rabbit third eyelids

RE: rabbit third eyelids

David Mills — Mon, 26 Sep 2016 23:25:42 GMT

[quote user="Martin Atkinson"]In which case the ophthalmologist should be taken to task.[/quote]

Give 'em a break - diabetic cataracts is the only bit of medicine ophthalmologists understand.

It never ceases to amaze me the number of owners of diabetics who miss appointments, insulin, etc, grumble about cost and then find £2-3k for cataract surgery when the eyes go tits up.

I love receiving snooty referral reports - it's by far and away the best way to decide where to send the next one to - hardly a shortage around London.

RE: rabbit third eyelids

Robin Grimmer — Mon, 26 Sep 2016 21:02:16 GMT

G to pc:

5.1 Overtly poor relationships between veterinary surgeons and/or veterinary nurses undermine public confidence in the whole profession.

5.2 Veterinary surgeons and veterinary nurses should not speak or write disparagingly about another veterinary surgeon or veterinary nurse. Colleagues should be treated fairly, without discrimination and with respect, in all situations and in all forms of communication

RE: rabbit third eyelids

Clive Ansell — Mon, 26 Sep 2016 17:46:06 GMT

[quote user="Martin Atkinson"]Equally I would hope that the referring vet in your case did send the clinical notes showing that the client did not comply with his/her recommendations. In which case the ophthalmologist should be taken to task.[/quote]

The history goes back years, and I'm guessing not all the clinical history was sent, just the recent and relevant notes. Either way I don't think colleagues should be so disparaging without being aware of all the facts.

Another recent one was a clinical report from a well known OOH provider criticising the user practice for not investigating and treating properly a dog with Addison's, including a teaching granny to suck eggs advice paragraph!. Again, a full investigation had been advised but declined by the penny pinching cost conscious client, and had they followed the advice given the crisis would have been averted.

RE: rabbit third eyelids

Martin Atkinson — Mon, 26 Sep 2016 17:10:02 GMT

[quote user="Clive Ansell"]

Presumably it would be (or not) in the referral vets clinical report sent to the referring vet on conclusion of the case?

I picked up on a very scathing, and frankly rude, report from an ophthalmic referral centre recently which really criticised the way the referring practice had been (not) managing a dog's diabetes. A quick glance at the clinical notes revealed that the client has repeated failed to attend for rechecks, blood tests and glucose curves and had refused to inject insulin twice daily. All the facts are need to make a judgement.

[/quote]This is a double edged sword isn't it. I would imagine the referring vet in Jason's case didn't write 'your tests were a waste of money' in the discharge notes and the client just picked up on/misinterpreted a loose comment in a consultation. Equally I would hope that the referring vet in your case did send the clinical notes showing that the client did not comply with his/her recommendations. In which case the ophthalmologist should be taken to task.

RE: rabbit third eyelids

Thomas Johnson — Mon, 26 Sep 2016 17:04:31 GMT

[quote user="Clive Ansell"]I picked up on a very scathing, and frankly rude, report from an ophthalmic referral centre recently which really criticised the way the referring practice had been (not) managing a dog's diabetes. A quick glance at the clinical notes revealed that the client has repeated failed to attend for rechecks, blood tests and glucose curves and had refused to inject insulin twice daily. All the facts are need to make a judgement.[/quote]

And in your example the referral vet would have had the clinical history so should have seen from reading it themselves what had happened.

RE: rabbit third eyelids

Clive Ansell — Mon, 26 Sep 2016 16:59:39 GMT

[quote user="Martin Atkinson"]

[quote user="jason davidson"]The rabbit was then referred and the client came back to us very unhappy as apparently the referring specialist told her that FNA samples of these masses are 98% inconclusive and we wasted had her money by doing one. The specialist told the owner straight away that it was cherry eye and booked the rabbit in for excision of the mass.[/quote]I would want to hear that from the horse's mouth. But if it is true I would take the specialist to task for telling a client something the referring vet did was a 'waste of money'.

More like a client who's pissed off because they've spent a lot of money hearing what they want to hear.

[/quote]

Presumably it would be (or not) in the referral vets clinical report sent to the referring vet on conclusion of the case?

RE: rabbit third eyelids

Evelyn Barbour-Hill — Mon, 26 Sep 2016 16:23:02 GMT

[quote user="jason davidson"]Please let me know your thoughts.[/quote]

If that's true (might not be) I wouldn't be using that specialist again.

RE: rabbit third eyelids

Martin Atkinson — Mon, 26 Sep 2016 15:42:59 GMT

More like a client who's pissed off because they've spent a lot of money hearing what they want to hear.

RE: rabbit third eyelids

jason davidson — Mon, 26 Sep 2016 13:35:39 GMT

Hi Marie

We have recently been treating a rabbit with a similar lesion and as it is an unusual lesion we decided to take an FNA sample of the mass before suggesting surgery.

Unfortunately the cytology was inconclusive due to low cell yield.

The rabbit was then referred and the client came back to us very unhappy as apparently the referring specialist told her that FNA samples of these masses are 98% inconclusive and we wasted had her money by doing one. The specialist told the owner straight away that it was cherry eye and booked the rabbit in for excision of the mass.

Please correct me if I am wrong but I have not seen very many cherry-eye cases in rabbits and I assume that they are pretty rare. I also believe that other masses on the eyelid, including tumours or abscesses are possible and that when there is doubt then an FNA is a suitable first diagnositic step.

Please let me know your thoughts.

Thanks

RE: rabbit third eyelids

grumpyoldman — Tue, 06 Sep 2016 17:16:30 GMT

looks like there is a rim of tissue developing around the limbus , maybe one of those chronic membrane conjunctivalisation cases . worth seeing if the membrane slowly grows over the cornea? The medial canthal swelling maybe prolapsed fat or lymphoid/lacrimal tissue . FNA could answer the question.

RE: rabbit third eyelids

Marie Kubiak — Tue, 06 Sep 2016 14:55:42 GMT

It's a bit odd- the few cherry eye cases I have seen present with a more ventral position of prolapse and have been in younger animals. Treatment was surgical with pocket technique and worked very well. Might be worth an ophthalmogist opinion as they probably see far more glandular prolapses?

Is that an ulcer on the cornea or just a bit of hair and mucus?

Bilateral acute prolapse is a bit unusual too- it is in the right age group for increased retrobulbar pressure with renal/idiopathic hypertension, mediastinal thymoma or dental abscessation. I have seen one case of 3rd eyelid masses due to lymphoma but that was more diffuse than this one.

I'd be tempted to try topical NSAIDs and if it doesn't resolve GA to examine fully and see exactly what is prolapsed, then replace if gland, biopsy if not! Also useful to check conscious BP and consider chest rads to evaluate mediastinum if anaesthetising.

Marie

RE: rabbit third eyelids

Martin Atkinson — Tue, 06 Sep 2016 14:19:18 GMT

Looks like cherry eye in dogs and maybe the treatment is the same. I have a great feeling of deja vu here but can't remember the outcome. Hopefully Marie will be along soon.

RE: rabbit third eyelids

kathryne hodgson — Tue, 06 Sep 2016 13:18:08 GMT

[quote user="kathryne hodgson"]

These photos are from a 6 y/o castrated male lion head, up to date with annual myxo/vhd1 vaccine and regular dental checks. He has a history of cheek teeth spikes but no dentals in the last few years and issue resolved on changing to hay-based diet. The eyes have been like this for 3 weeks now, with a slight reduction in size of the tissue since been on loxicom. no other associated clinical signs, eating well and no sneezing. I have just advised a 'wait and see' approach at present.

I suspect it is proliferative lymphoid tissue but am as a loss as to why and if it is relevant. Dos bunnies get hates syndrome like cats? Do they have prominent nictitans glands which i am just noticing as a normal anatomical structure?

No uveitis/cataracts/xs lacrimation or head tilt etc.

Any advice or help would be much appreciated.

Thanks in anticipation

Kathryne

[/quote]