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.     

Intralesional 5‐fluorouracil (5‐FU) for the treatment of eyelid squamous cell carcinoma in 5 horses

Eyelid squamous cell carcinoma in equine patients often presents a therapeutic challenge to practitioners due to the generally large area affected upon presentation. Surgical excision can be curative if wide enough margins are achieved, but this is not often attainable without enucleation. Other alternatives have been examined including cryotherapy, radiotherapy, brachytherapy, intralesional chemotherapy and photodynamic therapy. Intralesional chemotherapy using cisplatin, mitomycin‐C and bleomycin have been shown to be successful in treating eyelid squamous cell carcinomas but may be prohibitive to some owners due to the cost of therapy. To the authors' knowledge, this is the first case series to illustrate the effectiveness of intralesional 5‐fluoruracil in treating large equine eyelid squamous cell carcinomas. Macroscopic reduction in the size of the affected areas was noted in each case together with regression of clinical signs associated with the mass. This, coupled with the relative inexpensive nature of the procedure, makes this technique an attractive therapy for either primary treatment of eyelid squamous cell carcinoma or as a cytoreductive technique prior to surgical excision.     

Occurrence and expression of p53 suppressor gene and c‐Myc oncogene in dog eyelid tumors

Purpose To detect the occurrence and expression of the suppressor gene p53 and of the oncogene c‐Myc in eyelid tumors of dogs using the PCR, RT‐PCR, PCR‐ELISA and RT‐PCR‐ELISA techniques. These genes have not been described in dog eyelid tumors before. Methods Nine samples of eyelid or third eyelid epithelial tumors were obtained from the archives of the Department of Veterinary Pathology. Tumor diagnosis was confirmed by evaluation of hematoxylin‐eosin stained sections, and immunohistochemistry for cytokeratin AE1/AE3 and vimentin V9. A canine mammary tumor was used for positive control. Agarose gel electrophoresis, PCR‐ELISA and RT‐PCR‐ELISA were used to detect p53 and c‐Myc genes. Results The occurrence of p53 was detected in most of the eyelid tumors and third eyelid tumors studied (88.8%, n = 8) and was expressed in 75% of the positive samples, as indicated by ELISA. The c‐Myc gene was found in 77.7% (n = 7) of the samples and was expressed in eight samples. Conclusions Eyelid and third eyelid tumors of dogs express both the p53 and the c‐Myc genes as shown by PCR and RT‐PCR. However, PCR ELISA and RT‐PCR ELISA were more efficient in assessing occurrence and expression of these genes because they identified amplified products that were not detected by agarose gel electrophoresis.     

Feline entropion: a case series of 50 affected animals (2003–2008)

Aim  To evaluate the signalment, clinical signs, and etiopathogenesis of entropion in 50 cats.
Methods  Signalment and history of 50 cases of entropion in cats presented to a referral ophthalmology clinic. Animals were examined with direct and indirect ophthalmoscopy and slit-lamp biomicroscopy. Animals were treated surgically with a Hotz-Celsus procedure and results of surgery were evaluated between 4 and 22 weeks.
Results  Sixteen cats were young (mean age 4.1 ± 3.6 years) with pre-existing irritative ocular surface conditions such as conjunctivitis, corneal ulceration or sequestrum. Twenty-six cats were relatively older (mean age 11.3 ± 2.2 years) with involutional entropion with or without enophthalmos, presumed to result from a reduction in orbital tissue. Five cats were Persians with entropion associated with brachycephalic facial anatomy, whereas three were entire young adult male Maine Coones with in-turning associated with excessive facial 'jowl' tissue. Surgical treatment was curative in the majority of cases after one surgery although an increased amount of eyelid tissue was required to be removed for correction compared with similar surgery in the dog.
Discussion  This study has shown that entropion in cats may be caused in young animals as a result of continued blepharospasm related to irritative causes such as conjunctivitis or corneal ulceration or in older animals with lid laxity or globe enophthalmos. Lid in-turning was also seen in Persian and Maine Coone breeds.     

Leiomyoma of the third eyelid in a dog

A 14‐year‐old neutered male Dachshund presented for the evaluation of oculus dexter (OD) third eyelid elevation ongoing for approximately 2 months. Complete ophthalmic examination revealed a large, nonpainful, well‐demarcated, soft mass at the base of the right third eyelid causing elevation and mild hyperemia. The mass was freely moveable with the third eyelid, and no right globe deviation was noted. No other abnormalities were noted on physical examination, routine blood chemistry, complete blood count, serum T4, urinalysis, or urine cortisol/creatinine ratio. Ocular B‐mode ultrasonography showed an anechoic, well‐demarcated, homogenous, soft tissue mass at the base of the third eyelid with no orbital extension. A leiomyoma was diagnosed after multiple punch biopsies were obtained from the palpebral surface of the mass. The right third eyelid was excised surgically. Histopathology confirmed a completely excised, nodular, unencapsulated, expansile mass within the third eyelid. Positive smooth muscle actin and negative S‐100 immunohistochemistry confirmed a leiomyoma. Bundles of normal smooth muscle were also present adjacent to the mass. The mass was compressing the adjacent lacrimal gland and associated with moderate dacryoadenitis. Twelve months postoperatively, the right globe position and motility remain normal with no evidence of mass regrowth. To the author's knowledge, this is the first reported case of a leiomyoma of the third eyelid in any species. In this case, the mass was completely excised and no regrowth has occurred twelve months after surgery. This case along with independently reviewed canine third eyelids clearly demonstrates the presence of smooth muscle within the canine third eyelid.     

Adnexal surgery in dogs and cats

Abnormalities in eyelid position and function can lead to chronic irritation of cornea and conjunctiva. Corneal ulceration, vascularization and pigmentation are common consequences. Loss of vision, or loss of the globe may be the end result. The combination of ptosis and entropion of the upper eyelid is commonly seen in breeds with abundant forehead skin folds. Treatment options include surgical reduction of skin folds, suspending the brows, enforced secondary granulation of the upper eyelid, or a combination of procedures. Lid-shortening procedures reduce corneal exposure, improve functional blinking and reduce likelihood of traumatic proptosis. Although a lateral canthoplasty is technically easier to perform, a medial canthoplasty is the preferred method of eyelid shortening. An involuted lateral canthus with entropion is seen in certain dog breeds with a broad skull base and redundant facial skin. Surgical correction is by either applying traction to the lateral canthus, or by resection of the lateral canthal ligament. A combination of entropion, ectropion and macroblepharon may result in the presence of diamond shaped eyelids. Surgical correction involves the combination of several procedures. Upper eyelid agenesis is a congenital absence of part of the upper eyelid in cats. Treatment options include a skin-orbicularis flap from the lower eyelid with a conjunctival pedical graft, the transposition of the lower eyelid to the upper eyelid, cross lid flap and subdermal plexus flap, and subdermal collagen injection. Several techniques for reconstruction of upper and lower eyelid defects are described.     

Ultrasound findings in horses with severe eyelid swelling, and recognition of acute dacryoadenitis: 10 cases (2004-2010)

Objective To report the sonographic findings, treatment, and outcome of horses with severe eyelid swelling, to describe the sonographic appearance of enlarged lacrimal glands, and to describe the clinical features of acute dacryoadenitis. Materials and methods Medical records of all horses with severe eyelid swelling that underwent an ultrasound evaluation of the globe and periorbital structures from 2004–2010 were examined. Cases were limited to those in which the eyelid swelling was so severe that the globe could not be visualized. Results Ten horses met the criteria for inclusion in the study. All cases were unilateral and acute. Marked enlargement of the lacrimal gland was found in five cases, and supported the diagnosis of acute dacryoadenitis. Eyelid abscessation was found in three horses, accompanied by mild to moderate lacrimal gland enlargement in two of the three. Enlarged lacrimal glands were slightly heterogeneous in appearance and could be differentiated from an abscess by imaging the protrusion of the gland from beneath the supraorbital rim. Only two cases of severe eyelid swelling were soley traumatic. Conclusions Severe eyelid swelling was often associated with dacryoadenitis and/or eyelid abscessation. The detection of marked lacrimal gland enlargement in horses with an acute onset of severe painful eyelid swelling is consistent with a diagnosis of acute dacryoadenitis. Ultrasonographic evaluation of eyelid swelling of any degree is warranted to determine if enlargement of the lacrimal gland, etiology notwithstanding, is an underlying or contributing cause.     

Hemangiosarcoma of the third eyelid in a dog

Abstract A case of hemangiosarcoma of the third eyelid in a 7-year-old Caucasian Sheepdog is reported. A voluminous red mass protruding from the free edge of the third eyelid in the right eye was present. The mass and the free edge of the third eyelid were surgically excised. On histopathologic examination the tumor was seen to infiltrate the propria of the third eyelid and was composed of neoplastic mesenchymal cells forming irregular channels containing blood. These plump cells showed moderate anisocytosis and anisokaryosis with a low mitotic index. The surgical wound healed successfully and after 9 months there had been no recurrence. To the authors' knowledge, this is the first hemangiosarcoma of the third eyelid reported in the dog.     

Management of eyelid neoplasms in the dog and cat

Eyelid neoplasms are common in the older dog and typically benign. Eyelid neoplasms in the cat are less common and more often malignant. Resection of eyelid masses may be curative; however, restoration of the eyelid structure after mass excision is essential for maintaining long-term ocular surface health. Surgical techniques and instrumentation for eyelid surgery are reviewed. Indications, benefits. and limitations of sharp excision, cryotherapy, and laser excision and ablation are discussed. Neoplasia of the third eyelid is also discussed.     

A modification of the Mustardé technique for the surgical repair of a large feline eyelid coloboma

A one‐year‐old male domestic short haired cat was referred because of an area of keratitis that had developed adjacent to a particularly large unilateral eyelid coloboma. The defect was repaired using an undescribed three‐stage surgical technique, which is essentially a combination of existing techniques and consists of using the lower lid to re‐construct the upper lid and replacing the resultant lower lid defect with a full thickness graft from the upper lip. This technique is described and the results illustrated by photographs. A good functional and cosmetic result was achieved.     

State‐of‐the‐Art‐Review: Immunomodulatory effects of opioids

Objective – To review the immunomodulatory effects of opioids. Data Sources – Original research publications and review articles using the PubMed search engine with the following keywords – opioids, morphine, immuomodulation, and immunosuppression. Veterinary and Human Data Synthesis – Opioids have been shown to modulate the immune system in animal models by affecting both the acquired and innate arms of the immune system. Natural killer cell activity, T‐cell proliferation, antibody production, phagocytic cell function, and cytokine production have all been shown to be affected by opioids. Many of these effects are reversed by opioid antagonists. Opioids have also been shown to induce sepsis in laboratory animals. Opioid administration alters immune parameters in healthy humans at analgesic doses and may increase the risk of infection in some patient populations. Conclusions – While opioids remain the most powerful and widely used analgesics available, their negative effects on the immune system are well established in the laboratory setting. Thoughtful consideration should be given to the use of certain opioids in critically ill patients, especially those with pre‐existing immunocompromise.     

Correction of eyelid coloboma in four cats using subdermal collagen and a modified Stades technique

Four feline cases of bilateral eyelid coloboma were treated with injectable subdermal collagen and a modified Stades technique. This new technique was found to be easy to perform and the long-term results appear to be similar to other published reports.     

Moh’s micrographic surgery for the management of a periocular mast cell tumor in a dog

A 3‐year‐old neutered male boxer dog presented with a 6‐month history of a waxing and waning mass of the left dorsotemporal eyelid margin. Cytology and biopsy confirmed a diagnosis of mast cell neoplasia. Systemic staging of the dog failed to reveal any evidence of metastatic neoplasia. Owing to the location of the tumor within the eyelid margin and the wide surgical margins recommended for excision of mast cell tumors, Mohs micrographic surgery (MMS) was chosen for its potential to conserve tissues while providing intraoperative confirmation the tumor was completely excised. Utilizing MMS horizontal sectioning technique, 100% of the surgical margins were assessed prior to closure of the surgical wound. This represents the first time a comprehensive MMS protocol was used in a veterinary patient under general anesthesia.     

Facial varicosity affecting the lower eyelid of a horse

A 12‐year‐old Clydesdale cross mare was referred for investigation of right periocular vascular distension. Physical examination and ultrasonography confirmed the presence of a varicosity of the veins of the lower eyelid and transverse facial vein. The size of the varicose vein led to concerns about the potential progression in size of the lower eyelid to obstruct vision. Percutaneous encircling sutures were ineffective at occluding the vessel and surgical excision of the abnormal vein was performed. This treatment approach proved effective and 7 months post operatively the swelling has not recurred. This case demonstrates that varicosities can be successfully surgically resected in horses if there is a clinical indication.