Surgical repair of deep melting ulcers with porcine small intestinal submucosa (SIS) graft in dogs and cats

PURPOSE: To evaluate the efficacy of using a porcine small intestinal submucosa (SIS) graft for the surgical repair of deep melting ulcers in dogs and cats. METHODS: Two cats and five dogs presented with deep and large melting ulcers of the cornea. In each case, the necrotic and collagenolytic tissue of the cornea was removed by keratectomy. A SIS graft, 1 mm greater than the corneal defect, was rehydrated in sterile saline and sutured to the edges of the ulcer with a simple interrupted pattern of 9/0 polyglactin 910. A nictitating membrane flap was utilized in two cats and four dogs for 2 weeks. All cases were treated postoperatively with topical and systemic antibiotics, a systemic anti-inflammatory drug and topical atropine. All animals were re-evaluated 15 days, 4 weeks, 35-45 days, 2-3 months and 6 months postsurgery. RESULTS: At 15 days postsurgery, a superficial intense corneal neovascularization surrounded the SIS graft. No ocular discomfort was present and fluorescein staining was negative in all cases. At 4 weeks the SIS graft was thick and opaque in all cases, although in one cat the SIS graft had partially detached. Between 35 and 45 days, SIS graft integration was evident in all eyes, and corneal neovascularization had decreased progressively. All eyes healed without complications and retained corneal transparency. This occurred even in the presence of corneal perforation in two cases: one prior to and one during surgery. CONCLUSION: Results of our study suggest the SIS graft may be an effective alternative surgical treatment to the traditional conjunctival grafts commonly used to repair melting ulcers in dogs and cats. The advantages of using a SIS graft include good corneal transparency, preservation of corneal integrity and maintenance of vision.     

A retrospective study of 30 cases of frozen lamellar corneal graft in dogs and cats

Frozen lamellar corneal grafts and nictitating membrane flaps were used in 18 dogs and 12 cats to repair deep corneal defects. In all dogs either melting corneal ulcers or descemetoceles were present. In the 12 cats, nine had either a melting corneal ulcer or descemetocele, two animals had acute bullous keratopathy, and one cat had corneal sequestrum. Initial vascularization with gradual clearing of the graft occurred during the first 45 days postoperatively. At 60 days postoperatively, all eyes were visual. Frequent postoperative complications included: focal dehiscence of the wound ( n  = 9); melting of part of the graft ( n  = 7); and pigmentation of the graft ( n  = 4). The frozen lamellar corneal graft was a very safe technique, and restored the tectonic and the optical function of the cornea. It provided the best results in corneas with nonperforating corneal defects. This technique provides poorer results when the cornea was perforated prior to surgery or during the surgical procedure.     

Bacterial corneal diseases in dogs and cats

Corneal diseases are very common in small animals. Corneal disease associated with bacterial agents is frequent in the dog and maybe less frequent in the cat. The medical history, important steps of the ophthalmic examination, and the ophthalmic diagnostic tests that are relevant in such corneal conditions are outlined. Bacterial corneal diseases in dogs and cats are most commonly considered in one of two categories--bacterial ulcerative keratitis and corneal abscesses. The clinical aspects of these two entities as well as the therapeutic strategies available for general practitioners and ophthalmologists are discussed. Ulcerative keratitis is frequent; it represents the most common ocular diseases in dogs and cats. Because some of these corneal ulcers can be very severe, progress rapidly, and therefore are sight threatening, the crucial steps of their diagnosis and management are stressed. The use of a magnification system, fluorescein dye, and corneal cytology and culture, if indicated, is necessary for diagnosis at an early stage of the disease. The treatment of bacterial ulcerative keratitis should eradicate the infection, reduce or stop the corneal destruction and support the corneal structures, control the uveal reaction and the pain associated with it, and minimize the scarring. The prognosis depends on the stage and the severity of the corneal ulceration, the etiology of the condition, and the therapeutic choice. A close follow-up of animals with corneal ulceration is highly recommended because corneal ulcers can progress rapidly.     

Topical treatment of non-healing corneal epithelial ulcers in dogs with aminocaproic acid

The potential efficacy of topical epsilon-aminocaproic acid, an antiplasmin agent, in the treatment of persistent corneal epithelial defects was evaluated in a study of the medical records of 44 dogs, in which 51 eyes had been diagnosed with a corneal epithelial defect lasting more than 10 days, with no apparent underlying cause. At an initial examination all the affected eyes had had non-adherent epithelium removed. Thirty-four of the eyes in 28 dogs examined between January 2000 and March 2003 were also treated by the topical application of a solution of 35.7 mg/ml ophthalmic aminocaproic acid three times a day; the other 17 eyes in 16 dogs treated between October 1997 and March 1999 had received only topical treatment with gentamicin in addition to the debridement. Both groups were assessed clinically at weekly intervals for a maximum of three weeks. The two groups had approximately the same breed distribution, and there were no statistically significant differences between them in terms of their age, sex, affected side or duration of the corneal erosions. After three weeks, 32 of the 34 eyes treated with aminocaproic acid (94.1 per cent) had been cured, compared with seven of the 17 eyes treated with gentamicin (41.2 per cent) (P=0.0001). No adverse drug reactions were reported.     

Epidemiology, diagnosis, and treatment of blastomycosis in dogs and cats

Blastomycosis is one of the most common systemic fungal diseases in dogs in North America, but it is rarely diagnosed in cats. The typical route of infection is inhalation of aerosolized conidia of Blastomyces dermatitidis. From the respiratory tract, the developing yeast form may disseminate throughout the body and affect multiple organ systems, most commonly the lymphatic, skeletal and central nervous systems, eyes and skin. Disseminated disease often is associated with nonspecific signs of illness including lethargy, inappetence and fever, as well as signs referable to specific organ systems like chronic cough and dyspnea, peripheral lymphadenopathy, endophthalmitis, and central nervous signs. Diagnosis is typically made by detection of Blastomyces dermatitidis yeast in affected tissues by fine-needle aspiration cytology or histopathology. The treatment of choice is itraconazole. Prognosis is fair in dogs without central nervous disease and guarded in cats.     

Modulation of proteolytic activity associated with persistent corneal ulcers in dogs

Canines affected with corneal lesions demonstrate increased proteolytic activity at the affected site. Canines that develop persistent corneal ulcers and maintain elevated levels of proteolytic activity respond to protease inhibitor therapy with polysulpated glycosaminoglycan, PSGAG. In this study, the proteolytic activity expressed in lacrimal fluid of canines was evaluated as normal (1.15 U mL⁻¹) or healed (1.19 U mL⁻¹). Six of the 26 dogs affected with persistent corneal ulcers, however, had a protease level consistent with the unaffected control animals. These dogs did not appear to respond to PSGAG therapy. Two pathophysiologies for persistent corneal ulcers are indicated. Identifying which mode is active could help determine the therapeutic treatment needed.     

Current prevalence of Dirofilaria immitis in dogs, cats and humans from the island of Gran Canaria, Spain

The island of Gran Canaria is a hyperendemic area for canine dirofilariasis. The aim of the present study was to provide data on Dirofilaria immitis in dogs, cats, and humans on this island in 2010. The data confirms the prevalence in the overall canine population (19%), with a considerably higher prevalence (43%) in the autochthonous breed of Canarian Warren hound. The prevalence in the feline population (33%) is higher than that of the canine population, and the existence of specific D. immitis antibodies in the inhabitants of the island of Gran Canaria (12%) is confirmed. In both cats and humans, the prevalence, according to the different climate areas on the island, is related to the prevalence of D. immitis in dogs in the same area, which shows the key epidemiological role played by the canine host with regard to the transmission to other hosts of D. immitis.     

Ketoconazole in the treatment of dermatomycosis in cats and dogs

Ketoconazole (Nizoral^®, Janssen Pharmaceutica) a new systemic antimycotic was tested in dermatomycosis in cats and dogs. The daily dose (10 mg/kg body weight) was administered for 10 or 20 days without any other measures being taken. After the 20‐day treatments new hair growth was observed in 96.7 per cent of the cats and 89.9 percent of the dogs. Clinical cure was complete in 96.8 per cent of the cats and 90.5 per cent of the dogs.

Particularly the good tolerance in the cat was appreciated. There were practically no side‐effects in dogs (except vomiting in two pups) or in cats.     

Ketoconazole in the treatment of dermatomycosis in cats and dogs

Ketoconazole (Nizoral, Janssen Pharmaceutica) a new systemic antimycotic was tested in dermatomycosis in cats and dogs. The daily dose (10 mg/kg body weight) was administered for 10 or 20 days without any other measures being taken. After the 20-day treatments new hair growth was observed in 96.7 per cent of the cats and 89.9 per cent of the dogs. Clinical cure was complete in 96.8 per cent of the cats and 90.5 per cent of the dogs. Particularly the good tolerance in the cat was appreciated. There were practically no side-effects in dogs (except vomiting in two pups) or in cats.     

The use of porcine small intestinal submucosa for the repair of full-thickness corneal defects in dogs, cats and horses

OBJECTIVE: To evaluate the efficacy of using a porcine small intestinal submucosa (SIS) graft covered by a conjunctival flap for the surgical repair of full-thickness corneal wounds in dogs, cats and horses. PROCEDURE: All records dating from August 1999 to February 2003 from Purdue University Veterinary Teaching Hospital of patients that had undergone ophthalmic surgical procedures and received a SIS corneal graft for a full-thickness lesion were reviewed. Fifteen cases were identified including six dogs, two cats and seven horses. Requirements for inclusion in this study were that SIS was used as a corneal graft in a full-thickness corneal defect and that the graft was completely covered with a conjunctival flap. RESULTS: Of the 15 cases, one canine patient had received SIS following removal of an epibulbar melanocytoma. The remaining five canine patients had undergone this surgical procedure for the repair of corneal perforation. The two feline patients had been presented for corneal perforation following chronic ulceration. One equine patient had been presented for a deep melting ulcer, three for stromal corneal abscesses, and three for corneal perforations. Complications encountered postoperatively included aqueous leakage, conjunctival flap dehiscence, synechia, cataract and fibrin in the anterior chamber. Fourteen out of 15 patients were visual at the final re-evaluation. CONCLUSION: SIS is an inexpensive, easy-to-handle biomaterial that appears to be suitable for the repair of full-thickness corneal wounds in dogs, cats and horses. Results of our study support the conclusion that this relatively new product is an effective alternative to traditional implantation materials utilized in veterinary ophthalmology.