clin test 3 eyes, skin and bandages

Otodectic Mange ( ear mites)

• Otodectes cynotis ( ear mites)

  • Occurs in dogs and cats

  • More common in cats

  • Occurs in the external ear canal ( looks like coffee grounds)

What are the clinical signs of Ear mites

• Often bilateral ( both)

• Thick black discharge

• Intense pruritus ( itchy) causes scratching, head shaking and droopy ears

how to diagnosis otodectes cynotis

• Done using a ear cytology

  • get the gunk from the ear out using a cotton tipped applicator place on slide

• Use mineral oil on the slide and then exam the slide for ear mites and eggs

What is the treatment for otodectes cynotis

• Topical ear treatments like

  • Milbemite ( milbemycin)

  • Acarexx ( ivermectin)

  • Topical prevention

  • Revolution

  • Advantage multi

• Sometimes need multiple treatments die to the presence of the eggs

Cuteerebra larvae ( botfly larvae)

• The larvae of Cuterebra, commonly known as botfly larvae, infest various mammals including dogs, cats, ferrets, and rabbits. They dwell beneath the skin of the host, creating a noticeable breathing hole and may migrate to the central nervous system or respiratory system, requiring removal with forceps for treatment.

What do skin scrapes show

Mites like Sarcoptes and Demodex.

Skin cytology diagnosis what?

yeast and bacteria

Ear swabs diagnosis what

Bacteria and yeast

Scotch tape prep diagnosis what

Cheyletiella ( walking dandruff mite), yeast,and bacteria

What color should anal gland material be

Should be a light brown color and thin

Where are anal glands located

At 4 and 8 o’clock at the rectum superficial

What should be done before a bath

• Brush prior to bathing

• Clean ears

• Place artificial tears or paralyze ointment to protect corneas

• Place cotton balls in the ears

How often should medicated baths be done for

• 2-3 times a week

  • In healthy skin patients you don’t want to bathe more than every 4-6 weeks

What should not be done when bathing a patient

• Never leave patient in the tub

• Never allow water to collect in tub

• Never leave blower on animals for too long as it can lead to hyperthermia

• Used clippers to remove matted areas if unable to remove with Matt combs

• Do not use scissors

Should a flea and tick topical be applied before or after bathing

• It is important to avoid baths 1-2 days prior to or after applying the topical flea and tick prevention.

Miconoazole

Shampoo that kills yeast

Benzoyl peroxide

Shampoo that flushes the hair follicles

Ketoconazloe

kills yeast

chlorhexidine

Antibacterial and at higher concentrations yeast killing agent effective for infections.

Aloe and oatmeal

Shampoo that is good for slightly upset skin

When is a skin scrapping performed

When the patient has lots of skin lesions

How to preform a skin scrapping

• Squeeze skin beforehand

• Use a dull blade

• Dip it in mineral oil

• Hold skin taught

• Scrape toward your self

• keep the blade at an angle the top should not touch the skin

• Scrape till you see capillary bleeding

Trichogram

• Used hemostat to pull hairs surrounding lesions

• Place hairs in drops of mineral oil

• View under 10x annd 40x

• Does work for demodex in some cases

What is the correct order for dip quick staining

• Fixative ( light Blue methanol)

• Eosin ( red Eosin)

• Counter stain ( purple polychrome stain/thiazide)

Step one of dip quick staining

• Fixative ( light Blue methanol)

step two of f dip quick staining

• Eosin ( red Eosin)

what is step three of dip quick staining

• Counter stain ( purple polychrome stain/thiazide)

Culture and sensitivity steps

• Wear sterilize gloves

• Swab lesion of concern

• Place swab in media tube

• Send to lab

  • Used for chronic cases or cases that fail to respond to antibiotics

Punch Biopsy

• Administer lidocaine as a local block

• Used punch biopsy to remove a small section of the skin

• Place section on tongue depressor

• Suture area closed

• Submit to the lab

Cataracts

• Opacity of lens that causes reduced vision

• most common disease of the lens

• Caused by genetics, Diabetes or trauma to the lens

What causes cataracts

• Diabetes

• Genetics

• Trauma to the lens

What are the signs of cataracts

• Progressive loss of vision

• Opaque pupillary opening

How to diagnosis cataracts

requires using an ophthalmoscope to look through the pupil. If you cannot see the back of the eye, specifically the tapetum and retinal vessels, then cataracts are present.

Nuclear sclerosis

• Changes to the lens of the eye in dogs that does not affect vision

• Looks like cataracts

how are cataracts different from nuclear sclerosis

• Cataracts cause vision loss while nuclear sclerosis does not significantly affect vision.

• when looking at the eye with an ophthalmoscope you can see through the lens with cataracts you can’t

Glaucoma

• Caused by increased intramural pressure (IOP)

• Normal IOP values 15-25mmHg

• Often caused by genetics

• Can cause an animal to go blind very quickly

• Requires life long treatment

Glaucoma symptoms

• Painful red, squinting, bulging eye

• Can result in enucleation of one or both eyes

• If the pressure is elevated over 24 hours, permanent vision loss may occur

Normal IOP values

15-25mmHG

What pressure value diagnosis glaucoma

> 30mmHG

Glaucoma definition

Increased intraocular pressure due to excess production or decreased drainage of aqueous humor leading to potential optic nerve damage and vision loss.

What is the aqueous humor

• provides nourishment to lens and cornea

• Normally the amount of fluid produced equals the amount of fluid leaving the eye

Is glaucoma an emergency

Yes it is an emergency

Underlying diseases that cause secondary glaucoma

Neoplasia, trauma, uveitis, cataracts

How to diagnosis Glaucoma

test the intraocular pressure of the eye a high pressure ( >30) indicates glaucoma.

What needs to be used with a tonopen

A topical anesthetic like proparacaine

Proparacaine

• Topical anesthetics

• Two drops can last up to 25 minutes in dogs

• 1 drop would be 15 minutes in dogs

• One drop lasts 5 minutes in cats

Schiotz tonometer

• applanation technique to measure eye pressure

• The old way of getting an eye pressure

Tonopen uses what technique

• applanation technique

• A small metal plate or tip touches the central part of the cornea directly and sits there briefly to measure the pressure. This method requires a local anesthetic like proparacaine.

Tonovet uses what method

• The rebound technology.

• No topical anesthetic needed

• A tiny ball on a stick quickly touches the cornea and bounces off to measure the pressure. This method is so fast that it does not require a local anesthetic.

What can cause false elevated IOP

• Excessive restraint

• Patient stress

• Excessive pressure on the globe

• Squinting of patient

• Corneal disease

Uveitis

• Inflammation of the eye that supplies blood to the eye ( uveal tract)

• Low intraocular pressure

• Many causes can be which can be trauma, viruses, immune mediated and many systemic diseases

• this is painful

• the color of the eye may be different from each other

what is this?

Uveitis

what causes Uveitis

Uveitis can be caused by trauma, viral infections, autoimmune reactions, and systemic diseases that affect the uveal tract.

What type of pressure does Uveitis have

low ocular pressure

ocular neoplasia

Ocular neoplasia refers to the presence of tumors in or around the eye, which can be malignant or benign and may affect vision and surrounding tissues.

what is this?

ocular neoplasia

Proptosis

• When the globe of the eye moves forward out if its orbit

• Globe is luxated or displaced

• Causes lots of swelling and is painful

what is this?

Proptosis

What is proptosis causes by

• HBC and big dog little dog fight

• Brachycephalic dogs are prone to this

• Trauma

• Conformation

• Retrobulbar abscess or neoplasia

What are the clinical signs of proptosed

• Protrusion of the globe ( coming out of the socket real gross)

• Eyelids unable to close may be trapped behind globe

Treatment of proptosed

• Lubricate immediately

• Reduce the globe into the socket ( put that eye back in) ASAP to reduce trauma to optic nerve, if the eye is viable

• Enucleation if optic nerve severed

• Systemic and topical antibiotics

entropion

• Eyelids that roll in against the cornea

• Caused by: Congenital, Trauma causing scarring and distortion of life

• Severe blepharospasm ( eyelid open close/ blink all the time) from pain

What is this?

entropion

What are the signs of entropion

• Epiphora

• Chemosis

• Conjunctivitis

• Pain

• Corneal ulceration

• Photophobia

Ectropion

• Eyelids rolling away from the eye

• Caused by congenital defects or an over- correction of entropion

• Seen in Great Danes and Bassett hounds

What are the signs of ectropion

• Conjunctivitis

• Epiphora

• Keratitis ( corneal inflammation/ scarring)

what is this

ectropion

What is the treatment of ectropion

• Surgery to shorten the eyelid

• Not needed unless the condition is very bad

Chronic superficial keratitis ( pannus)

• Superficial corneal vascularization/scar tissue

• it is Progressive, bilateral, can result in blindness

what is Chronic superficial keratitis ( pannus) caused by

• Is an immune-mediated disease ( infiltration of cornea with lymphocytes, plasma cells)

• Ultraviolet light/high altitudes increases incidence

What are the signs of chronic superficial keratitis ( pannus)

• Opaque lesions that begin at limbus and extend into cornea

  • Milky, pink or tan lenses

What dog breed commonly gets chronic superficial keratitis

German Shepards

What is the treatment for chronic superficial keratitis ( pannus)

• Corticosteroids often lifelong

• Cyclosporine often lifelong

• Antibiotic eye ointment

Information clients need to know about Pannnus

• There is no cure

• If treatment is stopped, disease will return and progress

• High altitudes and sun will predispose animals to it

What is this

Chronic superficial keratitis

Progressive Retinal atrophy

A group of hereditary disorders causing loss of rods, cones and/or blood supply to the retina which leads to progressive vision loss.

Signs of progressive retinal atrophy

• Slow onset of blindness

• Loss of night vision ( rods)

• Loss of day vision ( cones)

How to diagnosis progressive retinal atrophy

• Ophthalmic exam

  • the retina will be Gray, and have a granular appearance

  • Narrowing of blood vessels will be seen and the optic nerve will be atrophy

Is there a treatment for progressive retinal atrophy

No there is no treatment

what is this?

progressive retinal atrophy

Information that should be given to the client about Progressive Retinal Atrophy

• It is an inherited disease

• Avoid buying affects dogs

• Have ocular exam by board certified ophthalmologist

• Blind animals will adapt well, but may have trouble with strange surrounding

• Cats needs a well balanced diet

  • Taurine deficiency can lead to PRA

Detached Retina

• Usually related to trauma

• Retina will look folded down form the back of the eye

• Animal will appear blind in affected eye

• No treatment

Does Detached retina have a treatment

• No there is no treatment

What test measures tear production

Schirmer tear test

What test is used to diagnose glaucoma or uveitis

IOP

What test is used to diagnose corneal ulcers

Fluorescein Stain

What is the scientific term for dry eye

Keratoconjunctivitis Sicca (KCS)

What is this

Descemetoceles

What is this

Melting ulcer

Blepharospasm

Eye that is painful but they keep blinking repeatedly

Strabismus or Nystagmus

• Cross eyes

• May happen in many different directions

What does an ocular physical exam include

• Palpebral reflex

• Menace response

• Check pupil symmetry

• Pupillary light reflexes

• Maze

• Schirmer tear test

• Fluorescein stain

• Tonometry

Schirmer tear test ( STT)

• Always do this first

• Measures tear production

• Less than 10mm/Min is a KCS diagnostic

• 10-15 mm/min is a gray area

• Normal > 18-23 mm/min

what is a normal STT

18-23 mm/min

Fluorescein stain test

• Detects defects in the cornea

• After flushing the eye and any stain is retained is diagnostic as a corneal ulcer

tonometry ( Tonopen)

• Measures intraocular pressure ( IOP)

• Normal ranges are 15-25 mmHG

What are the normal ranges of foR IOP

15-25 mmHG

How does the Fluorescein stain work

• Corneal Structure: The outermost layer of the cornea, the epithelial layer, is composed of lipids. Beneath this is the stroma, which is water-soluble, and then Descemet's membrane, which is lipid.

• Intact Cornea: In an intact, healthy cornea with no defects, when the water-soluble fluorescein stain is applied, the lipid epithelial layer will repel it, causing the stain to simply wash off.

• Corneal Defects (Erosions/Ulcers): If there is an erosion (a superficial defect in the epithelial layer) or an ulcer (a deeper defect), the lipid epithelial layer is compromised or gone. This allows the water-soluble fluorescein to penetrate and bind to the exposed, water-soluble stroma underneath.

  • When fluorescein stain is applied to the cornea, the lipid epithelial layer repels the stain if intact, causing it to wash off. In the presence of corneal defects, such as erosions or ulcers, the stain penetrates the compromised epithelial layer and binds to the stroma, making defects visible.

Rose Bengal stain

• Used to determine the mucin composition of the tear film ( defect in aqueous part)

• Used in feline herpes virus corneal ulcers ( more superficial erosions/ulcers)

• Used to help diagnose KCS TOO ( Used the same way as the other stain)

Tonopen

Requires topical anesthetic to measure intraocular pressure using a small, handheld device that gently applanates on the cornea.