Robert Lowe's Activities

Tonometer choice

Rob Loxley — Mon, 14 Nov 2022 17:47:55 GMT

Looking at a tonometer; my understanding is the Tonovet is easier than the Tonopen, but does anyone know the difference in practice between the tonovet and tonovetPlus – apart from £500?

Optimmune use post cherry eye removal

charlievelyn — Wed, 30 Nov 2022 12:03:26 GMT

Hello. I have a new patient who has a history of longstanding bilateral cherry eye prolapse and concurrent dry eye bilaterally (STT was 0 bilaterally at first recording). Numerous attempts at replacement failed and now both nictitans glands have been excised. (Apologies I have no data on post op STT scores as the case has arrived in my inbox but I have not seen the dog yet and no new scores have been recorded on the history.)

My question is: will ongoing use of Optimmune be "doing anything" given both nictitans glands have been removed? I appreciate that the nictitans gland is not responsible for 100% of tear production so I theorise that, yes, it will be helping somewhat with any ongoing dry eye? Just want to confirm before we keep going, potentially unnecessarily, with the Optimmune long term.

KCS in dogs - Is there another type?

Neil Wheadon — Wed, 23 Nov 2022 10:30:24 GMT

One for Robert Lowe (Arlo, how do you add names?) maybe

Great talk at LVS by Charlotte Dawson eluded to another type of KCS, where the schirmer is 'normal'. It's not in the notes, but I seem to recall it was a lack of lipid component?

In essence, the eye walks like a duck, looks like a duck, yet the schirmer tells you it isn't a duck. Her advise is 'treat it anyway'

So what's the discusion? Well to alert others that this is out there and if anyone has any further information and how to diagnose it that would be appreciated. In the questions after the lecture there was talk of fluoroscene addition and getting subtle breakdown in under 2.5 seconds

Neil

Uveal Tract Differences in Dogs and Cats

Aine Seavers — Thu, 06 Oct 2022 07:07:57 GMT

Recently had a dog with lipid aqueous eye-all now sorted including cause etc,

My question relates to a feline guru mate questioning my eye guru mate's notes on the cause where they diagnosedthe lipid laden aqueous or a ‘lipid tsunami’, and stated that occurs when the body had high levels of circulating lipids that can somehow break through the blood ocular barrier resulting in the deposition of lipid into the anterior chamber.

The feline guru questioned that report on the basis that Burmese cats have high TG levels all their life. They only get lipid aqueous when as young cats - they develop uveitis. This causes the normal barrier in the uveal tract to be permeable to the large TG molecules.

My reply was cats are not small dogs and have different anatomy everwhere so why not in the uveal tracts of the eye-if this is the case-would anyone know the difference.

I know about the differents vessel risk for diabetes as a species issue hence myquestion if anyone knows why the cat eye responds differently to lipid than dogs

Corneal Deposits in Cats

Yantha Smyth — Fri, 02 Sep 2022 10:24:44 GMT

Hi,
I have seen dogs with suspected lipid or calcium deposits on the cornea but never a cat, and wondering if it is a recognised thing and how or what you would do to investigate for underlying cause and/or treat it?

I saw a cat yesterday and the clients had noticed some small opacities on the cornea and brought in for examination.

4-5yo, overweight female spayed DSH

no signs of pain or ocular discharge, no inflammation- conjunctiva and sclera normal, no corneal oedema, anterior chambers clear, lenses clear, posterior appears normal. Normal lid anatomy, no previous ocular conditions or viral disease history.

one eye has a single white speck centrally, the other has a fine ‘sprinkle’ of very small white specks roughly central.

fluoret-ve

my only thought so far is to do bloods to check for hyperlipidaemia/triglycerides and wondering if the obesity could be linked, but given she is a ‘care’ cat for even exams, only want to recommend if likely to be useful.

I have not put on any treatment for now.

thanks for any input

Yantha

Corneal Ulcers - a tidal wave

Neil Wheadon — Thu, 30 Dec 2021 15:04:33 GMT

Is anyone else seeing lots of these? Brachycephalics especially

More to the point, does anyone have a way of getting these cured faster as I'm just about to see my 3rd chronic one this morning (I locum and these aren't all my cases)

My protocol seems to be

1) Antibiotics, preferably isathal as less drops

2) Remend - as often as the client can

3) Maybe Metacam

If no cure

Move to serum drops

These are for 'simple' ulcers and in that I mean normal schirmers, no eyelid defects

Help!!

Neil

Spotty retina

Charlotte Marshall — Thu, 25 Nov 2021 23:54:17 GMT

I have seen a 6 month old kitten tonight which seems a bit scrawny and not quite well. Apparently its much larger littermate bullies it and it doesn't eat well. I am suspicious it could be FIP.

When I checked it's eyes the right eye had lots of grey spots on the retina. I have struggled to find many images of retinal changes in cats other than haemorrhage but it looks a bit like one I found of chorioretinitis.

Could this be consistent with FIP? The other retina seems normal to me.

Which Ophthalmoscope ?

janine redman — Sun, 12 Sep 2021 19:27:17 GMT

Looking at purchasing an ophthalmoscope , what’s the difference between 3.5 and 2.5 mv ?
any advice on desk top charger , USB charger , ordinary batteries etc

thanks

Histopath lab choice

Beats — Sat, 27 Feb 2021 13:34:10 GMT

I'm reviewing where we send our histopath samples to after a recent 50% increase in histopath fee at current lab.

What I can't currently find is a list of ALL UK and Ireland labs offering histopathology for dogs/cats.

Can we make one?

Cat with plaque on the eye

Claire Godfrey — Wed, 02 Dec 2020 21:06:47 GMT

This is a 4 year old female neutered domestic short haired cat. She was presented after the owners had noticed the eye was sore for 2 weeks. The eye had purulent discharge and there was an ulcer present. The owners were keen to try to save the eye, but are aware enucleation maybe an option.

Currently treating the eye wih exocin and gel tears and the cat is on loxicom. Eye has PLR, menace is difficult to assess. Remarkably the cat is actually very comfortable with the eye. It is open, and there does not appear to be any epiphora. There is quite a large plaque there though.

Sorry this is not a great photo but will this eye heal or does it need something more drastic or is enucleation the way forwards??

Boxer ?keratitis

joanne mcallister — Tue, 19 May 2020 18:38:29 GMT

Hi, I would appreciate any input on this case. This boxer first came in 4-5 days after a dog attack with what looked like a superficial corneal ulcer and corneal oedema. It was treated initially with systemic NSAIDs, isathal and optixcare and I debrided the ulcer when it did not appear to be healing after 10 days and started Ciloxan drops. There is no longer any flourescine uptake and the eye has remained comfortable with no obvious photophobia. There is now a proliferative raised red area over the cornea and some corneal oedema still present. I started on prednisolone drops 1 week ago, assuming this was a keratitis but this has made no difference. he remains comfortable. These photos were taken today,

many thanks

Shar Pei Entropion (... modified brow suspension)

Beats — Fri, 18 Oct 2019 19:10:51 GMT

Discussion point 1: What is the best way to manage [specifically juvenile, e.g. 4 months old] shar pei entropion? (e.g. do you manage most cases the same way [and if not what changes your approach], how many cases do you treat a year, why do you use the techniques/approaches you do etc.)

Discussion point 2: Can anyone explain to me so that I understand precisely how to do a modified brow suspension as per the authors of www.ncbi.nlm.nih.gov/.../28444838 ?

I can't understand (to the level that I could replicate) how the diagram matches the text - I am confident this is because I don't properly understand what is being explained.

"After using the surgeon's fingers as a guide for artificially folding the excess of frontal skin, the number of slings and rows were decided for each eye and skin incisions marked with a sterile marker pen. The rostral row was located at the level of the orbital rim, the mid row at approximately 3–4 cm from the rostral incision and the caudal row at approximately 6–8 cm from the rostral incision. Monofilament nonabsorbable synthetic sutures of size 0–2 with reverse cutting needles of 24–45 mm size and 1/2 to 3/8 of curve were used to secure each sling. Starting from the caudal incision, and moving the skin caudally to the desired final position, the suture was passed horizontally (from right to left) beneath the frontalis muscle and anchored on the periosteum of the frontal bone. Then, the needle was redirected subdermally to the central row obliquely (from left to right), and the fixation process was repeated at the desired location. Just after, the needle was redirected subdermally to the rostral row obliquely and the fixation procedure repeated for the third time. Finally, the needle was passed subdermally back to the caudal row and both ends of the suture are secured with a mosquito forceps. One to four slings were placed above each eye, depending on the degree of pseudoptosis. All slings, from the two eyes, were tied at the same time to obtain a functional and symmetrical result. The skin incisions were closed with 4–0 or 6–0 polypropylene in a simple interrupted suture pattern."

Prospective veterinary student with recent severe hand injury

Robert Lowe — Mon, 28 Nov 2016 12:54:02 GMT

Dear Colleagues

A friend's child has always wanted to be a veterinary surgeon but recently suffered a major hand injury. Currently they only have a functioning forefinger and thumb in their dominant hand and this is not likely to change. We will be offering some work experience as planned prior to the injury but I was hoping to be able to offer some helpful advice on career options involving veterinary work.

Would anybody who has experience of such a situation either themselves or contact with similar scenarios be able to help me with this? ie. shifting focus to pathology / lab work or industry are two things that spring to mind but I have no experience of them. Indeed is it possible to perform as a veterinary surgeon with this type of injury?

Thanks in advance for your help

Rob

VetSurgeon.org

Sun, 19 Oct 2008 07:19:04 GMT