Ligneous conjunctivitis secondary to a congenital plasminogen deficiency in a dog

CASE DESCRIPTION: A 7-month-old 16.6-kg (36.5-lb) sexually intact female Golden Retriever was evaluated because of progressive severe bilateral membranous conjunctivitis, oral lesions, nasal discharge, and cough. CLINICAL FINDINGS: Histologic examination of conjunctival biopsy specimens revealed findings consistent with ligneous conjunctivitis. Circulating plasminogen activity was repeatedly low, and congenital plasminogen deficiency was identified as the underlying cause of the ocular, oral, and respiratory lesions. TREATMENT AND OUTCOME: Topical and subconjunctival administrations of fresh frozen plasma (FFP), topical administration of cyclosporine, and oral administration of azathioprine had no effect on the conjunctival membranes. Excision of the membranes followed by intensive treatment with topical applications of heparin, tissue plasminogen activator, corticosteroid, and FFP and IV administration of FFP prevented membrane regrowth. Intravenous administration of FFP increased plasma plasminogen activity to within reference limits, improved respiratory and oral lesions, and resulted in weight gain; discontinuation of this treatment resulted in weight loss, signs of depression, and worsening of lesions. After euthanasia because of disease progression, necropsy findings included mild hydrocephalus; multifocal intestinal hemorrhages; and fibrinous plaques in the oral cavity, nasopharynx, trachea, esophagus, and pericardium. Microscopically, the plaques were composed of fibrin and poorly organized granulation tissue. Fibrin thrombi were present within vessels in the lungs, oral cavity, and trachea. CLINICAL RELEVANCE: In dogs, congenital plasminogen deficiency can occur and may be the underlying cause of ligneous conjunctivitis. A combination of surgical and medical treatments may improve conjunctival membranes, and administration of FFP IV appears to be effective in treating nonocular signs of plasminogen deficiency.     

Features and outcome of a glomerulonephropathy associated with ligneous conjunctivitis in a Doberman pinscher dog

This report describes a 3-year-old female Doberman pinscher dog with ligneous conjunctivitis and a protein-losing nephropathy not associated with underlying plasminogen deficiency. Glomerulonephropathy in this circumstance had a positive outcome.     

Presentation,clinical pathological and post‐mortem findings in three related Scottish terriers with ligneous membranitis

Ligneous conjunctivitis and gingivitis were diagnosed in three related Scottish terrier dogs presented for investigation of severe conjunctivitis and respiratory signs. Hypoplasminogenaemia was confirmed in one of the three affected dogs. Supportive treatment was not effective, and the dogs died or were euthanased because of the disease. Post‐mortem analysis of two of the dogs revealed multiple abnormalities including severe proliferative fibrinous lesions affecting the conjunctiva, gingiva, trachea, larynx and epicardium and multiple fibrous adhesions throughout the thoracic and abdominal cavities. One dog had internal hydrocephalus and lacked a cerebellar vermis. Ligneous membranitis was confirmed on histopathology. This is a rare condition in dogs but an important differential diagnosis for severe conjunctivitis and gingivitis.     

Chlamydia infection in cats in New Zealand

Conjunctival swabs collected in 1991-92 from 333 pedigree and non-pedigree cats were tested for the presence of Chlamydia spp. antigen using an ELISA antigen kit. Forty (18.4%) of the 217 samples from cats with conjunctivitis were positive. Seven (6%) of 116 samples from cats which were in contact with cats with conjunctivitis but which showed no clinical signs at the time of sample collection were positive. Positive-testing cats were frequently from multi-cat households. Chlamydia spp. is present and associated with conjunctivitis in cats in New Zealand. Infection may occur concurrently with viral diseases. Feline calicivirus was recovered from 27 (21 with conjunctivitis) of 37 cats tested in five catteries. Four cats (with conjunctivitis) were FIV-positive.     

Multisystemic inflammatory disease in a borzoi dog

A six-week-old female borzoi puppy from a brother-sister mating developed a generalised illness characterised by anorexia, temporary intention tremor, episodic pyrexia, tachypnoea, conjunctivitis, otitis and neck pain. Haematological abnormalities included an inflammatory leukogram and regenerative anaemia. Blood cultures remained sterile; clinical chemistry values were unremarkable. The puppy had recurrent seizures and was euthanased when 18 weeks old. Post mortem examination revealed a multisystemic inflammatory disease involving thyroids, lymph nodes, spleen, pancreas, bladder and lung, but no lesions to account for the neurological signs. The cause of this generalised disease was not recognised. The histological features are unusual and resemble those described in other dogs of this breed.     

Lawsonia intracellularis proliferative enteropathy in a 3.5‐year‐old miniature horse

A 3.5‐year‐old miniature horse gelding was evaluated for signs of colic and decreased faecal production. Initial clinical pathology showed severe hypoproteinaemia with an albumin concentration <10 g/l. Abdominal ultrasound identified multiple loops of small intestine with significantly increased wall thickness. Diagnosis of equine proliferative enteropathy was based on clinical and laboratory findings, as well as a positive faecal polymerase chain reaction and positive antibody titre (>1:240) to Lawsonia intracellularis. Treatment with intravenous oxytetracylcine and additional supportive care gradually resolved the clinical and laboratory abnormalities.     

Chlamydia infection in cats in New Zealand

Conjunctival swabs collected in 1991-92 from 333 pedigree and non-pedigree cats were tested for the presence of Chlamydia spp. antigen using an ELISA antigen kit. Forty (18.4%) of the 217 samples from cats with conjunctivitis were positive. Seven (6%) of 116 samples from cats which were in contact with cats with conjunctivitis but which showed no clinical signs at the time of sample collection were positive. Positive-testing cats were frequently from multi-cat households. Chlamydia spp. is present and associated with conjunctivitis in cats in New Zealand. Infection may occur concurrently with viral diseases. Feline calicivirus was recovered from 27 (21 with conjunctivitis) of 37 cats tested in five catteries. Four cats (with conjunctivitis) were FIV-positive.     

Efficacy of pradofloxacin in cats with feline upper respiratory tract disease due to Chlamydophila felis or Mycoplasma infections

BACKGROUND: Upper respiratory tract disease (URTD) of cats is caused by a number of pathogens, including Chlamydophila felis and Mycoplasma spp. For effective treatment of both infections, doxycycline and enrofloxacin are recommended, but adverse effects limit their use in cats. HYPOTHESIS: That the fluoroquinolone pradofloxacin is effective against C. felis and Mycoplasma infection in cats with URTD or conjunctivitis. ANIMALS: Thirty-nine cats with signs of URTD or conjunctivitis. METHODS: Placebo-controlled, double-blind clinical trial. Cats were randomly entered into 1 of 2 treatment groups: treated PO with either 5 mg/kg pradofloxacin q24h or 5 mg/kg doxycycline q12h for 42 consecutive days. Changes in health status and clinical scores were evaluated. The presence of C. felis and Mycoplasma spp. was determined by quantitative polymerase chain reaction (PCR) and nested PCR of conjunctival swabs, respectively. RESULTS: At the beginning of the study, C. felis and Mycoplasma spp. were detected in 23 and 20 cats, respectively. Cats of both groups responded rapidly with a marked improvement in clinical signs within the 1st week. During treatment with either drug, C. felis DNA copy number declined quickly. Complete elimination of Mycoplasma spp. was achieved in both groups; however, whereas all cats receiving doxycycline eliminated C. felis, 4 cats treated with pradofloxacin remained PCR-positive. CONCLUSION AND CLINICAL IMPORTANCE: This study demonstrates that both pradofloxacin and doxycycline have good efficacy against C. felis and Mycoplasma spp., resulting in a marked improvement of clinical signs. However, C. felis DNA remained in some cats after treatment with pradofloxacin, suggesting that infection might not have been eliminated.     

Treatment of proliferative colitis in ferrets

Proliferative colitis associated with intracellular Campylobacter sp was diagnosed in 10 ferrets. The ferrets had a history of diarrhea (often blood-tinged or mucoid), dehydration, and chronic weight loss. Additional clinical signs included rectal prolapse, lethargy, fever, and a palpably thick colon. In 5 ferrets, the diagnosis was confirmed by colonic biopsy, via endoscopy. Supportive treatment in 5 ferrets did not alleviate the clinical signs or the proliferative intestinal disorder. oral chloramphenicol treatment (50 mg/kg of body weight, q 12 h for 10 to 21 days) resulted in marked clinical improvement and eradication of proliferative intestinal lesions in 5 ferrets.     

A novel herpesvirus associated with chronic superficial keratitis and proliferative conjunctivitis in a great horned owl (Bubo virginianus)

An adult great‐horned owl (Bubo virginianus; GHOW) presented with a history of recurrent corneal ulceration of the right eye (OD). Findings included ulcerative superficial keratitis, proliferative conjunctivitis, and iris pigmentary changes. The ulcer was initially nonresponsive to medical therapy, but showed rapid and appropriate healing following diamond burr debridement. Proliferative conjunctivitis markedly improved following topical antiviral therapy with cidofovir 1%, interferon alpha 2B ophthalmic solutions, and oral l ‐lysine. Histopathologic evaluation of a conjunctival biopsy revealed epithelial features suspicious for viral cytopathic changes and intranuclear structures suspicious for viral inclusions, suggestive of a possible viral‐induced papillomatous conjunctivitis. A novel alphaherpesvirus, referred to as Strigid Herpesvirus 1 (StrHV1), was identified using PCR and gene sequencing. This case represents a new clinical manifestation of a previously unreported herpesvirus in the GHOW. Identification of the herpes virus was critical to administration of appropriate therapy and resolution of the conjunctivitis, and corneal epithelial debridement promoted resolution of the chronic corneal epithelial defect.     

Experimental Salmonella-associated conjunctivitis in cats.

Cats were infected experimentally with Salmonella typhimurium via the conjunctiva. Clinical signs consisted of lacrimation, conjunctivitis, blepharospasm, prominent nictitating membrane and scleral injection. These signs were accompanied by an absolute neutrophilia and conjunctival smears indicative of moderate to severe suppurative inflammation. Ocular signs disappeared by day 6 postinfection. Salmonella typhimurium was cultured intermittently from the inoculated conjunctivae and rectal swabs through day 7. At necropsy, mesenteric and cervical lymph nodes were enlarged. Histopathological findings included chronic conjunctivitis and lymphoid hyperplasia in cervical and mesenteric lymph nodes. This study confirms that S. typhimurium can cause a primary conjunctivitis and that the ocular route of infection can lead to fecal excretion of Salmonella, in the absence of other clinical manifestations.     

Quantitative assessment of clinical signs for the detection of classical swine fever outbreaks during an epidemic

The performance of clinical signs as a diagnostic test for the detection of classical swine fever (CSF) outbreaks during the 1997-1998 CSF epidemic in The Netherlands was evaluated by constructing and analysing a receiver operating characteristic (ROC) curve. This curve assesses the discriminating ability of a diagnostic test over a range of test signals. The cut-off values for a defined diagnostic test to detect CSF outbreaks were set by different combinations of clinical signs observed. The area under the ROC curve, which is a quantitative measure of test performance, was significantly (P<0.001) larger than the area under the random ROC curve. This indicates that clinical signs have a significantly higher performance as a diagnostic test for the detection of CSF than for flipping a coin. However, the gain in diagnostic performance compared to a random process is not as much as we would wish it to be. The optimal efficient diagnostic test combined a sensitivity of 72.7% with a specificity of 52.7%, with a combination of the following clinical signs: unsteady gait/ataxia, not eating, not reacting to antibiotic treatment, conjunctivitis, hard faecal pellets.     

Feline immunodeficiency virus: prevalence, disease associations and isolation

Of 467 cat serums tested for antibody to feline immunodeficiency virus (FIV) 120 (26%) were positive. The average age of positive cats was 7.5 years (range 1 to 16 years), and 67% were male. Of 110 serums collected in 1980, 27 (24.5%) were positive. A wide variety of clinical signs including oral cavity disease, anorexia, weight loss, lethargy, depression, fever, respiratory and urinary tract disease, conjunctivitis, abscesses, anaemia and lymphadenopathy were observed in the cats with serum antibody. There was often a history of chronic disease or recurrence of particular or various clinical signs in these cats. FIV was isolated from 4 of 8 FIV antibody positive cats by cocultivation of patient lymphocytes with donor lymphocytes in the presence of interleukin 2.     

Subconjunctival Dirofilaria repens infection in a dog resident in the UK

Dirofilaria repens infection was diagnosed in a 5‐year‐old female German shepherd crossbreed, originally from Romania but brought into the UK in February 2014. The dog presented with conjunctivitis in March 2014 and then again 2 months later with additional ocular and nasal mucopurulent discharge. Bacterial cultures from the nasolacrimal duct were negative for bacterial growth. The case was referred in August 2014 for ophthalmic examination, which revealed abnormalities in both eyes, especially the left. They included mild palpebral conjunctival hyperaemia and marked follicular conjunctivitis, as well as a dorsonasal bulbar conjunctival mass. Serum biochemistry was unremarkable and a conjunctival biopsy taken from the dorsonasal bulbar conjunctival mass revealed eosinophilic/lymphoplasmacytic conjunctivitis. At re‐examination, nematodes were found in the area of the previous biopsy site and in the ventral palpebral conjunctival fornix. Polymerase chain reaction and sequencing confirmed these to be D. repens. Treatment with 10% imidacloprid and 2·5% moxidectin (Advocate Spot‐On) was successful, and clinical signs resolved over a 6‐week period. This case report indicates that D. repens infection should be considered as a possible aetiological cause of ocular lesions in dogs in the UK, especially those with a history of foreign travel. Implications for establishment and spread of D. repens in the UK are discussed.     

Conjunctival habronemiasis in a square‐lipped rhinoceros (Ceratotherium simum)

A captive female square‐lipped rhinoceros born in 1993 had been showing intermittent signs of bilateral conjunctivitis and conjunctival proliferation since 1998. Periodic improvement was noted, especially in winter, but overall the condition had deteriorated over the years. Treatment with various topical, intralesional, and systemic antibiotics and glucocorticosteroids was largely ineffective, as were repeated dewormings. No primary cause for these lesions was found in biopsies taken in 2000 and 2006, although a severe infiltrate of numerous eosinophils was observed in the latter. As the condition worsened, secondary corneal changes were noted, and eventually vision was lost due to proliferative conjunctival tissue. Aggressive resection of the proliferating tissue in 2013 restored vision and submitted biopsies yielded a diagnosis of severe allergic conjunctivitis, eosinophilic granuloma, and habronematid (Habronema or Draschia) larval infection. As no other rhinoceros in the herd was affected, including two calves born to the patient who were in close contact with their mother, it was concluded the presentation was most likely due to a hypersensitivity reaction to the dead or dying larvae. Fly repellent is now regularly applied around the eye of this rhinoceros, and a protective face mask has been fitted. Ongoing periodic relapses are treated with oral ivermectin, topical antibiotics, and steroids.     

Retrospective evaluation of the long-term outcome of non-surgical management of 74 dogs with clinical hip dysplasia

The long-term outcome for dogs treated non-surgically for clinical signs of canine hip dysplasia were evaluated retrospectively; 74 dogs were evaluated by a postal questionnaire sent to their owners, and 24 of these were also evaluated by a veterinary clinical examination. A total of 11 outcome variables were evaluated. Depending on the variable assessed, between 31 (41.9 per cent) and 49 (66.2 per cent) of the dogs remained clinically affected according to their owner's assessment, and between 17 (70.8 per cent) and 23 (95.8 per cent) of the 24 dogs had abnormalities attributed to hip osteoarthritis according to the veterinary assessment. Orthopaedic abnormalities other than hip dysplasia affected 17 of the 24 dogs. Long-term medications had been prescribed for the treatment of clinical signs associated with hip dysplasia in 41 of the 74 dogs.     

Pharmacokinetics of enrofloxacin and its efficacy in comparison with doxycycline in the treatment of Chlamydophila felis infection in cats with conjunctivitis

The concentrations of enrofloxacin were measured in the tears, saliva and serum of 14 cats with signs of upper respiratory tract infection and eight with no signs, after daily doses of 5 mg/kg. Enrofloxacin concentrations above the minimum inhibitory concentration of Chlamydophila felis were found in the saliva and tears of the cats with and without signs of upper respiratory tract infection. In a prospective randomised clinical trial, the efficacy of enrofloxacin against C. felis infection in cats with conjunctivitis was compared with the efficacy of doxycycline. Twenty-five cats were randomly assigned to treatment with either enrofloxacin or doxycycline for 14 days; 15 of the cats tested positive for C. felis by an immunofluorescent antibody test on conjunctival swabs. The two treatment groups showed equal improvements in the clinical signs of conjunctivitis and C. felis infection status; in each group three cats were still C. felis antigen-positive after the 14-day course of treatment, indicating a persistent infection. No side effects were observed in the cats treated with enrofloxacin.     

Allergic conjunctivitis in a juvenile black spider monkey.

Allergic conjunctivitis in a young spider monkey (Ateles fusciceps) was diagnosed on the basis of clinical signs, histomorphologic appearance of conjunctival biopsy specimens, and response to systemic corticosteroid therapy.     

Use of bisphosphonates to treat severe idiopathic hypercalcaemia in a young Ragdoll cat

A 3-year-old Ragdoll cat was referred for investigation of polyuria, polydipsia, vomiting, weight loss and hypercalcaemia. Serum biochemical abnormalities included total and ionised hypercalcaemia and hypophosphataemia. Following clinical investigations a diagnosis of idiopathic hypercalcaemia was made. Because of the severity of the hypercalcaemia and the associated clinical signs, treatment for hypercalcaemia was commenced with pamidronate. Major electrolyte abnormalities were detected but, remarkably, were accompanied by minimal clinical signs. The cat was subsequently treated with oral alendronate and is clinically normal 15 months later. Reports of the use of bisphosphonates in cats are limited and close monitoring of patients is recommended.     

Allergic conjunctivitis and conjunctival provocation tests in atopic dogs

Introduction Canine atopic dermatitis (cAD) is a very common disease, but little is known about eye involvement. The conjunctival provocation test (CPT) is used in human to study the ocular response to allergenic stimuli and to evaluate anti‐allergic therapy. To our knowledge it has not been used in dogs. Objectives To evaluate the prevalence of ocular signs in a population of atopic dogs and relate these with clinical cAD scores; and the usefulness of CPT for dust mites in atopic dogs with itchy eyes. Procedures Sixty cAD patients were evaluated for (i) ocular signs of allergic conjunctivitis including conjunctival hyperemia, chemosis, epiphora, ocular discharge, pruritus and corneal involvement, graded 0 to 3 according to severity, and (2) cAD Extent and Severity Index (CADESI‐03). Additionally, CPTs for Dermatophagoides farinae (n = 12) and Dermatophagoides pteronyssinus (n = 12) were performed in sensitized atopic dogs and 24 control dogs. Results Periocular and ocular signs of allergy were present in 60% (36/60) of cases. Conjunctival hyperemia (90%) was the most common sign. Severity of ocular signs was significantly correlated with eye pruritus (r_s = 0.690, P = <0.001) and skin lesions score for head region (r_s = 0.261, P = 0.04). A highly significant difference (P < 0.001, Fisher test) was found in CPTs between the test and the control groups. Conclusion Allergic conjunctivitis signs associated with cAD seem under valuated so these patients would benefit from an ophthalmologic evaluation. Furthermore, we found CPT to be a reliable, easy to perform and safe test for the etiologic diagnosis of allergic conjunctivitis in the dog.