Dacryoendoscopy for dacryocystitis management in a dog: A case report

The novel use of a sub-palpebral lavage line as an indwelling stent to manage unilateral nasolacrimal duct obstruction in a cat

OBJECTIVE

To describe a novel surgical approach to conjunctivorhinostomy for feline nasolacrimal duct obstruction.

ANIMAL STUDIED

A client-owned 4-year-old female spayed domestic shorthair cat presented with chronic unilateral nasolacrimal duct obstruction of the right eye.

METHODS

Following obstruction confirmation via complete ophthalmic examination and dacryocystorhinography, conjunctivorhinostomy was performed under general anesthesia, and an indwelling sub-palpebral lavage (SPL) line was placed to facilitate the formation of a new pathway for tear drainage. Specifically, the SPL footplate was sutured to the ventral conjunctival fornix with 5-0 nylon and 6-0 vicryl while the tubing was passed through the new pathway and the distal end of the tubing trimmed and tucked into a perinasal subcutaneous pocket. Two skin sutures closed the perinasal pocket and were removed 2 weeks postoperatively.

RESULTS

No immediate postoperative complications occurred. At 6 weeks and 6 months postoperatively, the distal SPL tubing was dislodged and visible out of the right nostril. This was uneventfully trimmed shorter, and no further complications occurred. The SPL component was easily removed 11 months postoperatively without complication. The patient's clinical signs dramatically improved; she was comfortable over 2 years after surgery.

CONCLUSION

To the authors' knowledge, this is the first report of using an SPL as an indwelling catheter for nasolacrimal duct surgery via conjunctivorhinostomy in a cat. This technique eliminated external stent sites for the patient, which was associated with a short use of an e-collar, and utilized materials readily available in a specialty hospital.

Nasolacrimal sac foreign body extraction using vitreoretinal forceps in 28 dogs

PURPOSE

To describe a novel technique of nasolacrimal foreign body extraction in dogs by using a 20G vitreoretinal forceps introduced through the superior lacrimal punctum.

METHODS

A retrospective review of the medical records of dogs with dacryocystitis due to nasolacrimal foreign bodies between the years 2001 and 2022 was performed. We recorded the breed, age, affected eye, type and number of foreign bodies, concomitant diseases, and the use of imaging techniques. All animals underwent the same procedure of a 20G vitreoretinal forceps insertion through the upper canaliculus reaching the lacrimal sac and retrograde extraction of the foreign bodies.

RESULTS

A total of 28 dogs were included, 16 males and 12 females, with a mean (±SD) age of 4.7 (±3.2) years. The most common breeds were Wire-Haired Dachshund (4/28; 14.29%) and Labrador Retriever (3/28; 10.71%). Additional imaging techniques were used, such as orbital ultrasound in 13 cases (13/28; 46.43%) and computed tomography in one case (1/28; 3.57%). The most common type of foreign body retrieved was grass awns, although seeds and plant debris were also found. Dacryocystitis resolved after removal of the foreign body and appropriate medical therapy was ensured in all cases in the 1-month postprocedure follow-up.

CONCLUSION

Extraction of nasolacrimal foreign bodies with vitreoretinal forceps is a novel, noninvasive, and easily applicable technique that, although not successful in all cases, can be attempted before performing more aggressive surgery.

Dacryocystitis in dogs caused by foreign bodies-Diagnosis and therapy in 14 Cases

OBJECTIVE

To describe foreign bodies (FBs) in the nasolacrimal sac of dogs, the history, and simple diagnostic and therapeutic approaches. Animals studied Fourteen dogs of different breeds, ages, and sexes were presented with unilateral dacryocystitis and had been treated without success for over 1-8 months.

PROCEDURES

Patient history, including prior treatment, was obtained from medical records. Slit-lamp examination was performed in all cases (SL 17, Kowa Company Ltd.). Jones tests 1 and/or 2 were performed in 13/14 cases. Dacryocystotomy was initiated with an incision into one canaliculus until the lacrimal sac was exposed and could be explored. After extracting the FB from the nasolacrimal sac, the surgical wound and canaliculus were left open. Aftercare included the administration of antibiotic eye drops with or without dexamethasone and systemic analgesia.

RESULTS

All 14 dogs were mesocephalic. Four of them were Dachshunds. Dacryocystotomy revealed plant-related FBs in all cases. The purulent discharge disappeared immediately after removal and did not recur during follow-up.

CONCLUSIONS

A simple dacryocystotomy is recommended for dogs with a strong suspicion of a foreign body in the lacrimal drainage system. Dacryocystorhinography appears to be an optional tool in these cases.

Evaluation of the upper and lower proximal lacrimal canaliculi using spectral-domain optical coherence tomography in normal Beagle dogs

OBJECTIVE

To confirm the feasibility of visualizing upper and lower proximal lacrimal canaliculi (LC) using spectral-domain optical coherence tomography (SD-OCT).

ANIMALS STUDIED

Eight eyes of four normal Beagle dogs.

PROCEDURES

To obtain an upper proximal LC image, the head was turned in the opposite direction to the eye being imaged, and the medial part of the upper eyelid was everted to expose the LC. To obtain a lower LC image, the lower eyelid was everted just below the punctum. Using "angle mode", the scan line was placed parallel on the long axis of the LC. The inlet LC width (LCW) was measured. Artificial tears (AT) were instilled, and LCW was compared before and after AT instillation. Additionally, the return time to the initial LCW inlet width was recorded.

RESULTS

Before AT instillation, there was a significant difference between the mean upper and lower LCW (91.8 ± 3.2 µm and 110.1 ± 8.4 µm, respectively). After AT instillation, the mean upper and lower LCW were 236.9 ± 27.7 µm and 238.4 ± 30.4 µm, respectively. Significant differences in the LCW before and after AT instillation in both the upper and lower LCWs were observed. The mean return time of the upper and lower LCW to their initial widths after AT instillation was within 4 min.

CONCLUSIONS

Spectral-domain optical coherence tomography was an effective method for providing high-resolution images of the upper and lower proximal LC. This method enables observation of LC changes after instillation of eyedrops in veterinary clinical practice.

Dacryoendoscopy for dacryocystitis management in a dog: A case report

A castrated, mixed‐breed, 10‐year‐old male dog developed a skin fistula from a ruptured periorbital swelling on the right eye; the patient was successfully treated with dacryoendoscope‐guided cannulation using a nasolacrimal tube. On presentation, computed tomography with concurrent dacryocystography (CT‐DCG) revealed obstruction of the right nasolacrimal duct and abnormal flow of contrast agents towards the root of tooth 109 at the right maxillary bone; however, the origin of the fistula remained unclear on CT‐DCG. Dacryoendoscopy was used to confirm the physical association between the fistula and the nasolacrimal duct; the fistula end was found to be near the right upper gum mucosa around tooth 107. CT‐DCG and dacryoendoscopy revealed that the periorbital swelling occurred owing to an infection or inflammation of the accessory nasolacrimal duct. The fistula end was connected to the oral cavity through a nasolacrimal tube installed in the oral mucosa. The tube was removed a week later, and the clinical symptoms completely resolved.