A case of lipogranulomatous conjunctivitis in a horse

OBJECTIVE

To describe a case of lipogranulomatous conjunctivitis in a horse.

ANIMAL STUDIED

A client-owned 12-year-old Standardbred gelding presenting with chronic conjunctivitis and palpebral masses.

METHODS

Complete ophthalmic examination, surgical excision, histopathology, and bacterial culture of biopsy samples were performed.

RESULTS

Upper and lower eyelids of both eyes were affected, with multiple yellow-to-white nodules on the palpebral conjunctiva, adjacent to the eyelid margin. Nodule removal was achieved via partial tarsal plate excision. Histopathological examination revealed granulomatous inflammation and large droplets of presumed free lipid in the conjunctival lamina propria. The animal was diagnosed with lipogranulomatous conjunctivitis. No postoperative ocular discomfort was observed for months; however, 3 years later, new conjunctival nodules were noticed, requiring a second surgical procedure on three of the eyelids. Transient entropion in the left lower eyelid was observed 2 months after the second surgery, and no recurrence of conjunctival nodules was observed after 18 months of follow-up.

CONCLUSION

To our knowledge, this is the first report of lipogranulomatous conjunctivitis in horses.

Management of lactating breast abscesses by ultrasound-guided needle aspiration and continuation of breastfeeding: A pilot study

INTRODUCTION

Needle aspiration of breast abscesses during lactation are currently recommended as an alternative to surgery only for moderate forms. In case of breast abscess, many patients stop breastfeeding on the advice of a health professional. We reviewed our experience of treatment of lactating breast abscesses by ultrasound-guided aspiration and suggest an algorithm of their management. We also analyzed the continuation of breastfeeding of these patients after advices from trained teams.

MATERIEL AND METHODS

We conducted a retrospective study from April 2016 to April 2017, including 28 patients referred for a breast abscess during lactation at the Duroc Breast Imaging Center. A management by ultrasound-guided aspiration was proposed to each patient. We collected data about the breastfeeding between October 2018 and January 2019.

RESULTS

A single aspiration was sufficient in 64.3% of cases. The delay between the occurrence of the abscess and the indication for drainage was significantly higher for patients who have needed finally surgical drainage (p = 0,0031). There were no difference of size of abscesses between patients receiving needle aspiration alone and those who have undergone surgery (p = 0,97). All patients who had been managed by needle aspiration continued breastfeeding after the treatment and 40% of the patients were still breastfeeding at 6 months.

CONCLUSION

The management of lactating breast abscess by ultrasound-guided needle aspiration is an effective alternative to surgery. It appears to be effective regardless of the size of the abscess and is compatible with the continuation of breastfeeding. Our study has indeed shown that if they are well advised, the majority of patients continue breastfeeding so that it is essential that health professionals be better trained regarding the management of breastfeeding complications.

Outcome of medical therapy for keratomalacia in dogs

OBJECTIVES

To evaluate the clinical and visual outcomes following intensive medical therapy for keratomalacia in dogs.

MATERIALS AND METHODS

Medical records were screened to identify dogs with corneal ulcers and keratomalacia. All patients were given the same topical treatment protocol with frequent administrations of tobramycin in combination with equine serum. Surgical treatment during the first 15 days of follow-up was considered as medical treatment failure.

RESULTS

We report on 57 ulcers with keratomalacia from 53 dogs. Medical treatment was successful in 31 of 57 ulcers with a median healing time of 5 days (range 2 to 15 days). At 60 days after epithelialisation, 14/15 medically-treated eyes were visual. In one case, corneal perforation was observed 1 month after healing and required surgical stabilisation.

CLINICAL SIGNIFICANCE

Intensive medical therapy has the potential to achieve healing of some ulcers with keratomalacia. Surgical stabilisation in response to progression of stromal loss was required in less than half of the cases.

Conjunctival bacterial and fungal flora and cutaneous fungal flora in healthy domestic rabbits (Oryctolagus cuniculus)

OBJECTIVES

To determine the normal conjunctival bacterial and fungal flora in healthy rabbits, to compare the fungal flora from the conjunctival sac with periocular cutaneous fungal flora and to evaluate potential changes in type of micro-organisms over time.

MATERIALS AND METHODS

Samples from 50 pet rabbits with a normal ophthalmic examination were obtained from conjunctival sacs using sterile cotton swabs and from the interpupillary skin space using a piece of sterile carpet. Samples were collected twice, 4 weeks apart, and cultured to evaluate bacterial and fungal populations.

RESULTS

Bacteria were recovered from 35.9% of conjunctival swabs. Corynebacterium species (32.4%), Staphylococcus species (18.3%), Pasteurella species (9.9%) and Moraxella species (8.5%) were the most frequently isolated organisms. Fungi were recovered from 14.6% of conjunctival swabs. The most common fungal genera were Aspergillus (37%), Scopulariopsis (14.8%) and Penicillium (11.1%). Fungal cultures from periocular integument yielded positive results in 96.3% of samples; the same fungal organism was isolated in both conjunctival and cutaneous culture in nine of 20 rabbits (45%). When comparing results 4 weeks apart in 32 of 50 animals, only three rabbits with a positive bacterial culture and one rabbit with a positive fungal culture had the same result at the subsequent test.

CLINICAL SIGNIFICANCE

Fungi and bacteria isolated from the conjunctival sac of rabbits may represent transient seeding from the environment. To our knowledge, this is the first report of fungal composition of the conjunctival sac of rabbits and evaluation of the potential transient nature of both bacterial and fungal composition of this conjunctival flora.