Feline entropion: a case series of 50 affected animals (2003-2008)

Evaluation of photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) in feline infectious keratitis-patient demographics, treatment protocols, risk factors, and treatment outcome: a retrospective study

OBJECTIVES

To describe patient demographics and treatment protocols in a population of feline patients undergoing photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) as an adjunctive treatment for infectious keratitis. Furthermore, to determine the proportion of PACK-CXL treatment success in the population studied, explore risk factors for treatment failure, and provide recommendations for future PACK-CXL clinical studies.

MATERIALS AND METHODS

Records from four veterinary ophthalmology practices were reviewed to identify eligible patients and extract data. Recorded variables included patient-related factors, ocular examination findings, PACK-CXL protocol parameters, and treatment outcome.

RESULTS

Records for 153 cats (154 eyes) were included. Median age in the treatment success group was 8 years (interquartile range (IQR) 4-12), with a median ulcer depth of 30% (IQR 30-40). Median age in the treatment failure group was 10.5 years (IQR 4.75-12) with a median ulcer depth of 45.9% (IQR 30-75). Persian cats were the most represented brachycephalic breed (52 out of 64 cats). Modified PACK-CXL protocols were used, including fast energy delivery (134 eyes), and increased fluence (52 eyes). The overall proportion of success was 88% (95% CI 84-93), which was variable between clinics. Eighty-two of 89 mesocephalic cat eyes (92%), and 54 of 65 brachycephalic cat eyes (83%) were classified as treatment successes.

CONCLUSIONS

PACK-CXL appeared to be a useful, adjunctive therapeutic modality for the treatment of infectious keratitis in the feline patient population presented here. Brachycephalic cats, older cats, and those with deeper ulcers may be at increased risk for treatment failure.

Long-term treatment outcomes and risk factors for recurrence in feline corneal sequestrum: 72 cases (2009-2017)

BACKGROUND

This study aimed to evaluate long-term treatment outcomes in feline corneal sequestrum (FCS), compare the recurrence rates between different surgical techniques, identify possible recurrence risk factors and monitor the development of FCS in the contralateral eye.

METHODS

The medical records of 72 cats (79 eyes) with FCS treated between 2009 and 2017 were retrospectively analysed.

RESULTS

The most commonly affected breeds were Persian, domestic shorthaired and Burmesecats. The mean age was 6.9 years. Sixty-five cats (90%) were affected unilaterally. Sixty-six eyes (83%) underwent surgery: keratectomy in 34 eyes (52%) and keratectomy followed by a graft procedure in 32 eyes (48%). Recurrence occurred in 13 out of 66 eyes (19%) at a median of 245 days after surgery. Skull conformation, location of the FCS, type of surgical procedure and concurrent ocular surgery did not significantly affect the recurrence rate. Eighteen cats (27%) developed FCS in the contralateral eye at a median of 635 days after surgery.

LIMITATIONS

Limitations are related to the retrospective nature of the study, the use of telephone follow-up for assessment of recurrence in some cats and the small number of cases.

CONCLUSIONS

Surgical excision had a successful outcome in most cases. The type of surgical procedure and skull conformation did not affect the recurrence rate. One-quarter of the cats developed FCS in the contralateral eye.

Prevalence of feline ophthalmic disorders in South Korea: a retrospective study (2009-2021)

OBJECTIVES

This study aimed to determine the prevalence and clinical presentation of ocular diseases in cats in South Korea.

METHODS

Medical records of cats that were presented for ophthalmology services at Seoul National University Veterinary Medical Teaching Hospital between 2009 and 2021 were reviewed. Collected data included patient signalment, clinical signs, diagnosed ophthalmic disorders and affected eyes. Odds ratios were calculated when a variable was over-represented.

RESULTS

This study recorded a total of 358 eyes (180 cats). Domestic shorthair (DSH) was the most common breed (42.2%), followed by Persian (13.9%) and Scottish Fold (8.3%); 14 (35.6%) other breeds were recorded. The median age at the first presentation was 3 years (range 2 months to 17 years); the highest percentage of cats presented at <1 year (21.7%). The most affected ocular structure was the cornea (28.5%), followed by the lens (19.9%) and uvea (15.3%). The most frequently reported disorders were corneal ulceration (13.2%), uveitis (11.9%), incipient cataract (11.0%), keratitis (5.4%), secondary glaucoma (5.2%) and sequestrum (4.2%). The Exotic Shorthair breed was significantly over-represented with regard to entropion and periorbital fat prolapse (P <0.01). The DSH breed was significantly over-represented with regard to eyelid agenesis (P <0.01).

CONCLUSIONS AND RELEVANCE

This study provides prevalence information for feline ophthalmic diseases and could contribute important data for diagnosing, treating and preventing feline ophthalmic diseases in South Korea.

Epidemiology and clinical presentation of feline presumed hereditary or breed-related ocular diseases in France: retrospective study of 129 cats

OBJECTIVES

This study aimed to describe the epidemiology and clinical presentation of presumed hereditary or presumed breed-related ocular diseases in a population of cats in France.

METHODS

Medical records from between September 2013 and August 2017 were reviewed to identify cats with at least one presumed hereditary or breed-related ocular disease. Cats with concurrent, or a history of, ocular or systemic infectious diseases were excluded. Signalment, history and clinical findings were recorded.

RESULTS

Of the 1161 cats that presented to our institution during the study period, 129 were diagnosed with at least one presumed hereditary or presumed breed-related ocular disease (11.1%, 95% confidence interval [CI] 9.3-12.9). Five ocular abnormalities had a prevalence of >1%: entropion, corneal sequestration, persistent pupillary membrane, cataract and retinal dysplasia. The prevalence of entropion was 2.2% (95% CI 1.3-3.0), with Persians (P = 0.03), Maine Coons (P <0.01) and male cats (P <0.01) being over-represented. The prevalence of corneal sequestration was 2.4% (95% CI 1.5-3.3), with Persians (P <0.01) and Exotic Shorthairs (P = 0.02) being over-represented. Persistent pupillary membranes and cataracts had the same prevalence of 2.3% (95% CI 1.5-3.2), with no particular sex or breed significantly over-represented. Retinal dysplasia had a prevalence of 1.6% (95% CI 0.8-2.3) and Persian cats were over-represented (P = 0.04). Anterior segment dysgenesis had a low prevalence (0.9%, 95% CI 0.4-1.5), with all affected cats being domestic shorthairs and this breed therefore was over-represented (P = 0.04).

CONCLUSIONS AND RELEVANCE

In a French population of cats, presumed hereditary or breed-related ocular diseases accounted for 11.1% of all ocular diseases. Cataracts, corneal sequestration, persistent pupillary membrane, entropion and retinal dysplasia were the most common conditions. Statistical breed over-representation was observed for entropion, corneal sequestration and retinal dysplasia. We recommend that more systematic screening of feline species is conducted.

Prevalence and characteristics of ocular diseases in Sphynx cats: A retrospective assessment (2012-2021) and comparison with non-Sphynx cats

PURPOSE

To describe the prevalence of ocular diseases in Sphynx cats, and compare disease characteristics with other feline breeds.

METHODS

Medical records of Sphynx cats presented to an ophthalmology referral center between 1/2012 and 4/2021 were examined. Cats of other breeds examined during the same period served as controls.

RESULTS

One hundred ten Sphynx cats were examined during the study period, diagnosed with corneal sequestrum (n = 42 cats), lower eyelid entropion (n = 25), presumed herpetic keratoconjunctivitis (n = 19), conjunctivitis (n = 7), corneal ulcers (n = 6), nasolacrimal duct atresia/obstruction (n = 6), corneal dystrophy (n = 3), eosinophilic keratitis (n = 2), uveitis (n = 2), non-ulcerative keratitis (n = 1), and cataract (n = 1). Corneal sequestrum was significantly more common in Sphynx versus non-Sphynx cats (odds ratio = 8.0, 95% CI = 5.3-12.2, p < .001), and age of diagnosis was significantly younger in Sphynx cats (2.0 ± 1.5 years vs. 5.9 ± 4.0 years, p < .001). Corneal sequestrum recurrence was noted in 19.4% Sphynx eyes and 6.4% non-Sphynx eyes undergoing surgery (p = .015). Lower eyelid entropion-most often bilateral (80%)-was significantly more common in Sphynx versus non-Sphynx cats (odds ratio = 4.1, 95% CI = 2.3-7.1, p < .001), and age of diagnosis was significantly younger in Sphynx cats (0.9 ± 1.4 years vs. 3.5 ± 3.3 years, p < .005).

CONCLUSIONS

Corneal sequestrum and entropion were overrepresented and diagnosed at an earlier age in Sphynx cats when compared with the general feline population. Given the high prevalence, early age of onset, and relatively high recurrence of corneal sequestrum in Sphynx cats, further studies are warranted to better understand etiopathogenesis and preferred therapies.

Lamellar Keratoplasty Using Acellular Bioengineering Cornea (BioCorneaVetTM) for the Treatment of Feline Corneal Sequestrum: A Retrospective Study of 62 Eyes (2018–2021)

Simple Summary

Corneal sequestrum is a specific and common corneal disease in cats. Surgery treatment is the recommended option. Acellular bioengineering cornea (ABC) is a popular and effective corneal transplantation material. However, no study has been published to evaluate the effectiveness and outcome of ABC lamellar transplantation for the treatment of feline corneal sequestrum (FCS). The purpose of this retrospective study was to evaluate the surgical effect of ABC lamellar transplantation in the treatment of FCS. All cats were diagnosed with FCS. All eyes received ABC lamellar transplantation for the first time, including 61 cats (62 eyes), aged 6–120 months. The average sequestrum size was 7.98 mm, with a medium of 7.75 mm (range, 4.75–11.75 mm), and the sequestrum thickness included 200 microns for 1 eye (1.61%), 300 microns for 28 eyes (45.16%), 400 microns for 29 eyes (46.77%), and 450 microns for 4 eyes (6.45%). All eyes retained vision after surgical treatment, and there was no recurrence during the follow-up period. This study has several limitations, including incomplete unification and standardization of data collection, some vacancies of follow-up time, inconsistency between then optical coherence tomography(OCT) examination and postoperative photo collection. Despite several limitations, our results show that ABC is easy to obtain and store, and has the choice of different sizes and thicknesses to achieve rapid corneal healing, and satisfactory visual and cosmetic effects in FCS treatment. Acellular bioengineering cornea can be a good alternative for the treatment of FCS.

Abstract

To retrospectively evaluate the effectiveness and outcome of lamellar keratoplasty using acellular bioengineering cornea (BioCorneaVet^TM) for the treatment of feline corneal sequestrum (FCS). The medical records of cats diagnosed with FCS that underwent lamellar keratoplasty with BioCorneaVet^TM between 2018 and 2021 with a minimum of 3 months of follow-up were reviewed. Follow-up examinations were performed weekly for 3 months, and then optical coherence tomography (OCT) examination was performed on select patients at 0, 3, 6, and 12 months post-operatively. A total of 61 cats (30 left eyes and 32 right eyes) were included. The Persian breed was overrepresented, 48/61 (78.69%). Four different thicknesses of acellular bioengineering cornea were used (200, 300, 400, or 450 microns), and the mean graft size was 8.23 mm (range, 5.00–12.00 mm). Minor complications were composed of partial dehiscence, and protrusion of the graft occurred in 7/62 eyes (11.29%). The median postoperative follow-up was 12.00 months (range, 3–41 months). A good visual outcome was achieved in 60/62 eyes (96.77%), and a mild to moderate corneal opacification occurred in 2/62 (3.23%). No recurrence of corneal sequestrum was observed. From the results, lamellar keratoplasty using acellular bioengineering cornea (BioCorneaVet^TM) is an effective treatment for FCS, providing a good tectonic support and natural collagen framework, and resulting in satisfactory visual and cosmetic effects.

Autologous lamellar keratoplasty for the treatment of feline corneal sequestrum: A retrospective study of 35 eyes (2012-2020)

OBJECTIVE

To evaluate the use of autologous lamellar keratoplasty for the treatment of feline corneal sequestrum (FCS).

PROCEDURE

The medical records of cats diagnosed with FCS that underwent autologous lamellar keratoplasty between 2012 and 2020 with a minimum of 2 months of follow-up were reviewed. After keratectomy of FCS, a button adjacent to the corneal limbus was harvested on the same eye and sutured to the recipient bed. A nictitating membrane flap was left in place until the first recheck except for one patient. Postoperative treatment with topical and systemic antibiotics and systemic nonsteroidal anti-inflammatory medications was prescribed. Follow-up examinations were carried out 2 weeks, 1 month and 2 months post-operatively and consisted of a complete ophthalmic examination.

RESULTS

A total of 35 cats (35 eyes) were included. The median follow-up time was 3.2 months (range, 2-59 months). Brachycephalic cats were overrepresented (85.7%). The mean graft size was 6.5 mm (range, 6-9 mm). Minor complications consisting of melting and partial integration of the graft occurred in 2/35 eyes (5.7%). Recurrence was observed in 1/35 eyes (2.9%) and was managed by a superficial keratectomy. A good visual outcome was achieved in all eyes, and a faint or mild corneal opacification occurred in 15/35 (42.9%).

CONCLUSIONS

Autologous lamellar keratoplasty is an effective treatment for FCS, providing good tectonic support to the affected cornea and resulting in good visual and cosmetic outcomes. These results should be verified in future prospective studies that include a larger number of cases and longer-term follow-up.

Facial conformation characteristics in Persian and Exotic Shorthair cats

OBJECTIVES

The primary objectives of the study were to examine the diversity in facial conformation characteristics within a group of Persian (PER) and Exotic Shorthair (EXO) show cats, and to contrast the results to findings within a group of non-purebred domestic shorthair (DSH) and domestic longhair (DLH) cats. The secondary objectives were to determine the PER/EXO show cat owners' perceptions of the breathing status of their cats, and to evaluate if remarks from the cat show judges concerning the cats' head and facial conformation were exclusively related to the aesthetic features of the cats.

METHODS

Sixty-four PER and 12 EXO show cats were prospectively examined at five international cat shows, and 20 DSH/DLH cats were examined at an animal hospital. Facial conformation characteristics were evaluated by examining photos of the cats. Owners of the PER/EXO show cats answered a questionnaire concerning their cats' health status, and they were encouraged to send in the judges' score sheets from the cat shows.

RESULTS

The PER/EXO show cats had higher diversity in facial conformation characteristics than the DSH/DLH cats, and high incidences of hypoplasia of the nose leather (95%), the nose leather top positioned above the level of the lower eyelid (93%), moderate-to-severe stenotic nares (86%), epiphora (83%) and entropion (32%). Owners of 6/76 PER/EXO show cats stated that their cat had increased respiratory sounds and/or trouble breathing at least once a week. The cat show judges' written comments were exclusively related to aesthetic features of the cats' head and facial conformation details.

CONCLUSIONS AND RELEVANCE

Hypoplasia of the nose leather, high position of the nose leather top, stenotic nares, epiphora and entropion were common findings in the PER/EXO show cats but not in the DSH/DLH cats. Few of the cat owners perceived that their cat had problems related to the airways.

Persian cats under first opinion veterinary care in the UK: demography, mortality and disorders

Persian cats are a popular cat breed worldwide, and especially in the US, Europe and Asia. This study aimed to describe the demography, common disorders and mortality in Persians under general practice veterinary care in 2013 in the UK. The study population of 285,547 cats overall included 3235 (1.1%) Persians. Mean adult Persian bodyweight was 3.9 kg (SD 0.9) and median age was 7.0 years (IQR 3.3–11.6). At least one disorder was recorded in 2099 (64.9%) Persians. The most common specific disorders were haircoat disorders (411, 12.7%), periodontal disease (365, 11.3%), overgrown nails (234, 7.2%), and ocular discharge (188, 5.8%). The most common disorder groups were dermatological (578, 17.9%), ophthalmological (496, 15.3%) and dental (397, 12.3%). Median longevity was 13.5 years (IQR 9.9–16.0). The most common grouped causes of death were renal disease (102, 23.4%), neoplasia (37, 8.5%) and mass-associated disorder (35, 8.0%). This is the first study to use general practice data to examine the overall health of Persian cats. With haircoat, ocular and dental disorders being the predominant disorders identified, this study highlights the need for increased owner awareness to manage and prevent the typical health problems associated with this breed’s phenotype.

Motivation of Owners to Purchase Pedigree Cats, with Specific Focus on the Acquisition of Brachycephalic Cats

Background: Cats are globally popular pets and pedigree cats are increasingly prevalent, with brachycephalic breeds being the most registered breeds. How owners decide upon and acquire their cats is poorly understood. Moreover, there are growing concerns about the health and welfare of brachycephalic (BC) dogs and recent studies are raising the awareness of health and welfare problems in BC cats. Methods: An online survey investigated owners' motivations, perceptions and behaviours prior to, during and following acquisition of non-pedigree (NP), extreme brachycephalic pedigree (BC; i.e., Persian and Exotic Shorthair) and mild to non-BC pedigree (P) cats. Results: The survey received 1367 valid responses (NP n = 882, P n = 400, BC n = 85 (6.2%)). There were marked differences between NP, P and BC owners' perception of their cats' health and welfare, reason(s) for acquisition and its process. Owners of NP were less influenced by appearance, behaviour and other features than P or BC owners. In contrast, P and BC owners were highly influenced by appearance, with P owners also placing greater importance on good breed health than BC owners. BC owners were less likely to recommend their breeds to prospective cat owners, apparently concerned by high maintenance requirements. Conclusion: Further research is needed to determine how decision-making is constructed and how it may be improved, especially in respect of welfare outcomes for extreme BC cats given the increased weighting given to appearance over health.

Consider the eye in preventive healthcare - ocular findings, intraocular pressure and Schirmer tear test in ageing cats

OBJECTIVES

Geriatric health screening in cats is highly recommended. However, information about normal and abnormal findings is scarce, especially regarding the eyes of ageing cats. This prospective study examined the influence of the ageing process on vision and ocular structures in older cats.

METHODS

A total of 209 cats (aged 9-24 years) underwent physical examination, vision assessment, slit lamp biomicroscopy and ophthalmoscopy. Systolic blood pressure (SBP) measurement, Schirmer tear test (STT) reading and rebound tonometry were performed. Systemic disease was not a criterion for exclusion.

RESULTS

Vision was good in 157/209 cats (75.1%) and impaired in 52/209 cats (24.9%). Increasing age and the occurrence of vision impairment were not statistically associated ( P = 0.053). Retinal oedema, retinal haemorrhage and/or retinal detachment (19 cats) and glaucoma (12 cats) were the most common findings in vision impaired cats. Increasing age was significantly associated with the occurrence of lenticular sclerosis ( P = 0.01) and attenuated retinal vessels ( P = 0.02). Increasing age and SBP were significantly associated with the occurrence of retinal detachment, haemorrhage and oedema ( P <0.001 each). In cats without evidence of hypertensive ocular damage, younger cats had a tendency for higher SBP values than older cats, although this difference was not significant. Mean intraocular pressure (IOP) was 16.5 ± 5.0 mmHg. Age did not significantly affect the IOP values ( P = 0.54). Mean STT was 15.8 ± 4.8 mm/min. The STT was found to increase with age ( P = 0.025).

CONCLUSIONS AND RELEVANCE

Although vision impairment is not a clinical sign of old age in cats, age-related changes may contribute to vision-threatening diseases. This study contributes to preventive healthcare by examining the influence of the ageing process on vision and ocular structures in older cats.

A review on ocular findings in mouse lemurs: potential links to age and genetic background

Mouse lemurs, the world's smallest primates, inhabit forests in Madagascar. They are nocturnal, arboreal and dependent on vision for their everyday lives. In the last decades, the grey mouse lemur became increasingly important for biomedical research, in particular aging research. Experiments which require the combination of visual fitness and old age consequently depend on a solid knowledge of ocular pathologies. Although ocular diseases in mouse lemurs have been described as being common, they have not received much attention so far. Yet it is important to know when and why ocular diseases in captive mouse lemurs may occur. This review aims to provide a comprehensive overview of known ocular findings in mouse lemurs. It summarizes the frequency of ocular findings in captive mouse lemur colonies and points to their likely causes and treatment options based on the evidence available from other animals and humans. In addition, it shall be discussed whether age or genetic background may affect their development. This review may be used as a reference for future studies which require an assessment of visual performance in mouse lemurs and help to evaluate observed clinical signs and ocular diseases. Furthermore, the high incidence of specific diseases may provide new perspectives and set the groundwork for a new animal model for ocular research.

Health and Behavioral Survey of over 8000 Finnish Cats

A comprehensive feline health survey was conducted to reveal breed-specific inheritable diseases in Finnish pedigree cats for genetic research. Prevalence of 19 disease categories and 227 feline diseases were defined in a study population of 8175 cats belonging to 30 breeds. Dental and oral diseases, with a prevalence of 28%, and dental calculus and gingivitis (21 and 8%, respectively) were the most prevalent disease category and diseases among all cats and in most of the breeds. An exception was Korats, which were more often affected by the diseases of the respiratory tract (23%) and asthma (19%). Other prevalent disease categories affected various organ systems, such as the skin (12%), the urinary system (12%), the digestive tract (11%), eyes (10%), the musculoskeletal system (10%), and genitals of female cats (17%). Prevalent health or developmental issues included repetitive vomiting (4%), tail kink (4%), feline odontoclastic resorption lesion (4%), urinary tract infections (4%), as well as cesarean section (6%) and stillborn kittens (6%) among female cats. We found 57 breed-specific conditions by Fisher’s exact tests and logistic regression analyses, including 32 previously described and 19 new breed-specific diseases. The genetic defect has already been found in six of them: polycystic kidney disease, progressive retinal atrophy, hypertrophic cardiomyopathy, and three types of tail malformations. Behavioral profiling revealed breed-specific traits, such as an increased human avoidance in British Short and Longhairs and a higher level of aggression in Turkish vans. Our epidemiological study reveals the overall health profile in Finnish pure and mixed breed cats and identifies many breed-specific conditions without molecular identity for genetic research.

Nonsutured Hotz-Celsus technique performed by CO2 laser in two dogs and two cats

It is described a new version of modified Hotz-Celsus technique performed in four patients, two cats and two dogs. The surgery was carried out using CO(2) laser in order to avoid bleeding and decrease the anesthetic time. Besides, the wound created was not sutured and it healed by secondary intention without any complication. As a conclusion, this modification is a successful alternative to treat entropion in a safe and fast way.

Modified Kuhnt-Szymanowski surgical procedure for secondary cicatricial ectropion in a horse

A 1-year-old Dutch Warmblood gelding was presented to the University of Florida's Large Animal Hospital (UF-LAH) for correction of ectropion of the right lower eyelid. The ectropion was the result of a lower eyelid laceration. A primary repair was performed by the referring veterinarian; however, the horse prematurely removed the sutures and the wound healed with inversion of the eyelid margin. Surgical correction of the entropion, with removal of tissue from the lower eyelid, resulted in cicatricial ectropion. During the initial evaluation at UF-LAH, a corneal ulcer was noted in the right eye because of exposure from the anatomically nonfunctional lower eyelid. A modified Kuhnt-Szymanowski procedure was performed to correct the ectropion and repair the eyelid margin. The surgical site healed appropriately with an acceptable cosmetic and functional result. No recurrences of corneal ulcers in the right eye were reported in the 18 months following surgical correction of the ectropion.

Treatment of corneal ulcers: when is surgery indicated?

PRACTICAL RELEVANCE

While corneal ulcers in cats frequently arise secondarily to feline herpesvirus (FHV-1) infection, and thus medical therapy is often indicated, other causes include trauma, eyelid abnormalities (agenesis, entropion, dermoids and neoplasia), tear film abnormalities and neurological deficiencies (trigeminal nerve paralysis or facial nerve paralysis). In some such cases, surgery is required. Treatment always needs to be tailored carefully according to the depth and progression of the ulcer, any concurrent ophthalmic disease, the patient's general health and demeanour, and owner compliance and financial circumstances.

PATIENT GROUP

All age groups and breeds can suffer with ulcerative keratitis although some breeds are over-represented for some types of corneal ulceration.

EVIDENCE BASE

The scientific literature on feline ulcerative keratitis is extensive. This article reviews the surgical indications for corneal ulceration in cats with reference to the current evidence base.