Page 477 - Cote clinical veterinary advisor dogs and cats 4th

214 Cornification Disorders

Acute General Treatment • Consider changing antibiotics if indicated • Negative menace response and negative dazzle
• Do not put pressure on the globe until the by culture and sensitivity results. and pupillary light reflexes at initial exam
VetBooks.ir • Elizabethan collar to prevent self-trauma Drug Interactions indicate grave prognosis for vision.
of a patient with corneal or scleral trauma
possibility of rupture is eliminated.
Do not use topical ophthalmic ointments if
• For small, nonperforating or very small,
sealed perforating wounds without uveal
prolapse, consider conservative therapy. globe rupture is suspected. PEARLS & CONSIDERATIONS
○ Topical antibiotic solution (e.g., neomycin/ Possible Complications Comments
polymyxin/gramicidin, gentamicin or • Retinal detachment • Consider sedation to keep patient calm and
tobramycin and cefazolin, or ciprofloxacin) • Cataracts prevent self-trauma.
q 6h • Chronic uveitis • Elizabethan collar to prevent self-trauma
○ Add broad-spectrum systemic antibiotics • Glaucoma
if perforating (e.g., amoxicillin-clavulanate • Endophthalmitis (inflammation of the uveal Prevention
13.75 mg/kg PO q 12h; base long-term tract and anterior and posterior compart- • Animals should be monitored when
choice on culture and sensitivity). ments of the eye with or without infection) introduced to new environment with other
○ Systemic antiinflammatory therapy with • Loss of vision and eye animals.
nonsteroidal antiinflammatories (e.g., car- • Cats may develop posttraumatic ocular • Dogs should not be allowed to ride in cars
profen 2 mg/kg PO q 12h or meloxicam sarcomas years after the original injury, with head out of window.
0.1 mg/kg PO q 24h) or antiinflammatory particularly if lens involved.
doses of prednisone (e.g., 0.5-1 mg/kg PO Technician Tips
q 24h) Recommended Monitoring Avoid pressure on neck and eye when handling
○ Topical atropine 1% solution q 6-24h if • Re-evaluate in 24-48 hours to ensure wounds affected animal.
significant uveitis (p. 1023) are sealed, inflammation is improving, and
• Perforating or deep, large, or gaping penetrat- there are no signs of infection. Client Education
ing wounds and wounds with uveal prolapse • Frequency of exam depends on response to Discuss the possibility of long-term complica-
require primary surgical repair (referable therapy. tions that could lead to loss of vision and loss
procedure) involving of an eye.
○ Replacement of viable uveal tissue or PROGNOSIS & OUTCOME
resection of nonviable uveal tissue SUGGESTED READING
○ Irrigation and reinflation of anterior • Intuitively, small, shallow penetrating wounds Miller PE: Ocular emergencies. In Maggs DJ, et
chamber of the cornea or lacerations involving only al, editors: Slatter’s Fundamentals of veterinary
○ Repair of cornea with appropriate-size the cornea have a good prognosis, whereas ophthalmology, ed 4, Philadelphia, 2008, Saunders,
suture material (8-0 to 10-0) complicated, perforating wounds with uveal p 419.
○ Careful inspection of lens; if lens rupture and/or lens involvement have a poorer AUTHOR: Ellison Bentley, DVM, DACVO
is noted, lens may need to be removed by prognosis for vision. EDITOR: Diane V. H. Hendrix, DVM, DACVO
phacoemulsification • Wounds involving sclera or sclera and uvea
have a grave prognosis for vision.
Chronic Treatment • Blunt trauma usually has a grave prognosis
• Monitor and treat for uveitis and wound for vision, particularly if extensive hyphema
dehiscence. is present.

Cornification Disorders Bonus Material Client Education
Online
Sheet
Epidemiology
BASIC INFORMATION • Vitamin A–responsive dermatosis: cocker
SPECIES, AGE, SEX spaniel, Labrador retriever, miniature
Definition • Primary (hereditary) causes: early in life for schnauzer, Gordon setters
A well-recognized class of scaling or greasy many conditions; diagnosed by ruling out • Zinc-responsive dermatosis: Alaskan Mala-
skin disorders resulting from primary (usually secondary disorders mute, Siberian Husky, Samoyed, Pharaoh
hereditary) or secondary (acquired) defects in • Secondary (acquired): any age; usually adult hounds
epidermal maturation, desquamation, or sebum animals (majority of cases) • Lethal acrodermatitis: bull terrier
production • Sebaceous adenitis (p. 901): standard poodle,
GENETICS, BREED PREDISPOSITION Akita, others
Synonyms • Primary idiopathic seborrhea: cocker spaniel, • Ichthyosis: golden retriever, American
• Keratinization defects/disorders West Highland white terrier, basset hound, bulldog, Jack Russell terrier, Norfolk terrier
• Keratoseborrheic disorders Shar-pei, dachshund, Doberman pinscher, (autosomal recessive)
• Many disorders were formerly grouped English springer spaniel, German shepherd,
under the heading seborrhea, but this term Irish setter, Labrador retriever CONTAGION AND ZOONOSIS
was nonspecific and inaccurate and is now • Primary hereditary seborrhea oleosa: Persian, Most are not contagious, but parasitic and fungal
obsolete. Himalayan, and exotic short-haired cats causes have contagious and zoonotic potential.

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