Surgical management and outcome of lower eyelid entropion in 124 cats

Objectives To evaluate the success rate of various surgical techniques for the management of lower eyelid entropion in cats. Design Retrospective study. Animals studied One hundred and twenty‐four cats with surgical correction of lower eyelid entropion of 200 eyes over a 13 year period. Methods Records of 124 cats were reviewed for signalment, type of entropion, surgical procedure performed and post‐operative result. Results Combinations of the Hotz‐Celsus (HC), lateral canthal closure and full thickness wedge resection techniques were used to treat 64 bilateral and 60 unilateral cases of lower lid entropion. Twenty‐three cats were under a year of age, 52 cats were aged between 2 and 8 years and 49 were over 8 years old. The overall success rate for a single surgical procedure (which may consist of multiple techniques) to correct lower eyelid entropion was 96.0% per eye. The remaining 4.0% had the entropion resolved with a second surgery. A combined HC and lateral canthal closure had a 99.21% success rate of resolving lower lid entropion. Geriatric cats were the most likely age group to develop corneal sequestra; 37% of cats in this group presented with entropion and corneal sequestra concurrently. Seventeen percent of cats that presented with unilateral entropion and did not have prophylactic surgery on the fellow eye went on to develop entropion in the fellow eye. Conclusions A combined HC and lateral canthal closure was the most effective surgical technique in managing lower eyelid entropion of cats in our study. Prophylactic lateral canthal closure in the unaffected eye is recommended.     

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.     

Temporo-mandibular joint condylectomy and its effect over occlusion in cats: cadaveric study

Objective : To determine the effect of unilateral condylectomy on dental occlusion in cats. Methods : Twelve feline cadaver heads were randomly submitted to either a right or left unilateral condylectomy of the temporo‐mandibular joint. The distance between the mandibular and maxillary canine tooth was measured before (B0) and after the unilateral condylectomy (P0). A right or left latero‐‐lateral standardised force (4 N) was applied to the mandibular mentus area before and after the surgical procedure. These measurements were analysed with a linear model for repeated measures. Results : The comparative analysis between pre‐ and postsurgical values indicated no significant variation in teeth displacement following condylectomy between B0 and P0 measurements. Statistically significant differences were detected after either left or right condylectomy with respect to all measurements after application of the standardised forces. Occlusion changes are significant when comparing bites before and after surgery. Clinical Significance : Unilateral condylectomy causes a significant increase in latero‐lateral amplitude of jaw movement which might clinically affect feline dental occlusion. Clinical studies are required to determine the effect of unilateral condylectomies on mastication and dental occlusion in feline patients.     

Reconstruction of the lower eyelid by third eyelid lateral advancement and local transposition cutaneous flap after "en bloc" resection of squamous cell carcinoma in 5 cats

OBJECTIVE: To describe a novel technique for blepharoplasty to cover a tissue defect involving >/=50% of the lower eyelid. STUDY DESIGN: Prospective clinical study. ANIMALS: Five cats with lower eyelid squamous cell carcinoma (SCC). METHODS: En bloc resection of SCC by removing >/=50% of the lower lid with either the medial or lateral canthus was performed without other adjunctive treatment for SCC. The lid defect was reconstructed with a transposition skin flap derived from the frontal (medial defect) or temporal (lateral defect) region. The third eyelid was advanced laterally without dissection from its insertion; its outer conjunctival layer was removed, and the skin flap was sutured with single interrupted sutures dorsally over the nictitating membrane, ventrally to the cutaneous edge of the surgical wound and medially or laterally (depending on the canthus removed) to the skin of the remaining lower lid. RESULTS: Satisfactory cosmetic and functional results were achieved and the Schirmer tear tests were normal. In 2 cats, the skin flap needed monthly hair trimming to avoid corneal lesions. CONCLUSIONS: After en bloc resection of SCC involving >/=50% of the lower eyelid, reconstruction can be achieved by relocation of the third eyelid and use of a cutaneous transposition flap sutured to the scarified external surface of the third eyelid. Eyelid apposition and lacrimal function were preserved. CLINICAL RELEVANCE: Blepharoplasty using a cutaneous transposition flap sutured to the scarified surface of a relocated third eyelid should be considered for reconstruction of lower eyelid defects with >/=50% tissue loss of the lid margin.     

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.     

Arytenoid Lateralization for Treatment of Laryngeal Paralysis in 10 Cats

Objective— To describe the signalment, history, clinical signs, surgical technique, and outcome for cats with laryngeal paralysis that had arytenoid lateralization.
Study Design— Case series.
Animals— Cats with laryngeal paralysis (n=10).
Methods— Medical records (1996–2002) for cats with laryngeal paralysis that had arytenoid lateralization were reviewed for signalment, history, clinical signs, degree of paralysis, cause, concurrent medical conditions, surgical technique, and outcome. Follow-up information was obtained from owners or referring veterinarians.
Results— Of 10 cats, 9 had bilateral and 1 had unilateral laryngeal paralysis. Arytenoid lateralization were unilateral (n=7), bilateral (1), and staged bilateral procedures (2), 10 days and 3 years apart, respectively. Postoperatively, 1 cat had persistent inspiratory noise because of minimal enlargement of the rima glottidis and 2 cats required a temporary tracheostomy for management of laryngeal swelling. Three cats developed aspiration pneumonia and died 4, 7, and 150 days after surgery; all 3 had bilateral (simultaneous or staged) procedures. Of the 7 remaining cats, 4 were alive at follow-up and 3 had died of causes unrelated to arytenoid lateralization. The calculated mean survival time for all 10 cats was 406 days (median, 150 days; range, 4–1825 days).
Conclusions— Arytenoid lateralization was effective at enlarging the rima glottidis and reducing signs of airway obstruction in most cats.
Clinical Relevance— Unilateral arytenoid lateralization is a feasible option for the surgical management of cats with marked clinical signs; however, bilateral procedures should be avoided or at least performed with considerable caution because of the apparent risk for aspiration pneumonia.     

Immunohistochemical analysis of cyclin A, cyclin D1 and P53 in mammary tumors, squamous cell carcinomas and basal cell tumors of dogs and cats

The involvement of cyclin A, cyclin D1 and p53 proteins in canine and feline tumorigenesis was analyzed immunohistochemically. In the present study, a total of 176 cases were examined, among which there were 108 canine cases (75 mammary lesions, 16 squamous cell carcinomas and 17 basal cell tumors) and 68 feline cases (43 mammary lesions, 20 squamous cell carcinomas and 5 basal cell tumors). Speckled nuclear staining for cyclin A was observed in 19/38 (50%) canine malignant mammary tumors and 18/37 (48.6%) feline mammary carcinomas, while this was not seen in benign mammary tumors of either dogs or cats. Marked intense nuclear cyclin A staining was seen in 7/16 (43.8%) canine squamous cell carcinomas and 18/20 (90.0%) feline squamous cell carcinomas. Only 3/17 (17.6%) canine basal cell tumors showed slight and scattered staining for cyclin A. Expression of cyclin D1 was very rare in both canine and feline tumors. Nuclear staining of p53 was found in 7/37 (18.9%) feline mammary carcinomas. Intense immunoreactivity for p53 was found in 6/16 (37.5%) canine squamous cell carcinomas and 8/20 (40%) feline squamous cell carcinomas. These results suggest that cyclin A may have a role in the proliferation of canine malignant mammary tumors, feline mammary carcinomas and squamous cell carcinomas of dogs and cats, and p53 may associate with the tumorigenesis of feline mammary carcinomas and squamous cell carcinomas of dogs and cats.     

Surgical management of bilateral,upper and lower eyelid entropion in 27 Shar Pei dogs,using the Stades forced granulation procedure of the upper eyelid only

ABSTRACT

Aims: To evaluate the outcome of surgical management of entropion of the upper and lower eyelids in Shar Pei dogs which had previously undergone temporary palpebral tacking, using the Stades forced granulation procedure of the upper eyelid only.

Methods: Medical records were retrospectively searched to identify Shar Pei dogs referred for bilateral entropion of both the lower and upper eyelids, and that were treated with the forced granulation procedure of the upper eyelid only. Dogs were included if they had previously undergone unsuccessful temporary palpebral tacking and had at least three follow-up examinations in the 30 days following surgery.

Results: Twenty-seven Shar Pei dogs with a median age of 7.9 (min 4, max 24) months were included in the study. Before surgery, all dogs showed signs of severe ocular discomfort with bilateral keratitis and visual deficit due to blepharospasm, enophthalmos and protrusion of the third eyelid. In 13/54 eyes, keratitis was associated with a corneal ulcer. When re-examined 4 weeks after surgery, correction of the upper eyelid entropion and associated trichiasis resolved ocular signs in 50/54 eyes. Mild bilateral lower entropion remained in two dogs postoperatively, which underwent revision surgery with the Hotz-Celsus technique. There were no cases of long-term recurrence of entropion or ocular irritation in the 38 eyes (19 dogs) which were re-examined 1 year after surgery.

Conclusion and clinical relevance: The forced granulation procedure performed on the upper eyelid only was effective for correction of entropion in the Shar Pei dogs included in this study. In our experience, it is preferable to operate on the upper eyelid alone, rather than attempting to correct upper and lower entropion during the same surgical operation. The dog can then be reassessed a few weeks later to determine whether the lower entropion is anatomical or secondary to the severe blepharospasm resulting from the painful ocular irritation.     

Unilateral arytenoid lateralisation for the treatment of laryngeal paralysis in four cats

A unilateral arytenoid lateralisation procedure was successfully performed in four cats with either unilateral or bilateral laryngeal paralysis. All of the cats were presented for the investigation of signs of exercise-related respiratory embarrassment and stridor. Other clinical signs seen included altered vocalisation, an inability to purr, coughing and lethargy. A diagnosis of either bilateral or left or right unilateral laryngeal paralysis was made in each case following visual inspection of the vocal folds with the aid of a laryngoscope under a light plane of anaesthesia. In two cases the paralysis was bilateral and the condition was considered to be either congenital or idiopathic. In the other two cases the condition was unilateral and was considered to be iatrogenic as a result of previous surgical procedures. The results of this technique were considered excellent in all cases.     

Sensitivity and specificity of cytologic evaluation in the diagnosis of neoplasia in body fluids from dogs and cats

Sensitivity and specificity were determined for the cytologic detection of malignant tumors in canine and feline body cavity effusions. In a prospective study, 424 body cavity effusions from dogs and cats were collected and evaluated, including 70 pleural and 163 peritoneal effusions from dogs, and 77 pleural and 114 peritoneal effusions from cats. Final diagnoses were confirmed in 339 of the 424 cases by clinical follow-up, necropsy, and in the case of malignant tumors, Histopathology. Malignant tumors were found in 18% of canine and 25% of feline body cavity effusions. Approximately one-half of tumors in both dogs and cats were carcinomas. Discrete cell tumors accounted for 56% of feline neoplastic effusions. The sensitivity of cytologic evaluation for the detection of malignant tumors in body cavity effusions was 64% for dogs and 61% for cats. Specificity was 99% for canine and 100% for feline effusions. Sensitivity and specificity were comparable to those obtained with cytologic evaluation of human samples.     

Inhibition of canine and feline alcohol dehydrogenase activity by fomepizole

OBJECTIVE: To determine and compare substrate specificity and kinetic rate constants of feline and canine alcohol dehydrogenase (ADH) with ethanol (EtOH) and ethylene glycol (EG) as substrates in vitro, with and without fomepizole. SAMPLE POPULATION: Livers from 3 dogs and 3 cats. PROCEDURE: Canine and feline ADH activity, in cytosolic fractions of homogenized liver, was determined by use of various concentrations of nicotinamide adenine dinucleotide (NAD), EtOH, or EG as substrates. Initial reaction velocities were calculated, and kinetic inhibition rate constants (Ki) for fomepizole were determined. RESULTS: Substrate specificity of canine and feline ADH for EtOH or EG was not significantly different. A 2-fold difference was detected in the maximal velocity of canine, compared with feline, ADH, using either substrate. Fomepizole Ki in feline hepatic homogenates was significantly greater than Ki in canine hepatic homogenates when either EtOH or EG was used as substrate (10- and 30-fold, respectively). A 6-fold increase in the concentration of fomepizole was required to achieve ADH inhibition, with feline homogenates equivalent to those of canine homogenates. CONCLUSIONS AND CLINICAL RELEVANCE: Feline ADH has lower enzymatic capacity for turnover or is less concentrated in liver than canine ADH with regard to EtOH and EG catalysis. Canine ADH was more effectively inhibited by fomepizole than feline ADH. Results suggest that higher dosages of fomepizole may be more effective to treat cats with EG intoxication than dosages reported to treat dogs.     

Stifle joint luxation in the dog and cat: the use of temporary intraoperative transarticular pinning to facilitate joint reconstruction.

Multiple ligament injuries of the canine and feline stifle joint which result in luxation are uncommon. Two cats and one dog, that had sustained such a joint injury were surgically treated. A rupture of the cranial and caudal cruciate ligaments, and at least one collateral ligament was observed in all of the three animals. Prosthetic reconstruction was used, as previously described, in combination with a novel technique of intraoperative placement of a temporary trans-articular pin (TTP) to maintain intra-operative anatomical reduction. TTP placement facilitated maintenance of joint alignment during surgical reconstruction and aided appropriate tensioning of the prosthetic sutures, preventing collapse of femorotibial joint compartments. The TTP was removed prior to closure of the joint allowing immediate post-operative joint mobilisation. Based on assessment by their owners, all the animals made a complete recovery. TTP was considered a relatively simple and effective adjunctive aid for surgical treatment of traumatic luxation of the stifle joint.     

Autoantibodies in feline hyperthyroidism

Thyroid autoantibodies have been demonstrated by indirect immunofluorescence in the sera of 10 of 29 (34 per cent) cats with hyperthyroidism. Antinuclear factor, rare in healthy cats, was found in a further four animals. Twenty-eight of the cats had a palpable goitre at first presentation. In 16 cases the goitre was unilateral, while in the others it was bilateral. Lymphocytic infiltration was present in nine of the 27 (33 per cent) thyroids examined histologically. Five of the sera gave a particularly strong reaction for thyroid antibodies. Four of these cases had bilateral goitres and lymphocytic infiltrations were found in four of the five thyroids (P less than 0.05). Twenty-one of the cats were followed up for a mean period of 11 months after operation, during which time three cats developed recurrent hyperthyroidism. Two had bilateral goitres with lymphocytic infiltration and the serum of both was strongly positive for thyroid microsomal antibodies. The third had unilateral goitre with lymphocytic infiltration and serum which was positive for antinuclear factor. In this case, the recurrence involved the lobe which had been previously operated on. Some cases of feline hyperthyroidism may be immunologically mediated and the condition is thus a potential model for some aspects of autoimmune thyrotoxicosis in man.     

The Activity Ratio of the Cytosolic MDH/LDH and the Isoenzyme Pattern of LDH in the Peripheral Leukocytes of Dogs,Cats and Rabbits

The activities of malate dehydrogenase (MDH) and lactate dehydrogenase (LDH) and the pattern of the isoenzymes of LDH were determined in the peripheral blood leukocytes of dogs, rabbits and cats. Rabbits had significantly higher plasma glucose concentrations than dogs or cats. Feline leukocytes showed higher LDH and lower MDH activities than canine or rabbit leukocytes. The M/L ratio, defined as the MDH activity divided by the LDH activity in cytosolic fractions, was considered to be a good indicator with which to evaluate the metabolic state in animal tissues. The M/L ratio was highest in canine and lowest in feline leukocytes. LDH-2 and LDH-3 isoenzymes were dominant in canine leukocytes. LDH-1 and LDH-2 were dominant in rabbit leukocytes, whereas LDH-5 was dominant in feline leukocytes. It was evident that there were significant differences in energy metabolism between the leukocytes of dogs, rabbits and cats.     

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.     

Activities of enzymes in some types of peripheral leucocytes may reflect the differences in nutrient metabolism between dogs and cats

Plasma metabolites and immunoreactive insulin (IRI) concentrations and enzyme activities of some types of peripheral leucocytes were measured to clarify one aspect of the differences in nutrient metabolism between dogs and cats. There were no significant differences in plasma concentrations of glucose, triglyceride, free fatty acids and IRI between dogs and cats. Higher total cholesterol and lower HDL cholesterol concentrations were observed in feline plasma, and H/T ratio (HDL/total cholesterol concentrations) was significantly lower than that in canine plasma. The cytosolic activities of fructokinase (FK), pyruvate kinase (PK), glucose-6-phosphate dehydrogenase (G6PD) and lactate dehydrogenase (LDH) were significantly higher and the activities of cytosolic malate dehydrogenase (MDH) and mitochondrial glutamate dehydrogenase (GLDH) were significantly lower in feline leucocytes than those in canine leucocytes. Higher activities of FK, PK and G6PD, which regulate the rate of biosynthesis of fatty acids, may reflect the different characteristics in nutrient metabolism in feline tissues from canine tissues.