Journal of Threatened Taxa |
www.threatenedtaxa.org | 26 April 2022 | 14(4): 20921–20925
ISSN 0974-7907
(Online) | ISSN 0974-7893 (Print)
https://doi.org/10.11609/jott.7611.14.4.20921-20925
#7611 | Received 07
August 2021 | Final received 10 March 2022 | Finally accepted 08 April 2022
Management of traumatic
ulcerative keratitis in a Red Serow
Deepjyoti Deka 1 , Panchami
Sharma 2, Arup Das 3, Kongkon
J. Dutta 4, Syed A. Arif 5
& Tinku Das 6
1 Department of Veterinary Surgery
& Radiology, 3 Veterinary Clinical Complex, 4
Veterinary Clinical Medicine, Ethics & Jurisprudence,
6 Department of Veterinary
Epidemiology & Preventive Medicine,
College of Veterinary Science,
Assam Agricultural University, Khanapara, Guwahati,
Assam 781022, India.
2 Assam State Zoo cum Botanical
Garden, Guwahati, Assam, India.
5 Department of Veterinary
Pathology, LCVSc, Assam Agricultural University,
North Lakhimpir, Assam 787051, India.
1 drdeepjyotideka@gmail.com, 2
panchami23@gmail.com, 3 arup.das.vety@aau.ac.in, 4 kongkon.dutta@aau.ac.in,
5 syedaarif786@yahoo.com
(corresponding author), 6 tinku.das@gmail.com
Editor: Bahar S. Baviskar, Wild-CER, Nagpur, India. Date
of publication: 26 April 2022 (online & print)
Citation:
Deka, D., P. Sharma, A. Das, K.J. Dutta, S.A. Arif
& T. Das (2022). Management of traumatic ulcerative keratitis in a Red Serow. Journal of Threatened Taxa 14(4): 20921–20925. https://doi.org/10.11609/jott.7611.14.4.20921-20925
Copyright: © Deka et al. 2022. Creative
Commons Attribution 4.0 International License.
JoTT allows unrestricted use, reproduction,
and distribution of this article in any medium by providing adequate credit to
the author(s) and the source of publication.
Funding: No funding agency/ financial assistance was involved to carry out this
report.
Competing interests: The authors declare no competing interests.
Acknowledgements: The authors would like to extend their sincere thanks
to the staff of Assam State Zoo cum Botanical Garden, Guwahati, Assam, for
their cooperation.
Abstract: Red Serow
Capricornis rubidus
is an elusive herbivore native to the montane forests of the Himalaya.
Currently it is categorized as ‘Vulnerable’ in the IUCN Red List and placed
under Schedule I species of the Wildlife Protection Act, 1972. A serow was presented with complaints of mild inappetence,
irritability, sporadic scratching of head over the enclosure barrier and serous
ocular discharge from the left eye. Based on detail clinical examination, the
animal was diagnosed with unilateral conjunctivitis, corneal oedema, and
ulcerative keratitis. A combination of Xylazine @ 1.5mg/ kg body weight and Zolatile® (zolazepam and tiletamine) @ 2.5 mg/kg body
weight was used to chemically restrain the animal, followed by
auriculo-palpebral nerve block using 1 ml of 2 % lignocaine hydrochloride. The
affected eye was adequately cleaned with isotonic sterile Normal Saline
solution (NSS). Combination of 0.5 ml of ceftriaxone and 0.5 ml of flubiprofen was injected into upper and lower palpebral
conjunctiva. The cornea and the third eyelid flap were carefully sutured using
5-0 and 3-0 Vicryl, respectively. Finally,
tarsorrhaphy was done using 2-0 nylon. Post-operative care consisted of an
antibiotic regimen of Cephalaxin @ 20 mg/ kg body
weight b-i.d-twice in a day for seven days along with
probiotic supplement (Vizylac®) and
Vitamin A capsules (Aquasol A®) orally
once daily for the next 30 days. The animal showed complete recovery within 30
days of proper treatment, monitoring, care and management.
Keywords: Capricornis rubidus,
Ceftriaxone, Flubiprofen, Vulnerable, Tarsorrhaphy.
The conjunctiva is a mucous
membrane that covers the inner aspect of each eyelid (Palpebral conjunctiva)
and the sclera of the eye (bulbar conjunctiva). Inflammation of this
conjunctival mucous membrane is known as conjunctivitis (Kumari
et al. 2016). It can be unilateral or bilateral and can be caused by
various etiological factors like virus, bacteria, fungi, parasites, allergens
(e.g., foreign proteins, pollen, drugs), irritant chemicals, and trauma (Gelatt 2014). Red Serow Capricornis rubidus
is an elusive, mostly solitary (Prater 1993)
herbivore belonging to the class Mammalia, order Artiodactylia,
family Bovidae, and subfamily Caprinae.
It is presently categorised as ‘Vulnerable’ in the IUCN Red List (Shepherd
2021) and as a schedule I species of the Wildlife Protection Act, 1972 (Aryal 2008). The serow is
oriental in origin (Schaller 1979) and is found within the geographical
boundaries of Jammu & Kashmir in India to Japan in the far east (Shackleton
& Lovari 1997). The present paper discuss about a
clinical case of traumatic ulcerative keratitis in a male serow
of 3.5 years of age belonging to the Assam State Zoo and Botanical Garden,
Guwahati, Assam. Surgical correction
with tarsorrhaphy technique was employed to protect the cornea and to attain
faster recovery of the affected cornea.
Case History and
Observation
The affected serow
was presented with a history of depression, slight inappetence, occasional
scratching of the head over the enclosure barrier, and ocular discharge from
the left eye.
Chemical restraining was planned
in order to conduct better and clear clinical examination of the affected eye.
On comprehensive clinical inspection, it was revealed that the serow was suffering from cloudiness of the cornea, redness
and swelling of the conjunctiva along with muco-purulent ocular discharge
(Image 1). All the physiological parameters were within the normal range. The
probable aetiology is believed to be of traumatic origin inflicted by a sharp
object or enclosure fence. On the basis of these clinical findings, a diagnosis
of ulcerative keratitis, unilateral conjunctivitis, and corneal oedema was
made. The serow responded well to te
external stimuli, viz., menace reflex, direct papillary light reflex, and
dazzle reflex. Fluorescent dye test revealed moderate ulcerated lesions
covering partially paraxial and perilimbal location ranging 1.5–2 mm in size.
Schirmer tear test was found to be higher (27 mm per minute). Tonometry test
revealed no other abnormality or intra-ocular pathology.
Treatment
It was planned to restrain the
animal chemically in the early morning hours to reduce sedation stress. For
chemical restraining, a combination of Xylazine @ 1.5 mg/kg body weight and Zolatile®(zolazepam and tiletamine) @ 2.5 mg/kg body
weight, were loaded into a pneumatic dart and was fired using a pneumatic gun.
Prior to anaesthesia, fasting for 20 hours followed by withdrawal of water for
the next 12 hours was advised. Upon darting, induction of anaesthesia was
observed within 5 minutes evident by the staggering movement, followed by
sternal recumbency after 10 minutes. A stage of complete surgical anaesthesia
was finally achieved within 20 minutes with lateral recumbency.
Auriculo-palpebral nerve block using 1 ml of 2% lignocaine hydrochloride was
injected to the affected side soon after complete sedation.
The affected eye was adequately
irrigated with isotonic normal saline solution (Image 2) to soothe irritation
and discomfort. Normal Saline Solution (NSS) is an isotonic solution that helps
in flushing out any loose foreign material in the eye. Mixture of antibiotic
and Non-steroidal anti inflammatory drug (NSAID)
preparation containing 0.5 ml of ceftriaxone and 0.5 ml of flubiprofen
respectively was injected into the conjunctiva (Image 3).
Following corneal suture using vicryl 5-0, the third eyelid flap was carefully sutured
using vicryl 3-0 (Image 4). For Tarsorrhaphy, the
eyelids were sewn together by simple interrupted technique using 2-0 nylon
suture(Image 5). Intravenous injection of Yohimbine (concentration 10 mg/ml) @
0.5 mg/kg was used to reverse the effects of anaesthesia.
The animal was subsequently
shifted to an isolated enclosure and was closely monitored for a period of 20
days. Cephalaxin @ 20 mg/kg body weight twice in a
day for seven days along with probiotic supplement (Vizylac®)
and Vitamin A capsule (Aquasol A®) orally
once daily was continued for the next 30 days. Further, the animal was kept
under normal diet during this duration.
On the tenth day, the sutures
were opened to assess the recovery of the operated eye. Formation of
granulation tissue was observed (Image 6). Subsequently, with proper care and
post-operative management, full recovery was achieved by one month,
uneventfully (Images 7 & 8).
Discussion
Eye injuries when treated within
24 hours there is higher chances of recovery, delay in same (more than 24
hours) may result in loss of eyesight, prolapse of corneal membrane and severe
complications (Rajak et al. 2015).
The animal showed complete
recovery within one month of the above mentioned treatment. This suggest that
tarsorrhaphy along with sub-conjunctival injection of ceftriaxone and flubiprofen is the best and safest option for the treatment
of conjunctivitis complicated with corneal ulceration, especially in wild
animals, as it becomes increasingly difficult to restrain them regularly which
may result in undue stress. (Fischer et al. 2019). Startup
(2008) opined that the probable cause of trauma/injury in case caged animals is
mostly inflicted by a sharp object, enclosure fence, grass blade or during
infighting. Also, continuous itching, rubbing, and photophobia seen in
ulcerative keratitis might have resulted into excessive lacrimation,
subsequently may have resulted in getting a higher range of Schirmer tear test
results during physical inspection (Senchyna &
Wax 2008).
Third eyelid flap provides
protection and supports the weakened cornea. It assists corneal healing by
decreasing evaporation of tears, warming of cornea, supplying inflammatory
cells, fibroblasts, blood and eventually providing better stability by reducing
trauma associated with movement of eyelids (Gellat et
al. 1994). Tarsorrhaphy was conducted to facilitate healing of corneal ulcer
and to prevent corneal exposure to environmental contamination (Acharya et al.
2020). Tarsorrhaphy is a convenient option and advisable in cases where
repeated handling of an animal is difficult. Also, in those cases where patient
may create sort of animal welfare issues/conflict or augments certain vetero-legal disputes.
The eyelids were sewn by simple
interrupted suture instead of vertical mattress suture. This helps in avoiding
chances of rupture of sutures during scratching the eye.
Further, specifically Vitamin A
supplement was added in the ration. Vitamin A is a fat-soluble vitamin having
wound-healing and anti-oxidant properties (Palace et al. 1999). Inclusion of
Vitamin A is necessary as it initiates epithelisation that accelerates
wound-healing especially, when it comes to perform surgical corrections of eye
diseases (Zinder et al. 2019).
Conclusion
Traumatic ulcerative keratitis is often considered to have a
good prognosis. However, the same may be challenging for field veterinarian
especially, when it is comes to wild fauna. Early identification of causes and
prompt diagnosis may be potentially curable with good prognosis in such cases.
In the present case, tarsorrhaphy along with sub-conjunctival injection of
ceftriaxone and flubiprofen was found to be
effective. Constant monitoring over health attributes and other supportive
medications has yielded a better response without any complication. Catamnesis revealed that the serow
had attained a stable condition with improved appetite and muscle volume.
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