OBJECTIVE To characterize and determine the incidence of acute-onset (ie, developing ≤ 6 weeks after surgery) postoperative infectious and sterile endophthalmitis in dogs following elective cataract surgery.
DESIGN Retrospective case series.
ANIMALS 2,630 eyes of 1,447 dogs that underwent elective unilateral or bilateral cataract surgery by phacoemulsification at Cornell University from 1995 through 2015.
PROCEDURES Medical records were reviewed to collect and summarize data regarding dog signalment, clinical findings, diagnostic test results, surgery characteristics, eye or eyes affected, concurrent major systemic diseases, treatments, and clinical outcome.
RESULTS Infectious endophthalmitis developed in 4 eyes of 4 dogs during the follow-up period, representing 0.15% of eyes and 0.28% of dogs that underwent surgery. Unilateral sterile endophthalmitis developed in 3 (0.11%) eyes of 3 (0.21%) dogs. All cases of infectious endophthalmitis were unilateral and in pseudophakic eyes and followed bilateral cataract surgeries. Clinical signs consistent with infectious endophthalmitis developed a median of 18 days after surgery and included marked and progressive hypopyon; Staphylococcus or Streptococcus spp were recovered from aqueous and vitreous humor samples. All eyes with infectious endophthalmitis responded poorly to medical treatment and were enucleated. In 2 eyes with infectious endophthalmitis, corneal incision nonunion with epithelial downgrowth was identified histologically and postulated as the route of bacterial entry into the globe.
CONCLUSIONS AND CLINICAL RELEVANCE Bacterial endophthalmitis following elective phacoemulsification was uncommon in the dogs of this study. Introduction of bacteria into the eye may occur during surgery or in the postoperative period from corneal incisions that fail to heal normally.
Objective—To determine the frequency of viral detection in conjunctival samples from client-owned domestic dogs with naturally acquired idiopathic conjunctivitis and to identify signalment, historical, and clinical findings positively associated with viral detection.
Animals—30 dogs with naturally acquired idiopathic conjunctivitis and a control population of 30 dogs without ocular disease.
Procedures—Complete physical and ophthalmic examinations were performed for each dog. Conjunctival swab specimens were analyzed by use of virus isolation and PCR assays for the following viruses: canine adenovirus-2 (CAV-2), canine distemper virus, canine herpesvirus-1 (CHV-1), canine parainfuenza virus, canine respiratory coronavirus, infuenza A virus, and West Nile virus. Signalment, clinical, and historical information was recorded and compared between study groups.
Results—Viruses were detected by either virus isolation or PCR methods significantly more frequently in conjunctival samples from dogs with conjunctivitis (7/30 [23.3%]) than dogs without conjunctivitis (0/30 [0%]). Canine herpesvirus-1 was isolated from 2 conjunctival samples and detected by use of PCR assay in 5 conjunctival samples. Canine adenovirus-2 was isolated from 1 conjunctival sample and detected by use of PCR assay in 2 conjunctiva samples. Sexually intact dogs and frequent exposure to dogs outside the household were positively associated with viral detection in the conjunctivitis group
Conclusions and Clinical Relevance—Results suggested that CHV-1 and CAV-2 are common etiologic agents of conjunctivitis in domestic dogs. Risk factors for viral conjunctivitis in dogs reflected increased exposure to other dogs and opportunities for contact with infectious secretions.
OBJECTIVE To determine the effects of topical ocular application of 1% trifluridine ophthalmic solution in dogs with experimentally induced recurrent ocular canine herpesvirus-1 (CHV-1) infection.
ANIMALS 10 specific pathogen–free Beagles.
PROCEDURES 12 months prior to the beginning of the randomized, masked, placebo-controlled 30-day trial, latent ocular CHV-1 infection was experimentally induced in each dog by topical ocular inoculation of both eyes with a field strain of CHV-1. Recurrent ocular CHV-1 infection was induced by oral administration of prednisolone for 7 days (starting day 1). Starting on the fourth day of prednisolone administration, each dog received 1% trifluridine solution or artificial tears (placebo) topically in both eyes 6 times daily for 2 days and then 4 times daily for 12 days. Ophthalmic examinations were performed every 2 days, and ocular disease scores were calculated. Ocular samples for CHV-1 PCR assays and blood samples for clinicopathologic analyses and assessment of CHV-1 serum neutralization antibody titers were collected at predetermined intervals.
RESULTS Conjunctivitis was clinically detected in all dogs by day 4. Compared with dogs receiving placebo, mean and total clinical ocular disease scores were significantly lower and median CHV-1 shedding duration was significantly shorter for the trifluridine-treated dogs. Both groups had increasing CHV-1 serum neutralization antibody titers over time, but no significant differences between groups were detected. Clinicopathologic findings were unremarkable throughout the study.
CONCLUSIONS AND CLINICAL RELEVANCE Topical ocular application of 1% trifluridine ophthalmic solution was well tolerated and effective at reducing disease scores and viral shedding duration in dogs with experimentally induced ocular CHV-1 infection, but may require frequent administration.
Objective—To determine the in vitro fluoroquinolone susceptibility profiles of Pseudomonas aeruginosa isolates from dogs with ulcerative keratitis.
Animals—27 dogs with P aeruginosa–associated ulcerative keratitis.
Procedures—P aeruginosa isolates from dogs with ulcerative keratitis were collected during a 3-year period. Isolates were tested by use of the disk diffusion method for their susceptibility to 7 fluoroquinolones that are available as commercial ophthalmic preparations. The antimicrobials included second- (ciprofloxacin, ofloxacin, norfloxacin, and lomefloxacin), third- (levofloxacin), and fourth-generation (gatifloxacin and moxifloxacin) fluoroquinolones. Isolates were designated as susceptible, intermediate, or resistant to the various antimicro-bials. The percentage of susceptible isolates was compared among individual fluoroquinolones and among fluoroquinolone generations.
Results—None of the dogs had received topical or systemic fluoroquinolone treatment prior to referral. Twenty-seven P aeruginosa isolates were collected during the study period. In vitro, bacterial resistance to the tested fluoroquinolones was infrequently identified (24/ 27 isolates were susceptible to all fluoroquinolones evaluated); susceptibility percentages ranged from 88.9% to 100% for individual antimicrobials. There were no significant differ-ences among isolate susceptibilities to the individual antimicrobials or among generations of fluoroquinolones.
Conclusions and Clinical Relevance—On the basis of these in vitro data, none of the 7 evaluated fluoroquinolones (individually or collectively by generation) appeared to offer a clinically important advantage in the treatment of P aeruginosa–associated ulcerative keratitis in dogs. Among the P aeruginosa isolates collected from dogs with ulcerative keratitis in this study, the likelihood of susceptibility to the fluoroquinolones evaluated was high.
Objective—To describe clinical, microbiological, in vivo confocal microscopic, and histopathologic features of fungal keratitis in alpacas and to estimate prevalence of the disease in a population of alpacas from the northeastern United States.
Design—Retrospective case series.
Procedures—Medical records of alpacas evaluated by the ophthalmology service of a veterinary teaching hospital were searched to identify animals with a clinical diagnosis of fungal keratitis and positive results for fungal culture of a corneal sample between 2003 and 2012. Signalment and historical, clinical, and microbiological details were recorded. Results of cytologic, histopathologic, and in vivo confocal microscopic corneal examinations were collected when available.
Results—Fungal keratitis was diagnosed in 11 of 169 (6.5%) alpacas that underwent ophthalmologic examination by the ophthalmology service during the study period. Ten of the 11 alpacas were evaluated in the summer or fall months. Corneal lesions included stromal ulcer, stromal abscess, corneal perforation, and nonulcerative keratitis. Aspergillus fumigatus and Fusarium solani were the most frequently cultured fungi. Fungi were also identified through corneal cytologic examination, histologic examination, or in vivo confocal microscopy in 9 alpacas. Historically, 2 alpacas were evaluated following external ocular trauma and 1 following corneal foreign body removal. Nine alpacas had received topical treatment with antimicrobials and 2 had antimicrobial-corticosteroid combinations administered topically prior to referral. Nine of 10 alpacas for which follow-up information was available were successfully treated, with globe and vision retention.
Conclusions and Clinical Relevance—Fungal keratitis was a relatively common ocular disease in this population of alpacas and appeared to share several clinical features with keratomycosis in horses.
Objective—To determine in vitro susceptibility patterns of fungi associated with keratomycosis in horses in the northeastern United States and compare those patterns with results of studies from other geographic regions.
Design—Retrospective case series.
Animals—68 horses with keratomycosis.
Procedures—Medical records of horses with a clinical diagnosis of keratomycosis, positive results of corneal fungal cultures, and susceptibility data were reviewed from the years 1987 to 2006. Fungal identification and in vitro antifungal susceptibility test results were recorded. The percentage of susceptible isolates was compared among antifungals for all isolates together and for the most common genera individually.
Results—74 fungal isolates from 68 horses that met inclusion criteria were identified. Aspergillus, Candida, and Fusarium spp were the most frequent isolates. Grouped isolates had the highest percentage of susceptibility to nystatin (87.7%), natamycin (87.5%), and clotrimazole (80.6%). Grouped isolates had the lowest percentage of susceptibility to fluconazole (15.8%) and miconazole (27.5%). Aspergillus spp (≥ 81.0%) were most susceptible to nystatin, clotrimazole, itraconazole, and natamycin. Candida spp (100%) were most susceptible to ketaconazole, natamycin, and nystatin. Fusarium spp (100%) were only consistently susceptible to natamycin.
Conclusions and Clinical Relevance—On the basis of in vitro susceptibility testing, nystatin, natamycin, or clotrimazole is recommended for initial topical treatment of keratomycosis in horses from the northeastern United States. Contrary to results of studies of ocular fungal isolates of horses from other regions, Candida spp were identified more frequently and miconazole had lower in vitro efficacy in the present study.
CASE DESCRIPTION A 10-year-old sexually intact male client-owned Texas rat snake (Elaphe obsoleta lindheimeri) was referred for evaluation because of a 5-month history of progressive bilateral ocular opacities and abnormal behavior.
CLINICAL FINDINGS On ophthalmic examination, the snake had bilateral mature cataracts and uveal cysts. No additional ophthalmic or physical abnormalities were detected. Results of CBC, serum biochemical analysis, and ocular ultrasonography were unremarkable.
TREATMENT AND OUTCOME Bilateral spectaculotomy was performed, followed by bilateral phacoemulsification and uveal cyst aspiration, without complication. Histologic evaluation of the phacoemulsified lens material revealed only nonspecific findings associated with cataractogenesis. Vision was restored and the abnormal behaviors resolved after cataract surgery. Long-term follow-up examination performed 60 weeks after surgery revealed no additional ocular or physical abnormalities.
CLINICAL RELEVANCE The ocular anatomic and physiologic characteristics of snakes can pose intraoperative and postoperative challenges to phacoemulsification, but the outcome achieved for this surgical case suggested that successful cataract surgery is possible in these species. This case further demonstrated that cataracts may be associated with reversible behavioral abnormalities in captive snakes.
To describe the in vivo confocal microscopy (IVCM) features of the corneal epithelium and stroma in dogs and cats with herpetic dendritic ulcerative keratitis.
6 client-owned dogs and 10 client-owned cats with herpetic dendritic ulcerative keratitis (affected group) and 10 dogs and 10 cats from specific-pathogen-free laboratory colonies (nonaffected group).
After complete ophthalmic examination, IVCM corneal examination was performed on the clinically diseased eyes of animals in the affected group and on both eyes of animals in the nonaffected group. Results by species were compared between groups.
In the affected group, all 6 dogs had unilateral ocular lesions (total, 6 eyes examined), whereas 7 cats had unilateral lesions and 3 cats had bilateral lesions (total, 13 eyes examined). For the nonaffected group, 20 cat eyes and 20 dog eyes were examined. Corneal epithelial morphological abnormalities were identified in all examined eyes of animals in the affected group and in no examined eyes of the nonaffected group. Hyperreflective punctate opacities and inflammatory cells were present in all epithelial layers in examined eyes of affected animals but were absent in nonaffected animals. Similarly, Langerhans cells and anterior stromal dendritic cells were identified in corneas of eyes examined for animals in the affected group but not in any eye of animals in the nonaffected group. Stromal changes were less consistent in the affected group, but absent in the nonaffected group.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that herpetic dendritic ulcerative keratitis in dogs and cats is associated with microanatomic corneal abnormalities that can be detected by IVCM.
OBJECTIVE To evaluate the effects of adjunctive treatment with autologous platelet-rich plasma (PRP) on corneal reepithelialization, vascularization, and fibrosis in dogs with spontaneous chronic corneal epithelial defects (SCCEDs).
ANIMALS 40 client-owned dogs with uncomplicated SCCEDs.
PROCEDURES All dogs were treated with diamond-burr epithelial debridement (DBD) of affected eyes, topical tobramycin solution and atropine sulfate ointment application, and Elizabethan collar placement for 4 weeks. Dogs were randomly assigned to topical ocular administration of autologous PRP (n = 20) or artificial tear solution (control group; 20) 4 times daily for 28 days. Recheck examinations were performed approximately 2 and 4 weeks after treatment began to evaluate SCCEDs for corneal reepithelialization, and semiquantitative corneal vascularization and corneal fibrosis scores were assigned according to affected corneal surface area. Results were compared between groups.
RESULTS All dogs completed the study. The SCCEDs had completely reepithelialized in 11 (55%) control dogs and 12 (60%) PRP-treated dogs by the 2-week reevaluation, and in 15 (75%) control dogs and 18 (90%) PRP-treated dogs by the 4-week reevaluation. No significant differences were identified between groups in these proportions nor in mean differences from pretreatment scores for corneal vascularization and fibrosis.
CONCLUSIONS AND CLINICAL RELEVANCE In this preliminary study involving dogs with uncomplicated SCCEDs, topical PRP administered as an adjunctive treatment following DBD had no significant effect on healing. A larger study is warranted to support or refute these findings and to determine the effects of adjunctive PRP treatment for dogs with complicated SCCEDs.
Objective—To characterize clinical ocular disease, viral shedding, and serologic response associated with primary canine herpesvirus-1 (CHV-1) ocular infection in naïve adult dogs.
Animals—12 specific pathogen-free adult Beagles.
Procedures—Dogs were topically inoculated in the right eye with CHV-1 (infection group; n = 8) or virus-free medium (control group; 4). Dogs were inoculated with or without corneal microtrephination and subconjunctivally administered corticosteroids. Conjunctiva, buffy coat, and serum samples for real-time PCR assay, virus isolation, and serum neutralization (SN) antibody titers were collected until postinfection day (PID) 224, and general physical and ophthalmologic examinations were performed.
Results—Dogs in the infection group developed bilateral, mild to moderate conjunctivitis that reached maximal intensity on PIDs 7 to 10. Ocular viral shedding was detected in all dogs in the infection group between PIDs 3 and 10. Infected dogs developed CHV-1 SN antibody titers, beginning at PID 7 and peaking on PID 21. All buffy coat PCR assay results were negative. Corneal microtrephination and subconjunctival corticosteroid administration did not significantly affect clinical disease or viral shedding. Following recovery from primary infection, dogs remained clinically normal, did not shed virus, and had slowly decreasing SN antibody titers. Dogs in the control group did not develop conjunctivitis, shed virus, or develop CHV-1 SN antibody titers.
Conclusions and Clinical Relevance—Primary ocular infection of adult dogs with CHV-1 was associated with self-limiting conjunctivitis and ocular viral shedding, which was evident in the absence of clinically detectable keratitis or systemic disease. Features of this infection resembled herpes simplex virus primary ocular infection in humans.