Nasolacrimal obstruction caused by root abscess of the upper canine in a cat

A 10‐year‐old, castrated male domestic short hair cat was presented to the Small Animal Clinic at the Western College of Veterinary Medicine with a presenting complaint of chronic, ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge but there were no apparent reasons for the ocular discharge, and nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease and a fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine and dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved. After 2 years, the epiphora has never reoccurred. This is a noteworthy case because a suspected root abscess resulted in extralumenal compression of the nasolacrimal duct, which shows the importance of a thorough oral examination when nasolacrimal obstruction is evident.     

Intraosseous approach to the nasolacrimal duct for removal of a foreign body in a dog

A Labrador retriever was evaluated because of chronic mucopurulent discharge from the left eye. A foreign body was identified in the nasolacrimal duct by use of dacryocystorhinography. Attempts to alleviate the inflammation by use of flushing and administration of antimicrobials were unsuccessful. At surgery, the infraorbital foramen was used as a landmark for a skin incision, because the nasolacrimal duct courses dorsal and parallel to the infraorbital canal. An air drill was used to remove the portion of the maxillary bone overlying the nasolacrimal duct, which exposed the intraosseous portion of the duct and allowed removal of a plant-material foreign body. The incision in the duct was allowed to heal by second intention, and the dog recovered without complications.     

Surgical treatment of recurrent dacryocystitis secondary to cystic dilatation of the nasolacrimal duct in a dog

A 3-year-old, castrated male golden retriever was presented for evaluation of recurrent ocular discharge of 4 months' duration from the left eye. Dacryocystorhinography was performed and demarcated a cystic dilatation of the left nasolacrimal duct with obstruction of the duct distal to the cystic cavity. Surgical exploration of the left maxillary sinus was performed to confirm the diagnosis and reestablish drainage into the nasal cavity. Recovery was uneventful, and the dog has been asymptomatic for >36 months postoperatively. This report documents the third published case of surgical treatment for cystic dilatation of the nasolacrimal duct.     

Differential diagnoses,investigation, and management of a periocular swelling close to the nasolacrimal duct in a horse – A case report of Dacryops

To describe the differential diagnoses, investigation, and management of a periocular swelling close to the nasolacrimal duct in a horse that was consistent with a nasolacrimal duct dacryops (lacrimal cyst). A 16‐year‐old gelding, Connemara cross presented with a history of a periocular swelling rostroventral medial to the right eye that had been sampled by the referring veterinary surgeon. A cystic lesion was diagnosed following standing computed tomography. Surgical removal of the cystic lesion was performed, and the tissue was submitted for histopathologic and immunohistochemical examination. Surgical removal of the cyst was curative, and there was no recurrence of clinical signs 7 months later. There was a small amount of mineralized material in the center of the cyst. Histopathologic and immunohistochemical examination confirmed a nasolacrimal duct cyst. Dacryops can form in horses as well as other species and appears to have a favorable outcome if surgically removed.     

Osseous metaplasia in the conjunctiva of a horse presenting with recurrent ulcerative keratitis

A 13‐year‐old Thoroughbred gelding presented with a 6 month history of recurrent conjunctivitis, dacryocystitis and corneal ulceration affecting the left eye (OS). Treatment had included multiple topical antibiotic and anti‐inflammatory preparations, nasolacrimal system flushing and an injection of methylprednisolone acetate (MPA) (Depomedrone) ¹ administered subconjunctivally into the left lower eyelid. No mechanical cause for the ulcerative keratitis could be visualised but digital palpation revealed a firm linear structure in the central palpebral conjunctiva of the lower eyelid. An excisional biopsy was performed and histopathological examination revealed the lesion to be a region of osseous metaplasia. Following excision of the lesion, the corneal ulcer resolved and the eye remained disease free over a 4 year follow‐up period. A causal link between the osseous metaplasia and the recurrent ulcerative keratitis was therefore suspected. This report describes the management of this case and discusses the pathogenesis of osseous metaplasia and the use of subconjunctival corticosteroids.     

Extraocular muscle dysinnervation disorder resembling Duane retraction syndrome in a 9‐month‐old French Bulldog

A 9‐month‐old French Bulldog was presented with a chronic history of lateral strabismus and intermittent third eyelid protrusion in the left eye. The neuro‐ophthalmological examination revealed mild ptosis of the left upper eyelid, mild lateral strabismus, and external ophthalmoparesis of the left eye. Retraction and ventral deviation of the left eye globe with protrusion of the third eyelid and elevation of the upper eyelid were elicited on attempted voluntary adduction of the left eye. Hematology, serum biochemistry, serology for infectious diseases, magnetic resonance of the head, and cerebrospinal fluid analysis did not reveal significant abnormalities. Forced duction test did not show signs of mechanical restriction in ocular motility. A suspected congenital cranial dysinnervation disorder resembling Duane retraction syndrome in humans was diagnosed based on the typical clinical signs and exclusion of structural abnormalities. The clinical signs remained stable for 9 months until the time of writing this report.     

Use of canaliculorhinostomy for repair of nasolacrimal duct obstruction in a horse

Obstruction of the nasolacrimal outflow pathway in horses is not uncommon. Causes of obstruction include foreign bodies, trauma, and congenital abnormalities. Placement of a nasolacrimal retention stylette may prove challenging.     

Dacryocystomaxillorhinostomy for chronic dacryocystitis in a dog

A 10-year-old female spayed Vizsla had intermittent mucoid ocular discharge from the right eye for 7 years. History, clinical findings, imaging studies, and culture and histopathology results confirmed chronic dacryocystitis with granuloma. A dacryocystomaxillorhinostomy was performed to preserve the functional portions of the nasolacrimal system remaining in this patient, as well as to promote healing of the lacrimal sac granuloma and secondary infection. Complete resolution of the clinical abnormalities was achieved, and the dog remains healthy 3 years postoperatively.     

Cholesterol granuloma of the maxilla in a dog

A case of cholesterol granuloma of the maxilla is described in a 13-year-old dog presented because of a long history of facial swelling, irritation and epiphora. Plain and contrast radiography indicated an intramaxillary mass with overlying bone destruction unrelated to the nasolacrimal duct. The lesion was excised and all clinical signs resolved.     

Maxillary bone epithelial cyst in a dog

A swelling ventromedial to the left eye of a one-year-old, neutered male Labrador failed to respond to antibiotic and anti-inflammatory therapy. Plain and contrast radiography revealed a spherical, radiolucent area, 1.5 cm in diameter, dorsomedial to the fourth maxillary premolar and rostral to the ethmoid region. The lesion was thin-walled, with a smooth radiopaque margin, and was clearly demarcated from the surrounding structures. Dacryocystography demonstrated no apparent physical association between the lesion and the nasolacrimal duct, the latter appearing normal. Ultrasonography of the lesion showed a round, anechoic structure consistent with the appearance of a cyst. Prior to surgical excision of the lesion, intralesional fluid was aspirated. Bacteriology of the fluid was negative for both aerobic and anaerobic organisms. Cytological examination of the fluid showed a few macrophages and small lymphocytes; neither significant inflammatory component nor neoplastic cells were found. Histology showed the lesion to be a benign epithelial cyst. The dog recovered uneventfully and there was no clinical evidence of recurrence within a two-year follow-up period.     

Canine dynamic left ventricular outflow tract obstruction: assessment of myocardial function and clinical outcome

Objective : The aims of this study were (i) to evaluate echocardiographic findings and myocardial function including pulsed wave tissue Doppler imaging in dogs with naturally occurring dynamic left ventricular outflow tract obstruction and (ii) to investigate the clinical outcome and response to therapy in these dogs. Methods : Two cases were retrospectively reviewed and three cases were prospectively evaluated including clinical findings, diagnostic test results (including standard Doppler echocardiography and pulsed wave tissue Doppler imaging), response to treatment and outcome. The two retrospective cases received no treatment. Other cases were treated with a β‐blocker. Results : All dogs had a variable intensity left apical systolic murmur. Concentric left ventricular hypertrophy, systolic anterior motion of the mitral valve and scimitar‐shaped left ventricular outflow tract Doppler flow profile were present in all cases. Pulsed wave tissue Doppler imaging interrogation of the interventricular septum revealed E′/A′ reversal in all but one patient. Regression of left ventricular hypertrophy and total resolution of the dynamic left ventricular outflow tract obstruction were observed in all cases. Clinical Significance : Young dogs are affected with a possible terrier breed predisposition. Dynamic left ventricular outflow tract obstruction may be distinguished from canine hypertrophic cardiomyopathy as progressive resolution of echocardiographic abnormalities was documented. Pulsed wave tissue Doppler imaging abnormalities provide further evidence for significant diastolic dysfunction associated with the hypertrophy.     

Bilateral congenital lacrimal fistula in a Brown Swiss bull

A five-year-old Brown Swiss bull was referred to the Department of Farm Animals, University of Zurich, because of bilateral epiphora that was unresponsive to treatment. Clinical examination revealed a fistulous opening medial to the medial canthus of both eyes and mucopurulent discharge from both openings. Attempts to flush the nasolacrimal duct via the lacrimal points resulted in the fluid exiting via the fistulous opening. Retrograde flushing of the nasolacrimal duct from the nasolacrimal opening resulted in the flush fluid flowing back out the nasolacrimal opening. Bilateral lacrimal fistula medial to the medial canthus of the eye was diagnosed based on the findings. The same anomaly was diagnosed a year later in 4?related female animals referred to our Department for other reasons. Three of the cases were sired by the bull described above and one was sired by his half-brother. Therefore, an autosomal recessive mode of inheritance of this anomaly was assumed. Clinical, epidemiological and molecular studies of the offspring of both bulls are underway to further investigate this anomaly.     

Acquired canaliculocele with intranasal extension in a dog

To describe a case of a nasolacrimal canaliculocele with intranasal extension in a dog. A 6‐year‐old neutered female Jack Russell Terrier was referred to the Centre Hospitalier Vétérinaire des Cordeliers for a slowly enlarging mass adjacent to the medial canthus of the right eye of 5 months duration. Ophthalmic exam, ultrasound, fine needle aspiration, dacryocystorhinography and computerized tomography examinations were performed. Rhinoendoscopic treatment with marsupialisation of the endonasal canaliculocele was performed. Physical examination revealed a 3 cm diameter, subcutaneous mass beneath the medial canthus of the right eye, with a defect in the maxillary bone below. Dacryocystorhinography demonstrated blockage at the level of the nasolacrimal duct. Fine needle aspiration confirmed the cavitary nature of the lesion. During rhinoendoscopy, a mass containing watery fluid was found. Following marsupialisation with a large mass wall resection, the lacrimal drainage system irrigated freely in the nasal chamber. The communication of the lumen of the diverticulum with the lumen of the superior but not the inferior canaliculus was clearly demonstrated during endoscopy. Given negative immunohistochemical staining for smooth muscle actin and desmin, nasolacrimal dacryocele appears to be the most likely diagnosis. Histological examination confirmed that no goblet cells were present in the wall of the diverticulum, which is consistent with the canaliculus rather than the lacrimal sac. Complete resolution was observed without recurrence one year after surgery. Despite its rarity, a canaliculocele should be considered in adult dogs with nasolacrimal duct obstruction. Marsupialisation seems to be the appropriate therapy.     

Lateral canthoplasty for facial nerve paralysis and exposure keratitis in a mouse

An 11-month old entire male mouse was presented with mucopurulent discharge and corneal scarring of the left eye. This mouse previously had a history of ear mites that responded to therapy, and had undergone surgery to remove a large discharging mass from the left side of the neck. The eye problem was noted prior to surgery, but after the ear mite infection. Examination revealed absence of a palpebral reflex in the left eye, and no spontaneous movements of the left ear or lip and whiskers. Examination of the left eye revealed extensive corneal vascularisation and pigmentation. Intraocular structures were not visible. A diagnosis of facial nerve paralysis and secondary exposure keratitis was made. Surgery was performed to close the lateral canthus and reduce corneal exposure. Following surgery the eye discharge ceased and corneal vascularisation resolved, however corneal pigmentation persisted.     

Dacryocystography in a cat with orbital pneumatosis

A 2‐year‐old neutered male European short‐haired cat was presented for a persistent discharge from the scar of previous left eye enucleation, performed 6 months prior by the referring veterinarian. A surgical exploration of the orbit was performed and retained nictitating membrane glandular and conjunctival tissues were removed. Eleven days later, the cat developed an orbital pneumatosis caused by retrograde movement of air through a patent nasolacrimal system and diagnosed by survey radiographic examination of the skull. Nasolacrimal system patency was assessed by dacryocystography performed by injection of iodinated contrast medium under pressure into the orbital cavity. Computed tomography dacryocystography confirmed the radiographic findings. The condition resolved following dacryocystography, possibly as an inflammatory response to the contrast medium. To our knowledge, this is the first case of orbital pneumatosis reported in a cat.     

Left ventricular outflow tract obstruction caused by a congenital accessory mitral valve leaflet and treated by open-heart surgery in a young dog

A 3-month-old Shetland sheepdog presented with a loud ejection murmur and exercise intolerance. Echocardiography revealed an accessory mitral valve leaflet, characterised by a valve-like structure separate from the mitral valve seen in the subaortic region of the ventricular septum. The left ventricular outflow tract was partially obstructed with a pressure gradient of 12 mmHg. Accessory mitral valve leaflet resection and mitral valvuloplasty were performed during open-heart surgery. Histology performed on the membrane-like structures were indicative of fibrous connective tissues. Postoperative echocardiography confirmed removal of the valve-like structure with resolution of the left ventricular outflow tract obstruction. The pressure gradient was decreased to 4.6 mmHg. The dog was in good condition and no further treatment was required 5 months after surgery. Both cardiac troponin I and NT-proBNP were markedly decreased. In this dog, surgical resection combined with mitral valve plasty resolved the left ventricular outflow tract obstruction and the clinical signs.     

Lacrimal bone agenesis in a dog

A 20-month-old neutered male dachshund dog was referred because of a 10-week history of swelling close to the medial canthus of the left eye. Recurrence of the lesion and cytological appearance of the fluid content were suggestive of inflammation. Computed tomography revealed a triangular-shaped bone defect in the skull deep to the lesion. Computed tomography dacryocystography demonstrated contrast medium pooling within the maxillary recess and nasal cavity rather than filling the lacrimal duct. Lacrimal bone agenesis was diagnosed.Key clinical message:Congenital skull including lacrimal bone agenesis may be responsible for swelling of the medial canthus of the eye and computed tomography dacryocystography is helpful in making a diagnosis.     

Mast cell tumour in the third eyelid of a mare

A 4‐year‐old Missouri Fox Trotter mare was referred to the Veterinary Teaching Hospital, Koret School of Veterinary Medicine with a reddish mass protruding from the third eyelid and adjacent palpebral conjunctiva of the left eye. On ophthalmic examination, the mare showed mild blepharospasm, mild mucopurulent discharge and mild corneal oedema in the left eye. Menace response, pupillary light reflexes and intraocular examination were normal. A rounded, fleshy red ulcerated mass, approximately 3 cm in diameter, expanded the edge of the outer surface of the medial third eyelid and conjunctiva of the ventromedial palpebral region. Physical examination was otherwise unremarkable. Based on history and clinical findings, surgical removal was elected. The tumour was excised and the conjunctiva in the area of tumour treated with cryotherapy. Histological evaluation revealed a mast cell tumour on the third eyelid. Nine months follow‐up revealed no recurrence.     

Pyloric obstruction secondary to epicardial pacemaker implantation: a case report

A 10-year old Lhasa Apso dog was presented for an acute history of exercise intolerance and hind limb weakness. High grade second degree atrioventricular block with an atrial rate of 200 beats per minute, ventricular rate of 40 beats per minute and an intermittent ventricular escape rhythm, was diagnosed on electrocardiograph. A transdiaphragmatic, unipolar, epicardial pacemaker was implanted without immediate surgical complications. Severe vomiting was noted 12 h post-operatively. Abdominal ultrasound and a barium study supported a diagnosis of pyloric outflow obstruction and exploratory abdominal surgery was performed. The pyloric outflow tract appeared normal and no other causes of an outflow obstruction were identified. The epicardial generator was repositioned from the right to the left abdominal wall. Pyloric cell pacing was presumed to be the cause for the pyloric obstruction and severe vomiting, and this was thought to be due to close proximity of the pacemaker generator to the pylorus situated in the right abdominal wall. Repositioning of the pulse generator to the left abdominal wall resulted in resolution of vomiting.     

Bilateral third eyelid ectopic cilia in an adult horse

A 15‐year‐old Cob mare presented with a 4‐month history of chronic epiphora and intermittent blepharospasm in the right eye. On ophthalmic examination, two translucent aberrant hairs were identified at the third eyelid margin corresponding to an area of corneal fibrosis and neovascularization. Partial excision of the third eyelid was performed, and histopathology confirmed ectopic hair follicles. Two weeks later, clinical signs recurred in the same eye. Examination revealed another pair of aberrant hairs on the bulbar surface of the third eyelid near its leading edge. This portion of the third eyelid was also excised, and histopathology confirmed two additional ectopic hair follicles. Eight months later, the horse developed similar clinical signs in the left eye. Ophthalmic examination showed a single aberrant translucent hair at the third eyelid margin associated with focal fibrosis and neovascularization of the ventromedial cornea. Partial excision of the third eyelid was performed, and histopathology confirmed an ectopic hair follicle within the third eyelid conjunctiva. Excision was curative at 4 years postoperatively with no further recurrence in either eye.