Feline intralenticular Encephalitozoon cuniculi: three cases from California.

Case series summary: Three domestic shorthair cats from California presented to veterinary ophthalmologists with immature cataracts. Other presenting clinical signs included corneal edema, anisocoria, anterior uveitis, elevated intraocular pressure, blepharospasm and/or lethargy. All patients were immunocompromised due to concurrent diseases and/or immunomodulatory drugs. Diagnostics included serial comprehensive ophthalmic examinations with tonometry, ocular ultrasound, electroretinogram and testing for other causes of feline uveitis. Testing for Encephalitozoon cuniculi included serology, histopathology and/or PCR of aqueous humor, lens material or paraffin-embedded whole eye. Treatments included antiparasitic medication, anti-inflammatory medication and supportive care in all three cases. Surgical treatment included enucleation (one case), bilateral phacoemulsification and unilateral intraocular lens placement (one case) and bilateral phacoemulsification with bilateral endolaser ciliary body ablation and bilateral intraocular lens implantation (one case). Both cats for which serologic testing for E cuniculi was performed were positive (1:64-1:4096). In all cats, diagnosis of intraocular E cuniculi was based on at least one of the following: lens histopathology or PCR of aqueous humor, lens material or paraffin-embedded ocular tissue. The clinical visual outcome was best in the patient undergoing phacoemulsification at the earliest stage of the cataract. Relevance and novel information: Encephalitozoon cuniculi should be considered as a differential cause of cataracts and uveitis in cats in California, the rest of the USA and likely worldwide.

Development of alternating, ipsilateral Horner syndrome and Pourfour du Petit syndrome associated with oesophagostomy tube placement in a cat.

CASE SUMMARY: A 12-year-old spayed female domestic shorthair cat was presented to a referral hospital for chronic intermittent hyporexia and weight loss. An abdominal ultrasound was performed, which revealed a mid-jejunal mass and mesenteric lymphadenomegaly. Surgical resection and placement of an oesophagostomy tube (O-tube) was performed. Upon recovery the cat exhibited signs of Horner syndrome, which resolved over the span of 2 weeks. Subsequently, the cat developed signs of unilateral Pourfour du Petit syndrome in the left eye at day 20 and unilateral Horner syndrome at day 25 ipsilateral to the O-tube insertion site. The O-tube was removed 32 days postoperatively, and Horner syndrome resolved 24 h later. Follow-up examination 15 months later did not show any recurrence of ocular signs. RELEVANCE AND NOVEL INFORMATION: To our knowledge, this represents the first report of alternating ipsilateral Horner and Pourfour du Petit syndrome in a single patient that underwent placement of an O-tube. Neurological complications after O-tube placement are uncommon, with only a single previously published report of a cat developing Horner syndrome after O-tube placement. Veterinarians should consider potential ocular and neurological complications after O-tube placement and monitor for such signs postoperatively.

Superficial Keratectomy and Conjunctival Advancement Hood Flap (SKCAHF) for the Management of Bullous Keratopathy: Validation in Dogs With Spontaneous Disease.

PURPOSE: To evaluate the efficacy of superficial keratectomy and conjunctival advancement hood flap (SKCAHF) for the treatment of bullous keratopathy in canine patients. METHODS: Nine dogs (12 eyes) diagnosed with progressive corneal edema underwent superficial keratectomy followed by placement of conjunctival advancement hood flaps. The canine patients were examined pre- and postoperatively using in vivo confocal microscopy, ultrasonic pachymetry (USP), and Fourier-domain optical coherence tomography (FD-OCT). All owners responded to a survey regarding treatment outcomes. RESULTS: Mean central corneal thickness (CCT) as measured by FD-OCT was 1163 ± 290 µm preoperatively and significantly decreased postoperatively to 795 ± 197 µm (P = 0.001), 869 ± 190 µm (P = 0.005), and 969 ± 162 µm (P = 0.033) at median postoperative evaluations occurring at 2.2, 6.8, and 12.3 months, respectively. Owners reported significant improvement (P < 0.05) in vision and corneal cloudiness at 6.8 and 12.3 months postoperatively. The percentage of cornea covered by the conjunctival flap was correlated (P = 0.0159) with a reduction in CCT by USP at 12.3 months postoperatively. All canine patients were comfortable pre- and postoperatively. CONCLUSIONS: SKCAHF results in a reduction of corneal thickness in canine patients with bullous keratopathy. The increase in corneal thickness over time, after performing SKCAHF, is likely because of progressive endothelial decompensation. This surgery is a potentially effective intervention for progressive corneal edema in dogs that may have value in treatment of human patients with bullous keratopathy.

Presumptive subdural empyema in a dog.

A 13 mo old mixed-breed dog was referred for acute lateralized forebrain signs. MRI of the brain demonstrated abnormalities consistent with severe meningitis and subdural empyema secondary to a retrobulbar abscess. The dog's clinical signs improved with antibiotic therapy, and repeat imaging showed resolution of subdural fluid accumulation presumed to be empyema with mild residual meningeal enhancement. Subdural empyema is an infrequent cause of encephalopathy in small animals and usually develops through direct extension of a pericranial infection. This report presents a case of presumptive subdural empyema in a dog that was successfully treated without surgical intervention. MRI is the preferred imaging modality for diagnosis of subdural empyema, and the characteristic imaging features are described.