Difference between revisions of "Uveitis - Cat and Dog"
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| Line 11: | Line 11: | ||
==Causes== | ==Causes== | ||
| − | + | ===Cats=== | |
'''Infectious causes''': | '''Infectious causes''': | ||
| Line 31: | Line 31: | ||
'''Idiopathic''' | '''Idiopathic''' | ||
| + | |||
| + | ===Dogs=== | ||
| + | |||
| + | '''Infectious causes''': | ||
| + | :''Brucella canis'' | ||
| + | :''Borrelia burgdorferi'' | ||
| + | :''Leptospira'' | ||
| + | :Septicaemia of any cause | ||
| + | :''Leishmania'' | ||
| + | :''Toxoplasma'' | ||
| + | :''Erlichia canis'' | ||
| + | :''Rickettsia rickettsii'' | ||
| + | :Adenovirus infection | ||
| + | :Distemper virus | ||
| + | :Herpes virus | ||
| + | :Rabies | ||
| + | :Systemic mycoses (cryptococcosis, histoplasmosis, blastomycosis..) | ||
| + | |||
| + | '''Neoplastic and paraneoplastic disorders''': histiocytic proliferative disease, hyperviscosity syndrome, GME, primary (melanoma) and secondary (lymphoma) neoplasms. | ||
| + | |||
| + | '''Metabolic causes''': Diabetes mellitus, hyperlipidaemia, systemic hypertension | ||
| + | |||
| + | '''Immune-mediated''': cataracts, immune-mediated thrombocytopenia, immune-mediated vasculitis, phacoclastic uveitis, [[Canine Uveodermatologic Syndrome|uveodermatologic syndrome]] | ||
| + | |||
| + | '''Miscellaneous''': drug-induced, idiopathic, pigmentary uveitis in the Golden Retriever, radiation therapy, trauma, toxaemia of any cause, ulcerative keratitis. | ||
==Clinical Signs== | ==Clinical Signs== | ||
| − | + | Animals will usually present because the owner has noticed a change in one or both eyes. There is usually a '''colour change''', cloudy or red most commonly. | |
The condition may be '''unilateral or bilateral'''. Bilateral disease is more common with systemic and auto-immune diseases, whereas trauma usually lead to unilateral signs. | The condition may be '''unilateral or bilateral'''. Bilateral disease is more common with systemic and auto-immune diseases, whereas trauma usually lead to unilateral signs. | ||
| − | '''Acute uveitis''' causes: pain, ciliary flush, miosis, aqueous flare, spongy swollen iris, decreased intra-ocular pressure | + | '''Acute uveitis''' causes: pain, ciliary flush, miosis, aqueous flare, spongy swollen iris, corneal oedema, decreased intra-ocular pressure |
'''Hyphaema''' may be present and make the eye appear red. | '''Hyphaema''' may be present and make the eye appear red. | ||
| Line 45: | Line 70: | ||
A fundus examination may reveal '''chorioretinitis and retinal detachment'''. | A fundus examination may reveal '''chorioretinitis and retinal detachment'''. | ||
| − | With '''chronic uveitis''', additional signs may include: neovascularisation of the iris, changes in iris pigmentation, secondary iris atrophy, synechiae, glaucoma and blindness. | + | With '''chronic uveitis''', additional signs may include: neovascularisation of the iris, changes in iris pigmentation, secondary iris atrophy, synechiae, cataract, glaucoma, lens luxation and blindness. |
==Diagnosis== | ==Diagnosis== | ||
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'''Serological testing''' for ''Toxoplasma'', FeLV, FIV | '''Serological testing''' for ''Toxoplasma'', FeLV, FIV | ||
| − | + | Additional diagnostic tests are selected according to diseases that are endemic to a particular practice area or on suspicion of a particular disease. | |
| + | |||
| + | Often, a precice aetiological diagnosis is not possible, and idiopathic uveitis is a diagnosis of exclusion. | ||
==Treatment== | ==Treatment== | ||
| Line 75: | Line 102: | ||
{{Learning | {{Learning | ||
|flashcards = [[Feline Medicine Q&A 16]] | |flashcards = [[Feline Medicine Q&A 16]] | ||
| + | |||
| + | [[Small Animal Emergency and Critical Care Medicine Q&A 14]] | ||
}} | }} | ||
Revision as of 08:00, 31 August 2011
Introduction
Uveitis refers to inflammation of the uvea.
Various parts of the uvea, aqueous humour and vitreous are continuous, and uveitis often involves many ocular structures.
The retina and choroid are adjacent and are frequently inflamed together.
Anterior uveitis referes to inflammation of the iris and ciliary body whereas posterior uveitis refers to inflammation of the choroid.
The pathogenesis of uveitis is still poorly understood, but immunologic reactions are involved. There are alterations in the vascular structure and permeability of uveal blood vessels following inflammation, and immune complexes can be deposited in vessels and lead to a chronic and recurrent disease.
Causes
Cats
Infectious causes:
- Feline Infectious Peritonitis
- FeLV causing lymphosarcoma
- FIV
- Feline Herpesvirus 1
- Toxoplasmosis
- Bartonella spp
- Systemic mycoses (cryptococcosis, histoplasmosis, blastomycosis, coccidiomycosis)
Neoplasia: Lymphoma, melanoma
Metabolic causes: hypertension, coagulopathies
Immune-mediated: cataract, phagoclastic uveitis, vasculitis
Trauma: blunt or penetrating injuries, corneal foreign bodies
Idiopathic
Dogs
Infectious causes:
- Brucella canis
- Borrelia burgdorferi
- Leptospira
- Septicaemia of any cause
- Leishmania
- Toxoplasma
- Erlichia canis
- Rickettsia rickettsii
- Adenovirus infection
- Distemper virus
- Herpes virus
- Rabies
- Systemic mycoses (cryptococcosis, histoplasmosis, blastomycosis..)
Neoplastic and paraneoplastic disorders: histiocytic proliferative disease, hyperviscosity syndrome, GME, primary (melanoma) and secondary (lymphoma) neoplasms.
Metabolic causes: Diabetes mellitus, hyperlipidaemia, systemic hypertension
Immune-mediated: cataracts, immune-mediated thrombocytopenia, immune-mediated vasculitis, phacoclastic uveitis, uveodermatologic syndrome
Miscellaneous: drug-induced, idiopathic, pigmentary uveitis in the Golden Retriever, radiation therapy, trauma, toxaemia of any cause, ulcerative keratitis.
Clinical Signs
Animals will usually present because the owner has noticed a change in one or both eyes. There is usually a colour change, cloudy or red most commonly.
The condition may be unilateral or bilateral. Bilateral disease is more common with systemic and auto-immune diseases, whereas trauma usually lead to unilateral signs.
Acute uveitis causes: pain, ciliary flush, miosis, aqueous flare, spongy swollen iris, corneal oedema, decreased intra-ocular pressure
Hyphaema may be present and make the eye appear red.
A combination of aqueous flare, hypopyon, keratic precipitates and cataract will make the eye appear cloudy.
A fundus examination may reveal chorioretinitis and retinal detachment.
With chronic uveitis, additional signs may include: neovascularisation of the iris, changes in iris pigmentation, secondary iris atrophy, synechiae, cataract, glaucoma, lens luxation and blindness.
Diagnosis
A thorough clinical examination and ophthalmic examination should enable a diagnosis of uveitis to be made.
Further investigation into the cause of the uveitis should include:
Complete haematology and biochemistry
Urinalysis
Thoracic radiography
Serological testing for Toxoplasma, FeLV, FIV
Additional diagnostic tests are selected according to diseases that are endemic to a particular practice area or on suspicion of a particular disease.
Often, a precice aetiological diagnosis is not possible, and idiopathic uveitis is a diagnosis of exclusion.
Treatment
Treatment should be targeted at the specific cause if one has been found.
Additional treatment can be given to:
Control inflammation: topical or systemic corticosteroids, topical or systemic NSAIDs, topical immunosuppressive drugs such as cyclosporin.
Prevent undesirable sequelae: mydriatics to reduce synechiae formation and secondary glaucoma (atropine or tropicamide), anti-glaucoma agents if necessary
Relieve pain: atropine helps reduce ciliary spasm. The patient can also be placed in a dark room to alleviate photophobia. A systemic opioid analgesia may be necessary in severe cases.
| Uveitis - Cat and Dog Learning Resources | |
|---|---|
 Test your knowledge using flashcard type questions |
Feline Medicine Q&A 16 |
References
Maggs, D. (2008) Slatter's fundamentals of veterinary ophthalmology Elsevier Health Sciences
Turner, S. (2008) Small animal ophthalmology Elsevier Health Sciences
Peiffer, R. (2008) Small animal ophthalmology: a problem-oriented approach Saunders