Severe Corneal Edema in a Dog Naturally Infected by Leishmania spp.

Background: Visceral leishmaniasis (VL) is an infectious disease caused by the protozoan Leishmania infantum that is transmitted to dogs and humans by sandflies. The incidence of eye injuries in VL is high. They occur in 20 to 81% of infected dogs and include blepharitis, granulomatous conjunctivitis, scleritis, keratitis, anterior uveitis, keratoconjunctivitis sicca, and secondary glaucoma. However, some dogs present only the clinical signs of eye damage. The main objective of this manuscript is to report a case of anterior uveitis with severe corneal edema in a dog with VL that underwent clinical and surgical ophthalmic treatments after miltefosine therapy.Case: An 8-month-old, intact male Labrador Retriever with brown fur presented with pruritus, diffuse desquamation, and conjunctival hyperemia on physical evaluation. On the basis of an ophthalmic examination, nodular conjunctivitis and uveitis were diagnosed in both eyes. Moreover, laboratory examination results showed hyperproteinemia, increased serum alkaline phosphatase activity, and positive reactions to immunochromatographic tests for VL. Clinical treatment was instituted from the moment of diagnosis, when miltefosine and allopurinol were prescribed. At the end of treatment, based on laboratory examination results, only allopurinol was prescribed at a lower dose than initially prescribed for treatment continuation. Topical medications (prednisolone eye drops and sodium hyaluronate) were recommended for the ophthalmic changes. One week after the start of topical treatment, the dog showed an improvement in eye inflammation but still had bilateral corneal edema. A hyperosmotic agent was prescribed to improve edema, and a surgical procedure was recommended if there was no improvement. The physician opted for the surgical procedure in one of the eyes that had not shown significant improvement after the clinical treatment.Discussion: VL is a zoonosis, and the domestic dog is the main reservoir. These animals often have dermatological conditions, and the ophthalmic changes observed can be unilateral or bilateral, with more than one change in the same eye. Lymphoplasmacytic or granulomatous anterior uveitis is the most prevalent change, as the uvea and conjunctiva are important lymphoid areas of the eye; this also explains the high incidence of uveitis and conjunctivitis in dogs with VL. In uveitis, corneal edema is driven by endothelial cell damage induced by prostaglandins, which interfere with the function of the endothelial pump and interrupt the normal dehydrated state of the cornea. Severe corneal edema can result in the formation of fluid-filled multifocal bubbles in the corneal stroma—a condition called bullous keratopathy. These bubbles accumulate under or inside the corneal epithelium, and they can burst spontaneously, leading to corneal erosions or ulcerations. Drug therapy with hyperosmotic agents could, in principle, reduce the formation of bubbles. Surgical options to decrease edema and blistering include a permanent conjunctival graft or thermokeratoplasty. Thermokeratoplasty induces the formation of superficial scars in the corneal stroma, applying multiple cauterization foci to the stroma exposed in the areas of bullous keratopathy and epithelial ulceration. In conclusion, the surgical therapeutic choice results in better visual quality in patients who do not respond well to clinical treatment

Peripheral Nerve Sheath Tumor in the Upper Eyelid in a Dog

Background: Schwannomas are benign neurogenic tumours of peripheral nerves. They originate from Schwann cells, which form the neural sheath.Peripheral nerve sheath tumors are most commonly found on the head and neck regions of both dogs and people. Schwannomas are rarely observed in ophthalmic areas. When they occur, ocular Schwannomas are usually located in the orbit, uveal tract and conjunctiva. The occurrence of uveal schwannoma, a subset of PNST has been well documented in the veterinary literature. This is the first report of a palpebral PNST in the dog. The lip-to-lid flap is a feasible technique to reconstruct the upper eyelid following wide surgical removal of a tumor in the dog.Case: A 9-year-old, spayed female mixed-breed dog was referred for evaluation of a large mass involving the right upper eyelid for a duration of approximately one month. The inspection revealed sero-sanguinolent discharge and an oval-shaped mass occupying more than 70% of the right upper eyelid. The dog was alert and the ophthalmic and general physical examination did not revealed abnormalities. Ocular ultrasonography did not show significant findings. A fine-needle aspirate of the palpebral tumor was not elucidative, even so, a presumptive diagnosis of eyelid neoplasia was considered most likely. Excision of the entire mass with a 2 cm margin was performed. The third eyelid and dorso-medial bulbar conjunctiva were also removed. Upper eyelid reconstruction was performed based on a similar technique previously described in cats (lip-to-lid flap). As a result, neoplastic spindle cells exhibited immunoreactivity for S100 and intense cytoplasmic staining for vimentin, supporting the diagnosis of schwannoma. Fifteen days later, the margins of the subdermal pattern flap were healed and skin sutures were removed. On the last follow-up, 9 months post-surgery, the dog was visual, and the flap was well incorporated and covered the ocular surface. Ten months later, another large mass arising from the right inferior palpebral conjunctiva was observed. Once ultrasound revealed orbital invasion exenteration combined with orbitectomy were performed, and the defect was covered with an auricular axial pattern flap. Although the second tumor had the same histological and immunohistochemical characteristics of the first mass additional staining for Ki67 was used to investigate the biological behavior of both masses.Discussion: Reported eyelid neoplasms in dogs include adenomas and adenocarcinomas of the meibomian glands, melanomas, fibroma, fibrosarcoma, histiocytoma, mastocytoma, lipomas, papillomas, and squamous cell carcinomas. To the author´s knowledge, however, this is the first case description of a PNST affecting the eyelid in a dog. The histologic distinction between PNSTs and other spindle cell tumors, including myxosarcoma, fibrosarcoma, leiomyosarcoma, hemangiopericytoma, and melanoma can be challenging and requires immunohistochemical stainin. S100 is an acidic protein that identifies various nervous tissue cells, including Schwann cells, and the majority of canine PNSTs diffusely express this molecule. As in the case presented here, neoplastic cells of different ocular and adnexal structures were also positive for S100 and vimentin in all PNSTs previously reported in the veterinary literature. This is the first report of PNST affecting the eyelid in a dog. The lip-to-lid flap is a feasible technique to reconstruct the upper eyelid following wide surgical removal of a tumor in dogs. However, the authors suggest radical surgery combining orbitectomy, exenteration and a miocutaneous flap if PNST is diagnosed in the eyelids of dogs. They also caution once recurrence is possible and can be more aggressive.Keywords: lip-to-lid transposition, S100, vimentin, desmin, Ki67, dog

Peripheral nerve sheath tumor in the upper eyelid in a dog

Background: Peripheral nerve sheath tumors are most commonly found on the head and neck regions of both dogs and people. Schwannomas are rarely observed in ophthalmic areas. When they occur, ocular Schwannomas are usually located in the orbit, uveal tract and conjunctiva. The occurrence of uveal schwannoma, a subset of PNST has been well documented in the veterinary literature. PNST has never been observed in the eyelids of dogs. Therefore, the present report aimed to describe the surgical treatment and outcome of a PNST located in the upper eyelid of a dog. Case: A 9-year-old, spayed female mixed-breed dog was referred for evaluation of a large mass involving the right upper eyelid for a duration of approximately one month. The inspection revealed sero-sanguinolent discharge and an oval-shaped mass occupying more than 70% of the right upper eyelid. A presumptive diagnosis of eyelid neoplasia was considered most likely. Excision of the entire mass with a 2 cm margin was performed. The third eyelid and dorso-medial bulbar conjunctiva were also removed. Upper eyelid reconstruction was performed based on a similar technique previously described in cats (lip-to-lid flap). As a result, neoplastic spindle cells exhibited immunoreactivity for S100 and intense cytoplasmic staining for vimentin, supporting the diagnosis of schwannoma. Fifteen days later, the margins of the subdermal pattern flap were healed and skin sutures were removed. On the last follow-up, 9 months post-surgery, the dog was visual, and the flap was well incorporated and covered the ocular surface. Ten months later, another large mass arising from the right inferior palpebral conjunctiva was observed. Once ultrasound revealed orbital invasion exenteration combined with orbitectomy were performed, and the defect was covered with an auricular axial pattern flap. The second tumor had the same histological and immunohistochemical characteristics of the first mass. Both tumors expressed Ki67; however, the PI in the second mass was higher (7.9%) than the first (3.4%). Discussion: Reported eyelid neoplasms in dogs include adenomas and adenocarcinomas of the meibomian glands, melanomas, fibroma, fibrosarcoma, histiocytoma, mastocytoma, lipomas, papillomas, and squamous cell carcinomas. To the author’s knowledge, however, this is the first case description of a PNST affecting the eyelid in a dog. The histologic distinction between PNSTs and other spindle cell tumors, including myxosarcoma, fibrosarcoma, leiomyosarcoma, hemangiopericytoma, and melanoma can be challenging and requires immunohistochemical stainin. S100 is an acidic protein that identifies various nervous tissue cells, including Schwann cells, and the majority of canine PNSTs diffusely express this molecule. As in the case presented here, neoplastic cells of different ocular and adnexal structures were also positive for S100 and vimentin in all PNSTs previously reported in the veterinary literature. This is the first report of PNST affecting the eyelid in a dog. The lip-to-lid flap is a feasible technique to reconstruct the upper eyelid following wide surgical removal of a tumor in dogs. However, the authors suggest radical surgery combining orbitectomy, exenteration and a miocutaneous flap if PNST is diagnosed in the eyelids of dogs. They also caution once recurrence is possible and can be more aggressive

Nasolacrimal Duct Neoplasm in a Bitch

Background: Nasolacrimal duct tumors are divided into primary and secondary, with primary tumors being rare in all species. Secondary involvement of the lacrimal sac and duct can occur from any skin lesion involving the eyelid and/or conjunctiva and from any neoplastic process involving the paranasal sinuses. Lacrimal sac metastatic lesions may originate from any distant site and include carcinomas or melanomas, with squamous cell carcinoma being the most common type. The objectives of the present report were to describe a case of squamous cell carcinoma in the nasolacrimal duct and to emphasize the importance of a good ophthalmic evaluation.   Case: A 16-year-old spayed bitch white poodle was presented to the veterinary clinic. The owner complained that the animal had epiphora and mucoid secretion in the right eye, eyelid hyperemia in both eyes, and sporadic sneezing with blood. On ophthalmic examination, the animal was initially diagnosed with nasolacrimal duct obstruction and right eye (OD) blepharitis and OU uveitis. Fourteen days after the first evaluation, the nasolacrimal duct region increased, with the presence of bloody secretion. Biomicroscopy showed nodules inside the lacrimal duct, in the punctum region. The animal was sedated to obtain a fragment of the nodule for histopathological analysis, and a subsequent oral cavity evaluation identified a nodule in the transition region between the 4th premolar and 1st molar, which was sent for cytology. Cytology of the medial corner region of the RE showed epithelial and mesenchymal cells with malignancy characteristics, and the biopsy was suggestive of malignant epithelial neoplasia (carcinoma). A surgical procedure for nodule resection was ruled out because bone involvement was extensive, and chemotherapy was selected. The patient died 2 months after the 1st consultation. The diagnosis was confirmed through necropsy via immunohistochemical tests, demonstrating squamous cell carcinoma (SCC) both in the mouth and the nasal and ocular sinuses. Discussion: The most common conditions affecting the nasolacrimal drainage system in dogs are those causing obstructions. These may be congenital, arising from a developmental defect of micropunctum or agenesis of the punctum, they may be acquired, arising from infection and inflammation. SCC is a malignant neoplasm originating in the stratified squamous epithelium. The predisposing factors in cats and dogs include lack of adnexal pigmentation and, possibly, chronic irritation of the ocular surface. A light coat is considered a relevant factor, especially in regions with little hair coverage. In addition to a mass lesion, other clinical signs of eyelid or ocular surface tumors may include epiphora, conjunctival vascular injection, mucopurulent ocular discharge, 3rd eyelid protrusion, conjunctival/corneal roughness or ulceration, and corneal neovascularization or pigmentation. Clinical presentations are nonspecific. Neoplasms, whether nasal and/or in the maxillary sinus, can invade the nasolacrimal duct and spread to the nasal cavity, and neoplasms in the nasal cavity can invade the nasolacrimal duct. Ophthalmic evaluation along with good inspection of the oral cavity is a useful tool in the diagnosis of eye neoplasms that may have effects on the oral cavity or vice versa due to the strong association between them. Early diagnosis is crucial for the clinical or surgical management of each case of ophthalmic neoplasia and for therapeutic success. Keywords: neoplasm, tumor, nasolacrimal duct, dog, eye. Título: Neoplasia de ducto nasolacrimal em uma cadela Descritores: neoplasia, tumor, canalículo lacrimal cão, olho.

Effects of 1% Topical Brinzolamide on Intraocular Pressure in Healthy Dogs

Background: Glaucoma is one of the most common causes of blindness in dogs, and is generally characterized by death of the retinal ganglion cells associated with a rapid loss of vision. Increased intraocular pressure (IOP) occurs in patients with primary glaucoma, due to genetic abnormalities in pectinal ligaments and the trabeculae of the iridocorneal angle, producing inadequate drainage of aqueous humor. IOP is the result of the dynamic equilibrium between the production and drainage of aqueous humor. Intraocular surgery, anterior lens luxation, systemic diseases, immune-mediated, neoplastic and infectious diseases lead to the breakdown of the blood-aqueous barrier and increase the amount of protein and cells in aqueous humor, which can block this drainage pathway. Under these conditions, becomes indispensable the pharmacological control of IOP by reducing aqueous humor production. The main objective of the present study was to evaluate the effects of topical 1% brinzolamide on intraocular pressure (IOP) in twelve healthy dogs.Materials, Methods & Results: The age range of affected dogs was 1-5 years, with a mean age of 2.5 years. Twelve dogs were included in this study. All animals were healthy based on clinical, ophthalmic and hematological examinations. Selected animals were kept in a room with 500 lux luminosity, 56.8% relative humidity, 20°C temperature, exposed to 12 h of light/dark cycle, were fed twice daily and water ad libitum. All animals were adaptation to the procedures and examiners and IOP was measured by applanation tonometry at 08:00 a.m., 11:00 a.m., 02:00 p.m., 05:00 p.m., and 08:00 p.m., for 7 days and 2 days of baseline. Subsequently, one eye of each dog was randomly assigned, the eye received one drop of 1% brinzolamide at 08:30 a.m., 02:30 p.m., and 08:30 p.m. during four consecutive days and adelfo eyes received one drop of sterile saline solution and were considered control eyes. During the treatment phase and on the day after the treatment had finished, all parameters were evaluated in a blind fashion at the same pre-established time points. The value for IOP during the baseline of the treated eye were 16.77 ± 0.22 mmHg. The baseline period, values did not differ significantly between treated and control eyes. Comparison between the first day of brinzolamide-treated eyes with the average daily values of the two days of the baseline period showed that IOP decreased significantly 8.88%. IOP after four days of daily instillations of brinzolamide was able to decrease overall IOP by 1.42 mmHg (8.47%) when compared with the baseline period. Overall IOP values in the brinzolamide-treated eyes decreased 1.02 mmHg (6.24%) when compared to the control eyes. There were no statistically significant differences when compared control eye to baseline. Three times daily instillations of 1% brinzolamide in healthy dogs significantly decrease 8.47% IOP. During the post-treatment period, the average daily values of the brinzolamide-treated eyes remained 1.52 mmHg below the average daily values observed at baseline period.Discussion: The present research showed that, the average daily IOP values in the brinzolamide-treated eyes decreased 1.49 mmHg (8.88%) at the end of the first day, 1.69 mmHg (10.07%) at the end of the fourth day, and the cumulative IOP values after four days of treatment, were able to decrease by 1.42 mmHg (8.53%). Three times daily instillations of 1% brinzolamide in healthy dogs significantly decrease IOP, and therefore may be indicated to management of intraocular hypertension and glaucoma

Parasitism by Dioctophyma renale in a Dog: Clinical and Surgical Aspects

Background: Dioctophimosis is a parasitic disease caused by Dioctophyma renale, more commonly known as "giant Kidney worm," and can be found in other organs or free in the abdominal cavity, which is related to the patient's eating habits. Most of the animals affected are asymptomatic. The diagnosis is made through ultrasonography, finding eggs of the parasite in the urine, or necropsy. The treatment of choice is nephrectomy of the affected kidney. We aimed to report the accidental diagnosis of parasitism by D. renale in an 8-year-old dog, which was surgically treated by nephrectomy of the right kidney after evident destruction of the renal parenchyma on ultrasonography.Case: An 8-year-old Boxer female dog underwent a physical examination and showed a mass in the region of the left caudal thoracic breast, bilateral alopecia on flanks, and purulent ocular secretions. Laboratory tests of complete blood count (CBC) and serum biochemical profile, X-ray examination, and ultrasonography were requested. Anemia was observed on the erythrogram, and enzymes (creatinine, urea, alanine aminotransferase [ALT], and albumin) were within normal limits. There were no abnormalities on X-ray examination, and abdominal ultrasonography showed slight splenomegaly, enlarged left kidney, reduced corticomedullary region, measuring approximately 7.63 cm longitudinally. In the right kidney, loss of the renal parenchyma, measuring approximately 5.49 cm in diameter and the presence of a cylindrical and rounded structure, typical of D. renale infection. After this, a urinalysis was suggested, which revealed the presence of the helminthic eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affected kidney as treatment. The kidney showed destruction of the renal parenchyma. A single parasite was removed, measuring approximately 46 cm in length. The patient was successfully treated and was hospitalized for 4 days for observation and evaluation of function of the contralateral kidney.Discussion: The parasitic infection of the animal was due to the ingestion of fish contaminated by the aquatic anelid Lumbriculus variegatus, and the reported patient had access to home-cooked food and ingested water near the farm. D. renale is the largest nematode capable of parasitizing the kidney, reaching up to 100 cm in length, and was 46 cm long in the present case. Usually, when there is unilateral involvement, the vast majority of parasitized animals do not present clinical signs or show nonspecific signs such as hematuria and apathy, or as observed in the present case, the patient is asymptomatic. The diagnosis often occurs through ultrasonography and urine tests, which are considered essential to diagnose the parasite, but the diagnosis is often made on necropsy. Due to its proximity to the duodenum, the parasite is usually found in the right kidney, and it may be found in other organs as well. In the present case, the parasite was found in the right kidney of the patient. Usually, hypertrophy of the contralateral kidney (7.86 cm in this case) is observed on ultrasonography, which is a compensatory mechanism for the lack of normal function of the affected kidney of the affected kidney. The case occurred in the state of Mato Grosso, where there are no records of parasitism by D. renale in domestic dogs, compared with other states. Since the parasite usually affects the kidney, the treatment of choice is nephrectomy, especially if the other kidney can compensate for the absence of the other kidney, a technique that proved to be effective with excellent prognosis in the patient described

Comparison of the Effects of Maropitant, Lidocaine, and Dextroketamine Administered by the Intratesticular Route in Dogs Undergoing Elective Orchiectomy

Background: Balanced anesthesia achieved with combinations of inhaled and injectable drugs administered systemically or in loco-regional anesthetic blocks, is widely used in veterinary medicine. The use of anesthesia and/or local analgesia has already demonstrated benefits in the performance of elective orchiectomy in different species, there is no literature that evaluates the use of the maropitant intratesticular route. The present study evaluated the cardiorespiratory variables and analgesia produced by intratesticular blockade with maropitant, lidocaine, or dextroketamine during the trans-operative period along with the discharge and anesthetic recovery of dogs that underwent elective orchiectomy. Materials, Methods & Results: Used twenty-four dogs from routine elective orchiectomy, considered healthy based on the results of clinical and hematological tests. The animals were randomly divided into three groups and was applied intratesticularly 2% lidocaine at a dose of 1 mg/kg (GL), 5% dextrocetamina at a dose of 2.5 mg/kg (GC), or 1% maropitant  at a dose of 1 mg/kg (GM). Anesthesia induction was performed with propofol (to effect), and stabilization of inhalational anesthesia was achieved with 1.7 V% of sevoflurane diluted in 100% oxygen administered through a calibrated vaporizer and appropriate anesthetic system based on the animal's weight, being kept under spontaneous ventilation, After induction, we waited 10 min for stabilization of exhaled anesthetic concentration and then administered one of the treatments intratesticularly. After five min from the local block the surgical procedure was started during up to 15 min. Heart rate (HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), oxygen saturation of hemoglobin (SatO2), end-tidal carbon dioxide partial pressure (EtCO2), end-tidal sevoflurane concentration (EtSevo) in exhaled air, and body temperature (T°C) were measured before intratesticular administration of the agent and at specific time points during surgery, in addition to assessments of analgesia and evaluation of discharge and anesthetic recovery. Statistical analysis was performed using the Kolmogorov-Smirnov test (P > 0.10). The parameters HR, RR, SAP, DAP, MAP, T, EtCO2, and SatO2 were evaluated by analysis of variance (ANOVA), followed by the Scott-Knott test (Software R® 3.2.0 - 2013), considering a significance level of P < 0.05. The results did not show inter-drug differences for the evaluated variables.Discussion: It was decided not to use premedication (MPA), so that we could accurately assess the analgesic effect of drugs, lidocaine, dextroketamine and maropitant, on intratesticular block during elective orchiectomy. In this study we demonstrated that these drugs promoted analgesia, because the trans-surgical values were relatively lower compared to baseline and within physiological limits for the species. In addition, it was noted that local analgesia used was efficient since even at the time of ligature and the incision spermatic cord which is described in the literature as the most painful part of the surgical procedure. The post-anesthetic recovery and discharge were quick in the absence of MPA, local analgesia without residual effects and the use of sevoflurane. The sevoflurane has a very low blood gas coefficient solubility, resulting in a recovery fast. Therefore, we can conclude that all of the drugs promoted analgesia and cardiorespiratory stability as well as rapid anesthetic recovery for elective orchiectomy in this species

Síndrome de Haw em felino: relato de caso / Feline haw syndrome: case report

A Síndrome de Haw é uma enfermidade comum aos felinos, sem distinção sexual, de ocorrência aos animais jovens, e é caracterizada pela protusão bilateral aguda da terceira pálpebra, devido uma posição inadequada anatômica da inervação autossômica simpática e quando o tônus muscular liso se torna diminuído ou ausente, seu  desenvolvimento  é idiopático podendo estar associada a infecções virais. O objetivo desse trabalho é relatar o caso de uma gata de 1 ano de idade, levada pelo tutor ao atendimento veterinário por apresentar dificuldade visual e de caça. Ao exame oftálmico observado protusão bilateral de terceira pálpebra e sem outros sinais sistêmicos. Foi adotado para conduta diagnóstica a instilação de agente simpaticomimético, sendo 1 gota de colírio de fenilefrina 10% em ambos os olhos, aguardado 20 minutos e observado o retorno da terceira pálpebra para o canto medial do olho, levando a confirmação diagnóstica de Síndrome de Haw. Vale ressaltar que alterações no sistema simpático pós ganglionar tendem a responder as medicações simpaticomiméticas em um período médio de 20 minutos, como observado nesse caso. Conclui-se que a síndrome de Haw é uma afecção de extrema importância na clínica oftálmica de felinos jovens, acarretando desconforto ao animal, pela dificuldade de enxergar, o que gera transtorno também ao tutor. Sendo assim, para os casos de Síndrome de Haw é de grande relevância que se faça o diagnóstico diferencial com outras patologias que apresentam sinais clínicos semelhantes, para que o diagnóstico seja correto e a conduta terapêutica de sucesso, proporcionando qualidade de vida ao animal como observado no caso apresentado

Ceratite eosinofílica em felino: relato de caso / Eosinophilic keratitis in feline: case report

Os felinos desenvolvem doenças restritas a espécie, o que geralmente leva a respostas inflamatórias moderadas. Dentre essas alterações exclusivas da espécie felina podemos destacar a CEF A ceratite eosinofílica felina (CEF) se manifesta através de uma massa que surge do limbo nasal ou temporal, córnea periférica e conjuntiva bulbar, de característica branca a rosada, irregular, vascularizada e edemaciada. A causa da CEF ainda é incerta, porém, possui correlação com resposta imunomediada, levantando a possibilidade de o herpes vírus felino (FHV-1) ter atuação na patogenia. O objetivo desse relato, é a descrição de um caso de CEF, em felino, fêmea, 4 anos, ressaltando a importância do diagnóstico e tratamento corretos. O animal foi atendido por serviço oftálmico especializado, após diversas tentativas de tratamentos anteriores e segundo a tutora, o animal apresentava vermelhidão e a presença de uma membrana na superfície ocular direita a vários dias. Ao exame oftálmico foi observado blefarite em olho direito (OD), hiperemia conjuntival em OD, reflexo de ameaça presente, reflexo pupilar direto e consensual presentes e pressão intraocular (PIO) 12 mmHg em OD e 15 mmHg em olho esquerdo (OS), teste de Jones positivo e notou-se em superfície de OD presença de celularidade eosinofílica que não permitia a visualização da câmara anterior. Os mesmos exames oftálmicos em (OS) não denotaram nenhuma alteração. Para certificação da suspeita diagnóstica foi realizada citologia ocular que apontou resultado compatível com quadro de ceratite eosinofílica felina. Adotado tratamento tópico do OD com os colírios, predfort®, 1 gota, QUID, tacrolimus 0,03%, 1 gota, BID e Adptis fresh, 1 gota, TID, todos realizados durante 15 dias consecutivos. Após 15 dias de tratamento o animal retornou ao serviço veterinário demonstrando significativa melhora do quadro que o levou ao atendimento inicial, e optou-se pela manutenção do colírio de tracrolimus 0,03%, 1 gota, BID em olho direito por mais 15 dias. É possível concluir através deste relato que a Ceratite eosinofílica felina é uma patologia de grande relevância na clínica oftálmica de felinos uma vez que existe grande incidência entre gatos do Herpes vírus felino e esse possivelmente estar relacionado a evolução da CEF. Sendo que o seu diagnóstico e adoção de tratamento corretos são de grande importância para o prognóstico favorável do quadro, acarretando sucesso terapêutico e qualidade de vida ao animal

Description of Clinical and Surgical Aspects of Four Cases of Lip Commissure to Eyelid Transposition for Repair of Eyelid Coloboma in Cats

Background: Eyelid coloboma or eyelid agenesis is the most common congenital disease in cats. It can affect both the upper and the lower lids and is commonly bilateral. This congenital defect has been reported in several breeds, such as Persian and Domestic Short-Haired Cat. Generally, this defect results in inversion of the colobomatous eyelid, which can cause trichiasis and inflammatory keratitis and corneal ulceration. The only effective treatment is blepharoplasty. This paper describes the clinical and surgical aspects of four patients treated by lip commissure to eyelid transposition for the repair of eyelid coloboma using the technique described in 2010. Results of this procedure have never been reported in Brazil. Cases: Seven eyes of four cats presenting eyelid coloboma affecting up to two thirds of the eyelid were evaluated in this study. Two of the four cats were males and two were females; their average age was 3 years. All patients were admitted at the same institution, and the main issues were purulent discharge and impaired vision. Diagnosis was based on physical and ophthalmic examination. Non-ulcerative keratitis was present in all cases. Corneal ulcer was diagnosed in three patients by the fluorescein dye test. In two cats, a corneo-conjunctival dermoid was found at the temporal-dorsal region of one eye, and measured approximately 0.3 mm; and the other two exhibited microphthalmia in one eye. No abnormalities were seen in the anterior chamber, lens, and vitreous. One of the cats exhibited retinal detachment, and one exhibited testicular agenesis, both of the abnormalities diagnosed by ultrasound. Complete blood count and biochemical tests were performed in all patients before general anesthesia for the corrective procedure. Before surgery, eyes with ulcerative and non-ulcerative keratitis were treated with topical antibiotics and lacrimommimetics. In the 7 eyes, lip commissure to eyelid transposition technique was used for correction of the colobomatous defect. The procedure consisted of a mucocutaneous flap that simulates a natural eyelid. Corneo-conjunctival dermoids were also removed at the same time by superfcial keratectomy. In the postoperative period, all patients received oral non-steroidal antiinflammatory drug and an antibiotic, as well as cleansing of the surgical wound. All patients exhibited improvement of corneal abnormalities following one week of the procedure. However, three cats had suture dehiscence on the lip commissure, which healed by secondary intention after a week. Two weeks after surgery, superfcial necrosis was observed at the tip of the edge of the transplanted flap, in all cats. In order to promote healing, the necrotic edges were debrided at the time of sutures removal, 10 to 15 days after surgeries; at this time, both lip commissure and eyelid wound had already healed. Facial distortion was presente owing to skin overlapping on the site of the flap. All patients had their ability to blink restored, and there was absence of trichiasis on the flap. However, three cats had thichiasis caused by retraction of the pre-existing eyelid at the medial canthus. Discussion: Good functional and esthetic results were achieved, similarly to those previously described, which allows us to consider that this technique is appropriate for eyelid reconstruction in eyelid coloboma or agenesis cases. Nevertheless, this procedure can have some complications, such as suture dehiscence, facial deformity, superfcial necrosis of the edges of the flap, and trichiasis of the pre-existing eyelid of the medial canthus. To overcome these issues, authors suggest removal of the skin under the flap to decrease facial distortion, and removal of the whole pre-existing eyelid, in order to avoid trichiasis caused by retraction of this tissue. Keywords: blepharoplasty, congenital defect, eyelid, feline