Eye Injuries in Cats with Head Trauma

Abstract

Head trauma may lead to damage of soft tissue and bones of skull by an external force. The modified Glasgow coma scale (mGCS) is used to evaluate the prognosis and classify the neurological status of cats and dogs with head trauma. The aim of this study is determine the ophtalmic pathologies and the incidence of these pathologies as a result of head trauma in cats. In addition, any possible correlation between intraocular pressure (IOP) and mGCS will be investigated in traumatized cats. The animal material of the study consisted of 18 cats with acute head trauma. The animals were properly restricted so that mGCS scores were recorded. Systematic eye examination was performed as far as the clinical condition of the patient allowed during the clinical examination and treatment of the traumatized cats. Proptosis was observed in 4 cats (22.22%) as unilaterally in 3 cats and bilaterally in 1 cat. Subconjunctival hemorrhage was observed in 7 cats (38.88%) as bilaterally in 2 cats and unilaterally in 5 cats. Unilateral hyphema was observed in 2 cats (11.11%). Three cats had anisocoria (16.66%), 2 cats had unilateral nystagmus (11.11%), and 1 cat had unilateral Horner's syndrome (5.55%). In cats with glaucoma the median mGCS was 8 (score 4-15), while non-glaucoma the median mGCS was 9 (score 6-14). However, no statistical correlation was found between mGCS and glaucoma (p>0.05). The results of this study indicate that glaucoma, subconjunctival hemorrhage and proptosis are the most common pathologies in cats with head trauma and these pathologies should not be ignored during the intervention of the head trauma patients. In addition, it is thought that irreversible loss of vision can be prevented by frequently repeated IOP measurements, regardless of the mGCS score, in cases with head trauma.

Keywords

• Cat
• head trauma
• eye injury
• mGCS
• trauma

Kafa Travmalı Kedilerde Göz Yaralanmaları

Abstract

Kafa travması, harici bir kuvvetle yumuşak doku ve kafatası kemiklerinin hasar görmesine neden olabilir. Modifiye Glasgow koma skalası (mGCS), kafa travmalı kedi ve köpeklerin prognozunu değerlendirmek ve nörolojik durumlarını sınıflandırmak için kullanılır. Bu çalışmanın amacı, kedilerde kafa travması sonucu oluşan oftalmik patolojileri ve bu patolojilerin görülme sıklığını belirlemektir. Ayrıca travma geçirmiş kedilerde göz içi basıncı (GİB) ile mGCS arasındaki olası ilişki araştırılacaktır. Araştırmanın hayvan materyalini akut kafa travmalı 18 kedi oluşturmuştur. Hayvanlar uygun şekilde kontrol altına alınıp, mGCS skorları kaydedildi. Travma geçiren kedilerin klinik muayenesi ve tedavisi sırasında hastanın klinik durumunun izin verdiği ölçüde sistematik göz muayenesi yapıldı. Proptozis 4 kedide (%22.22); 3 kedide unilateral, 1 kedide bilateral olarak gözlendi. Subkonjonktival kanama 7 kedide (%38.88); 2 kedide bilateral, 5 kedide tek taraflı olarak gözlendi. 2 kedide (%11.11) tek taraflı hifema görüldü. Üç kedide anizokori (%16.66), 2 kedide unilateral nistagmus (%11.11) ve 1 kedide tek taraflı Horner sendromu (%5.55) görüldü. Glokomlu kedilerde medyan mGCS 8 (skor 4-15), glokom olmayan kedilerde medyan mGCS 9 (skor 6-14) olarak kaydedildi. Ancak mGCS ile glokom arasında istatistiksel bir ilişki bulunamadı (p>0.05). Kafa travmalı kedilerde glokom, subkonjonktival kanama ve proptozis patolojilerinin en sık görülen patolojiler olduğu ve kafa travmalı hastaların müdahalesinde bu patolojilerin göz ardı edilmemesi gerektiği sonucuna varıldı. Ayrıca kafa travmalı olgularda mGCS skoru ne olursa olsun göz içi basınç ölçümlerinin sık sık tekrarlanmasıyla geri dönüşü olmayan görme kaybının önlenebileceği düşünülmektedir.

Keywords

• Göz yaralanması
• kafa travması
• kedi
• mGCS
• travma

References

1. Adamantos S, Garosi L. Head trauma in the cat: 1. Assessment and management of craniofacial injury. J Feline Med Surg. 2011; 13(11):806–814.
2. Barnes Heller H, Bentley E. Neurologic causes of canine anisocoria. Today’s Vet Pract. 2016; 77–83.
3. Bonner SE, Reiter AM, Lewis JR. Orofacial manifestations of high-rise syndrome in cats: A retrospective study of 84 cases. J Vet Dent. 2012; 29(1):10–18.
4. Dewey C, Fletcher D. Head-trauma management. In: Practical Guide to Canine and Feline Neurology, Ed; Dewey C, da Costa RC, 3rd Ed., Wiley Blackwell, 2015; pp. 237–248.
5. DiFazio J, Fletcher DJ. Updates in the management of the small animal patient with neurologic trauma. Vet Clin North Am Small Anim Pract. 2013; 43(4):915–940.
6. Garosi L, Adamantos S. Head trauma in the cat: 2. Assessment and management of traumatic brain injury. J Feline Med Surg. 2011; 13(11):815–823.
7. Kaur S, Kaushik S, Singh Pandav S. Traumatic glaucoma in children. J Curr Glaucoma Pract. 2014; 8(2):58–62.
8. Knight R, Meeson RL. Feline head trauma: a CT analysis of skull fractures and their management in 75 cats. J Feline Med Surg. 2019; 21(12):1120–1126.

9. Kolata RJ. Trauma in dogs and cats: An overview. Vet Clin North Am Small Anim Pract. 1980; 10(3):515–522.
10. Kuo KW, Bacek LM, Taylor AR. Head trauma. Vet Clin North Am Small Anim Pract. 2018; 48(1):111–128.
11. Laffey JG, Kavanagh BP. Hypocapnia. N Engl J Med. 2002; 347(1):43–53.
12. Mandell DC, Holt E. Ophthalmic emergencies. Vet Clin North Am Small Anim Pract. 2005; 35(2):455–480.
13. Opperman E. Head trauma in the feline patient – an update. Vet Nurs J. 2014; 29(6):194–197.
14. Platt S. Treatment options for head trauma patients. 33rd World Small Anim Vet Congr. Dublin: WSAVG; 2008.
15. Platt S, Olby N. Neurological emergencies. In: BSAVA Manual of Canine and Feline Neurology, Ed; Platt S, Olby N, 4th Ed., BSAVA. 2004; pp. 320–336.
16. Platt S, Radaelli S, McDonnell J. The prognostic value of the modified Glasgow coma scale in head trauma in dogs. J Vet Intern Med. 2001; 15(6):581.
17. Saastamoinen J, Rutter CR, Jeffery U. Subconjunctival haemorrhage in 147 dogs. J Small Anim Pract. 2019; 60(12):755–760.
18. Sande A, West C. Traumatic brain injury: a review of pathophysiology and management. J Vet Emerg Crit Care. 2010; 20(2):177–190.
19. Stocchetti N, Maas AIR, Chieregato A, van der Plas AA. Hyperventilation in head injury. Chest. 2005; 127(5):1812–1827.
20. Tundo I, Southerden P, Perry A, Haydock RM. Location and distribution of craniomaxillofacial fractures in 45 cats presented for the treatment of head trauma. J Feline Med Surg. 2019; 21(4):322–328.
21. Wheler CL, Grahn BH, Pocknell AM. Unilateral proptosis and orbital cellulitis in eight African hedgehogs (Atelerix albiventris). J Zoo Wildl Med. 2001; 32(2):236–241.