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Reynolds BD, Nagel HG, Perry E, Whittaker CJ, Caruso KA, Annear MJ, Irving WM, McCarthy PM, Dion A, Yi JMS, Hall E, Smith JS. Ophthalmic findings associated with Australian tick paralysis (holocyclotoxicity) in hospitalized domestic dogs and cats. Vet Ophthalmol 2024. [PMID: 38468143 DOI: 10.1111/vop.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE To describe ophthalmic findings in hospitalized canine and feline patients with tick paralysis (TP) and investigate possible predisposing factors. ANIMALS STUDIED Forty-seven dogs and 28 cats hospitalized with TP assessed with an ophthalmic examination performed by an ABVO resident. METHODS Dogs and cats were hospitalized with TP from October 2021 to January 2022 and had an ophthalmic examination performed by an ABVO resident. Patient signalment data, information regarding tick number and location, hospitalization duration, medications used, and patient paralysis grades were recorded. Statistical analysis was performed to correlate findings. RESULTS Corneal ulcers developed in up to 34.8% of dogs and up to 42.9% of cats hospitalized with TP. An absent palpebral reflex ipsilaterally increased the odds of a concurrent corneal ulcer being present by 14.7× in dogs and 20.1× in cats (p < .0001). Palpebral reflexes were absent in 38.3% of dogs and 35.7% of cats hospitalized with TP and were correlated with more severe gait paralysis (p = .01) and respiratory paralysis (p = .005) in dogs, and respiratory paralysis in cats (p = .041). STT-1 findings <10 mm/min were present in 27.7% of dogs and 57.1% of cats examined and were associated with increasing gait paralysis (p = .017) and respiratory paralysis (p = .007) in dogs, and increasing gait paralysis in cats (p = .017). CONCLUSIONS Simple corneal ulcers, loss of a complete palpebral reflex, and reduced STT-1 scores frequently occurred in dogs and cats hospitalized for TP. The frequency of these findings increased as the degree of patient paralysis increased.
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Affiliation(s)
- B D Reynolds
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - H G Nagel
- Terrey Hills Animal Hospital, Sydney, New South Wales, Australia
| | - E Perry
- Northside Emergency Veterinary Service, Sydney, New South Wales, Australia
| | - C J Whittaker
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - K A Caruso
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - M J Annear
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - W M Irving
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - P M McCarthy
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - A Dion
- Northside Emergency Veterinary Service, Sydney, New South Wales, Australia
| | - J M S Yi
- Northside Emergency Veterinary Service, Sydney, New South Wales, Australia
| | - E Hall
- University of Sydney, Sydney, New South Wales, Australia
| | - J S Smith
- Eye Clinic for Animals, Sydney, New South Wales, Australia
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Reynolds BD, Perry E, Nagel HG, Whittaker CJ, Caruso KA, Annear MJ, Irving WM, McCarthy PM, Dion A, Yi JS, Hall E, Smith JS. Retrospective assessment of ophthalmic disease development in domestic dogs and cats when hospitalised with tick paralysis caused by Ixodes holocyclus. Aust Vet J 2024. [PMID: 38369322 DOI: 10.1111/avj.13325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/19/2023] [Accepted: 01/21/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE To investigate the incidence and predisposing factors leading to the development of corneal ulcers and the loss of a palpebral reflex in hospitalised canine and feline patients with tick paralysis (TP). ANIMALS STUDIED A total of 102 dogs and 100 cats retrospectively were assessed from previously hospitalised patients. METHODS A retrospective cohort study was performed on 102 different canine and 100 different feline patients who were hospitalised for TP from October 2020-January 2022. Patient data were collected, and logistic regression was conducted to determine factors affecting the palpebral reflex and the development of corneal ulcers. RESULTS Corneal ulcers occurred in 23/102 (22.5%) dogs during hospitalisation and were strongly associated with an incomplete palpebral reflex ipsilaterally during hospitalisation (P < 0.001), hospitalisation ≥3 days (P = 0.004), mechanical ventilation ≥3 days (P = 0.015) or a tick location cranial to C1 (P = 0.003). An incomplete palpebral reflex during hospitalisation was observed in 29/102 (28.4%) dogs and was significantly associated with decreasing patient weight (P = 0.018), increasing days hospitalised (P = 0.001), having a tick found cranial to C1 (P = 0.004), highest recorded GP grade (P = 0.01), highest recorded RP grade (P = 0.005), use of amoxycillin-clavulanic acid during hospitalisation (P = 0.002) and use of piperacillin/tazobactam during hospitalisation (P = 0.003). There was a significant association between the loss of a complete palpebral reflex and mortality during hospitalisation in dogs (OR = 4.5, P = 0.029). Corneal ulcers occurred in 10/100 (10.0%) cats during hospitalisation, and was significantly more likely to occur to an eye if an incomplete palpebral reflex was observed ipsilaterally during hospitalisation (OR = 20.1, P < 0.0001) and with increasing patient age (P = 0.019). The absence of a complete palpebral reflex during hospitalisation was observed in 18/10 (18.0%) cats and was significantly associated with increasing days hospitalised (P = 0.034). There was no significant association between the loss of a complete palpebral reflex and mortality during hospitalisation in cats. CONCLUSIONS The frequency of corneal ulcers and loss of palpebral reflexes were significant in dogs and cats hospitalised by TP, with many factors contributing to the risk of these developing.
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Affiliation(s)
- B D Reynolds
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - E Perry
- Northside Emergency Veterinary Service, Sydney, New South Wales, 2084, Australia
| | - H G Nagel
- Terrey Hills Animal Hospital, Sydney, New South Wales, 2084, Australia
| | - C J Whittaker
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - K A Caruso
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - M J Annear
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - W M Irving
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - P M McCarthy
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
| | - A Dion
- Northside Emergency Veterinary Service, Sydney, New South Wales, 2084, Australia
| | - Jm-S Yi
- Northside Emergency Veterinary Service, Sydney, New South Wales, 2084, Australia
| | - E Hall
- University of Sydney, Sydney, New South Wales, 2006, Australia
| | - J S Smith
- Eye Clinic for Animals, Sydney, New South Wales, 2064, Australia
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Abstract
HISTORY AND CLINICAL FINDINGS For 4 years a 56-year-old woman had been suffering from chronic urticaria. In the past two years she had developed recurrent fever, each 1-3 days in duration. In the last 6 to 8 months she also had severe aching in the legs. There were no significant findings on physical examination other than non-itching urticarial rash over trunk and limbs. INVESTIGATIONS Blood sedimentation rate was increased (maximum 88/110 mm), as were WBC count (16,200/microliter, 83% neutrophils) and the activity of alkaline leucocyte phosphatase (225 U/l). Monoclonal IgM gammopathy type kappa and circulating IgM immune complex (15.4 mg/dl) were demonstrated in serum. Skin biopsy of a new urticarial lesion revealed vasculitis. Iliac crest biopsy was unremarkable and showed no lymphoid cell infiltration. Bone scintigraphy revealed bilaterally increased storage in femur and tibia. Magnetic resonance imaging demonstrated marrow infiltration without space-occupying features in the affected femur and tibia. TREATMENT AND COURSE Conjunction of fever, generalised urticaria, joint/bone pain and monoclonal gammopathy of kappa type having established the diagnosis of Schnitzler's syndrome, treatment with ibuprofen was started (initially 1,200 mg daily by mouth, followed by reduction to 600 mg daily). All symptoms rapidly improved and the bone changes regressed, but not the monoclonal gammopathy. But when the ibuprofen dosage had been decreased to 600 mg daily, the urticaria recurred, though in milder form. CONCLUSION This case demonstrates the efficacy of ibuprofen in the treatment of the Schnitzler's syndrome. Furthermore reversibility of scintigraphic bone lesions could be demonstrated under ibuprofen treatment.
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