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Objective: To investigate systemic absorption and gastrointestinal (GI) adverse effects of topical ketorolac 0.5% and diclofenac 0.1% ophthalmic solutions., Animals: 11 healthy purpose-bred Beagles., Methods: Dogs were randomly assigned to receive either ketorolac (n = 6) or diclofenac (5), 1 drop in both eyes 4 times daily for 28 days. Upper GI endoscopy was performed on days 0 and 29 with mucosal lesion scores (0 to 7) assigned to each region evaluated. Plasma samples were collected on days 14, 21, and 28 for measurement of diclofenac and ketorolac using high-performance liquid chromatography-mass spectrometry., Results: GI erosions and/or ulcers developed in all ketorolac-treated dogs and 1 of 5 diclofenac-treated dogs. Post-treatment mucosal lesion score for the antrum was higher in the ketorolac group than in the diclofenac group (P = .006) but not significantly different for any other region. Post-treatment antral mucosal lesion scores were significantly related to plasma ketorolac concentrations (P < .001). Ketorolac and diclofenac were detected in the plasma at all time points (median ketorolac day 14, 191 ng/mL; day 21, 173.5 ng/mL; and day 28, 179.5 ng/mL; and median diclofenac day 14, 21.1 ng/mL; day 21, 20.6 ng/mL; day 28, 27.5 ng/mL). Vomiting and decreased appetite events were observed uncommonly and were not significantly different between treatment groups., Clinical Relevance: GI ulceration and erosion developed after ophthalmic administration of ketorolac and diclofenac, with higher plasma concentrations and more severe GI lesions associated with ketorolac. Clients should be alerted to this potential risk with ophthalmic use and informed to watch for systemic clinical signs that would warrant veterinary reevaluation.

Case Description: A 9-month-old miniature Hereford heifer was evaluated for a mass on the right inferior eyelid that had progressed in size over 3 months., Clinical Findings: Physical examination revealed a firm, ulcerated, pedunculated mass on the right inferior eyelid that extended from the medial quarter to beyond the lateral canthus of the eye. The base of the mass measured 7.4 × 6.7 cm, and the dorsal margin of the base of the mass was approximately 3 mm ventral to the inferior eyelid margin. Histologic evaluation of incisional biopsy specimens from the mass was consistent with fibrosarcoma., Treatment and Outcome: The mass was surgically resected with care taken to preserve the eyelid margin. The resulting 10 × 8.5-cm surgical wound was treated with adjunct CO 2 laser therapy and closed by primary closure at its medial and central aspects and placement of a 4.6 × 2.6-cm lyophilized equine amnion multilayer graft and 2 sheets of 4-ply porcine small intestinal submucosa at its lateral aspect. The grafts were kept moist by alternating topical antimicrobial and artificial tear ointments for 3 weeks. The wound healed without complications, resulting in a functional and aesthetically pleasing outcome despite the development of moderate ectropion at the lateral aspect of the inferior eyelid., Clinical Relevance: Results suggested that a combination of extracellular matrix scaffolds may be an alternative to extensive skin flaps for management of large dermal wounds, particularly wounds resulting from blepharoplasty where preservation of an eyelid margin is desired.

Objective: To assess reliability of the Schirmer tear test-1 (STT-1) for measurement of tear production in cats in various environments, investigate whether sympathetic stimulation impacts measurements, and determine whether meaningful conclusions regarding lacrimation in cats can be drawn from STT-1 measurements obtained with STT strip placement for < 1 minute., Animals: 176 cats examined in a private practice (n = 100), a feral cat clinic (56), or a veterinary teaching hospital (20)., Procedures: The STT-1 was performed in both eyes of each cat. Measurements were recorded at 10- or 30-second intervals for 1 minute. Cats at the teaching hospital were tested once in a quiet examination room (unstimulated conditions) and once in the same room with loud prerecorded noises (stimulated conditions), with a 30-minute interval between tests and evaluation of cats' heart rates before and after STT-1. Data were analyzed with parametric statistical tools and a nonlinear mixed-effect model., Results: 30- and 60-second STT-1 measurements were significantly correlated ( r = 0.94). The STT-1 measurements did not differ under nonstimulated versus stimulated conditions, despite significant changes in heart rates that indicated sympathetic stimulation. A hyperbolic model of STT-1 kinetics was validated, allowing for extrapolation of measurements obtained in < 60 seconds and generation of reference values (95% predictive intervals) for various test durations. Median (95% predictive interval) 30- and 60-second STT-1 measurements were 9.1 mm (4.8 to 15.6 mm) and 14.3 mm (8.2 to 22.3 mm), respectively., Conclusions and Clinical Relevance: The STT-1 was a reliable diagnostic test in all settings; results were not affected by sympathetic stimulation, and a shorter duration of testing could be considered in selected cases.

Objective: To determine reference values, intertest correlations, and test-retest repeatability of Schirmer tear test 1 (STT-1), phenol red thread test (PRTT), tear film breakup time (TFBUT), tear osmolarity, and meibometry in healthy cats., Design: Evaluation study., Animals: 135 healthy domestic cats aged 0.5 to 12.8 years., Procedures: Each test was performed once in 120 cats and repeated in 40. Pearson correlation was used to assess correlation among tests. Intraclass correlation coefficients (ICCs) and 95% limits of agreement (LOA) were used to evaluate test-retest repeatability., Results: Median (95% central range) values were 18 mm/min (9 to 34 mm/min) for STT-1, 29 mm/15 s (15 to 37 mm/15 s) for PRTT, 12.4 seconds (9.1 to 17.7 seconds) for TFBUT, 322 mOsm/L (297 to 364 mOsm/L) for osmolarity, and 32 meibometry units (MU; 11 to 114 MU) for peak meibometry value. The STT-1 and PRTT values were positively correlated. Age was weakly associated with TFBUT and osmolarity. Meibometry measurements were higher for strips that contacted the tear film (285 MU) than for those that touched the eyelid margin only (32 MU). All ICCs were < 0.75, and 95% LOA were wide., Conclusions and Clinical Relevance: Tear deficiency should be suspected in cats with STT-1 < 9 mm/min, PRTT < 15 mm/15 s, or TFBUT < 9 to 10 seconds. Generally poor correlation among tests suggested that thorough tear film analysis requires performance of multiple tests in concert. Relatively poor test-retest repeatability should be considered when repeated tests are used to monitor tear film dysfunction and response to treatment.