41
edits
Changes
Jump to navigation
Jump to search
Indolent Ulcers - Dogs (view source)
Revision as of 15:06, 20 February 2014
, 15:06, 20 February 2014Created page with "An '''indolent ulcer''' is a '''superficial corneal ulcer''' that fails to heal despite no apparent underlying cause. Authors differ on the time before an ulcer is classified ..."
An '''indolent ulcer''' is a '''superficial corneal ulcer''' that fails to heal despite no apparent underlying cause. Authors differ on the time before an ulcer is classified as indolent, with some saying an ulcer is indolent after '''7 days''' with no healing, others after '''14 days'''. Indolent ulcers are also known as '''Superficial Chronic Corneal Epithelial Defects''', '''Recurrent Epithelial Erosions''' or '''Boxer Ulcers'''.
==Signalment==
Indolent ulcers are seen in '''Boxer''' dogs of any age, and '''middle aged''' or older dogs of any breed.
==Clinical Signs==
A superficial ulcer failing to heal within 7 or 14 days. The ulcer is normally surrounded by a lip of non-adherent epithelium which flourescein dye applied will run under, staining the stroma of the cornea beyond the edges of the ulcer. There is usually no infection and the eye is only moderately painful at worst.
==Treatment==
There are several techniques used to treat indolent ulcers.
===Debridement===
Under [[Local Anaesthetics|topical anaesthesia]] a '''cotton bud''' is used to remove any loosely adherent epithelium. The debridement may need to be repeated multiple times for healing to occur. In a retrospective study, 84% of cases treated with debridement alone healed, with a median healing time of 21 days.<ref name="multilple">Stanley, Hardman, Johnson Results of grid keratotomy, superficial keratectomy and debridement for the management of persistent corneal erosions in 92 dogs Veterinary Ophthalmolgy 1:233-238 1998</ref>
===Grid Keratectomy===
Following '''debridement''', a '''25 gauge needle''' may be used to create a grid of linear striations extending across the ulcer. This often requires [[sedation]] or [[general anaesthesia]]. In a retrospective study all ulcers healed after grid keratectomy was performed, though 13% of cases required a second grid keratectomy. Median healing time was 11 days.<ref name="multilple">Stanley, Hardman, Johnson Results of grid keratotomy, superficial keratectomy and debridement for the management of persistent corneal erosions in 92 dogs Veterinary Ophthalmolgy 1:233-238 1998</ref>
===Superfical Keratectomy===
In a retrospective study all cases healed after a single procedure. <ref name="multilple">Stanley, Hardman, Johnson Results of grid keratotomy, superficial keratectomy and debridement for the management of persistent corneal erosions in 92 dogs Veterinary Ophthalmolgy 1:233-238 1998</ref>
'''General Anaesthesia''' and '''magnification''' is required for this procedure, and consideration should be given to referral to an ophthalmolgist.
==Control==
There is little evidence on how to prevent recurrence. Some authors suggest applying ocular lubricants may be benefical.
==References==
<references />
Maggs, D et al (2007) '''Slatter's Fundamentals Of Veterinary Ophthalmology''' (Fourth Edition) ''Saunders''
Peiffer, Robert J, and Petersen-Jones, Simon M (2008) '''Small Animal Ophthalmology''' (Fourth Edition) ''Saunders''
Riis, Ronald C (2002) '''Small Animal Ophthalmology Secrets''' ''Hanley and Belfus, Inc''
[[Category:Corneal Diseases - Dog]]
==Signalment==
Indolent ulcers are seen in '''Boxer''' dogs of any age, and '''middle aged''' or older dogs of any breed.
==Clinical Signs==
A superficial ulcer failing to heal within 7 or 14 days. The ulcer is normally surrounded by a lip of non-adherent epithelium which flourescein dye applied will run under, staining the stroma of the cornea beyond the edges of the ulcer. There is usually no infection and the eye is only moderately painful at worst.
==Treatment==
There are several techniques used to treat indolent ulcers.
===Debridement===
Under [[Local Anaesthetics|topical anaesthesia]] a '''cotton bud''' is used to remove any loosely adherent epithelium. The debridement may need to be repeated multiple times for healing to occur. In a retrospective study, 84% of cases treated with debridement alone healed, with a median healing time of 21 days.<ref name="multilple">Stanley, Hardman, Johnson Results of grid keratotomy, superficial keratectomy and debridement for the management of persistent corneal erosions in 92 dogs Veterinary Ophthalmolgy 1:233-238 1998</ref>
===Grid Keratectomy===
Following '''debridement''', a '''25 gauge needle''' may be used to create a grid of linear striations extending across the ulcer. This often requires [[sedation]] or [[general anaesthesia]]. In a retrospective study all ulcers healed after grid keratectomy was performed, though 13% of cases required a second grid keratectomy. Median healing time was 11 days.<ref name="multilple">Stanley, Hardman, Johnson Results of grid keratotomy, superficial keratectomy and debridement for the management of persistent corneal erosions in 92 dogs Veterinary Ophthalmolgy 1:233-238 1998</ref>
===Superfical Keratectomy===
In a retrospective study all cases healed after a single procedure. <ref name="multilple">Stanley, Hardman, Johnson Results of grid keratotomy, superficial keratectomy and debridement for the management of persistent corneal erosions in 92 dogs Veterinary Ophthalmolgy 1:233-238 1998</ref>
'''General Anaesthesia''' and '''magnification''' is required for this procedure, and consideration should be given to referral to an ophthalmolgist.
==Control==
There is little evidence on how to prevent recurrence. Some authors suggest applying ocular lubricants may be benefical.
==References==
<references />
Maggs, D et al (2007) '''Slatter's Fundamentals Of Veterinary Ophthalmology''' (Fourth Edition) ''Saunders''
Peiffer, Robert J, and Petersen-Jones, Simon M (2008) '''Small Animal Ophthalmology''' (Fourth Edition) ''Saunders''
Riis, Ronald C (2002) '''Small Animal Ophthalmology Secrets''' ''Hanley and Belfus, Inc''
[[Category:Corneal Diseases - Dog]]