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Imposimato I, Mariella J, Freccero F, Gialletti R. Corneal Ulcers in Critically Ill Foals in Intensive Care: Case Series of Standard Treatment and Corneal Cross-Linking. J Equine Vet Sci 2023; 130:104910. [PMID: 37625627 DOI: 10.1016/j.jevs.2023.104910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
Riboflavin/UV-A corneal cross-linking (CXL) has been applied to treat corneal ulcers in adult horses, but its use in critically ill neonatal foals has not been described. Five cases of hospitalized, critically ill neonatal foals that were in intensive care with corneal ulcers, the ophthalmic treatment, and their outcome up to 1 year are described. A single treatment of CXL phototherapy was performed in three of five foals (five eyes). The application of a riboflavin ophthalmic solution for 20 minutes was followed by the UV-A light irradiation at 30 mW/cm2 for 3 minutes. Topical antibiotic administration was withdrawn after CXL. Two other foals received standard treatment. Descriptions of ocular lesions, fluorescein staining, and photographic documentation were recorded. The visual outcome, corneal transparency, and aesthetics, as well as healing time were evaluated in the follow-up. The frequency of topical medication considerably decreased in cases treated with CXL. Corneal opacity and pain decreased within 3 days following CXL. In the foals treated with CXL, the ulcers healed (fluorescein stain negative) in 24, 28, and 35 days after the onset of clinical signs and 10, 15, and 21, after CXL. No fibrosis or corneal scars were found in the cases treated with CXL. The two standard treatment cases healed after 26 and 36 days respectively. Corneal cross-linking may be an additional or alternative treatment of corneal ulcers in critically ill neonatal foals and may reduce the use of antibiotics.
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Affiliation(s)
- Ilaria Imposimato
- Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Ozzano dell'Emilia, Bologna, Italy.
| | - Jole Mariella
- Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - Francesca Freccero
- Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - Rodolfo Gialletti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
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Stewart RM, Lack AC, Telle MR, Ellis JK, Betbeze CM. Dorsally placed commercially available subpalpebral lavage systems have low complication rates in horses. J Am Vet Med Assoc 2022; 260:1057-1062. [DOI: 10.2460/javma.22.01.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
OBJECTIVE
To retrospectively evaluate the complication rate following dorsal placement of a commercially available 1-hole subpalpebral lavage system (SPL) at a veterinary teaching hospital.
ANIMALS
102 client-owned horses with ophthalmic disease.
PROCEDURES
Medical records of horses (2010 to 2020) with ophthalmic disease were reviewed to determine whether a commercially available SPL system was dorsally placed. Data collected from the medical record included signalment, presenting complaint(s), diagnosis, ophthalmic procedures performed, SPL laterality, hospital service that placed the SPL, anesthetic technique for placement (general anesthesia or sedation with local nerve blocks), duration of SPL management while hospitalized or at home, type of enclosure for the horse, use of eye protection, duration of time the SPL was in place, location of SPL management (home vs hospital), types and numbers of medications administered, recorded complications, and outcome of the globe. Complications experienced during treatment were categorized as either ocular or nonocular. The χ2 test for independence test and Fisher exact test were performed to examine the relationship between the department that placed the SPL, method of anesthesia, antimicrobial administration, type of facial protection used, and complication type and rate.
RESULTS
Overall complication rate for SPL systems was 29.1% (37/127), with 21.2% (27/127) being ocular complications and 7.9% (10/127) being nonocular complications. SPL complication rate was not affected by any variable that was examined.
CLINICAL RELEVANCE
Commercially available SPL systems placed dorsally have a low ocular complication rate. These SPL systems may be placed by veterinarians with varied training backgrounds and managed at home without significantly increasing complication rate.
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Affiliation(s)
- Ruth M. Stewart
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | - Amy C. Lack
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | - Mary R. Telle
- Department of Mathematics, Florida Gulf Coast University, Fort Myers, FL
| | - Jerald K. Ellis
- Department of Mathematics, Florida Gulf Coast University, Fort Myers, FL
| | - Caroline M. Betbeze
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
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Tahoun A, Elnafarawy HK, Elmahallawy EK, Abdelhady A, Rizk AM, El-Sharkawy H, Youssef MA, El-Khodery S, Ibrahim HMM. Epidemiological and Molecular Investigation of Ocular Fungal Infection in Equine from Egypt. Vet Sci 2020; 7:vetsci7030130. [PMID: 32911615 PMCID: PMC7558555 DOI: 10.3390/vetsci7030130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 11/16/2022] Open
Abstract
Diagnosis and treatment of ocular fungal infection in equine seems very challenging for owners and clinicians. The present study aimed to identify and characterize fungal species isolated from the eyes of clinically healthy and diseased equines (N = 100) from Dakahlia Governorate, Egypt. The work also involved morphological and molecular characterization of the major fungal species. In addition, correlations between the occurrence of isolated fungi and some of the potential risk factors were also investigated. Interestingly, the prevalence rate of ocular mycosis in all examined equines in the study was 28% and there were major clinical signs associated with ocular fungal infection. Moreover, the identified fungal species included Aspergillus flavus, A. fumigatus, A. niger, Penicillium spp., Mucor spp., and Alternari spp. with a corresponding prevalence rate of 63.9%, 27.8%, 15.3%, 18.1%, 13.9%, and 4.2%, respectively, in healthy equine eyes, while their prevalence in diseased equine eyes was 57.1%, 32.1%, 21.4%, 7.1%, 3.6%, and 0%. Furthermore, a statistical significant association (p < 0.05) was found between the frequency of isolation of A. fumigatus and Penicillium and several risk factors (breed, sex, and ground type), while the remaining risk factors and occurrence of fungi were not statistically correlated. A subset of the Aspergillus species samples positive by polymerase chain reaction (PCR) were sequenced and their phylogenetic analysis identified three species of Aspergillus. Taken together, our study provides novel data related to the occurrence of ocular mycosis in equine in Egypt. Given the zoonotic potential of some identified fungi, our data may be helpful for implementation of novel diagnostic and therapeutic strategies for combating this sight-threatening infection in equine.
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Affiliation(s)
- Amin Tahoun
- Department of Animal Medicine, Faculty of Veterinary Medicine, Kafrelshkh University, Kafrelsheikh 33511, Egypt;
| | - Helmy K. Elnafarawy
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; (H.K.E.); (M.A.Y.); (S.E.-K.)
| | - Ehab Kotb Elmahallawy
- Department of Zoonoses, Faculty of Veterinary Medicine, Sohag University, Sohag 82524, Egypt
- Department of Biomedical Sciences, University of Leon, s/n, 24071 León, Spain
- Correspondence: (E.K.E.); (H.M.M.I.)
| | - Abdelhamed Abdelhady
- Parasitology and Animal Diseases Department, National Research center, Dokki, Giza, 12622, Egypt;
| | - Amira M. Rizk
- Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Benha University, Benha 13518, Egypt;
| | - Hanem El-Sharkawy
- Department of Poultry and Rabbit Diseases, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh 33511, Egypt;
| | - Mohamed A. Youssef
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; (H.K.E.); (M.A.Y.); (S.E.-K.)
| | - Sabry El-Khodery
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; (H.K.E.); (M.A.Y.); (S.E.-K.)
| | - Hussam M. M. Ibrahim
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; (H.K.E.); (M.A.Y.); (S.E.-K.)
- Correspondence: (E.K.E.); (H.M.M.I.)
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Martabano BB, Linde Henriksen M, Powell CC. Prevalence of equine ulcerative keratomycosis in Colorado and association of environmental factors: A retrospective and descriptive study (2002–2017). EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. B. Martabano
- Department of Clinical Sciences Comparative Ophthalmology College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - M. Linde Henriksen
- Department of Clinical Sciences Comparative Ophthalmology College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - C. C. Powell
- Department of Clinical Sciences Comparative Ophthalmology College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
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Mustikka MP, Grönthal TSC, Pietilä EM. Equine infectious keratitis in Finland: Associated microbial isolates and susceptibility profiles. Vet Ophthalmol 2019; 23:148-159. [PMID: 31364808 PMCID: PMC7004187 DOI: 10.1111/vop.12701] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/05/2019] [Accepted: 06/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To retrospectively describe laboratory findings, treatment, and outcome associated with equine infectious keratitis in Finland. ANIMALS AND PROCEDURES Medical records of horses diagnosed with infectious keratitis in University of Helsinki Equine Hospital from January 2007 to June 2018 were reviewed. RESULTS Forty-seven cases were included. Keratomycosis was diagnosed in 27 eyes and bacterial keratitis in 20 eyes. Aspergillus flavus was the most frequent fungal isolate (9/17, 53%), followed by Cylindrocarpon sp. (3/17, 18%) and Aspergillus fumigatus (2/17, 12%). Susceptibility was tested for 10/11 Aspergillus sp. isolates; all were susceptible to voriconazole while only two were susceptible to amphotericin B. Cylindrocarpon sp. isolates were resistant to both agents. Streptococcus equi subsp. zooepidemicus was the most frequent bacterial isolate (9/19, 47%), followed by other streptococci (4/19, 21%). All 13 Streptococcus sp. isolates were susceptible to penicillin, and all tested isolates (n = 11) were also susceptible to chloramphenicol. Mean duration of medical treatment was longer in fungal keratitis (38 days) than in bacterial keratitis (25 days) (P < .001). Twenty-six of the eyes underwent globe-sparing surgery in addition to medical therapy. Recovery was achieved in 66% (31/47) of all cases and in 59% (16/27) and 75% (15/20) (P = .264) of cases with keratomycosis and bacterial keratitis, respectively. CONCLUSIONS Although Aspergillus sp. and S zooepidemicus were the most frequently encountered isolates, cytology, culture, and susceptibility testing are essential to differentiate bacterial and fungal keratitis and guide the clinician to choose the most efficient treatment.
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Affiliation(s)
- Minna P Mustikka
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Thomas S C Grönthal
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Elina M Pietilä
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
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Sherman AB, Clode AB, Gilger BC. Impact of fungal species cultured on outcome in horses with fungal keratitis. Vet Ophthalmol 2016; 20:140-146. [PMID: 27061354 DOI: 10.1111/vop.12381] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the significance of Aspergillus and Fusarium spp., as identified by culture, on clinical outcome in equine keratomycosis. METHODS Retrospective analysis of 66 horses (66 eyes) evaluated at the NCSU-VH diagnosed with keratomycosis from which Aspergillus or Fusarium spp. were cultured. Horses were classified into those who improved with medical management alone or those who required surgical intervention to improve. Horses who underwent surgery were divided into globe-sparing procedures or enucleation. Effects of bacterial co-infection, previous topical steroid or antifungal use, and time of year on fungal genus and outcome were evaluated. RESULTS Aspergillus spp. was cultured from 41 eyes (63%), while 24 eyes (37%) cultured Fusarium spp. One horse cultured both species and was not included in further evaluation. From the horses that cultured Aspergillus spp., 28 eyes (68%) required surgical intervention to control the infection: 21 (75%) of these eyes maintained globe integrity, while 7 eyes (25%) were enucleated. Of those horses with Fusarium spp., 14 eyes (58%) required surgical intervention: 11 (79%) of these eyes maintained globe integrity, while 3 eyes (21%) were enucleated. Genus of fungus cultured was not significantly associated with the need for surgical intervention nor was it significantly associated with the necessity of globe-sparing surgery versus enucleation. Additionally, bacterial co-infection, previous steroidal or antifungal use, and time of year did not affect outcome or type of fungal species cultured. CONCLUSION Equine keratomycosis from Fusarium spp. compared to keratomycosis from Aspergillus spp. is not associated with a different clinical outcome.
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Affiliation(s)
- Amanda B Sherman
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Dr, Raleigh, NC, 27607, USA
| | - Alison B Clode
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Dr, Raleigh, NC, 27607, USA
| | - Brian C Gilger
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Dr, Raleigh, NC, 27607, USA
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Proietto LR, Plummer CE, Maxwell KM, Lamb KE, Brooks DE. A retrospective analysis of environmental risk factors for the diagnosis of deep stromal abscess in 390 horses in North Central Florida from 1991 to 2013. Vet Ophthalmol 2015. [PMID: 26215543 DOI: 10.1111/vop.12297] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this investigation was to identify potential environmental risk factors for the diagnosis of equine deep stromal abscesses (DSA) in the subtropical climate at the University of Florida Veterinary Medical Center (UFVMC). METHODS Cases included were selected from the UFVMC medical record and imaging database, and included all cases of equine DSA diagnosed during the period from December 1991 to December 2013 in patients residing in north central Florida. Patient date of diagnosis and atmospheric data was obtained for north central Florida for the corresponding time period. Univariate and multivariate general linear models were generated testing effects and interactions between environmental conditions. RESULTS When year, sulfur dioxide (SO2 ) and wind were analyzed in the presence of each other, a one-mile per hour increase in wind (P = 0.005) significantly increased the number of DSA cases by 1.63 cases per year. When the influence of temperature was evaluated in conjunction with year and nitrogen dioxide (NO2 ), the number of cases decreased by 0.1534 per year for every degree increase in temperature (°C) (P = 0.039). CONCLUSIONS Wind speed is the first significant atmospheric risk factor to be identified for DSA formation in the horse. The importance of environmental variance in the incidence of DSA indicates that the pathogenesis of DSA formation may be multifactorial, interdependent and provides support in some horses for the micropuncture hypothesis of DSA formation related to the involvement of environmental conditions causing precorneal tear film and epithelial damage.
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Affiliation(s)
- Laura R Proietto
- SACS, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32608, USA
| | - Caryn E Plummer
- Small Animal Clinical Sciences, University of Florida, PO Box 100101, Gainesville, FL, 32610-0101, USA
| | - Kathleen M Maxwell
- Small Animal Clinical Sciences, University of Florida, PO Box 100101, Gainesville, FL, 32610-0101, USA
| | | | - Dennis E Brooks
- LACS, University of Florida, 2015 SW 16 Avenue, Gainesville, FL, 32608, USA
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Maxwell KM, Plummer CE, Brooks DE. The fungal plaque form of equine keratomycosis. ACTA ACUST UNITED AC 2015. [DOI: 10.7243/2054-3425-3-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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