A Clinical Case from the Archives : 17/09/2004

Posted on September 17, 2004 by davidwilliams

[tab name=”The Case”]What is causing the swelling around this 3 year old chicken’s eye?
[/tab][tab name=”David’s view”]This is a typical case of intraorbital sinusitis, probably of bacterial or mycoplasmal origin as described by Pass and Riddell in (Chronic rhinitis and sinusitis in budgerigars (Melopsittacus undulatus). Avian Dis. 1987 31:425-7) and by Chin and Goshgarian (Infraorbital sinusitis associated with Pasteurella multocida in pen-raised ring-necked pheasants. Avian Dis. 2001 45:540-3). The infraorbital sinus passes around the inferior margin of the globe and extends into the posterior part of the orbit, hence any inflammation there leads to periorbital and conjunctival swelling as seen here.
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A Clinical Case from the Archives : 15/09/2004

Posted on September 15, 2004 by davidwilliams

[tab name=”The Case”]This 7 year old Cocker Spaniel has a mucoid discharge from both eyes, worse first thing in the morning. The owner considered that he had an ocular infection but topical antibiotic ointment has had no effect. What is the likely diagnosis, how would you test for it and what treatment would you use?[/tab][tab name=”David’s view”]This dog has keratoconjunctivitis sicca or dry eye and the diagnostic test is the Schirmer tear test. This dog had a tear wetting of 3mm in one minute demonstrating dry eye to be the problem.A tear replacement such as Viscotears would be useful initially but the optimal treatment is topical cyclosporine in Optimmune, given twic edaily as a direct lacrimogenic agent.[/tab][end_tabset] 

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A Clinical Case from the Archives : 04/09/2004

Posted on September 4, 2004 by davidwilliams

[tab name=”The Case”]This three year old Netherland dwarf rabbit was presented with this non-painful but blinding ocular condition. What is occuring in this eye and what possible treatments might be used to emliorate the disease?[/tab][tab name=”David’s view”]The dense white mass lesion in the iris with vascularisation is virtually pathognomonic for a lens-induced uveitis associated with Encephalitozoan cuniculi infection. The pathogenesis appears to be that the parasite enters the lens in utero and exits later sometimes giving cataract and sometimes a lens-induced inflammation, characteristically appearing as a variably vascularised white mass. Treatment can be by phacoemulsification of the lens, but a medical therapy if surgery is not possible, involves anti-inflammatory medication with topical steroid or NSAID and anti-parasitic systemic medication such as oral albendazole.[/tab][end_tabset] 

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A Clinical Case from the Archives : 04/09/2004

Posted on September 4, 2004 by davidwilliams

[tab name=”The Case”]An 8 year old female neutered German Shepherd Dog is presented to you with this appearance of the ocular surface. What is the black mass likely to be and what is the white curved lesion next to it? What treatment would you suggest and what is the prognosis for the eye and for the dog more generally?[/tab][tab name=”David’s view”]The black mass is a limbal melanoma, more commonly seen in German Shepherd Dogs than in many other dog breeds. The white curved line is an arc of corneal lipid. The edge of the melanoma forces the corneal collagen lamellae apart allowing lipid to enter the cornea. Sometimes this is associated with raised circulating lipid levels, but not in this dog. Surgical resection by superficial keratectomy is the prefered therapeutic option. Cryotherapy of the bed of the corneal ulcer thus created is advised as melanomas are exquisity cryosensitive. It can be difficult to achieve adequate surgical margins in the depth of the cornea (a good reason for operating early in the genesis of the lesion rather than leaving it until later) and local recurrence is possible but these melanomas do not metastasise and the lesion is thus not life-threatening. Note the other similar but smaller more dorsally at the limbus – this should also be resected.[/tab][end_tabset] 

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A Clinical Case from the Archives : 04/09/2004

Posted on September 4, 2004 by davidwilliams

[tab name=”The Case”]This 9 month old Fresian bullock is one of a number in a group with corneal lesions ranging from corneal ulceration to fibrosis with granulation tissue. What is the condition and what are the factors involved in the genesis of the lesions? What treatment would you recommend and what prophylactic measures should be taken with the rest of the group?[/tab][tab name=”David’s view”]This is infectious bovine keratoconjunctivitis (also known as New Forest Eye), with a stromal abscess in this animal caused by Moraxella bovis. No fly control measures have been used on this animal and thus bacterial spread by flies has been substantial. Treatment using subconjunctival antiboiotic (long acting amoxycillin or tetracycline) will improve the condition but long-term corneal scarring is likely in such a case. Fly control measures such as repellant ear tags, or moving the cattle away from fields next to wooded areas, are important in reducing the disease.[/tab][end_tabset] 

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A Clinical Case from the Archives : 23/08/2004

Posted on August 23, 2004 by davidwilliams

[tab name=”The Case”]This 3 year old male neutered Golden Retreiver was referred after having been seen with a sunken right globe. The tentative diagnosis was Horner’s syndrome. What are the other signs pathognomonic of the condition and what would be the procedure to make a definitive diagnosis?[/tab][tab name=”David’s view”]The dog has indeed got Horner’s syndrome, with a miotic pupil, ptosis and enophthalmos characterised by third eyelid protrusion. This is common in Golden Retrievers and can be temporarily ameliorated by use of topical 0.1% phenylephrine, an adrenergic agonist. Rapid resolution of signs as occurred in this dog, shows that the third order neurone is affected with denervation hypersensitivity manifest at the motor end plate of the nerve.[/tab][end_tabset] 

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A Clinical Case from the Archives : 16/08/2004

Posted on August 16, 2004 by davidwilliams

[tab name=”The Case”]This five year old male neutered cat has developed a striking corneal lesion with vascularisation and white deposit. What is the conditon and what is the optimal treatment?[/tab][tab name=”David’s view”]This cat has eosinophikic keratitis. Treatment is difficult with topical streroid three times daily being unsuccessful and parenteral megoestrol acetate have little effect. Surgical removal by superficial keratectomy was used here with steroid treatment given to prevent recurrece of the lesion.[/tab][end_tabset] 

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