound images can be used to reliably measure various anterior segment structures. Clinically relevant findings in the anterior segment of canine eyes may be detectable by use of HRUS. (Am J Vet Res 2005;66:1775–1779)
Abstract
OBJECTIVE To evaluate potential risk factors for development of primary angle-closure glaucoma (PACG) in Bouviers des Flandres.
DESIGN Prospective, observational study.
ANIMALS 98 Bouviers des Flandres.
PROCEDURES All dogs underwent slit-lamp biomicroscopy, indirect ophthalmoscopy, gonioscopy, applanation tonometry, streak retinoscopy, and A-scan, B-scan, and high-resolution ultrasonography. Iridocorneal angles and degree of pectinate ligament dysplasia sheeting were graded, and an angle index was mathematically derived for each eye on the basis of these values. Ciliary clefts evaluated by high-resolution ultrasonography were classified as open, narrow, or closed. Owners were contacted by telephone 7 to 9 years after the initial examination to determine whether dogs had a subsequent diagnosis of PACG. Relationships between previously recorded variables and the development of PACG were evaluated by logistic regression methods. Available pedigrees were reviewed to assess genetic relationships among affected dogs.
RESULTS 9 of 92 (9.8%) dogs with follow-up information available developed PACG. An angle index < 1 and presence of a narrow or closed ciliary cleft in 1 or both eyes were each significantly associated with development of PACG. Odds of developing PACG for dogs with an angle index < 1 (indicating marked reduction in outflow capacity through the iridocorneal angle), a narrow or closed ciliary cleft in > 1 eye, or both findings were 13, 20, and 28 times those for dogs that did not have these findings, respectively. All dogs that developed PACG shared 1 common male sire or grandsire.
CONCLUSIONS AND CLINICAL RELEVANCE Several anatomic factors were significant risk factors for development of PACG in this population of dogs. Results also suggested a genetic component for the disease.
Objective
To evaluate a combined cycloablative and gonioimplantation technique for treatment of glaucoma in dogs.
Design
Retrospective study.
Animals
18 adult dogs with glaucoma.
Procedure
Medical records of dogs that received a valved gonioimplant and a cyclodestructive procedure (cyclocryoablation or diode laser cyclophotocoagulation) during a 6-year period were reviewed. Retention of vision and intraocular pressure control were assessed, as well as number and nature of complications.
Results
19 eyes of 18 dogs received a valved gonioimplant and either cyclocryoablation (n = 12) or diode laser cyclophotocoagulation (7). At ≥ 1 year after surgery, 11 of 19 eyes had vision and 14 of 19 eyes had intraocular pressure < 25 mm Hg. Two dogs (2 eyes) were lost to follow-up 3 and 6 months after surgery. Despite the alternative route for aqueous humor flow created by the gonioimplant, 7 eyes had increased intraocular pressure (27 to 61 mm Hg) < 24 hours after surgery. Other complications included excessive intraocular fibrin, focal retinal detachment, corneal ulcer, retinal hemorrhage, cataract, and implant migration.
Conclusions and Clinical Relevance
Combined cycloablation and gonioimplantation appears to be a promising technique for retention of vision and control of intraocular pressure in dogs with glaucoma. (J Am Vet Med Assoc 1999;215:1469–1472)
Abstract
OBJECTIVE
To compare the effectiveness of preoperative bupivacaine inferotemporal retrobulbar blocks to postoperative liposome-encapsulated bupivacaine (Nocita) line blocks for analgesia following enucleation.
ANIMALS
39 client-owned dogs (40 eyes) presenting to the Ophthalmology Service for enucleation.
METHODS
Dogs were randomly assigned to receive either a preoperative inferotemporal retrobulbar block with 0.5% bupivacaine or a peri-incisional line block with liposome-encapsulated bupivacaine (Nocita) at closure. Patients underwent unilateral enucleation and were hospitalized for 24 hours after surgery. Pain scores were performed by a masked observer with the Glasgow Composite Measure Pain Scale and the University of Wisconsin Ocular Pain Scale at 0.25, 0.5, 1, 2, 4, 6, 8, and 24 hours following surgery. Intraoperative use of blood pressure and anesthetic support mediations as well as need for rescue pain control were recorded and compared between groups.
RESULTS
There was no significant difference in rescue rates between treatment groups. When comparing the use of medical intraoperative heart rate, blood pressure, or anesthetic plane support, there were no significant differences in use between groups.
CLINICAL RELEVANCE
Use of preoperative bupivacaine retrobulbar blocks and postoperative Nocita line blocks were equally effective at postoperative pain control with similarly low complication rates.
Abstract
Objective—To develop and compare 3 techniques for retrobulbar injection of local anesthetic agents for ocular surgery and analgesia in dogs.
Design—Prospective study.
Animals—17 dogs (including 9 cadavers).
Procedures—Inferior-temporal palpebral (ITP), perimandibular, and combined superior-inferior peribulbar injection techniques were compared by assessing the distribution of latex after injection into the orbits of 5 canine cadavers; magnetic resonance imaging (MRI) evaluation of the distribution of contrast agent after injection in the retrobulbar space of 4 canine cadavers; and assessment of the efficacy and MRI evaluation of the anatomic distribution of injections of a lidocainecontrast agent mixture in 4 anesthetized, nonrecovery dogs. By use of the preferred technique (ITP), the ocular effects of lidocaine anesthesia were evaluated in 4 dogs; during a 2-week period after treatment, dogs underwent ophthalmic examination, Schirmer tear testing (STT), intraocular pressure (IOP) measurement, and Cochet–Bonnet esthesiometry.
Results—Of the 3 techniques, the ITP technique was the preferred method for retrobulbar administration of anesthetic agent in dogs because it was efficacious (pupil dilation and central rotation of the globe achieved in all eyes), easiest to perform, and provided thorough coverage of the intraconal retrobulbar space without complication. During the 2-week follow-up period, the ITP injection did not significantly affect STT, IOP, or Cochet-Bonnet esthesiometry values in dogs.
Conclusions and Clinical Relevance—In dogs, retrobulbar administration of anesthetic agents via the ITP technique is a potential alternative to systemic administration of neuromuscular blocking agents for ophthalmic surgery and provides the additional benefit of local ocular analgesia.
