Effect of xylazine and ketamine on intraocular pressure in horses

Effect of anesthetic induction with propofol, alfaxalone or ketamine on intraocular pressure in cats: a randomized masked clinical investigation

OBJECTIVE

To compare the effect of propofol, alfaxalone and ketamine on intraocular pressure (IOP) in cats.

STUDY DESIGN

Prospective, masked, randomized clinical trial.

ANIMALS

A total of 43 ophthalmologically normal cats scheduled to undergo general anesthesia for various procedures.

METHODS

Following baseline IOP measurements using applanation tonometry, anesthesia was induced with propofol (n = 15), alfaxalone (n = 14) or ketamine (n = 14) administered intravenously to effect. Then, midazolam (0.3 mg kg^-1) was administered intravenously and endotracheal intubation was performed without application of topical anesthesia. The IOP was measured following each intervention. Data was analyzed using one-way anova and repeated-measures mixed design with post hoc analysis. A p-value <0.05 was considered significant.

RESULTS

Mean ± standard error IOP at baseline was not different among groups (propofol, 18 ± 0.6; alfaxalone, 18 ± 0.7; ketamine, 17 ± 0.5 mmHg). Following induction of anesthesia, IOP increased significantly compared with baseline in the propofol (20 ± 0.7 mmHg), but not in the alfaxalone (19 ± 0.8 mmHg) or ketamine (16 ± 0.7 mmHg) groups. Midazolam administration resulted in significant decrease from the previous measurement in the alfaxalone group (16 ± 0.7 mmHg), but not in the propofol group (19 ± 0.7 mmHg) or the ketamine (16 ± 0.8 mmHg) group. A further decrease was measured after intubation in the alfaxalone group (15 ± 0.9 mmHg).

CONCLUSIONS AND CLINICAL RELEVANCE

Propofol should be used with caution in cats predisposed to perforation or glaucoma, as any increase in IOP should be avoided.

Effects of acute stress, general anesthetics, tonometry, and temperature on intraocular pressure in rats

Intraocular pressure (IOP) is important for eye health as abnormal levels can led to ocular tissue damage. IOP is typically estimated by tonometry, which only provides snapshots of pressure history. Tonometry also requires subject cooperation and corneal contact that may influence IOP readings. The aim of this research was to investigate IOP dynamics of conscious animals in response to stressors, common anesthetics, tonometry, and temperature manipulations. An eye of male Brown-Norway rats was implanted with a fluid-filled cannula connected to a wireless telemetry system that records IOP continuously. Stress effects were examined by restricting animal movements. Anesthetic effects were examined by varying isoflurane concentration or injecting a bolus of ketamine. Tonometry effects were examined using applanation and rebound tonometers. Temperature effects were examined by exposing anesthetized and conscious animals to warm or cool surfaces. Telemetry recordings revealed that IOP fluctuates spontaneously by several mmHg, even in idle and anesthetized animals. Environmental disturbances also caused transient IOP fluctuations that were synchronous in recorded animals and could last over a half hour. Animal immobilization produced a rapid sustained elevation of IOP that was blocked by anesthetics, whereas little-to-no IOP change was detected in isoflurane- or ketamine-anesthetized animals if body temperature (BT) was maintained. IOP and BT decreased precipitously when heat support was not provided and were highly correlated during surface temperature manipulations. Surface temperature had no impact on IOP of conscious animals. IOP increased slightly during applanation tonometry but not rebound tonometry. The results show that IOP is dynamically modulated by internal and external factors that can activate rapidly and last long beyond the initiating event. Wireless telemetry indicates that animal interaction induces startle and stress responses that raise IOP. Anesthesia blocks these responses, which allows for better tonometry estimates of resting IOP provided that BT is controlled.

Effect of multiple head positions on intraocular pressure in healthy, anesthetized horses during hoisting

OBJECTIVE

To evaluate changes in intraocular pressure (IOP) with variable head position in healthy, anesthetized horses in hoisted inversion and to assess the influence of various cofactors (age, sex, body weight, body condition score, and neck length) on IOP changes during hoisting.

ANIMALS STUDIED

Seventeen healthy adult horses without significant ocular abnormalities.

PROCEDURES

Subjects were administered intravenous xylazine/butorphanol premedication and ketamine/midazolam induction with xylazine/ketamine boluses for anesthetic maintenance. While hoisted, IOP was measured in triplicate for each eye via rebound tonometry (TonoVet) at neutral head position (ie, eyes level with the withers), at multiple 5 cm increments above and below neutral (-20 cm through +20 cm) using foam pads for head support, and with eyes above heart level via manual support.

RESULTS

In hoisted positions, IOP ranged from 18 to 51 mmHg. Intraocular pressure significantly decreased with head position elevated ≥+15 cm from neutral and significantly increased when lowered ≤-5 cm from neutral. Neck length significantly influenced IOP (P = .0328) with linear regression indicating a median (range) increase of 0.244 (0.034-0.425) mmHg in IOP for every 1 cm increase in neck length. Age, sex, breed, body weight, body condition score, and eye (OD vs OS) did not significantly influence IOP. Intraocular pressure only varied significantly between eyes at +10 cm above neutral (OS > OD, 1.7 ± 0.6 mm Hg, P = .0044).

CONCLUSIONS

Intraocular pressure in healthy, anesthetized horses varies with head position during hoisting; increased neck length may be associated with larger changes in IOP during hoisting.

Intraocular pressure following four different intravenous sedation protocols in normal horses

BACKGROUND

Intravenous sedation is frequently necessary for ophthalmic examination in horses. Common sedation protocols have not been directly compared in terms of relative intraocular pressure (IOP) reduction, duration of IOP reduction and time to maximum IOP reduction.

OBJECTIVES

To compare the effects of standing sedation protocols on IOP.

STUDY DESIGN

Randomised cross-over experiment.

METHODS

Twelve healthy horses received four intravenous sedation protocols with a 48 hours washout: 0.5 mg/kg xylazine and 0.01 mg/kg butorphanol (SED1); 10 µg/kg detomidine and 0.01 mg/kg of butorphanol (SED2); 10 µg/kg detomidine (SED3); 0.5 mg/kg xylazine (SED4). IOP was measured with rebound tonometry before sedation (Tpre) and 5, 10, 15, 30, 45 and 60 minutes post-sedation (Tpost). Post-sedation readings were taken with the head elevated to the Tpre position. Separately, IOP readings were also obtained following sedation with the head not elevated (TpostHeadDown). IOP values were compared using mixed ANOVA and ANCOVA models respectively with significance at P < .05.

RESULTS

All protocols decreased IOP compared with baseline with greatest reduction at Tpost5. IOP at Tpre (mean ± SD) was 21.8 ± 4.4 mm Hg. At Tpost5, IOP was 16.3 ± 3.8 mm Hg (SED1), 14.5 ± 2.9 mm Hg (SED2), 17.1 ± 3.8 mm Hg (SED3) and 16.9 ± 4.2 mm Hg (SED4). SED2 Tpost5 IOP was lower than other treatments. Considering all time points following sedation, SED3 IOP readings were higher than other treatments. TpostHeadDown IOPs were higher than readings taken with the head elevated (P < .001).

MAIN LIMITATIONS

Animals with ocular disease were not studied. No animals received mock sedation or equivalent.

CONCLUSIONS

A combination of detomidine and butorphanol causes greater IOP reduction 5 minutes following sedation than other commonly used sedation protocols. IOP reduction is less pronounced when detomidine is used alone. Consideration of head height is important when performing IOP measurements in horses.

Comparison of two rebound tonometers in healthy horses

Objective

To obtain a reference range for evaluation of intraocular pressure (IOP) in horses using Tonovet Plus^®, to compare the IOP readings obtained with Tonovet^® and Tonovet Plus^®, and to evaluate the repeatability of readings.

Animals studied and Procedures

Intraocular pressure of 30 client‐owned horses (60 eyes) with no signs of illness or ocular disease was evaluated using Tonovet^® and Tonovet Plus^® rebound tonometers. Horses’ mean age was 10.7 (range 6‐17) years. Triplicate measurements were performed without using sedatives or local anesthetics, with minimal restraint.

Results

Calculated reference intervals (the CLSI robust method) were 14.4‐27.2 mmHg for Tonovet^® and 16.0‐26.1 mmHg for Tonovet Plus^®. Mean values (± standard deviation, SD [± coefficient of variation, CV]) obtained with Tonovet Plus^® (21.6 ± 2.45 mmHg [11.3%]) were on average 0.6 mmHg higher than with Tonovet^® (21.0 ± 3.14 mmHg [15.0%]), and a negligible statistical difference between the devices was found using the paired sample t test (P = .049). The correlation coefficient for the averaged triplicate measurements was 0.73. The average CV was 4.6% and 4.4% for Tonovet^® and Tonovet Plus^®, respectively.

Conclusions

The repeatability of measurements was very good with both devices. The readings between the two devices differed statistically significantly, but the correlation was considered good and the variation was numerically small, and thus, the difference was considered clinically irrelevant. When monitoring disease process or treatment response in an individual patient, repeated readings are best performed using a similar device to avoid false interpretation of results.

Inter-user and intra-user variation of two tonometers in horses

BACKGROUND

It is currently unknown which of the two devices most commonly used in equine ophthalmology for intraocular pressure (IOP) estimation demonstrates the lowest inter-user and intra-user variation.

OBJECTIVES

To assess the inter-user and intra-user variation of two tonometers in sedated and unsedated horses.

STUDY DESIGN

Randomised masked cross-over trial.

METHODS

Four examiners used the rebound (ICare^® TonoVet) and applanation (TonoPen^® ) tonometers to measure the intraocular pressure (IOP) in triplicate in 10 normal horses before and after sedation with xylazine. For inter-user variation, coefficient of variation (CV) values were calculated from the mean of each examiner for each condition combination. For intra-user variation, CV values were calculated from the individual measurements of each examiner for each condition combination. CV values were also assessed in relation to other variables using ANOVA.

RESULTS

The rebound tonometer was found to have lower inter-user (15.4% vs 21.7%, P = .01) and intra-user (9.1% vs 16.1%, P < .0001) variation in unsedated horses and lower intra-user (8.4% vs 14.7%, P < .0001) variation in sedated horses than the applanation tonometer. Both instruments had similar inter-user variation in sedated horses. For the rebound tonometer, sedation did not affect inter-user or intra-user variation, but for the applanation tonometer inter-user variation was lowest while horses were sedated (16.0% vs 21.7%, P = .03). No other variable assessed was found to have an effect on IOP.

MAIN LIMITATIONS

No animals with ocular disease were included in this study.

CONCLUSIONS

The rebound tonometer may be the preferred instrument to minimise intra-user and inter-user variation for IOP measurement in unsedated horses. The rebound tonometer is also likely to be the preferred instrument to minimise intra-user variation in sedated horses. If the applanation tonometer is used to perform IOP measurement in horses, it is recommended that this is performed while horses are sedated to minimise inter-user variation for this instrument.

Effect of auriculopalpebral nerve block on equine intraocular pressure measured by rebound tonometry (TonoVet® )

OBJECTIVE

To assess rebound tonometry intraocular pressure (IOP) in unsedated horses without and with auriculopalpebral (AP) nerve blocks.

ANIMALS STUDIED

Twenty-two client- and twenty university-owned horses (84 total eyes) with unremarkable ophthalmic examinations were evaluated.

PROCEDURE

One eye of each horse was chosen randomly, an AP block performed for that eye, and IOP measured in both eyes with a TonoVet^® . The process was repeated for the contralateral eye 72 hours later under the same conditions as the initial measurements. Horses were unsedated for nerve blocks and tonometry. Linear mixed-effects models were used for comparisons with statistical significance threshold of 0.05.

RESULTS

Overall, blocked eyes had an 0.8 mm Hg lower average IOP than unblocked eyes (P = .039). IOP for client-owned horses was on average 3.2 mm Hg lower than in UGA-owned horses (P = .025) and was more impacted by AP block (1.4 mm Hg lower average in client-owned blocked versus unblocked eyes (P = .006)). Block effectiveness was ranked on a subjective scale ("good", "poor", no block/control), and IOP was on average lower in eyes with a good block (P = .008).

CONCLUSION

Although there were statistically significant differences in IOP between blocked and unblocked eyes, between client- and UGA-owned horses, and between eyes with good and poor AP blocks, these differences were not clinically significant. Thus, AP blocks remain a useful tool for evaluating equine ophthalmic health with minimal impact on IOP assessment.

Lack of effects of intramuscular medetomidine on intraocular pressure in clinically normal cats

Objectives

This study aimed to determine the effects of intramuscular medetomidine on the results of tonometry in healthy cats.

Methods

Sixteen healthy cats were randomly divided into two groups of eight cats. The first group was sedated with intramuscular medetomidine alone (100 µg/kg) and the second group received only saline (0.5 ml/5 kg). Intraocular pressure (IOP) values were measured immediately before (T0) and after the injections at 15 mins (T15) and 25 mins (T25) in both groups.

Results

Sedation with medetomidine did not cause a statistically significant change in the mean IOP values. The pretreatment mean ± SD IOPs in the treatment and control groups were 16.2 ± 3.1 and 15.9 ± 4.0 mmHg, respectively. In the medetomidine group the mean ± SD IOPs at T15 and T25 were 16.1 ± 4.1 ( P = 0.9) and 14.6 ± 2.2 ( P = 0.1).

Conclusions and relevance

Based on this study in healthy cats, medetomidine may be a good choice as a sedative agent in uncooperative cats when IOP measurements are needed. Further investigations in cats with abnormal IOPs are warranted.

Effect of intravenous administration of romifidine on intraocular pressure in clinically normal horses

OBJECTIVE

To evaluate the effect of intravenous administration of romifidine on the intraocular pressure (IOP) in horses.

ANIMALS STUDIED

Twenty-four horses with no ocular abnormalities.

PROCEDURE

Horses were randomly assigned into two equal groups (treatment and control). All horses in the treatment group received an intravenous (IV) injection of romifidine (40 μg/kg). The horses in the control group were administrated an intravenous injection of 0.9% saline (0.4 mL/100 kg). In both groups, the IOP values were measured immediately (T0 ) pre-administration and at 5 (T5 ), 15 (T15 ), 30 (T30 ), 45 (T45 ), 60 (T60 ), 90 (T90 ), and 120 (T120 ) min after drug administration.

RESULTS

The pre-treatment values (T0 ) of IOP for right and left eyes were 24.25 ± 3.5 and 25.16 ± 3.4 mmHg, respectively. A significant decrease in IOP values was observed in both right and left eyes of the horses in treatment group at T5 , T15 , T30 , T45 , T60 , and T90 in comparison with the baseline values (P < 0.05). The lowest level of IOP in romifidine-treated groups was recorded at T45 for the right and left eyes (10.25 ± 2.3 and 11.25 ± 3.5 mmHg, respectively).

CONCLUSION

Romifidine significantly decreased IOP in clinically normal horses and may be used safely for surgery or diagnostic ocular procedures in horses when specific control of IOP is required.

The effects of intravenous romifidine on intraocular pressure in clinically normal horses and horses with incidental ophthalmic findings

DESIGN

Original study.

OBJECTIVE

To evaluate the effect of sedation with romifidine hydrochloride 1% (Sedivet: Boehringer-Ingelheim) on intraocular pressure (IOP) in the normal horse and horses with incidental ophthalmic findings as measured by applanation tonometry.

ANIMALS

Nineteen clinically normal horses (13 geldings, six mares) and eight horses (three geldings, five mares) with incidental ophthalmic findings were included in this study.

PROCEDURES

All horses underwent complete ophthalmic examination with pharmacologic mydriasis a minimum of 2 weeks prior to IOP evaluation. Baseline intraocular pressure values were obtained following auriculopalpebral nerve block and topical anesthetic. Immediately thereafter, romifidine was administered intravenously (75 µg/kg) and the IOP recorded at 5, 15, 30, 45 and 60 min postsedation in both eyes. Five successive readings were obtained at each time point, the low and high value discarded, and three remaining readings averaged for a mean.

RESULTS

The changes with time were consistent between eyes and OD and OS results were pooled. The mean IOP at baseline was 26.35 ± 5.57 mmHg. Mean IOP values were significantly lower than baseline at 5 (P < 0.0001), 15 (P < 0.0001), 30 (P = 0.0003), 45 (P < 0.0001) and 60 (P = 0.0005) minutes. The largest change from baseline (16.7%) was noted at t = 15 min.

CONCLUSIONS AND CLINICAL RELEVANCE

Administration of romifidine significantly decreased the IOP from baseline at all time points measured. The greatest decline in IOP was noted at 15 min postsedation. Results are consistent with other studies noting a decline in IOP with administration of α-2 agonists.

Effects of ketamine, propofol, or thiopental administration on intraocular pressure and qualities of induction of and recovery from anesthesia in horses

OBJECTIVE

To assess the effects of ketamine hydrochloride, propofol, or compounded thiopental sodium administration on intraocular pressure (IOP) and qualities of induction of and recovery from anesthesia in horses.

ANIMALS

6 healthy adult horses.

PROCEDURES

Horses were sedated with xylazine hydrochloride (0.5 mg/kg), and anesthesia was induced with guaifenesin followed by ketamine (2 mg/kg), propofol (3 mg/kg), or thiopental (4 mg/kg) in a crossover study with ≥ 1 week between treatments. For each horse, IOP in the right eye was measured with a handheld applanation tonometer before and after xylazine administration, at the time of recumbency, and every 3 minutes after induction of anesthesia until spontaneous movement was observed. Cardiorespiratory responses and venous blood measurements were recorded during anesthesia. Induction of and recovery from anesthesia were subjectively evaluated by investigators who were unaware of the anesthetic treatment of each horse. Data were analyzed via a repeated-measures ANOVA with Holm-Ŝidák post hoc comparisons.

RESULTS

Compared with findings after xylazine administration (mean ± SD, 17 ± 3 mm Hg), thiopental decreased IOP by 4 ± 23%, whereas propofol and ketamine increased IOP by 8 ± 11% and 37 ± 16%, respectively. Compared with the effects of ketamine, propofol and thiopental resulted in significantly lower IOP at the time of recumbency and higher heart rates at 3 minutes after induction of anesthesia. No other significant differences among treatments were found.

CONCLUSIONS AND CLINICAL RELEVANCE

These findings support the use of thiopental or propofol in preference to ketamine for horses in which increases in IOP should be minimized.

Effect of head position on intraocular pressure in horses

OBJECTIVE

To evaluate the effect of head position on intraocular pressure (IOP) in horses.

ANIMALS

30 horses.

PROCEDURES

Horses were sedated with detomidine HCl (0.01 mg/kg, IV). Auriculopalpebral nerve blocks were applied bilaterally with 2% lidocaine HCl. The corneas of both eyes were anesthetized with ophthalmic 0.5% proparacaine solution. Intraocular pressures were measured with an applanation tonometer with the head positioned below and above heart level. The mean of 3 readings was taken for each eye at each position for data analysis. The effect of head position on IOP was assessed and generalized estimating equations were used to adjust for the correlation from repeated measures of the same eye and intereye correlation from the same horse.

RESULTS

Of the 60 eyes, 52 (87%) had increased IOP when measured below the heart level. A significant difference (mean +/- SE, 8.20 +/- 1.01 mm Hg) was seen in the mean IOP when the head was above (17.5 +/- 0.8 mm Hg) or below (25.7 +/- 1.2 mm Hg) heart level. No significant effect of sex, age, or neck length on IOP change was found.

CONCLUSIONS AND CLINICAL RELEVANCE

Head position has a significant effect on the IOP of horses. Failure to maintain a consistent head position between IOP measurements could potentially prevent the meaningful interpretation of perceived aberrations or changes in IOP.

Effects of ketamine, diazepam, and their combination on intraocular pressures in clinically normal dogs

OBJECTIVE

To evaluate the effects of ketamine, diazepam, and the combination of ketamine and diazepam on intraocular pressures (IOPs) in clinically normal dogs in which premedication was not administered.

ANIMALS

50 dogs.

PROCEDURES

Dogs were randomly allocated to 1 of 5 groups. Dogs received ketamine alone (5 mg/kg [KET5] or 10 mg/kg [KET10], IV), ketamine (10 mg/kg) with diazepam (0.5 mg/kg, IV; KETVAL), diazepam alone (0.5 mg/kg, IV; VAL), or saline (0.9% NaCl) solution (0.1 mL/kg, IV; SAL). Intraocular pressures were measured immediately before and after injection and at 5, 10, 15, and 20 minutes after injection.

RESULTS

IOP was increased over baseline values immediately after injection and at 5 and 10 minutes in the KET5 group and immediately after injection in the KETVAL group. Compared with the SAL group, the mean change in IOP was greater immediately after injection and at 5 and 10 minutes in the KET5 group. The mean IOP increased to 5.7, 3.2, 3.1, 0.8, and 0.8 mm Hg over mean baseline values in the KET5, KET10, KETVAL, SAL, and VAL groups, respectively. All dogs in the KET5 and most dogs in the KETVAL and KET10 groups had an overall increase in IOP over baseline values.

CONCLUSIONS AND CLINICAL RELEVANCE

Compared with baseline values and values obtained from dogs in the SAL group, ketamine administered at a dose of 5 mg/kg, IV, caused a significant and clinically important increase in IOP in dogs in which premedication was not administered. Ketamine should not be used in dogs with corneal trauma or glaucoma or in those undergoing intraocular surgery.

Validation of an ocular microdialysis technique in rabbits with permanently implanted vitreous probes: systemic and intravitreal pharmacokinetics of fluorescein

The purpose of this work is to validate a novel ocular microdialysis sampling technique in rabbits with permanently implanted vitreous probes. This objective is achieved by studying the vitreous pharmacokinetics of fluorescein following systemic and intravitreal administration. The rabbits were divided into two groups (groups I and II) based on whether or not they were allowed a recovery period following surgical implantation of probes. The integrity of the blood-retinal barrier was determined by the vitreal protein concentrations and the fluorescein permeability index. Vitreal protein concentrations returned to baseline 48 h after probe implantation and therefore experiments were conducted 72 h post-implantation of probes in rabbits where recovery period was allowed. The permeability indices for fluorescein after systemic administration in group I (without recovery period) and group II (with recovery period) indicated that the integrity of the blood-retinal barrier was maintained and were found out to be 0.55 +/- 0.27 and 0.71 +/- 0.38%, respectively, for the vitreous chamber. Following microdialysis probe implantation in the group II rabbits, the blood-retinal barrier integrity was not compromised. A novel microdialysis technique in rabbits with permanently implanted probes for studying the pharmacokinetics of posterior segment has been developed and characterized.

Efeitos da infusão contínua de cetamina sobre a pressão intra-ocular em cães hipovolêmicos anestesiados com desflurano

Compararam-se os efeitos de duas doses de cetamina, administradas em infusão contínua, sobre a pressão intra-ocular (PIO) de 18 cães submetidos à hipovolemia e à anestesia com desflurano. Promoveu-se a hipovolemia em todos os cães, retirando-se 40 ml de sangue/kg de peso. A anestesia foi induzida com desflurano, através de máscara facial, até que a intubação orotraqueal fosse permitida. Decorridos 30 minutos, para estabilização dos parâmetros, iniciou-se a infusão contínua de cetamina. Os cães foram distribuídos, aleatoriamente, em três grupos (n= 6). O grupo I (controle) recebeu solução salina estéril; o grupo II (GII) recebeu cetamina, na dose de 100mig/kg/min, e o grupo III (GIII), cetamina na dose de 200mig/kg/min. A PIO foi medida por tonometria de aplanação. Foram mensurados freqüência cardíaca (FC), ritmo cardíaco, pressão arterial média (PAM), débito cardíaco (DC), pressão venosa central (PVC) e pressão parcial de CO2 no final da expiração (ETCO2). O desflurano não influenciou os resultados da PIO, porém observou-se discreta ação da cetamina em todos os grupos. Foi possível estabelecer relação direta entre os valores de PIO e de ETCO2. A PIO apresentou relação direta somente com a ETCO2.

Standing sedation and pain management for ophthalmic patients

Several ocular procedures, including examination, removal of corneal foreign bodies, nictitans surgery, eyelid repair, and tumor excision,can be successfully performed in the appropriately restrained and sedated standing horse. Sedation is best achieved with xylazine,with or without the addition of acepromazine. Additional analgesia can be provided with appropriate local anesthetic blocks. Surgical conditions are greatly improved by using an auriculopalpebral and supraorbital block and topical anesthetics. More elaborate standing sedation involving continuous rate infusions of lidocaine or detomidine combined with butorphanol may facilitate more involved surgery with appropriate support staff and equipment in animals that are at high risk for general anesthesia or when the latter is not an option. Short-term or long-term analgesia is most commonly provided with nonsteroidal anti-inflammatory drugs, but several newer techniques, including lidocaine and butorphanol infusions, may be effective. Topical treatment with opioids to provide analgesia and opioid antagonists to enhance corneal healing is an exciting new development that may revolutionize our approach to corneal ulcer therapy in the future if current research findings are supportive.

Effect of reproductive status on intraocular pressure in cats

OBJECTIVE

To measure intraocular pressure (IOP) and progesterone concentrations in cats and to examine their reproductive organs to determine whether reproductive status affects IOP in cats.

ANIMALS

75 sexually intact domestic shorthair cats scheduled to be neutered, including 28 males, 21 females not in estrus, 13 females in estrus, and 13 pregnant females.

PROCEDURES

Applanation tonometry was conducted to measure IOP and radioimmunoassay was used to determine progesterone concentrations. Reproductive organs were examined at time of surgery.

RESULTS

The IOP in female cats that were in estrus was significantly higher than IOP in female cats that were not in estrus. Progesterone concentrations significantly affected IOP in pregnant cats.

CONCLUSIONS AND CLINICAL RELEVANCE

In cats, IOP is affected by changes in reproductive status. Such changes should be considered when interpreting tonometry results in this species.

Treatment of equine glaucoma by transscleral neodymium:yttrium aluminum garnet laser cyclophotocoagulation: a retrospective study of 23 eyes of 16 horses

Contact neodymium:yttrium aluminum garnet (Nd:YAG) laser transscleral cyclophotocoagulation (TSCP) was performed on 23 eyes of 16 horses for treatment of glaucoma. The mean highest preoperative IOP was 51 +/- 17 mmHg. Follow-up evaluation was available for 19 eyes 1 day after surgery, 14 eyes from 1 to 2 weeks, 16 eyes from 4 to 6 weeks, 9 eyes from 12 to 16 weeks, and 10 eyes greater than 20 weeks after laser treatment. The mean intraocular pressure (IOP) the day following surgery was 34 +/- 13 mmHg. The mean IOP for each follow-up period was: one to two weeks postoperative, 23 +/- 9 mmHg; four to six weeks, 24 +/- 7 mmHg; 12-16 weeks, 28 +/- 10 mmHg; and >/= 20 weeks, 22 +/- 9 mmHg. IOP measurements were significantly different from pretreatment values for all follow-up intervals except for weeks 12-16 (P < 0.05). Treatment success was defined as maintenance of IOP < 30 mmHg. Treatment success was achieved in 93%, 88%, 78%, and 70% of the treated eyes at the 1-2 weeks, 4-6 weeks, 12-16 weeks, and the >/= 20 weeks re-evaluation, respectively. No significant difference was found between the number of eyes visual at presentation (52.2%) and visual at 20 weeks (60%). The most common laser complications were conjunctival hyperemia (21.7%) and corneal ulcers (13.0%). Results of this study indicate that Nd:YAG TSCP is an effective method of controlling IOP and preserving vision in horses with glaucoma. An effective Nd:YAG laser protocol for TSCP in the equine glaucomatous eye is a power setting of 11 W, duration of 0.4 s, applied 5 mm posterior to the limbus at 60 sites, resulting in a total energy dose of 264 J.

Intraocular pressure in normal dairy cattle

Intraocular pressure (IOP) was measured in normal dairy cows by applanation tonometry. In the first study of 15 Holstein and 17 Jersey cows the mean IOP by Mackay-Marg tonometry was 27.5 +/- 4.8 mmHg (range 16-39 mmHg); no significant differences (P < 0.92) were observed between the Holstein and Jersey breeds. In the second study of 15 Holstein and 12 Jersey cows, the mean IOPs by Mackay-Marg and TonoPen-XL tonometry were 28.2 +/- 4.6 mmHg (range 19-39 mmHg) and 26.9 +/- 6.7 mmHg (range 16-42 mmHg), respectively. Comparisons of the Mackay-Marg and TonoPen tonometers indicated no significant differences (P < 0.16). The mean and range of IOP in normal dairy cows within 2 SD (95% of the population) is 27 mmHg with a range of 16-36 mmHg.

Effect of topical administration of 2% dorzlamide hydrochloride or 2% dorzlamide hydrochloride-0.5% timolol maleate on intraocular pressure in clinically normal horses

OBJECTIVE

To evaluate the effect of topical administration of 2% dorzolamide hydrochloride or 2% dorzolamide hydrochloride-0.5% timolol maleate on intraocular pressure (IOP) in clinically normal horses.

ANIMALS

18 healthy adult horses without ocular abnormalities.

PROCEDURE

The IOP was measured at 5 time points (7 AM, 9 AM, 11 AM, 3 PM, 7 PM) over 11 days. On days 1 and 2, baseline values were established. On days 3 through 5, horses received 2% dorzolamide HCI (group D, n = 9) or 2% dorzolamide HCl-0.5% timolol maleate (group DT, 9) in 1 randomly assigned eye every 24 hours immediately following each daily 7 AM IOP measurement. On days 6 through 9, each drug was given every 12 hours (7 AM and 7 PM) in the treated eye. Measurements on days 10 and 11 assessed return to baseline. Mixed linear regression models compared mean IOP difference for each drug at each time period.

RESULTS

Mean IOP decreased significantly in all eyes during the 2 dose/d period, compared with the baseline, 1 dose/d, and follow-up periods.

CONCLUSIONS AND CLINICAL RELEVANCE

Administration of either drug every 24 hours for short-term treatment does not reduce IOP significantly. Administering either drug every 12 hours induced a significant reduction of IOP; however, controlling for all variables, the reduction was less than 2 mm Hg.

Intraocular pressure and eye enlargement in chicks

In chicks, the application of optical devices that blur vision results in eye enlargement and ametropia. The research presented here investigated changes in intraocular pressure (IOP), specifically intravitreal pressure, that occur with eye enlargement induced by this means. Plastic goggles (domes) were glued over one eye in 25 domestic chicks. Plastic rings were glued around one eye in 25 control chicks to control for the mechanical effects of the treatment but which left their vision undisturbed. Following two weeks of treatment, domes and rings were removed and IOP was measured. Mean IOP of the domed eyes was 1.14 mm Hg lower than that of control eyes, a difference that was not statistically significant. The eyes of an additional group of 20 chicks that experienced similar treatments were refracted; these refractions revealed that the dome-treated eyes had a mean refractive state that was 7.98 D myopic relative to the ring controls, which was statistically significant. The results indicate that IOP does not change significantly in chicks with experimental eye enlargement induced by retinal-image degradation.

Management of facial injuries

Because of the excellent blood supply to the head region, superficial lacerations to the soft tissue structures of the head generally heal rapidly without treatment. Lacerations of the equine tongue frequently go unnoticed because difficulty in eating usually is not apparent. The majority of lacerations heal if left untreated, with no loss in function. Surgical repair is indicated to promote healing and prevent deformity, to amputate a severely compromised apex, and to alter a scar or defect that is unacceptable to the owner. Surgical principles to be adhered to include thorough debridement and copious lavage, multiple layer closure, and placement of tension sutures away from the primary suture line and tied on the dorsum of the tongue. Full-thickness lip lacerations should be repaired using multiple-layer closure and tension sutures tied on the skin surface away from the primary suture line. Reconstructive techniques have been described for extensive lip lacerations when primary repair was inadequate or tissue loss was severe. Thorough evaluation of the equine lid, adnexa, and orbit is essential in determining severity of injury and appropriate treatment methods as well as for establishment of a prognosis. The injury may be minor or more severe, leading to blindness, disfigurement, or loss of the eye itself. Depression fractures involving the frontal, maxillary, or nasal bones are frequently open fractures. Skin abrasions, epistaxis, facial deformity, crepitus, and pain are clinical signs seen with this type of injury. Bone and soft tissue reconstruction should be performed to minimize potential complications. Facial fractures left untreated can result in facial deformity, sequestration, sinusitis, and osteomyelitis.