Clinical comparison of the Welch Allyn SureSight™ handheld autorefractor vs. streak retinoscopy in dogs

Objective To compare the Welch Allyn SureSight? wavefront autorefractor with retinoscopy in normal dogs. Animals studied Fifty privately owned dogs (100 eyes) of 20 breeds, free of ocular disease. Mean ± SD age: 5.7 ± 3.25 years (range: 6 months–13 years). Procedures The refractive error was determined in each eye by two experienced retinoscopists using streak retinoscopy as well as by an autorefractor operated by two different examiners. Measurements were performed before and approximately 30–45 min after cycloplegia was induced by cyclopentolate 0.5% and tropicamide 0.5% ophthalmic solutions. Results Mean ± SD noncyclopleged retinoscopy net sphere was ?0.55 ± 1.14 (range: ?3.75 to 3.5) diopters (D). Mean cyclopleged retinoscopy net sphere was ?0.52 ± 1.18 (range: ?4.25 to 2) D. Mean ± SD noncyclopleged autorefractor spherical equivalent (SE) was ?0.42 ± 1.13 D (range: ?3.36 to 2.73) D. Mean cyclopleged autorefractor SE was 0.10 ± 1.47 (range: ?5.62 to 3.19) D. Noncyclopleged autorefraction results were not significantly different from streak retinoscopy (whether noncyclopleged or cyclopleged, P = 0.80 and P = 0.26, respectively). Cyclopleged autorefraction results were significantly different from noncyclopleged or cyclopleged streak retinoscopy (P < 0.0001 in both states). There was no significant difference between noncyclopleged and cyclopleged streak retinoscopy (P = 0.97). Conclusions Noncyclopleged autorefraction shows good agreement with streak retinoscopy in dogs and may be a useful clinical technique. Cycloplegia does not significantly affect streak retinoscopy results in dogs.     

Chemical immobilization of Weddell seals (Leptonychotes weddellii) by ketamine/midazolam combination

ObjectiveTo provide reliable, effective immobilization for Weddell seals under extreme field conditions using an injectable ketamine/midazolam combination.Study designObservational study.AnimalsThirty adult Weddell seals (12 male, 18 female) in Erebus Bay, Antarctica, body mass (mean ± SD) 412 ± 47 kg, aged 9–27 years.MethodsSeals were immobilized with a target dose of 2 mg kg^?1 ketamine hydrochloride and 0.1 mg kg^?1 midazolam hydrochloride (IM), based on visually estimated body mass. When required, maintenance doses were administered at a target of 0.5 mg kg^?1 ketamine hydrochloride and 0.025 mg kg^?1 midazolam hydrochloride (IV).ResultsComplete immobilization was achieved in 33 of 40 injections (14 of which were repeat events on the same individual). Time to immobilization averaged 12 ± 4 minutes, with a duration of initial immobility of 38 ± 19 minutes. Total immobilization time varied by handling protocol, including condition assessment and muscle biopsy (Protocol 1, 60 ± 13 minutes), condition assessment and instrument attachment (Protocol 2, 154 ± 13 minutes), and condition assessment, muscle biopsy and instrument retrieval (Protocol 3, 48 ± 8 minutes). Overall, a total immobilization time of 114 ± 60 minutes was accomplished with 4 ± 4 maintenance doses, and an average recovery time of 36 ± 17 minutes. Most effects of the anesthetic combination were unrelated to mass, age, sex or total body fat. However, leaner seals had longer duration of initial immobility (% and kg total body fat) and recovery times (kg fat). Apnea events were uncommon and treated effectively with doxapram. No animals died.Conclusions and clinical relevanceReliable and effective field immobilization of Weddell seals was accomplished with a low dose of ketamine hydrochloride and midazolam hydrochloride, utilizing IM injection initially and IV maintenance methods.     

Surgical management of orbital nodular granulomatous episcleritis in a dog

A 27 kg, 6‐year‐old, male castrated German shorthaired pointer presented to the University of Missouri, Veterinary Teaching Hospital with the complaint of progressive exophthalmia of 2 years duration optical density (OD). Lack of retropulsion OD was noted on physical examination. Anterior segment examination OU and fundic examination OS did not reveal any abnormalities. Examination of the fundus OD revealed focal scleral indentation of the inferior nasal globe. The indentation changed location with globe movement OD. MRI and CT scan revealed a well‐circumscribed, approximately 2 cm in diameter mass located caudal and ventral to the affected globe that appeared to communicate with the nictitating membrane with absence of any bony involvement. A modified lateral orbitotomy was recommended and performed to remove the orbital mass and nictitating membrane en‐bloc. Histopathology and immunohistochemistry of the mass confirmed a diagnosis of nodular granulomatous episcleritis (NGE). Postoperatively, the dog developed absolute keratoconjunctivitis sicca (KCS). Examples of primary episcleral inflammation in the dog include diffuse episcleritis, NGE, nodular fasciitis, fibrous histiocytoma, proliferative conjunctivitis/keratoconjunctivitis, pseudotumor, and Collie granuloma. The etiology of these episcleral inflammations is presumed to be immune mediated. To our knowledge, this is the first report of NGE affecting the orbital region of a dog. Development of absolute KCS resulting from excision of the nictitating membrane is also supported by this case.     

Cell type-specific loss of BDNF signaling mimics optogenetic control of cocaine reward

The nucleus accumbens is a key mediator of cocaine reward, but the distinct roles of the two subpopulations of nucleus accumbens projection neurons, those expressing dopamine D1 versus D2 receptors, are poorly understood. We show that deletion of TrkB, the brain-derived neurotrophic factor (BDNF) receptor, selectively from D1+ or D2+ neurons oppositely affects cocaine reward. Because loss of TrkB in D2+ neurons increases their neuronal excitability, we next used optogenetic tools to control selectively the firing rate of D1+ and D2+ nucleus accumbens neurons and studied consequent effects on cocaine reward. Activation of D2+ neurons, mimicking the loss of TrkB, suppresses cocaine reward, with opposite effects induced by activation of D1+ neurons. These results provide insight into the molecular control of D1+ and D2+ neuronal activity as well as the circuit-level contribution of these cell types to cocaine reward.     

Clinical Presentation and Outcome of Cats with Circumcaval Ureters Associated with a Ureteral Obstruction

Background

Circumcaval ureters (CU) are a rare embryological malformation resulting in ventral displacement of the caudal vena cava, which crosses the ureter, potentially causing a ureteral stricture.

Objectives

To evaluate cats with obstructed CU(s) and report the presenting signs, diagnostics, treatment(s), and outcomes. Cats with obstructed CU(s) were compared to ureterally obstructed cats without CU(s).

Animals

193 cats; 22 circumcaval obstructed (Group 1); 106 non‐circumcaval obstructed (Group 2); 65 non‐obstructed necropsy cases (Group 3).

Methods

Retrospective study, review of medical records for cats treated for benign ureteral obstructions from AMC and University of Pennsylvania between 2009 and 2013. Inclusion criteria: surgical treatment of benign ureteral obstruction, complete medical record including radiographic, ultrasonographic, biochemistry, and surgical findings.

Results

Seventeen percent (22/128) of obstructed cats had a CU (80% right‐sided) compared to 14% (9/65) non‐obstructed necropsy cats (89% right‐sided). Clinical presentation, radiographic findings, and creatinine were not statistically different between Groups 1 and 2. Strictures were a statistically more common (40%) cause of ureteral obstruction in Group 1 compared to Group 2 (17%) (P = .01). The MST for Groups 1 and 2 after ureteral decompression was 923 and 762 days, respectively (P = .62), with the MST for death secondary to kidney disease in both groups being >1,442 days. Re‐obstruction was the most common complication in Group 1 (24%) occurring more commonly in ureters of cats treated with a ureteral stent(s) (44%) compared to the subcutaneous ureteral bypass (SUB) device (8%) (P = .01).

Conclusions and Clinical Importance

Ureteral obstructions in cats with a CU(s) have a similar outcome to those cats with a ureteral obstruction and normal ureteral anatomy. Long‐term prognosis is good for benign ureteral obstructions treated with a double pigtail stent or a SUB device. The SUB device re‐obstructed less commonly than the ureteral stent, especially when a ureteral stricture was present.     

Balloon dilatation of nasopharyngeal stenosis in a dog

CASE DESCRIPTION: A dog was examined because of a 6-month history of upper airway stridor that began after postoperative regurgitation of gastric contents. CLINICAL FINDINGS: Constant stridor was evident during inspiration and expiration, although it was worse during inspiration. The stridor was no longer evident when the dog's mouth was manually held open. Computed tomography, rhinoscopy, and fluoroscopy were used to confirm a diagnosis of nasopharyngeal stenosis. TREATMENT AND OUTCOME: The dog was anesthetized, and balloon dilatation of the stenosis was performed. Prednisone was prescribed for 4 weeks after the procedure to decrease fibrous tissue formation. Although the dog was initially improved, signs recurred 3.5 weeks later, and balloon dilatation was repeated. This time, however, triamcinolone was injected into the area of stenosis at the end of the dilatation procedure. Two months later, although the dog did not have clinical signs of stridor, a third dilatation procedure was performed because mild stenosis was seen on follow-up computed tomographic images; again, triamcinolone was injected into the area of stenosis at the end of the dilatation procedure. Three and 6 months after the third dilatation procedure, the dog reportedly was clinically normal. CLINICAL RELEVANCE: Findings suggest that balloon dilatation may be an effective treatment for nasopharyngeal stenosis in dogs.