Canine Conjunctivitis and Blepharitis

Tumor-like lymphoplasmacytic conjunctivitis in the third eyelid in a dog

This report aims to describe a case of tumor-like lymphoplasmacytic conjunctivitis in a 7-year-old spayed-female Pomeranian. On complete ophthalmic examination, a mass with papillary projections was noted on the bulbar surface of the right third eyelid. Debulking of the mass was performed while preserving as much of the third eyelid as possible. On the histopathological examination, the mass was diagnosed as lymphoplasmacytic conjunctivitis with mild epithelial hyperplasia. Although a slight regrowth of the mass was noted 3 weeks after surgery, intralesional injection of triamcinolone acetonide led to its disappearance. There was no further recurrence after 5 months.

An assessment of bacterial contamination of indirect ophthalmoscopes and condensing lenses used in clinical practice: A multi-center study

PURPOSE

To investigate bacterial contamination of indirect ophthalmoscopes and condensing lenses used in three UK veterinary referral centers, and the impact of an implemented cleaning protocol.

METHODS

Bacteriology samples from 10 indirect ophthalmoscopes and 10 condensing lenses were taken at each center (n = 30 T0), before initiating one of three cleaning frequencies (every 2 weeks/once weekly/daily) for 28 days. The most contaminated indirect ophthalmoscope and condensing lens from each center were re-sampled 30 min prior to (T1; n = 9) and 30 min after (T2; n = 9) the final clean. Sensitivity testing was completed using MIC.

RESULTS

Seventy-three isolates representing 15 different bacterial populations (genus/species) were cultured from 36 of 48 (75%) swabs tested. The most frequently cultured isolates were Staphylococcus spp. 30%, Micrococcus 22%, and Bacillus 14%. Pseudomonas aeruginosa, Pantoea, and Staphylococcus pseudintermedius demonstrated resistance to >50% of antibiotics against which they were tested. Eighty-three percent of T0 samples (54 isolates across 11 species, median 2 isolates/swab), all T1 samples (15 isolates across 8 species, median 2 isolates/swab), and 22% of T2 samples (4 isolates across 4 species, median 0 isolates/swab) were contaminated. Head contact points were most contaminated irrespective of time point. A T1 sample was 57 times more likely (95% CI: 2.4-1376) to have a positive culture than a T2 sample (p = .01).

CONCLUSIONS

Baseline contamination was high, representing a potential source of nosocomial infection in ophthalmic patients and handlers of diagnostic equipment. No center implemented a cleaning protocol prior to this study. Routine cleaning reduces bacterial contamination.

Follicular conjunctivitis in dogs: A retrospective study (2007-2022)

OBJECTIVE

To evaluate the incidence, clinical features, treatment, and outcome of canine follicular conjunctivitis (CFC).

PROCEDURE

Medical records of dogs diagnosed with CFC were reviewed. Data recorded included signalment, duration of clinical signs and treatment details prior to presentation, concurrent ocular/systemic diseases, ocular clinical signs, cytology, treatment, follow-up, and outcome. Blepharospasm, signs of self-trauma, hyperemia, chemosis, ocular discharge, and follicle location and severity (0.5-4) were retrospectively evaluated. Based on severity, treatment consisted of topical 0.1% diclofenac or 0.1% dexamethasone sodium eyedrops. Dogs were classified into young (YD < 18 months) and adult (AD ≥ 18 months).

RESULTS

One hundred and fifty-three dogs (276 eyes) were included in the study: 83YD (54%) and 70AD (46%). Males and bilateral disease were over-represented in both groups. Severity was associated with young age (p = .032) and bilaterality (p = .025), and not with dermatological diseases (p > .05). No differences in follicular location were observed except for more frequent involvement of the nictitating membrane (MN) in YD (p = .02). Response to treatment was faster in AD (p = .001), with complete resolution in 80.6% of the eyes (100/124) at 1 month. YD treated with diclofenac showed faster resolution than those treated with 0.1% dexamethasone (p = .009).

CONCLUSIONS

Although CFC is a bilateral ocular disease occurring at any age, the clinical presentation is influenced by age. Follicular conjunctivitis in adult dogs is less sever, less commonly affects the NM, and responds more quickly to topical treatment. One month of topical diclofenac may be adequate for mild cases, and 1 month of topical 0.1% dexamethasone is recommended as initial therapy for moderate to severely affected cases.

Atypical antibiotic-responsive Staphylococcus pseudintermedius-associated tumor-like meibomitis in the upper eyelid: A case report of two dogs

OBJECTIVE

To present the clinical signs and treatment methods for atypical tumor-like meibomitis in two dogs.

ANIMALS STUDIED

A 4-year-old castrated-male Coton de Tulear (Case 1) and a 6-year-old spayed-female Maltese dog (Case 2).

PROCEDURE

Full ophthalmic examination revealed a well-circumscribed, firm, and raised solitary mass on the upper eyelid of the left (Case 1) and right eye (Case 2). Case 1 showed a recurrent mass with a diameter of 2-3 mm, which was excised by the referring veterinarian. The possibility of meibomian gland involvement was suggested histopathologically. Case 2 had a history of blepharitis treated with systemic corticosteroids 4 years ago.

RESULTS

Topical and systemic antibiotics and anti-inflammatory drugs were administered to reduce inflammation and prevent secondary infections. In Case 1, the mass appeared static at the beginning of medication; however, after stopping antibiotics while tapering steroids, the mass increased in size and was associated with suppurative discharge. In Case 2, the mass continued to grow despite treatment, showing a similar infection pattern. Cytological examination revealed neutrophilic inflammation with cocci infection, and bacterial culture confirmed the presence of Staphylococcus pseudintermedius in both cases. When steroid administration was stopped and antibiotic administration was initiated according to the results of the antibiotic susceptibility test, the mass rapidly decreased in size and completely disappeared. There was no recurrence on follow-up.

CONCLUSIONS

A unilateral antibiotic-responsive tumor-like solitary mass on the upper eyelid resolved without surgical treatment. Medical treatment must be considered when treating atypical eyelid masses, and the use of appropriate antibiotics through antibiotic susceptibility testing is important.

Blepharitis and Neoplasms of the Canine Eyelid Margin and Skin

Canine eyelid masses (tumors) should include the differential clinical diagnoses of neoplasia and blepharitis. They have many common clinical signs including tumor, alopecia, and hyperemia. Biopsy and histologic examination remains the most effective diagnostic test to establish a confirmed diagnosis and appropriate treatment. Neoplasms are typically benign (tarsal gland adenomas, melanocytomas, and so forth) with the exception of lymphosarcoma. Blepharitis is noted in 2 age groups including dogs aged less than 1.5 years and middle aged to older dogs. Most blepharitis cases will respond to specific therapy once an accurate diagnosis is established.

Diagnostic approach and grading scheme for canine allergic conjunctivitis

BACKGROUND

In humans, allergic conjunctivitis is a well described disease. In contrast, allergic conjunctivitis has not received much attention from the veterinary community so far. Canine allergic conjunctivitis (cAC) is one of the possible manifestations associated with canine atopic dermatitis (cAD), being often underdiagnosed and undertreated. Our aim is to contribute to disease characterization and clinical stagingfor cAC severity.

RESULTS

A retrospective observational study including 122 dogs that underwent a complete ophthalmological and dermatological examinations and diagnosed with allergic conjunctivitis was conducted. A total of six ophthalmic clinical signs were considered for disease characterization and clinical staging: conjunctival hyperemia, chemosis, ocular pruritus, epiphora, seromucoid to mucopurulent discharge and keratitis, classified from 0 (absent) to 3 (severe). Scores comprised between 1-5 were considered mild, 6-10 moderate and 11-18 severe. The majority of dogs (64%) presented with moderate cAC followed by 24% of mild stages and only 12% of severe presentations. The severity of allergic conjunctivitis was not correlated to sex or age at the time of diagnosis and all presented with a bilateral form of the disease. Chemosis (84%), hyperemia (83%) and ocular pruritus (79%) was observed in 55% of the cases. Seromucoid to mucopurulent discharge (62%) and epiphora (69%) were less frequent, with keratitis being the least encountered clinical sign (15%). The degree of keratitis showed a positive correlation with both severity and chronicity of cAC (rho = 0.21-0.29, p ≤ 0.02)). Severity of cAD and cAD were not significantly correlated (p-value = 0.4).

DISCUSSION AND CONCLUSION

The triad hyperemia, chemosis and ocular pruritus, already known in human medicine to be a reliable way of diagnosing human allergic conjunctivitis, also proved to be important in cAC Mild forms of the disease may pass unnoticed, ocular pruritus being hard to assess in canine patients.The proposed standardized diagnostic approach and novel grading scheme for cAC may be of value for both veterinary ophthalmologists and dermatologists, as well as general practitioners.

Survey of cytokines on ocular surfaces of atopic dogs by multiplex analysis using two sampling methods - a pilot study

BACKGROUND

Conjunctivitis in atopic dogs has already been described yet is rarely observed, and likely underdiagnosed in practice.

OBJECTIVES

To assay various cytokines in tears and conjunctivae from atopic and normal dogs, and to compare canine atopic dermatitis-associated conjunctivitis with controls.

ANIMALS

Ten atopic and ten normal client-owned dogs.

METHODS AND MATERIALS

Ocular surfaces were sampled bilaterally in a prospective study, using two different methods. Tear samples were obtained with a sterile swab previously moistened with saline solution (method A). Conjunctival impressions were obtained with a conjunctival impression device (method B). For each sample, the concentrations of a panel of 13 cytokines were measured by multiplex analyses. CADESI-4, pruritus (PS) and conjunctival (CS) scores were determined.

RESULTS

Among the measured cytokines, only granulocyte-macrophage colony-stimulating factor (GM-CSF), keratinocyte-derived chemokine (KC)-like and interleukin (IL)-8 were above the limit of quantification in most samples. Absolute amounts of each cytokine were always higher in samples obtained with method A than with method B. GM-CSF amounts were lower in atopic dogs (method A, P=0.02; method B, P=0.0005). KC levels were higher in atopic dogs, yet the differences were not significant. IL-8 amounts were higher in atopic dogs (method A, P=0.0003; method B, P=0.006).

CONCLUSIONS AND CLINICAL RELEVANCE

Regardless of the method, these preliminary results suggest an overexpression of IL-8 in conjunctivae and tears of atopic dogs despite subtle conjunctival symptoms. As IL-8 is commonly found in many inflammatory conditions, further studies are needed to determine its specificity in atopic conjunctivitis.

Blepharitis in dogs: a clinical evaluation in 102 dogs

BACKGROUND

Blepharitis is a common finding in many dogs with various skin diseases.

OBJECTIVES

To establish a definition for canine blepharitis versus periocular dermatitis (POD), to evaluate the clinical findings and underlying skin diseases of blepharitis, and to document the effects of blepharitis on tear production in dogs.

ANIMALS

One hundred and two privately owned dogs with clinical signs of blepharitis and a definitive diagnosis of skin disease.

METHODS AND MATERIALS

Prospective evaluation of clinical signs and underlying diseases in dogs with blepharitis alone compared to dogs with blepharitis and POD.

RESULTS

Brachycephalic dogs were significantly more likely to present with blepharitis than other breeds. Twenty five dogs had blepharitis alone [three dogs (2.9%) without and 22 dogs (21.5%) with cutaneous lesion beyond the periocular skin]. Seventy one of 102 (69%) presented with POD in addition to blepharitis. In six cases a differentiation between blepharitis and POD was not possible. Typical lesions included alopecia/hypotrichosis (97%), erythema (93%), eyelid oedema (50%) and crusts (39.2%). Allergic skin disease (52%) was the most common underlying cause of blepharitis, followed by infectious/parasitic diseases (21.5%), autoimmune disorders (17.7%) and neoplasia (4.9%). Four dogs could not be allocated to any of these disease groups. A diagnosis of parasitism was always accompanied by POD. Reduced tear production was detected in ten of the 53 dogs tested (18.8%).

CONCLUSION

Blepharitis occurring in the absence of other skin lesions is rare. The most common underlying cause of blepharitis is allergic dermatitis. Measurement of tear production should be recommended in all cases of blepharitis.

Bacterial contamination of slit lamps in veterinary ophthalmology

PURPOSE

Healthcare-associated infection (HAI) is a well-known problem in human medicine. The contamination of medical devices with pathogenic organisms is less studied in veterinary medicine. The purpose of this multicenter study was to evaluate the bacterial contamination of slit lamps throughout Europe and part of the United States. The efficacy of standard cleaning was additionally investigated.

METHODS

Samples from adjustment wheels of slit lamps were taken by different veterinary ophthalmologists and submitted for culture (n = 29). The efficacy of cleaning protocols was evaluated by taking a second sample after routine cleaning (n = 29). Sensitivity testing was performed for pathogenic bacteria using the minimum inhibitory concentration (MIC) or disc diffusion (Kirby-Bauer) method. Statistical analysis was performed using Fisher's exact test.

RESULTS

Seventeen of 29 slit lamps were contaminated before cleaning. The most frequently cultured bacteria were Staphylococcus spp. and coliform bacteria. Twelve of 29 slit lamps showed no bacterial growth before and after cleaning. There was a significant difference before and after cleaning (P = 0.0008), with only 4/29 contaminated samples after cleaning.

CONCLUSION

Contamination with pathogenic bacterial species is frequent in slit lamps used by veterinary ophthalmologists. A risk of cross-contamination in clinical patients has to be considered. Routine cleaning reduces bacterial contamination significantly.

Canine herpesvirus-1 ocular diseases of mature dogs

Canine herpesvirus-1 (CHV-1) is an alphaherpesvirus with a host range restricted to canids. Latent CHV-1 infection is endemic in domestic dog populations worldwide. The role of CHV-1 in severe systemic neonatal infections and as an aetiology of infectious infertility and abortion has been appreciated for decades; however, ocular diseases of mature dogs conclusively associated with CHV-1 infection were only recently described. Clinically, CHV-1 infection may produce a diverse range of adnexal and ocular surface lesions in mature dogs, including blepharitis, conjunctivitis, ulcerative keratitis, and nonulcerative keratitis. These conditions can develop during primary or recurrent ocular CHV-1 infection. Recurrent CHV-1 infections associated with reactivation of latent virus may be observed during a variety of situations and in association with numerous different viral reactivation stimuli, including the administration of immunosuppressive pharmaceuticals. The understanding of CHV-1 pathophysiology and ocular infections in mature dogs has expanded rapidly during the past few years, but much remains to be elucidated. As the number of dogs living with chronic immunomodulatory systemic diseases and receiving immunosuppressive therapeutics continues to grow, the clinical importance of CHV-1 ocular infections is also likely to increase.