Page 653 - Cote clinical veterinary advisor dogs and cats 4th

298 Eosinophilic Bronchopneumopathy

other than the modified Hotz-Celsus are rarely • Surgical correction of spastic entropion leads • Surgical overcorrection of entropion could
done and may require referral. The amount of to ectropion. result in ectropion; therefore, err on the
VetBooks.ir sedation or anesthesia. Recommended Monitoring • Correction of naturally occurring ectropion
side of caution. Future surgical correction
skin to be removed must be determined before
of undercorrection is much easier to manage.
• Leave temporary tacking sutures or tem-
• Cases of mild entropion
○ Consider modified Hotz-Celsus procedure
conformation is reached or for 2-3 weeks,
(involves elliptical skin incision adjacent porary tarsorrhaphy in place until adult is rarely needed unless it is severe or occurs
in conjunction with entropion on the same
to the eyelid margin). until concurrent ocular disease resolves. eyelid.
• Lateral canthal entropion • Permanent entropion and/or ectropion
○ Creation or cutting of the lateral canthal repairs require suture removal approximately Prevention
ligament (modified Wyman’s lateral 10-14 days after surgery if nonabsorbable Avoid breeding affected or closely related dogs
canthoplasty or lateral canthal tenotomy, suture is used. Absorbable polyglactin 910 with developmental entropion or clinically
respectively) (Vicryl or Vicryl Rapide) is excellent for this significant developmental ectropion.
○ Modified Hotz-Celsus and eyelid-shortening use because it becomes soft when wet and
procedures may be required. does not require removal. Technician Tips
• Medial canthal entropion Any animal that has entropion should have a
○ Medial canthoplasty procedure (e.g., PROGNOSIS & OUTCOME Schirmer tear test and fluorescein stain done.
pocket flap or Wyman technique)
○ Localized modified Hotz-Celsus procedure • Prognosis for restoring normal eyelid Client Education
• Ptosis and upper eyelid entropion confirmation is good. If the initial repair is ineffective or the disease
○ Stades procedure to evert upper eyelid • Recurrence of entropion is possible, depending progresses, additional surgical procedures
margin on underlying cause and surgical treatment. may be required. Many large-breed dogs with
Ectropion: ectropion develop conjunctivitis, but that alone
• Surgery rarely needed unless severe or if PEARLS & CONSIDERATIONS does not warrant surgery. Some kennel clubs
concurrent entropion is present prohibit showing of dogs that have had cosmetic
• Cases of severe ectropion: consider modi- Comments surgeries.
fied Kuhnt-Szymanowski technique (lid- • Treat any concurrent ocular disease before
shortening technique) surgically addressing entropion. SUGGESTED READING
• Cicatricial (scar-induced) ectropion: V-Y • Determination of whether the entropion is Maggs DJ: The eyelids. In Maggs DJ, editor: Slatter’s
blepharoplasty may be used. spastic or developmental is paramount when fundamentals of veterinary ophthalmology, ed 5,
determining the course of treatment (tacking St. Louis, 2013, Elsevier.
Possible Complications vs. surgical).
• Temporary tacking sutures may pull through • No single surgical procedure is effective RELATED CLIENT EDUCATION
the skin, requiring repeat procedure(s) until for correction of all forms of entropion SHEETS
animal is mature or until underlying condi- and/or ectropion (see Chronic Treatment
tion is resolved. above). How to Administer Eye Medications
• Undercorrection or overcorrection of • The modified Hotz-Celsus can be used on How to Assemble and Use an Elizabethan Collar
entropion any area of the lid for entropion, and its
• Correction of subclinical ectropion predis- size and shape vary with the location and AUTHOR: Shannon D. Boveland, DVM, DACVO
poses to entropion. severity of the entropion. EDITOR: Diane V. H. Hendrix, DVM, DACVO

Eosinophilic Bronchopneumopathy Client Education
Sheet

BASIC INFORMATION • No strict corresponding disease in cats; EBP • Depression and weight loss are absent
is distinct from feline asthma • Pruritus (rare)
Definition
Idiopathic eosinophilic inflammation of airways, GENETICS, BREED PREDISPOSITION PHYSICAL EXAM FINDINGS
interstitium, and sometimes alveoli and/or Any breed; Siberian Huskies and Alaskan • Cough and retch
nasal cavities. The disease is well recognized, Malamutes may be predisposed. • Crackles, wheezes, and increased broncho-
but uncommon. vesicular sounds
Clinical Presentation ○ Auscultation may be normal
Synonyms HISTORY, CHIEF COMPLAINT • Tachypnea/dyspnea
Eosinophilic pneumonia, pulmonary infiltrates • Most common: chronic cough poorly • Fever (rare)
with eosinophils (PIE), canine idiopathic responsive to antimicrobials. Cough may • Bronchospastic reactions, such as expiratory
eosinophilic bronchopneumopathy (EBP; the be intermittent, frequent, or persistent and dyspnea and wheezes (rare)
most current term), eosinophilic bronchitis is often accompanied by a terminal gag/retch.
Severe, productive coughing can occur, with Etiology and Pathophysiology
Epidemiology expectoration of thick respiratory secretions, • A hypersensitivity reaction is sus-
SPECIES, AGE, SEX gagging, and/or retching. pected as the main pathophysiologic
• Dogs of either sex and any age • Nasal discharge (serous or mucopurulent) process.
• Young to middle-aged adults predisposed • Exercise intolerance • The precipitating cause is rarely identified.

www.ExpertConsult.com