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VMCVM SAM 3 > Canine Ophthalmic Manifestations of Systemic Disease > Flashcards

Canine Ophthalmic Manifestations of Systemic Disease Flashcards

1
Q

orbital diseases: exophthalmia

A
  1. orbital neoplasia: non-painful, slowly progressive and usually unilateral; PX is TERRIBLE
  2. inflammatory: bad teeth, orbital cellulitis; Fever and PAINful and rapid onset
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2
Q

orbital diseases: enophthalmia

A
  1. loss of orbital contents (cachexia, dehydration, old masticatory myositis)
  2. Horner’s Syndrome POST-ganglionic 76-80%; older goldens, hypothyroid, diabetics with peripheral neuropathy – look in the EARS too
    - Ptosis, miosis, enophthalmos, third eyelid protrusion
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3
Q

How can you tell if Horner’s Syndrome is POST-ganglionic?

A

Phenylephrine will make it BETTER and it will come back in 20 minutes or Less!

45 minutes to reverse indicates PRE-Ganglionic (ie: somewhere in the brain)

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4
Q

Where do you always look if patient has Horner’s?

A

the EARS — check the ears!!

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5
Q

Eyelid disorders: Infectious

A

bacteria (staph) fungal (MALASSEZIA) parasitic (demodex)

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6
Q

What is the classic sign of Ivermectin toxicity/overdosing?

A

DILATED PUPILs

Blindness and optic neuritis can also happen in acute overdoses,

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7
Q

Eyelid disorders: inflammatory

A
  1. Atopy - recurrent BILATERAL steroid response to conjunctivits — TX w/ Atopica, systemic steroids
  2. puppy strangles/juvenile cellulitis - THICK, HARD LIDS, scabby pinnae, big cervical LN. – TX Systemic Steroids
  3. Vaccine reactions - tx with e-collar, epinephrine, IV antihistamines, careful of AIRWAY obstruction
  4. immune-mediated diseases (pemphigus; systemic histiocytosis of bernese mountain dogs; VKH-like syndrome; lupus-discoid; dermatomyositis)
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8
Q

Eyelid inflammatory: immune-mediated: Pemphigus

A

TX Systemic immunosuppressives

horrible, weepy blepharitis; mucocutaneous junctions all scabby and crusty

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9
Q

Eyelid inflammatory: immune-mediated: systemic histiocytosis of Bernes Mountain Dogs

A

SEVERE BLEPHARITIS and Uveitis can happen too

GENETIC disease, don’t breed them.

Tx systemic immunosuppressives

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10
Q

Eyelid inflammatory: immune-mediated: VKH-Like Syndrome

A

Young to middle aged

AKITAS

melanocytes attacked – depigmentation of NOSE and CHIN

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11
Q

Eyelid inflammatory: immune-mediated: Lupus - Discoid (SLE more rarely)

A

perinasal and periocular rash in humans

blepharitis/facial dermatitis

KCS with polyarthritis and glomerulonephritis

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12
Q

Eyelid inflammatory: immune-mediated: dermatomyositis

A

COLLIE disorder and RARE

Periocular dermatitis around the lids

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13
Q

Conjunctiva and Sclera: Discoloration

A
  1. juandice - hemolysis, the SCLERA is NOT discolered, its the CONJUNCTIVA (moves freely)
  2. pallor - ANEMIA
  3. hemorrhage - COAGULOPATHIES
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14
Q

Conjunctiva and Sclera: Inflammatory diseases

A
  1. allergic conjunctivitis
  2. episcleritis (intraocular) - immune-mediated in Cocker Spaniels with DIFFUSE scleritis and other allergy issues
  3. Nodular granulomatous episclerokeratitis in COLLIEs (lumpy bumpy skin lesions NOSE and FACE TX w/ systemic steroids and topical azathioprine and cyclopsporine)
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15
Q

Conjunctiva and Sclera: Infectious diseases

A
  1. Distemper (acute KCS and conjunctivitis, BILATERAL mucopurlent discharge, Snotty Nose, Febrile, Hard-Pad Disease, Neurologic signs)
  2. rickettsial diseases - RMSF and ehrlichiosis cause REALLY RED CONJUNCTIVA with +/- fever
  3. Neoplasia - 3rd eyelid LSA; eyelid/conjunctival melanoma (not as bad as limb or oral) limbal in Labs; Palpebral/3rd eyelid Melanomas are the WORST but still not as bad as oral/extremity melanomas
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16
Q

Nasolacrimal/Tears: Primary KCS

A

due to immune-mediated adenitis of lacrimal and third eyelid glands
associated with ATOPY – Cyclosporine A and Tacrolimus responsive

Anytime you have an animal with KCS there may be other things causing!!

17
Q

Nasolacrimal/Tears: Neurogenic KCS

A

due to lack of parasympathetic innervation; may also see Dry Nose on same side of face

NOT responsive to Cyclosporine A, it’s not immune-mediated

Unilateral - Check the EARS

18
Q

Nasolacrimal/Tears: Drug induced KCS

A
  1. Sulfasalazine - GI Tx of IBD –> Monitor STT
  2. Trimeth-Sulfa - tx of bacT infections –> Monitor STT
  3. Etodolac - not around anymore really; induced tear film deficiency –> Monitor STT

CAN go back to normal once drug is stopped, BUT once the tear production goes to ZERO, it is PERMANENT.

19
Q

Cornea: Lipid Degeneration

A

can be:

  • inherited
  • primary
  • 2˚ for lipid metabolism dz (hypothyroid, Cushing, DM)

Sparkly crystals in the STROMA, benign

20
Q

Cornea: Edema in conjunction with anterior uveitis

A
  • Infectious canine hepatitis/CAV-1 or from the VACCINE

UNILATERAL - YOUNG, and vaccinated with a CHEAP vaccine

21
Q

Cornea: Edema from using Tocainide

A

old-school antiarrythmic agent damaging corneal endothelial cells

used in boxers and dobermans a while ago

22
Q

Lens: Diabetic Cataract

A

MIDDLE-AGED, RAPID onset and BILATERAL with “Y-suture clefts and equatorial cuffing”

Osmotic cataracts from formation of sorbitol

Most common cause of cataracts

23
Q

Anterior Uvea: Hyphema

A 
trauma
glaucoma
retinal detachments
post-op intraocular sx
coagulopathies
uveitis
intraocular mass/neoplasia
24
Q

Anterior Uvea: Lipemic Aqueous Humor

A

look for cause of systemic lipemia
CATS and Diabetic Dogs - especially Diab. Schnauzers

Bilateral or Unilateral and can happen post-prandial and go away – indicating not uveitis or edema

25
Q

Anterior Uvea: HW Dz

A

RARELY can see worm in anterior chamber

26
Q

Posterior Segment Disease: Posterior Uveitis (chorioretinitis/retinitis)

A

Distemper and gold medallion lesions

Acute chorioretinitis cryptococcosis

27
Q

Posterior Segment Disease: Chorioretinal hemorrhage

A
  1. coagulopathies - infectious and toxic
  2. hyperviscosity syndromes
  3. hypertension - vascular TORTUOSITY, not in cat (Diabetic dogs, Cushings, CRF, pheochromocytomas, HyperT in cats)
  4. neoplasia
28
Q

Posterior Segment Disease: Retinal “degeneration”: SARDS - Sudden Acquired Retinal Degeration Syndrome (rare)

A

Photoreceptors just DIE – normal one day, Blind the next.
Electroretinogram tells NOT optic neuritis.
**Cushinoid Systemic signs.

RARE in dogs

29
Q

Posterior Segment Disease: Retinal “degeneration”: Vitamin E Deficiency

A

Little DARK SPOTS on the Tapetum
- high fat diets, vit. e deficient RPE hyperpigmentation
aka Central Progressive Retinal Atrophy

30
Q

Posterior Segment Disease: Retinal “degeneration”: Optic Disk Disease

A

Optic Neuritis: will see a SWOLLEN DISC, peripapillary edema, exudates, or hemorrhage. Blind with DEC. PLR

If retrobulbar, disc may look normal.

BLIND ANIMAL – Pug encephalopathy, can show up as this. GME can look like this

  • Reticulosis or GME/granulomatous meningoencephalitis: +/- other neuro signs
  • Crypto: subretinal exudates, +/- other neuro signs
  • toxo: rare in dogs. multifocal chorioretinal scarring (gray lines) or active exudates
  • distemper: seen in acute dz; FUZZY disc, DEC PLR, vision loss
31
Q

Posterior Segment Disease: Retinal “degeneration”: Optic Disk Atrophy

A

see PALE or HYPERPIGMENTED disc, contracted, lack of vascularity over disc surface. May be BLIND with dec. or no PLR.

Distemper
Previous optic neuritis
Toxin: LEAD, arsenic, thallium, ivermectin in collies and herding breeds.

VMCVM SAM 3 (7 decks)

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