Questions and Answers
What is the limitation of a study that suggests a causal relationship between nKCS and medication application in dogs?
The sample size was small and the data was retrospective
What is the primary mechanism of action of pilocarpine in treating canine neurogenic keratoconjunctivitis sicca?
Stimulation of lacrimal gland postganglionic innervation
What is the suspected cause of neurogenic keratoconjunctivitis sicca in dogs?
Application of otic medications containing terbinafine and florfenicol
Which of the following is a potential complication of otic medication use in dogs?
Signup and view all the answers
What is the primary objective of the study?
Signup and view all the answers
What is the potential complication of using otic medications in dogs?
Signup and view all the answers
What is the name of the condition characterized by reduced tear production in dogs, often associated with endocrinopathies?
Signup and view all the answers
What is the name of the statistical method used to control the false discovery rate in multiple testing?
Signup and view all the answers
What is the diagnostic criterion used to confirm neurogenic keratoconjunctivitis sicca in the study?
Signup and view all the answers
What is the term for the association of otitis media with chronic otitis externa in dogs?
Signup and view all the answers
How many client-owned dogs were included in the study?
Signup and view all the answers
Which of the following is a common symptom of canine neurogenic keratoconjunctivitis sicca?
Signup and view all the answers
What is the timeframe for the onset of clinical signs of neurogenic keratoconjunctivitis sicca in dogs after application of otic medications?
Signup and view all the answers
What is the application of nonhypotensive autonomic agents in veterinary ophthalmology?
Signup and view all the answers
What is the term for the study of the diagnosis and treatment of disorders of the eye?
Signup and view all the answers
What is the name of the medication combinations suspected to cause neurogenic keratoconjunctivitis sicca in dogs?
Signup and view all the answers
What is the neurological manifestation of ear disease in dogs?
Signup and view all the answers
Which of the following is a potential cause of canine neurogenic keratoconjunctivitis sicca?
Signup and view all the answers
What is the term used to describe the dryness of the eyes in dogs?
Signup and view all the answers
What is the purpose of using magnetic resonance imaging (MRI) in dogs with chronic otitis externa?
Signup and view all the answers
What is the name of the medical condition characterized by a deficiency in tear production in dogs?
Signup and view all the answers
What is the regulatory agency responsible for overseeing the use of otic medications in dogs?
Signup and view all the answers
What is the primary mechanism by which otic medications are thought to cause neurogenic keratoconjunctivitis sicca in dogs?
Signup and view all the answers
Which of the following is a potential complication of canine neurogenic keratoconjunctivitis sicca?
Signup and view all the answers
What is the primary site of lesions that result in postganglionic innervation defects leading to nKCS in dogs?
Signup and view all the answers
Which nerves are affected in dogs with unilateral, severe ocular discomfort and a Schirmer tear test (STT) value of close to zero?
Signup and view all the answers
What is the common ocular symptom observed in dogs with nKCS, in addition to reduced tear production?
Signup and view all the answers
What is the suspected cause of nKCS in dogs that develop the condition within 1 day of applying otitis externa medications?
Signup and view all the answers
What is the site of synapse of preganglionic fibers that innervate the lacrimal gland in dogs?
Signup and view all the answers
What is the nasolacrimal duct anatomy relevant to nKCS in dogs?
Signup and view all the answers
What is the documented median time from application of ear medication to documented return of clinically normal tear production in dogs with nKCS?
Signup and view all the answers
What is the percentage of dogs in the study that developed a corneal ulcer as a complication of nKCS?
Signup and view all the answers
What is the potential underlying cause of keratoconjunctivitis sicca in horses with hypothyroidism?
Signup and view all the answers
What is the potential consequence of otic medication use in dogs?
Signup and view all the answers
What is the role of metalloproteinases in ocular diseases?
Signup and view all the answers
What is the significance of the nasolacrimal duct in ocular health?
Signup and view all the answers
What is the potential association between otitis externa and neurogenic keratoconjunctivitis sicca in dogs?
Signup and view all the answers
What is the significance of parasympathetic denervation in the lacrimal gland?
Signup and view all the answers
What is the potential consequence of hypothyroidism on ocular health in horses?
Signup and view all the answers
What is the role of the facial nerve in lacrimal gland innervation?
Signup and view all the answers
What is the result of pathology at any point along the efferent lacrimal gland innervation pathway?
Signup and view all the answers
What is the role of matrix metalloproteases in KCS?
Signup and view all the answers
What is the effect of denervation of postganglionic fibers in mice on basal tear secretion?
Signup and view all the answers
What is the consequence of loss of globulins and the flushing action of tears in KCS dogs?
Signup and view all the answers
What is the timeframe for return of normal tear production in nonreferral dogs?
Signup and view all the answers
What is the neural structure that was transected in rabbits to result in loss of tear production and decreased lacrimal gland size?
Signup and view all the answers
What is the presumed cause of corneal ulcers in dogs with nKCS?
Signup and view all the answers
What is the tendency of primary care veterinarians compared to ophthalmologists in rechecking dogs with nKCS?
Signup and view all the answers
Study Notes
Neurogenic Keratoconjunctivitis Sicca (nKCS) in Dogs
- nKCS is a suspected novel cause of neurogenic keratoconjunctivitis sicca (nKCS) secondary to florfenicol, terbinafine hydrochloride, mometasone furoate (Claro and Neptra) or florfenicol, terbinafine, betamethasone acetate (Osurnia)
Clinical Course and Long-term Prognosis
- 29 client-owned dogs were identified with clinical signs of nKCS after application of otitis externa medication containing terbinafine and florfenicol
- Onset of clinical signs of nKCS within 1 day after application of otitis externa medications
- Low Schirmer tear test value (< 15 mm/min) of affected eyes
Research Methodology
- Online survey and word-of-mouth recruitment were conducted to identify dogs that developed clinical signs of nKCS
- Retrospective analysis of medical records of dogs meeting inclusion criteria
Otitis Externa Medications
- Terbinafine and florfenicol are suspected to cause nKCS in dogs
- Claro and Neptra, and Osurnia are otitis externa medications containing terbinafine and florfenicol
Related Research
- Neurological manifestations of ear disease in dogs and cats (Garosi et al., 2012)
- Occult otitis media in dogs with chronic otitis externa (Lorek et al., 2020)
- Ototoxic effect of topical oxiconazole and terbinafine in rats (Aydın et al., 2012)
- Canine neurogenic keratoconjunctivitis sicca (Matheis et al., 2012)
- Evaluation of novel dry eye model (Toshida et al., 2007)
Neurogenic Keratoconjunctivitis Sicca (nKCS)
- nKCS is a rare and uniquely presenting form of dry eye caused by the loss of efferent innervation to the lacrimal gland.
- It can lead to acute, complete loss of the aqueous portion of the tear film.
- Dogs typically present with unilateral, severe ocular discomfort and a Schirmer tear test (STT) value of close to zero.
- Concurrent ipsilateral xeromycteria and secondary corneal ulcerations are common.
Causes of nKCS
- Preganglionic lesions: otitis media or interna, petrositis.
- Postganglionic lesions: total ear canal ablation, bulla osteotomy, orbital trauma.
Efferent Lacrimal Gland Innervation Pathway
- The pathway is complex, and pathology at any point along this pathway can result in nKCS.
- The transection of the superficial petrosal nerve in rabbits led to loss of tear production and a decrease in lacrimal gland size.
Clinical Relevance
- Dogs that developed nKCS within 1 day after application of otitis externa medications containing terbinafine and florfenicol had a good prognosis for return of normal tear production within 1 year.
- The median time from application of ear medication to documented return of clinically normal tear production was 86 days (range, 19 to 482 days).
- Being referred to an ophthalmologist and having a deep ulcer were associated with a longer time to documentation of Schirmer tear test ≥ 15 mm/min.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz is based on a study on the signs of nKCS in dogs after medication application. It explores the causal relationship between the medication and the signs of nKCS.
