Risk factors for corneal conjunctival grafting failure in dogs at four referral centers in the southern United States (203 patients): 2015-2021.

OBJECTIVE: To report risk factors associated with conjunctival graft failure in dogs at four referral specialty centers. PROCEDURES: Records of 203 dogs (229 eyes) undergoing conjunctival graft repair of ulcerative keratitis at four hospitals from 2015 to 2021 were reviewed. Success was defined as full graft integration with globe retention at the last postoperative evaluation; vision status was reported separately. Factors assessed included patient signalment, ophthalmic examination findings, surgical factors, and follow-up information. RESULTS: Conjunctival graft failure occurred in 11% (25/229) of eyes and was significantly associated with ulcer depth, with corneal perforations having increased odds of graft failure compared with descemetoceles (odds ratio [OR] = 3.22, 95% confidence interval [CI] 1.11-9.32; p = .03) and stromal ulcers (OR = 10.89 [95% CI 1.38-86.18], p = .02). Brachycephalic dogs were significantly more likely than non-brachycephalic dogs to experience graft failure (OR = 5.02 [95% CI 1.42-17.74], p < .01). Surgery on the opposite eye relative to surgeon handedness was significantly associated with an increased risk of graft failure (OR 4.28 [95% CI 1.53-11.94], p < .01). The use of 7-0 and 8-0 suture versus 9-0 (p = .03) and the use of a combined simple continuous and interrupted pattern (p = .03) were significantly associated with an increased risk of graft failure. At the last follow-up, (median 61.5 days), 87% of dogs were visual. CONCLUSIONS: Corneal perforations, surgery on the opposite eye relative to surgeon handedness, suture size and pattern, and brachycephalic conformation were significantly associated with an increased risk of graft failure in this study. These characteristics can be considered when determining prognosis for ulcerative keratitis requiring surgical intervention.

Retinoschisis: a retrospective study of an uncommon retinal change in cats and dogs.

Retinoschisis is a poorly documented form of retinal degeneration characterized by cyst-like splitting that occurs between the inner nuclear and outer plexiform layers. The pathogenesis of retinoschisis is incompletely understood, but congenital, acquired and secondary aetiologies (glaucoma, inflammation, neoplasia) are described in humans. This retrospective study investigated the prevalence and associated histological and clinical features of retinoschisis in cats and dogs submitted for biopsy over a 10-year period. Of 140 samples with documented 'retinal vacuolation', four out of 120 (3%) canine samples and one out of 20 (5%) feline samples had changes consistent with retinoschisis. In most cases (80%), there was concurrent retinal detachment. In cases with available histories, increased intraocular pressure, proptosis and retinal detachment were reported clinical findings. In cats and dogs, retinoschisis is a retinal change that is generally secondary to other ocular lesions.

Sulcus intraocular lens implantation in 17 dogs using a modified ab externo technique.

OBJECTIVE: To describe a modified ab externo method of sulcus intraocular lens (IOL) fixation and report outcomes of eyes treated with this approach. PROCEDURES: Records of patients with lens instability or luxation that underwent a lensectomy and sulcus IOL implantation from January 2004 to December 2020 were reviewed. RESULTS: Nineteen eyes of 17 dogs had a sulcus IOL placed via a modified ab externo approach. The median follow-up time was 546 days (range 29-3387 days). Eight eyes (42.1%) developed POH. A total of six eyes (31.6%) developed glaucoma and required medical management long term to control IOP. The IOL position was satisfactory in most cases. Nine eyes developed superficial corneal ulcers within 4 weeks following surgery, all of which healed without complication. At the time of the last follow-up, 17 eyes were visual (89.5%). CONCLUSIONS: The technique described represents a potentially less technically challenging option for sulcus IOL implantation. The success rate and complications are similar to previously described approaches.

Pathology in Practice.

In collaboration with the American College of Veterinary Pathologists.

Ocular findings in cats with blastomycosis: 19 cases (1978-2019).

OBJECTIVE: To document ocular findings in cats with blastomycosis. ANIMALS: 35 cats with blastomycosis. PROCEDURES: Medical records from 1978 through 2019 were reviewed to identify cats with confirmed Blastomyces infection. Cats were grouped as having or not having ocular involvement. Clinical signs, histopathologic findings, and response to treatment were evaluated. RESULTS: 21 of the 35 (60%) cats with confirmed blastomycosis had ocular abnormalities. Two of 21 cats with ocular abnormalities also had systemic hypertension and were excluded. Of the remaining 19 cats, 15 (79%) had bilateral ocular signs. Ten (53%) cats had inflammatory ocular lesions, and 9 (47%) had neuro-ophthalmic abnormalities. Six of the 19 (32%) cats appeared to be completely blind, and 5 (26%) appeared to be unilaterally blind. For the 10 cats with inflammatory ocular lesions, the most common lesions were anterior uveitis (9/20 eyes), active chorioretinitis (6/20 eyes), and retinal detachment (4/20 eyes). For the 9 cats with neuro-ophthalmic abnormalities, the most common abnormalities were a negative menace or tracking response (10/18 eyes) and negative pupillary light response (4/18 eyes). CLINICAL RELEVANCE: Results suggested that ocular involvement is common in cats with blastomycosis and that both inflammatory lesions and neuro-ophthalmic abnormalities can be seen. Blastomycosis should be considered in the differential diagnosis for cats with anterior uveitis, posterior segment inflammation, or neuro-ophthalmic abnormalities, and a complete ophthalmic examination should be performed in all cats with confirmed or suspected blastomycosis.

Comparison of antimicrobial resistance patterns in dogs with bacterial keratitis presented to a veterinary teaching hospital over two multi-year time periods (1993-2003 and 2013-2019) in the Southeastern United States.

OBJECTIVE: To report clinical characteristics of dogs with bacterial keratitis, identify the most common bacterial isolates within this population, characterize the bacterial isolates' antimicrobial resistance patterns, and compare those resistance patterns to previously reported resistance patterns. ANIMAL STUDIED: Dogs diagnosed with bacterial keratitis between 2013 and 2019. PROCEDURES: Data pertaining to breed; Schirmer tear test I results; use of cyclosporine, tacrolimus, or corticosteroids at time of ulcer diagnosis; bacterial genus or species isolated; and resistance to selected antimicrobials as measured by Kirby-Bauer disk diffusion were collected. Resistance patterns were compared to those reported by Tolar et al. (2006). RESULTS: One hundred seventy bacterial isolates were cultured from 138 eyes from 130 dogs. Of these dogs, 45% were brachycephalic, 62% had STT <15 mm/min, and 28% were receiving a corticosteroid at the time of examination. The most common isolates were Staphylococcus pseudintermedius (31%), ß-hemolytic Streptococcus spp. (28%), and Pseudomonas aeruginosa (18%). Compared to the 1993-2003 study period, there were significant increases in resistance to cephalothin and polymyxin B among S. pseudintermedius isolates. ß-hemolytic Streptococcus spp. and P. aeruginosa isolates had no significant changes in resistance to the tested antimicrobials. CONCLUSION: Isolates of S. pseudintermedius, ß-hemolytic Streptococcus spp., and P. aeruginosa had minimal changes in resistance between the two study periods. In this population, monotherapy with ciprofloxacin or combination therapy of tobramycin and a first-generation cephalosporin continue to be appropriate for use in cases of suspected bacterial keratitis while awaiting results of susceptibility testing.

Retrobulbar and Tongue Base Pyogranulomatous Myositis Resulting in Strabismus in a Dog: Case Report.

A seven-year-old female spayed Australian Shepherd was presented for a 3-day history of left eye ventromedial strabismus, episcleral injection, protrusion of the third eyelid, miosis, and enophthalmia. Magnetic Resonance Imaging (MRI) identified lesions in the left medial pterygoid muscle and left tongue base. Cytology and histopathology revealed pyogranulomatous inflammation with rod-shaped bacteria and pyogranulomatous myositis, respectively. One month of oral antibiotics resolved both lesions. Repeat MRI showed a mild decrease in size of the left medial pterygoid muscle consistent with fibrosis. Clinically, residual, positional ventral strabismus remained upon dorsal neck extension, but all other ophthalmic abnormalities resolved. To the authors' knowledge, this is the first report of pyogranulomatous myositis causing this constellation of clinical signs and of repeat imaging depicting resolution of these lesions with therapy.

Efficacy of long-term topical flurbiprofen in limiting lens capsule opacities following phacoemulsification in dogs.

OBJECTIVE: To assess lens capsule opacity (LCO) following phacoemulsification in dogs receiving long-term topical ophthalmic flurbiprofen sodium 0.03%. ANIMAL STUDIED: Twenty-five client owned dogs undergoing phacoemulsification surgery for either diabetic or nondiabetic cataracts. METHODS: Prospective, randomized, masked clinical study assessing two groups of dogs for twelve months following phacoemulsification. All dogs underwent a complete eye examination and were photographed at each visit, beginning three weeks post-surgery, and repeated at 2, 3, 6, and 12 months post-surgery. Post-operative treatment protocols were similar for both groups, except that Group F received topical flurbiprofen once daily for 12 months and Group A received artificial tears once daily for 12 months. Digital photographs were analyzed for LCO using a subjective grading scale (0-4). The change in capsular opacities from 3 weeks to 12 months post-surgery was evaluated for each dog, and the groups were compared. RESULTS: There were 25 dogs evaluated post-phacoemulsification at each designated time point of the study. There were 12 dogs in Group A and 13 dogs in Group F. There was no significant statistical difference in LCO score between Groups A and F at baseline (3 weeks post-surgery), 6 months post-surgery, or 12 months post-surgery. Scores did not change significantly from baseline to 12 months within or between groups. CONCLUSIONS: Topical ophthalmic flurbiprofen sodium 0.03% solution applied once daily for 12 months following phacoemulsification does not appear to lead to a decrease in LCO formation as compared to artificial tears control.

Tear film concentrations of topically applied 0.5% oxytetracycline ointment in normal canine eyes.

OBJECTIVE: To determine the tear film levels of oxytetracycline in normal canine eyes after application of the ophthalmic ointment, Terramycin™ (0.5% oxytetracycline, polymyxin B sulfate), to guide appropriate treatment frequency. ANIMALS STUDIED: Ten research beagles. PROCEDURES: Ten research beagles with confirmed normal eyes were administered 0.02 mL of Terramycin™ ophthalmic ointment onto the dorsal bulbar conjunctival surface of the right eye. Tear samples were collected via dye-less Schirmer tear strips at 2, 4, 6, 8, and 12 hours post-administration. The sample for each timepoint was collected on a separate day, and concentrations of oxytetracycline were determined using high-performance liquid chromatography (HPLC). RESULTS: There was a semi-logarithmic decline in the median tear concentration of oxytetracycline. The median (2.5th and 97.5th percentiles) tear concentrations of oxytetracycline at 2, 4, 6, 8, and 12 hours were 43.5 µg/mL (11.1-302.2 µg/mL), 28.7 µg/mL (8.04-113.7 µg/mL), 16.1 µg/mL (4.96-37.7 µg/mL), 9.2 µg/mL (4.52-28.1 µg/mL), and 6.11 µg/mL (4.36-26.7 µg/mL), respectively. Mean (±SD) drug recovery via HPLC was 88% (±7.5%). CONCLUSIONS: Ophthalmic Terramycin™ achieves a substantially higher tear level than the MIC for common bacterial corneal pathogens up to 12 hours post-administration in normal eyes. Anti-collagenolytic tear levels were not achieved at the timepoints evaluated or with the manufacturer-prescribed dosing frequency. HPLC can be used to analyze tear concentrations of ophthalmic ointment formulations.

Effect of attentional focus levels on spontaneous eyeblink rate in horses.

OBJECTIVE: Spontaneous eyeblink rate (SEBR) is inversely proportional to the level of attentional focus in humans. The objective of this study was to evaluate the effects of attentional focus on SEBR in horses. PROCEDURES: Twenty client-owned horses (2.5-23 years of age, five mares, 15 geldings) were evaluated. A GoPro HERO5 Session™ video recorder was attached to the halter and directed toward the eyes. Horses were acclimated for two hours before study commencement. Horses were filmed in five scenarios requiring different levels of attention: alone in a stall ("stall"), stall with an observer ("person"), standing in an arena ("stand"), walking in an arena ("walk"), and trotting in arena ("trot"). Each of the five scenarios was filmed for ten minutes. Video recordings were reviewed, and SEBR (incomplete, complete, and total blinks) was measured for both eyes in each scenario. RESULTS: The median (25%,75%) total SEBRs (blinks/min) were as follows: STALL: OD-16.6 (12.4, 24.3), OS-18.8 (11.5, 26.9); PERSON: OD-17.7 (14.6, 24.2), OS-17.4 (13.9, 24.4); STAND: OD-18.7 (15.1, 24.4), OS-19.4 (16.2, 24.7); WALK: OD-40.1 (34.1, 44.8), OS-40.6 (33.8, 44.7); and TROT: OD-39.7 (30.3, 44.6), OS-39.4 (28.6, 45.0). The total SEBRs at walk and trot were significantly greater than SEBR in stationary scenarios. CONCLUSIONS: Despite requiring increased levels of attentional focus, activities involving motion caused increased SEBR in horses. We hypothesize the need for additional tear distribution due to tear evaporation (associated with air movement over the corneas) prevailed over the level of attentional focus to increase the SEBR.

Ophthalmic findings in 10 captive, anesthetized chimpanzees (Pan troglodytes).

OBJECTIVES: To document ophthalmic findings, Schirmer's tear test I (STT), and intraocular pressure (IOP) values for anesthetized chimpanzees (Pan troglodytes). ANIMALS STUDIED: Ten captive chimpanzees from Zoo Knoxville and Chattanooga Zoo. PROCEDURES: Ten chimpanzees were anesthetized for annual physical examinations, blood collection, and ophthalmic examination. Each was anesthetized with intramuscular (IM) injections of dexmedetomidine, midazolam, and ketamine. Ophthalmic findings and STT and IOP values in addition to general health information were recorded for each chimpanzee. Pupillary diameter was measured after topical tropicamide administration. A Shapiro-Wilk test of normality was done for age, weight, STT values, IOP values, and pupil size. RESULTS: Ages ranged from 11 to 42 years. Weight range was 40.9-83.6 kg. The mean STT was 13.4 ± 5.3 mm/min. The mean IOP was 14 ± 4.2 mm Hg. Seven of the 10 chimpanzees were considered geriatric, and each had perilimbal lipid deposits. Sedative-associated miosis was successfully counteracted with a regimen of repeated applications of tropicamide, enabling complete fundic examination. CONCLUSIONS: A complete ophthalmic examination can be done on anesthetized chimpanzees with the protocol used in this study.

Long-term outcome of phacoemulsification in raptors-A retrospective study (1999-2014).

OBJECTIVE: To determine long-term outcome of phacoemulsification in raptors at the University of Tennessee Veterinary Medical Center. ANIMALS STUDIED: Seven nonreleasable diurnal raptors including, four bald eagles (Haliaeetus leucocephalus), two red-tailed hawks (Buteo jamaicensis), and one peregrine falcon (Falco peregrinus) that had undergone phacoemulsification. All birds showed behavioral changes attributable to visual deficits prior to surgery. PROCEDURES: All birds underwent phacoemulsification for cataracts. Four underwent bilateral phacoemulsification, and three had unilateral surgery. Due to a low sample size, statistics were not done. RESULTS: Six raptors (nine eyes) had long-term follow-up (median 75 months, range 28 to 105 months). Seven of these eyes (78%) were visual at last examination. Of those visual eyes, two developed mild to moderate posterior synechiae, four had mild to moderate capsular opacities, and one developed a lipid keratopathy. The remaining two eyes with long-term follow-up were from the same red-tailed hawk. Both eyes developed fibropupillary membranes that were blinding. One eye was pseudophakic, and the other was aphakic and also developed a rhegmatogenous retinal detachment. Another bald eagle was euthanized two months after surgery due to refractory glaucoma; one eye was pseudophakic. CONCLUSIONS: Phacoemulsification is a viable treatment for captive raptors with cataracts. The most severe complications occurred relatively soon after surgery. Captive raptors appear to adapt well to aphakia.

Blink patterns and kinematics of eyelid motion in ophthalmologically normal horses.

OBJECTIVE To describe qualitative blinking patterns and determine quantitative kinematic variables of eyelid motion in ophthalmologically normal horses. ANIMALS 10 adult mares. PROCEDURES High-resolution videography was used to film blinking behavior. Videotapes were analyzed for mean blink rate, number of complete versus incomplete blinks, number of unilateral versus bilateral blinks, and subjective descriptions of blinking patterns. One complete blink for each horse was analyzed with image-analysis software to determine the area of corneal coverage as a function of time during the blink and to calculate eyelid velocity and acceleration during the blink. RESULTS Mean ± SD blink rate was 18.9 ± 5.5 blinks/min. Blinks were categorized as minimal incomplete (29.7 ± 15.6%), moderate incomplete (33.5 ± 5.9%), complete (30.8 ± 13.1%), and complete squeeze (6.0 ± 2.8%); 22.6 ± 9.0% of the blinks were unilateral, and 77.3 ± 9.1% were bilateral. Mean area of exposed cornea at blink initiation was 5.89 ± 1.02 cm2. Mean blink duration was 0.478 seconds. Eyelid closure was approximately twice as rapid as eyelid opening (0.162 and 0.316 seconds, respectively). Deduced maximum velocity of eyelid closure and opening was -16.5 and 7.40 cm/s, respectively. Deduced maximum acceleration of eyelid closure and opening was -406.0 and -49.7 cm/s2, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Kinematic variables of ophthalmologically normal horses were similar to values reported for humans. Horses had a greater percentage of complete squeeze blinks, which could increase tear film stability. Blinking kinematics can be assessed as potential causes of idiopathic keratopathies in horses.

Phacoemulsification outcomes in Boston terriers as compared to non-Boston terriers: a retrospective study (2002-2015).

OBJECTIVES: To compare visual outcome and cause of blindness between two groups of dogs undergoing phacoemulsification. ANIMALS STUDIED: Study population consisted of 35 Boston terriers (BT; 70 eyes) and 77 non-Boston terriers (NBT; 154 eyes) that underwent bilateral phacoemulsification surgery. PROCEDURES: Medical records were reviewed to determine visual outcome, complications leading to blindness and follow-up. A Kaplan-Meier survival curve was used to estimate surgical success at 1 and 2 years postoperatively. RESULTS: Eleven of 35 BT developed known vision loss, with 12 of 70 (17.1%) eyes becoming blind within one year of surgery, and 17 of 77 NBT developed known vision loss, with 19 of 154 (12.3%) eyes becoming blind within 1 year of surgery. No further vision loss was reported among those BT with a 2-year follow-up. In the NBT group, seven additional dogs, a total of 24 of 77 NBT developed vision loss, with a known total of 31 of 154 (20.1%) eyes becoming blind within two years of surgery. These results were not significantly different. The overall surgical success in both groups based on individual eyes was estimated to be between 80 and 90% at 1 year postsurgery and between 65 and 80% at 2 years postsurgery. Glaucoma was the leading cause of vision loss in both groups. CONCLUSIONS: There was no significant difference in visual outcomes between a group of BT and a group of NBT undergoing bilateral phacoemulsification at the University of Tennessee between 2002 and 2015. Glaucoma was the leading cause of vision loss in both groups.

The Efficacy and Safety of Topical Rocuronium Bromide to Induce Bilateral Mydriasis in Hispaniolan Amazon Parrots ( Amazona ventralis ).

The efficacy and safety of topically applied rocuronium in Hispaniolan Amazon parrots ( Amazona ventralis ) was assessed in a group of 10 adult birds. A complete ophthalmic examination (including Schirmer tear test, ocular reflexes, applanation tonometry, fluorescein staining, and slit-lamp biomicroscopy) was performed, and rocuronium bromide (0.15 mg in both eyes) was administered. Pupillary light reflex (PLR) and pupillary diameter were recorded in a darkened room at the following time points: 0, 10, 20, 30, 40, 50, 60, 80, 100, 120, 140, 160, 180, 200, 220, 240, 300, and 360 minutes, and 24 hours. Fluorescein staining in both eyes was performed at 24 hours. By 10 minutes, PLR was absent in all birds (at 5 minutes, 8 birds; at 10 minutes, remaining 2 birds). Pupil diameter differed significantly from baseline at all time points. Additionally, PLR was decreased in 7/10 birds at 360 minutes and normal in all birds at 24 hours. Superficial corneal ulceration was observed at 24 hours in the left eye of 2/10 of the birds after fluorescein stain application. This study demonstrated that rocuronium bromide was an effective mydriatic agent in Hispaniolan Amazon parrots with rapid onset and prolonged duration of action.

Tear film osmolality and electrolyte composition in healthy horses.

OBJECTIVE: To evaluate the tear film osmolality and electrolyte composition in healthy horses. ANIMALS: 15 healthy adult horses. PROCEDURES: Each horse was manually restrained, and an ophthalmic examination, which included slit-lamp biomicroscopy, indirect ophthalmoscopy, and a Schirmer tear test, was performed. Tear samples were collected from both eyes with microcapillary tubes 3 times at 5-minute intervals. The tear samples for each horse were pooled, and the osmolality and electrolyte concentrations were measured. The mean (SD) was calculated for each variable to establish preliminary guidelines for tear film osmolality and electrolyte composition in healthy horses. RESULTS: The mean (SD) tear film osmolality was 283.51 (9.33) mmol/kg, and the mean (SD) sodium, potassium, magnesium, and calcium concentrations were 134.75 (10), 16.3 (5.77), 3.48 (1.97), and 1.06 (0.42) mmol/L, respectively. The sodium concentration in the tear film was similar to that in serum, whereas the potassium concentration in the tear film was approximately 4.75 times that of serum. CONCLUSIONS AND CLINICAL RELEVANCE: Results provided preliminary guidelines with which tear samples obtained from horses with keratopathies can be compared. Measurement of tear film osmolality in these horses was easy and noninvasive. The tear film concentration of divalent cations was greater than expected and was higher than the divalent cation concentrations in the tear films of rabbits and humans. These data may be clinically useful for the diagnosis and monitoring of hyperosmolar ocular surface disease in horses.

Biometry, keratometry, and calculation of intraocular lens power for the bald eagle (Haliaeetus leucocephalus).

OBJECTIVE: To document intraocular measurements and predict intraocular lens (IOL) power specific to the bald eagle. ANIMALS STUDIED: Eleven adult, captive bald eagles. PROCEDURES: Axial globe length (AGL), anterior chamber depth (ACD), crystalline lens thickness (CLT), and the distance from the cornea to the posterior lens capsule (CPLC) were measured in eight adult bald eagles using B-mode with vector A-mode ultrasound. Keratometry was done on four eagles. Two estimates for postoperative anterior chamber depth (PACD) were obtained from four aphakic eyes from three eagles by measuring from the apex of the anterior cornea to the center of an imaginary line that would connect the remaining edges of the anterior lens capsule across the capsulorhexis (PACD1) and from the apex of the anterior cornea to halfway between the anterior and posterior lens capsule (PACD2). IOL strength was predicted using the Colenbrander, Binkhorst, and Fyodorov theoretical formulas. RESULTS: Mean ± SD biometry for phakic eyes was AGL = 26.57 ± 0.45 mm, ACD = 4.45 ± 0.18 mm, CLT = 5.49 ± 0.14 mm, and CPLC = 10.00 ± 0.33 mm. Mean predicted PACD1 was 6.1 ± 0.66 mm, and PACD2 was 6.4 ± 0.70 mm. Mean horizontal and vertical corneal refractive power was 39.91 ± 0.43 diopters (D) and 40.02 ± 0.08 D, respectively. Calculated IOL power ranged from +16.4 to 17.4 D. CONCLUSIONS: Calculations using ultrasonographic biometry, keratometry, and theoretical IOL formulas suggest that the strength of an IOL necessary to return an aphakic bald eagle to emmetropia is between +16.4 and +17.4 D.

Flash electroretinography in the bald eagle (Haliaeetus leucocephalus).

Photopic and scotopic flash electroretinograms (fERGs) were done on 12 adult captive anesthetized bald eagles (Haliaeetus leucocephalus) following a complete ophthalmic exam. The b-wave amplitude in the bald eagle exceeds that seen in other species when using a similar protocol. This data may be used clinically as a reference for bald eagles undergoing fERG evaluation for retinal disease or as a preoperative screening tool before phacoemulsification.

Expression of epidermal growth factor receptor and human epidermal growth factor receptor 2 in periocular squamous cell carcinomas of horses.

OBJECTIVE: To determine whether epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) are expressed in periocular squamous cell carcinomas (SCCs) of horses. SAMPLE: Biopsy specimens of SCCs from 46 horses. PROCEDURES: Pathology records were searched retrospectively for biopsy specimens of periocular SCCs obtained from horses. Slides of the specimens were reviewed histologically to confirm the SCC diagnosis and stained for EGFR and HER2 by immunohistochemical methods. For both EGFR and HER2, the immunohistochemical staining intensity and percentage of stain-positive cells on the slides were determined. RESULTS: 43 of 46 (93%) SCCs were immunoreactive for EGFR. The median score for EGFR staining intensity was 4 (range, 2 to 12), and the median number of mitotic figures was 8 mitotic figures/10 hpfs (range, 0 to 34 mitotic figures/10 hpfs). Mitotic index was not correlated with the percentage of EGFR stain-positive cells or staining intensity. Of the 43 EGFR-immunoreactive SCCs, 38 had stain present primarily in the cytoplasm and 5 had stain equally distributed between the cytoplasm and cell membranes. Thirty-five of 46 (76%) SCCs were immunoreactive for HER2. Mitotic index was not correlated with the percentage of HER2 stain-positive cells or staining intensity. Of the 35 HER2-immunoreactive SCCs, the stain was present primarily in the cytoplasm and 7 had stain equally distributed between the cytoplasm and cell membranes. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that most periocular SCCs of horses expressed EGFR and HER2, which suggested that equine periocular SCCs might respond to treatment with EGFR inhibitors.