Surgical Management of ocular Setariasis in Equines with Needle Paracentesis

September 9, 2020

362

Surgical Management of ocular Setariasis in Equines with Needle Paracentesis

K. P Singh*1, Saurabh Singh2, R.V. Singh3, Praneeta Singh4 and S.K.Singh5

Government Veterinary Hospital, Deoranian, Bareilly,
Department of Animal Husbandry, Uttar Pradesh, India

1: Veterinary Officer, Government Veterinary Hosptal, Deoranian, Bareilly, Uttar Pradesh E mail: drkpsvet@rediffmail.com
2: Manager Veterinary Services, Brooke Hospital for Animals (India), Email: saurabh7vet@gmail.com
3: Assistant Professor, Department of Pharmacology, Bhavdiya institute of Pharmaceutical Sciences and Research, Faizabad, Uttar Pradesh Email: rvsinghranvijay@gmail.com
4: Assistant Professor, Department of Livestock Product Technology, C.V.A.Sc., GBPUAT, Pantnagar, U.S.Nagar, Uttrakhand E mail: vet_praneeta12@rediffmail.com
5: Veterinary Officer, Government Veterinary Hosptal, Harakh, Barabanki, Uttar Pradesh E mail: sryp72@gmail.com
*Corresponding Author: Veterinary Officer, Government Veterinary Hosptal, Deoranian, Bareilly, Uttar Pradesh E mail: drkpsvet@rediffmail.com

ABSTRACT:

A total 8 horses were present at Government veterinary Hospital, Deoranian, Bareilly with the history of impaired visions, varying degree of corneal opacity, epiphorea, blepharospasm, ocular discomfort and lacrimation of affected eyes since 7-10 days. The examination of affected eyes in all the animals revealed vigorous wavy movement of white thread like worm in aqous humor of anterior chamber of affected eye in all the horses. Diagnosis on the basis of correlation of history, clinical sign and activity of worm in aqous humour and was confirmed by removal of worm from the affected eye. The worm was identified as Setaria species based on the microscopic examination. All the horses were restrained in lateral recumbency followed by auriculo palpebral nerve block was performed by injection of 2% lignocaine hydrochloride. The affected eye was irrigated with normal saline solution followed by 4-5 drops of 2 % linocaine hydrochloride was instilled to perform topical anesthesia. A 16 guage neddle was inserted in anterior chamber of eye through 4 O’ clock position of cornea/ corneo scelaral junction approximately 1 mm away from the limbus as the worm appeared near the site. The eye worm was escaped through needle hub due to aqous humor pressure. After removal of worm, flunixin meglumine @ 1.1 mg/ Kg body weight intravenous on first day and topical application of gentamicin and dexamethasone eye drop 4q 6 h for 20 -30 days was carried out to avoid concurrent infection and inflammatory changes in eyes. So, In the present study, all the 8 (100 %) animal showed successful management of removal of setaria species from the anterior chamber of eye of equines with paracentesis of 16 guage needle without any postoperative complications.
Key Words: Corneal opacity; eye worm; equines; needle paracentesis; Setaria species

Introduction:

Equine ocular Setariosis is caused by Setaria digitata and Setaria equina (Parrah et al., 2004). Ocular Setariosis has been reported by many authors in India (Bhadwal et al., 1998). The condition is caused by erratic migration of immature stage of Setaria species. The ocular setariasis spreads mostly in summer and autumn when the mosquito vectors are more prevelent (Mrituanjay et al., 2011; Al-Azawi et al., 2012). All equines are generally more prone for ocular worm (Pratap et al., 2005; Jaykumar et al; 2012; Radwan et al., 2016). The immature worm can also invade the eye (Sreedevi et al., 2002; Tuntivanich et al., 2011) through the vascular system (Townsend, 2013). The infected animals usually showed sign of photophobia and lacrimations (Basak et al., 2007). The erratic movement of worm with in the eye causes severe irritation to cornea leading to corneal opacity and blindness to affected animals (Bhadwal et al., 1998). Localization of worms in anterior chamber of eye of equine leads to constant irritation and painful condition (Patra et al., 2000). The disease is characterized by persistent itching, lacrimation, blepharospasm, corneal opacity and reduced performance (Radostitis et al., 2000). Various drugs like diethyl carbamazine, mercury per chloride and ivermectin have been tried with mixed responses (Bhatt et al., 1999). The present study was conducted to evaluate the efficacy of needle paracentesis for management of ocular setariasis in equines.

History and Clinical:

Observations:

A total 8 horses were present at Government veterinary Hospital Deoranian, Bareilly with the history of impared visions, varying degree of corneal opacity (Figure 3), epiphorea, blepharospasm, ocular discomfort and lacrimation of affected eyes since 7-10 days. The examination of affected eyes in all the animals revealed vigorous wavy movement of white thread like worm in aqous humor of anterior chamber of affected eye in all the horses. Menace reflex for vision were positive in affected eye in all the animals. Clinical examination in all the animals reveled rectal temperature, heart rate respiratory rate and capillary refill time were normal in ranges.

Diagnosis and Treatment:

Diagnosis on the basis of co-relation of history, clinical sign and activity of worm in aqous humour and was confirmed by removal of worm from the affected eye. The worm was identified as Setaria species based on the microscopic examination (Figure 4 and 5 ). Similar type of ocular Setariosis with erratic migration in eye of horse were reported by various workers (Ansari and Buchoo, 2005; Yadav et al., 2005; Jaiswal et al., 2006). All the horses were restrained in lateral recumbency followed by auriculo palpebral nerve block was performed by injection of 2 % lignocaine hydrochloride. The affected eye was irrigated with normal saline solution followed by 4-5 drops of 2 % lignocaine hydrochloride was instilled to perform topical anesthesia for fixataion of eye ball (Figure 1). A 16 guage neddle was inserted in anterior chamber of eye through 4 O’ clock position of cornea/ corneo scelaral junction approximately 1 mm away from the limbus as the worm appeared near the site (Figure 2). The eye worm was escaped through needle hub due to aqous humor pressure. Aqous leakage was minimum as needle puncture hole was very tiny. The pierce site was left as such without suturing. The affected eyes in all the horses were flushed with normal saline solution to remove debris, if any present. After removal of worm, flunixin meglumine @ 1.1 mg/ Kg body weight intravenous on first day and topical application of gentamicin and dexamethasone eye drop 4q 6 h for 20 -30 days was carried out to avoid concurrent infection and inflammatory changes in eyes.

Results and Discussion:

The both medical and surgical treatments have been advocated for equine ocular filariasis (Muhammad and Saquib, 2007) but the best treatment is the surgical removal of the parasite (Tuntivanich et al., 2011) that can be performed under general anesthesia or regional nerve blocs with or without sedation. Lumb and Jones (2001) reported regional nerve blocks like supraorbital, auriculopalpebral and retrobulbar can be performed using 2 % lignocaine as per standard method. The cornea and sclera may be desensitized most effectively spraying topical application of 1 % solution of amethocaine (Durham et al., 1992) or 1 % tropicamide (Mc Mullen et al., 2014). The adult species of Setaria is commonly seen in peritoneal cavity and was found to be harmless to the host (Mritunjay et al., 2011). However, erratic migration of larvae into anterior chamber causes changes in cornea leading to corneal opacity. Successful removal of needle paracentesis using 18 gauge needle was found to be effective for removal of intraocular worm (Jaykumar et al., 2012). In the present study, the worm was removed under fixation of eye ball with auriculo palpebral nerve block and topical instillation of 2 % lignocaine hydrochloride by needle paracentesis using 16 gauge needle in all the animals and was found to be effective and time saving procedures. Post-operatively antibiotics and steroids instillation was advice to reduce inflammation and control odema (Figure 5and 6 ). All the animal showed recovery after 20-30 days of worm removal. Sharma et al. (2005) reported that corneal opacity at the site of stab incision is the most common post operative complication. Sometime it diffuses to involve the whole upper quadrant (Patil et al., 2012). Various drugs have been tried in clinical Setariosis with mixed therapeutic response (Klei et al., 1980; Sharma, 1993; Bhatt et al., 1999). Therefore, surgical intervention followed by chemotherapy may be advocated as a successful treatment for cases of equine worm. Clinical sign such as photophobia, corneal opacity and epiphora were evident in present study. This might be due to movement of larvae and presence of serrated cuticle in worm (Jaiswal et al., 2006). Hungerford (1990) observed that presence of paracites in eye may cause corneal endothelial damage with clouding of cornea, uveitis, chorioreinitis and blindness. The erratic migration of adult Setaria digitata towards eye with corneal opacity was also reported (Shin et al., 2002; Mohan et al., 2009). Occurrence of ocular Setariosis in horse might be due to feeding of infected mosquitoes and deposition of infected larvae around eyes (Solsby, 1982). Singh et al. (1976) recommended needle stabbing technique was economical and time saving. However, application of needle could be relatively difficult in violent horses. Success with anterior chamber paracentesis using almost similar technique has been reported (Morzok and Desouky, 2008). The occurrence of filarial nematodes may be minimized by treatment with ivermectin @ 200-300 micrograms/ Kg body weight given orally (Muhammad and Saquib, 2007).

Conclusion:

In the present study, it can be concluded that needle paracentesis technique was highly effective in all the 8 (100 %) animals, for management of ocular setariasis in equines without any post operative complications.

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