Pesq. Vet. Bras. 35(1):55-61, janeiro 2015 DOI: 10.1590/S0100-736X2015000100012

Red eyes in the necropsy floor: twenty cases of in dogs and cats1

Tessie Beck Martins2 and Claudio S.L. Barros2*

ABSTRACT.- Martins T.B. & Barros C.S.L. 2015. Red eyes in the necropsy floor: twenty cases of hyphema in dogs and cats. Pesquisa Veterinária Brasileira 35(1):55-61. Programa de Pós-Graduação em Medicina Veterinária, Universidade Federal de Santa Maria, Camobi, Santa Maria, RS 97105-900, Brazil. E-mail: [email protected]

mechanisms and can easily be detected in routine ophthalmic or necroscopic examination as discoloredHyphema (hemorrhagered eye(s). The within purpose the anterior of this study chamber is to ofreport the eye) the cancause be ofcaused hyphema by several diag- -

unilateralnosed as a (14 postmortem cases out offinding 20) or in bilateral dogs and (6/20) cats. Twenty disorder cases, in dogs 14 anddogs cats and and six extensioncats of seve of ral ages and breeds and of both sexes were included in the study. Hyphema presented as a (15/20) or occurred as a primary ocular lesion (5/20) in four dogs and one cat. Primary hemorrhage varied from minimal to diffuse. Hyphema was secondary to systemic disease

hyphema was always unilateral. In four of these cases, the cause of hyphema was trauma inand decreasing remaining order case was of frequency, caused by theyphacoclastic included vasculitis in a dog(8/15), with systemic bilateral hypertensionhypermature (5/15),. and Various acquired causes coagulopathies of disorders (2/15). Vasculitis were found due related to feline to infectioussecondary peritonitis hyphema: accounted for half of the cases (n=3) of systemic hyphema in cats. The various pathological aspects and pathogenesis of hyphema in dogs and cats are described and discussed. INDEX TERMS: Ophthalmic pathology, intraocular hemorrhage, vasculitis, systemic hyper- tension.

RESUMO.- [Olhos vermelhos na sala de necropsia: vinte primária em cinco dos 20 casos (quatro cães e um gato). casos de hifema em cães e gatos.] Hifema, hemorragia na O hifema primário foi sempre unilateral; em quatro desses câmara anterior do olho, pode ser causada por vários me- casos, a causa foi traumatismo e o caso restante foi causado canismos e pode facilmente ser detectada no exame oftál- por uveíte facoclástica em um cão com catarata hiperma- mico de rotina ou na necropsia como olho(s) vermelhos(s). dura bilateral. Várias causas de distúrbios hemorrágicos O objetivo deste trabalho é relatar as causas de hifema foram encontradas em relação ao hifema secundário: em diagnosticado como um achado postmortem em cães e ordem decrescente de frequência foram: vasculite (8/15), gatos. Vinte casos, 14 cães e seis gatos de várias idades e hipertensão sistêmica (5/15) e coagulopatias adquiridas raças, e de ambos os sexos foram incluídos no estudo. O hi- (2/15). Os vários aspectos patológicos e a patogênese do fema em cães e gatos teve uma apresentação unilateral (14 hifema são descritos e discutidos. casos dos 20) ou bilateral (6/20), e a extensão da hemor- TERMOS DE INDEXAÇÃO: Patologia oftálmica, hemorragia intrao- ragia variou de mínima a difusa. O hifema era secundário cular, vasculite, hipertensão sistêmica. à doença sistêmica (15/20) ou ocorreu como lesão ocular INTRODUCTION 1 Received on January 5, 2014. Accepted for publication on January 19, 2015. Hyphema, or hemophthalmos (Dubielzig et al. 2010), is de-

2 Programa de Pós-Graduação em Medicina Veterinária, área de concen- (Miller 2008). There are numerous potential intraocular traçãoPart em of PatologiaDoctoral DegreeVeterinária, of the Centro first author. de Ciências Rurais (CCR), Univer- causesfined as for hemorrhage hyphema, withinsuch as the blunt anterior or penetrating chamber of trauma, the eye sidade Federal de Santa Maria (UFSM), Av. Roraima 1000, Camobi, Santa Maria, RS 97105-900, Brazil. *Corresponding author: claudioslbarros@ uol.com.br primary or metastatic neoplasia, iatrogenic procedures inflammation, (Dubielzig et al. 2010),

55 56 Tessie Beck Martins and Claudio S.L. Barros

(Willis 2003), congenital anomalies, and chronic RESULTS -

(Powell 2002). Hyphema may also result from systemic di Twenty cases, fourteen dogs and six cats, were included in- etseases, al. 2008), including severe widespread acute anemia inflammation (Komáromy (Powell et al. 1999),2002) this study. Ages varied between seven months and sixteen systemicand vasculitis , associated and with disorders infectious of diseaseshemostasis (Sorrell (Du- years. Twelve animals, including all cats, were mixed bre bielzig et al. 2010), like coagulopathies and hyperviscosity ed, and seven were purebred; in one protocol, information syndromes (Willis 2003). Indeed, many of the mechanisms catsabout and breed female was dogs. not available. Males and females appeared that cause intraocular hemorrhage may also result in he- in the same proportion, although there were more male morrhage in other parts of the body, and that makes hyphe- Hyphema presented as collection of blood within, but minimalnot always to limiteddiffuse, to, but the such anterior feature chamber could not of onebe systema (14/20)- (Komáromyma a “red flag” et al. for 1999). life threatening systemic hemorrhagic or two (6/20) eyes. Extension of hemorrhage varied from- diseaseIn a small as well animal as for routine sight-threatening necropsy, seldom ocular there illnesses is a detailed dissection of the eyes unless the history, clinical tically evaluated because few protocols contained that in - formation. Usually, gross description was limited to “blood- tion (Moreland 2009), but hyphema is usually easily detec- in anterior chamber (hyphema)”. In most cases (15/20), tablesigns, (Bjerkåsor obvious et necropsyal. 2009), changes and its observationwarrant detailed can beatten the hyphema was secondary to systemic disease whilst prima ry ocular lesions were less common (5/20). or not available. The purpose of this study is to report the Primary ocular disease was cause for hyphema in one first clue to the cause of death when clinical history is poor cat and four dogs, and these lesions were always unilateral. In the cat and three of the dogs (4/5), hemorrhage was due- cause of hyphema diagnosed as a postmortem finding in ratingto head corneal trauma, that was (caused followed by car by accidentocular proptosis in one dog in twenty dogs andMATERIALS cats submitted AND to METHODS necropsy. one dog. In two dogs, hemorrhage was secondary to perfo the Veterinary Pathology Laboratory, at the Federal University of inand the presumed anterior animaland/or fight posterior in another , dog). presumably Ocular lesionsdue to Records from necropsies performed between 2000 and 2013 by were characterized by multiple small foci of hemorrhage- Santa Maria (LPV-UFSM), were reviewed. Reports from dogs and another.vascular Finally,rupture. one A thincase pre-iridal of primary fibrovascular ocular lesion membra causing cats in which hyphema was diagnosed at the time of the necropsy history, cause of death or reason for euthanasia, general and ocu- ne (PIFM) was present in one dog, and traumatic uveitis, in were included in this study. Data collected included signalment,- thors attended the necropsy of part of these animals, especially duringlar clinicopathologic the years of 2011 abnormalities, and 2012. and final diagnoses. The au hyphema was precipitated by phacoclastic uveitis in a dog - with bilateral hypermature cataract (Fig.1); a ruptured sy, before removal from their orbits, under natural light and/ was surrounded by pyogranulomatous inflammation, and In all cases, eyes were evaluated grossly during necrop blood and fibrin filled the anterior and posterior chamber. Iridal and ciliary blood vessels were markedly ingurgitated, or fluorescent-lit room. In some cases, the head of the animal hyphaeand lymphocytes invasion of and gastric plasma mucosal cells were blood present vessels. in the . was placed facing the sun in order to enhance the red color in- This dog died because of mycotic gastritis associated with- the anterior chamber. No ophthalmologic test was performed. ted to systemic hyphema: in decreasing order of occurren- After postmortem enucleation, eyebulbs were cleaned from ex ce, Variousthey included causes vasculitis of bleeding (8/15), disorders systemic were hypertension found rela tra-ocular tissues and placed in formalin or Davidson’s fixative, (5/15), and acquired coagulopathies (2/15). opticcleaved microscopy. within 48 hours and processed routinely for confection of hematoxylin-and-eosin slides, which were evaluated through- ral [right eye (oculus dexter; OD) or left eye (oculus sinister; OS)] or bilateralHyphema [both was eyes classified (oculus according uterque; toOU)]; distribution, according as to unilate nature Vasculitis due to feline infectious peritonitis (FIP) was of hemorrhage, as systemic or ocular; and according to mecha- presentedthe main cause bilateral of hyphema hyphema. with A systemicthird cat, origin that had in cats, a blood and - clotaccounted for hyphema for half (Fig.2),of feline had cases also in thishemorrhagic study. Two uveitis animals in - ralizednism of diseasebleeding. [e.g. Hemorrhage cardiac failure, was considered feline infectious of systemic peritonitis natu re when the ocular lesions were part of or secondary to a gene presentthe contralateral in all animals, eye, butand therechorioretinits, was no free in one. blood Vascular in the anterior chamber. Pyogranulomatous anterior uveitis was (FIP)], whereas the term ocular nature was used when bleeding seen in other organs. In one animal, aside from the vascular could be explained by lesions targeting eye structures specifically necrosis was not obvious in any of the eyes, but it could be (such as corneal trauma or cataract). Classification according to- mechanism of hemorrhage was based on a previous study about- causes of hyphema in animals (Komáromy et al. 1999), where le changes, PIFM was present in both eyes. sions were divided by categories considering its etiopathogene Vasculitis was secondary to septicemia/endotoxemia disorders;sis, as follows: hyperviscosity trauma; thrombocytopenia;syndrome; systemic thrombocytopathy;hypertension; neo- in three cases – two dogs with pyometra (Fig.3-4) and one vascularizationcoagulopathy; vasculitisof uveal and and retinal uveitis; tissues; noninflammatory congenital anomalies; vascular cat with septic peritonitis secondary to perforated gastric and anemia. ofulcer discreet (Fig.5). neutrophilic Presentation vasculitis, was bilateral thrombi in and the leucocytos dogs and- unilateral in the cat. Lesions in these cases were composed

Pesq. Vet. Bras. 35(1):55-61, janeiro 2015 57

Red eyes in the necropsy floor: twenty cases of hyphema in dogs and cats

1 2

3 4

5 6 Fig.1. Dog #10, unilateral hyphema, right eye (OD), ocular nature. Fig.2. Cat #3, unilateral hyphema, left eye (OS), systemic nature. The anterior chamber contains a large amount of blood due to There is a blood clot occupying half of the anterior chamber. a phacoclastic uveitis. Cataract also affected the left eye. This Iris and are easily seen here. Icterus can also be noted, dog died due to septicemia. Fig.3. Dog #17, bilateral hyphema (OU), systemic nature. Both an- anand advanced that explains stage why of feline the color infectious of the peritonitis.eyes changed from blue - to green, as noticed by the owner. This cat was euthanized at red as a consequence of pyometra. Fig.4. Dog #17, bilateral hyphema (OU), systemic nature, same as terior chambers are completely filled with blood. Death occur Fig.5. Cat #2, unilateral hyphema, right eye (OD), systemic natu- red color. Blood is lightly translucent in this case. Figure 3. Head was positioned towards the sun to highlight the clearness of the contralateral eye. This cat suffered a septic Fig.6. Dog #19, bilateral hyphema (OU), systemic nature. Instead peritonitisre. In contrast secondary with the to hemorrhagica perforated gastriceye, one ulcer. can notice the

meningitis-arteritisof the traditional red syndrome. color, in this dog a light brown blood is present in both eyes. Cause of death was steroid-responsive

Pesq. Vet. Bras. 35(1):55-61, janeiro 2015 58 Tessie Beck Martins and Claudio S.L. Barros tasis in small caliber vessels in the vascular tunic of the eye, - mary cause of systemic hypertension in three animals, all - with five occurrences (Fig.7). Cardiac failure was the pri as well as in other organs. also had bilateral mature cataract due to (Fig.8). A to vasculitisIn one dog, due a secondaryunilateral hyphemato intravascular, was secondary metastatic to wine- fourthof which dog, died that due use to to distributive be treated forshock. epilepsy, One of died these after dogs an despread melanoma. In this case, hyphema was attributed episode of seizure and pulmonary edema. Microscopic le- - presentoplastic incells. many Neoplastic other organs. cells could be seen at few uveal vessels and lining the anterior chamber. Metastasis were sions in these four cases were subtle, and restricted to dila reason for unilateral hyphema in one dog, as part of ste- anteriorted vessels chamber. with mildly Lastly, thickened one dog walls had in bilateral the uvea, hyphema roid-responsiveLeucocytoclastic meningitis-arteritis vasculitis as cause syndrome of uveitis (Fig.6). was theIn dueand .to systemic In all hypertension,of them, hemorrhage but in thiswas case,restricted hemorrha to the- - ghout the body, including meninges and anterior uvea. Mi- - this dog, there were multiple foci of hemorrhage throu ge was due to retinal detachment. This dog was euthanized anddue tosevere end-stage-kidney intraocular hemorrhage, disease that bothculminated in the withanterior ne croscopically, hemorrhage was secondary to vascular wall- phrotic syndrome. There was bilateral retinal detachment necrosislying cause and of infiltration hemorrhage by in neutrophils. the anterior chamber in dogs, subretinal space (Fig.9). Retinal arterial vessels had ma- Systemic hypertension was the most common under and posterior chamber and , as well as in the

7 8

9 10 Fig.7. Dog #14, unilateral hyphema, right eye (OD), systemic nature. Fig.8. Dog #13, unilateral hyphema, left eye (OS), systemic nature. The anterior chamber is diffusely red, effacing internal structu- There is a minimal collection of blood in the anterior chamber res such as iris. Scleral vessels are lightly ingurgitated and third as a result of systemic hypertension. Bilateral cataract is also is hyperemic. This dog died due to cardiac failure. present. This dog died due to cardiac failure. Fig.9. Dog #16, bilateral hyphema (OU), systemic nature. Vertical Fig.10. Dog #20, unilateral hyphema, left eye (OS), systemic natu- - morrhage that occupies sub-retinal space, anterior and poste- part of the anterior chamber. Blood did not clot during or after section of this shows diffuse retinal detachment and he- there. In necropsy. this case, One hyphema can also is characterizednotice the marked by dark diffuse blood hypere filling- mia in the third eyelid. Acquired coagulopathy presumably rior chamber, and vitreous body. Contralateral eye was iden due to rodenticide poisoning lead this dog to death. renaltical. Thisfailure. animal was euthanized due to nephrotic syndrome. Hyphema was caused by systemic hypertension secondary to

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Red eyes in the necropsy floor: twenty cases of hyphema in dogs and cats Table 1. Canine and feline hyphema diagnosed during necropsy at LPV-UFSMa (2000-2013) Signalment Features of hyphema Type/Cause of death # Sp.b Sex Breed Agec Nature/ Mechanism Distribution 1 Cat Fd Mixed 3 Ocular/ Trauma, penetrating Ef/Multiple OSe (retinal detachment) trauma 2 Cat F Mixed 11 Systemic/ Vasculitis, Nh/Septicemia ODg septicemic (peritonitis) 3 Cat Mi Mixed 1 Systemic/ Vasculitis and uveitis, E/FIPj OS pyogranulomatous (dry form) 4 Cat M Mixed <1 Systemic/ Vasculitis and uveitis, E/FIP OUk pyogranulomatous (dry form) 5 Cat M Mixed <1 Systemic/ Vasculitis, uveitis E/FIP OU and chorioretinits, (dry form) pyogranulomatous 6 Cat M Mixed NAl Systemic/ Coagulopathy, N/ Presumed roden- OU acquired ticide poisoning 7 Dog F Pinscher 3 Ocular/ Trauma, blunt N/Multiple OD (eye proptosis) trauma 8 Dog M NA 4 Ocular/ Trauma, N/Multiple OD penetrating trauma 9 Dog F Mixed 16 Ocular/ Trauma, N/Septicemia OD penetrating (intestinal necrosis) 10 Dog F Mixed 8 Ocular/ Vasculitis, lens-induced N/Septicemia OD (phacoclastic uveitis) (mycotic gastritis)* 11 Dog M Mixed 15 Systemic/ Vasculitis, N/Widespread OD neoplastic melanoma* 12 Dog CFm Pinscher 10 Systemic/ Systemic N/Cardiac failure OD hypertension (endocardiosis) 13 Dog F Mixed 11 Systemic / Systemic N/Cardiac OS hypertension failure (HCMn)* 14 Dog M Mixed 10 Systemic/ Systemic N/Cardiac OD hypertension failure (DCMo) 15 Dog M Dachshund 8 Systemic/ Systemic N/Idiopathic OS hypertension epilepsy 16 Dog M Dobermann 7 Systemic/ Systemic hypertension E/Renal OU (retinal detachment) failure (NSp) 17 Dog F Pinscher 9 Systemic/ Vasculitis, N/Septicemia OU septicemic (pyometra) 18 Dog F Pinscher 1 Systemic/ Vasculitis, N/Septicemia OU septicemic (pyometra) 19 Dog F Pinscher 11 Systemic/ Vasculitis N/ OS (leucocytoclastic) SRMAq 20 Dog CMr Mixed 6 Systemic/ Coagulopathy, N/ Presumed roden- OD acquired ticide poisoning a Laboratório de Patologia Veterinária da Universidade Federal de Santa Maria, b species, c in years, d female, e left eye (oculus sinister), f euthanasia, g right eye (oculus dexter), h natural, i male, j feline infectious peritonitis, k both eyes (oculus uterque), l not available, m castrated female, n hypertrophic cardiomyopathy, o dilated cardiomyopathy, p nephrotic syndrome, q steroid-responsive meningitis-arteritis, r castrated male, * bilateral cataract. hyphema in this study. damage. rkedly thickened walls. This was the most severe case of posteriorData on uvea signalment, and retina, characteristics without other of signs hyphema, of vascular and acquired coagulopathy presumably caused by rodenticide cause of death or reason for euthanasia of each case are Two animals, a dog and a cat, presented hyphema due to- present at Table 1. poisoning (Fig.10). Toxicological analysis was not perfor DISCUSSION med in any of these cases. The presumptive diagnosis was- tionbased of in rodenticide) the clinical history,amidst thegross gastric findings contents, of large multifocal amounts hemorrhages,of dark granules and (which non-clotted resembled blood, a commercial including thepresenta blood comparedHyphema to was primary considered ocular secondary disease (25%). to systemic Vasculitis disease from - in a large proportion of cases in this study (75%) when rhage in multiple internal organs, and blood did not clot common underlying causes for the development of hyphe- duringwithin necropsy. the eye. In Microscopically, both cases, there multifocal were fociareas of of hemor acute, various causes and systemic hypertension were the most blunt or penetrating (20%), and acquired coagulopathy ma, 45% and 25%, respectively, followed by trauma, either moderate hemorrhage were observed in the anterior and Pesq. Vet. Bras. 35(1):55-61, janeiro 2015 60 Tessie Beck Martins and Claudio S.L. Barros

(10%). Concurrent involvement of more than one mecha- 2008), although the classic necrotizing vasculitis is seen nism is common in hyphema formation (Komáromy et al. only rarely (Njaa & Wilcock 2012). Additional to the da- caused1999), andby primary we believe ocular that lesions. this happened at least in three magedThree vascular animals walls presented as source hyphema of bleeding, due bilateralto septicemic PIFM situationsAccording in thisto internal study. Discussion medicine startsliterature, with hyphemablunt or were present in at least one cat. sharp trauma to the globe is the most frequent cause for - vasculitis,cer lead to twoa severe dogs peritonitis. and one cat. In Bothall cases, dogs small died caliber due to pyometra, while the cat died after a perforated gastric ul hyphema in small animals (Powell 2002), while here it could be seen diffusely, including in the ocular vessels. In was the third in decreasing order. This difference might vessels with thrombi and neutrophilic leukocytostasis- Perhapsrelate to traumaticthe way hyphema hyphema was is less approached complicated in thanthis study,other lic uveitis and choroiditis and intravascular microthrombi. typeswhere of ocular hyphema hemorrhage in everyday was practice evaluated and during simply necropsy. does not the eyes, there was anterior and posterior mild neutrophi in large animals, especially horses and cattle (Aroch et al. life-threating diseases that manifest intraocular hemorrha- 2008),Ocular reflexesbut may ofhappen septicemia in small are animals more commonly due to, for reported instan- ge,reach as mostthe necropsy hyphemas floor are assmall frequently and resorbed as other spontaneou systemic,- ce, pyometra (Komáromy et al. 1999). A second mechanism

Whereas blunt trauma to the head seldom results in septicemia, thrombocytopenia can occur from the exces- hyphemasly in a few because days (Miller the eyeball 2008). is protected by anterior por- might have played a role in these cases. In overwhelming- tions of the bony and orbital soft tissues, severe blunt nated intravascular coagulation (Aroch et al. 2008), and trauma to the anterior orbital rim or periorbital soft tissues hyphemasive consumption (Komáromy of platelets, et al. 1999). which can lead to dissemi and eyeball may cause hemorrhage in the anterior cham- ber (Komáromy et al. 1999) due to retinal detachment or tear of the (Book et al. 2008). The dog that su- Hyphema was secondary to metastatic neoplasia in one- ffered blunt trauma presented hyphema after being hit by a tisdog. (Komáromy In this case, et bleedingal. 1999). was Spontaneous attributed unilateral to intravascular hyphe- maneoplastic has long thrombi, been cited and asits a nature clue to was the classified presence as of vasculi intrao- - car and suffering ocular proptosis. Penetrating trauma with corneal laceration and traumatic uveitis were due to car ac cular neoplasia, even though the explanation was obscure. cident (two cases) and a presumed animal fight (one case). granulationIt now seems tissue that thefrom bleeding the stroma originates of the from iris (orthe retina)fragile Cataract was considered the primary underlying cause vessels of a PIFM, which is no more than a proliferation of- of hyphema in one dog. It is believed, however, that there- teralwas concurrent phacoclastic involvement uveitis and of, profuse at least, intraocular one mechanism hemor in- formed as an “accidental” response to the diffusion of gro- rhage,this case. especially This dog in presentedanterior chamber. bilateral Becausecataract hyphemawith unila is despreadwth factors neoplasm, produced this by dog the had tumor bilateral itself cortical(Wilcock cataract. 2008). a frequent manifestation of traumatic uveitis, but is rarely However,Vasculitis no PIFM due to was steroid-responsive observed in this dog.meningitis-arteritis Besides the wi seen with phacolytic uveitis (Grahn 2002), we believe that- but(SRMA) the histologicwas implicated ocular aslesions cause seem of hyphema to justify in such one diag dog.- the hemorrhage was influenced by an ongoing septicemic nosis.The authors The dogcould presented not find a leucocytoclastic,report of hyphema neutrophilic due SRMA, condition due to zygomycotic gastritis. There were no evi dence of hyphae within the hyphemic eye, but a marked - vascularVascular invasion endothelial was observed cell abnormalities in the gastric may wall. result Mild in vasculitis with thrombi and hemorrhage in the brain and transmuralprotein exudation extravasation was observed of blood in thefrom contralateral vascular channels eye. ofocular predominantly vessels. The neutrophils characteristic and lesionscattered of SRMA lymphocytes, is fibri plasmanoid arteritis cells and and macrophages leptomeningeal and inflammation associated necrotizing consisting blood-aqueous barrier and hyphema. Vasculitis may result fromin the primary iris and or ciliary secondary body, immune-mediatedresulting in breakdown destruction of the create ischemic changes in the nervous parenchyma, and in of endothelial cells (e.g., immune-mediated vasculitis, toxo- chronicfibrinoid lesions arteritis. re-canalization Acute thrombosis of thrombi of the may vasculature occur (Sum may- plasmosis), infectious diseases (e.g., leptospirosis, Rocky mers et al. 1995). Mountain spotted fever, feline infectious peritonitis), neo- Hyphema attributable to systemic hypertension is most common in old cats and dogs, and is usually caused by car- sepsis) (Komáromy et al. 1999). plasia,Half or of systemic feline cases inflammatory of hyphema response happened syndrome as part of (e.g., feli- 1999). Chronic high arterial pressure results in arterioscle- rosisdiac (Miller and autoregulatory 2008) or renal arteriolar insufficiency vasospasm. (Komáromy Arteriolar et al. disease causes ischemia and capillary permeability changes ne infectious peritonitis (FIP). Hemorrhage was bilateral in and eventually hemorrhage. Intraocular hemorrhage may commontwo cats andin the unilateral purely effusive in one. formOcular of theinvolvement disease (Dubiel is very- therefore occur as a direct result of vascular damage (Du- zigcommon 2010). in Because “dry” form the ofnature FIP (Aroch of the etdisease al. 2008) is vasculitis, and less - hemorrhage into the anterior chamber, retinal hemorrha- lar hypertension are attributable to retinal detachment and ges and detachment may develop (Stiles 2006, Aroch et al. hemorrhage,bielzig 2010). most However, likely most in response cases of hyphemato choroidal from vascular vascu

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Red eyes in the necropsy floor: twenty cases of hyphema in dogs and cats hypertension (Komáromy et al. 1999). Retinal detachment titutions, CNPq and ISU, their staff and faculty, should be gratefully ack- - ther possible source of bleeding in the anterior chamber nowledged. (Dubielzigcan also lead 2010). to pre-iridal Hyphema fibrovascular may be less proliferation,commonly caused ano REFERENCES by tearing of retinal vasculature that occurs during retinal Aroch I., Ofri R. & Sutton G.A. 2008. Ocular manifestations of systemic diseases, p.374-418. In: Maggs D.J., Miller P.E. & Ofri R. (Eds), Slatter’s detachment (Komáromy et al. 1999). In this study, syste- Fundamentals of Veterinary . 4th ed. Saunders Elsevier, St Louis. Bjerkås E., Ekesten B., Narfström K. & Grahn B. 2009. , mic hypertension was observed in five dogs, with seven to- p.116-202. In: Peiffer R.L. & Petersen-Jones S.M. (Eds), Small Animal eleven years of age. Cardiac failure was the most common- Ophthalmology: a problem-oriented approach. 4th ed. Saunders, Phila- cause, with three occurrences, while renal failure was ob delphia. served in a dog that was euthanized because of a severe ne Book B.P., Van der Woerdt A. & Wilkie D.A. 2008. Ultrasonographic abnor- tophrotic occur syndrome. secondarily This to dogvascular was the damage. only to A present dog that retinal died - res: 33 cases (1991-2002). J. Vet. Emerg. Crit. Care 18:383-387. duedetachment. to a dilated In thecardiomyopathy other dogs, hemorrhage also had diabetes was presumed mellitus malities in eyes with traumatic hyphema obscuring intraocular structu and bilateral cataract. As cardiac failure, diabetes can cause Dubielzig R.R., Ketring K.L., McLellan G.J. & Albert D.M. 2010. Non-surgical trauma, p.81-114. In: Ibid. (Eds), Veterinary Ocular Pathology: a compa- systemic arterial hypertension, and the primary cause for Grahn B.H. 2002. Phacolytic uveitis, p.205-207. In: Riis R.C. (Ed.), Small rative review. Elsevier, Edinburgh. Animal Ophthalmology Secrets. Hanley and Belfus, Philadelphia. vascular damage was not clear in this case because both- Komáromy A.M., Ramsey D.T., Brooks D.E., Ramsey C.C., Kallberg M.E. & despreaddiseases were hemorrhages, in advanced including stage of development.unilateral hyphema, in - Presumed rodenticide poisoning was the cause of wi pend. Contin. Educ. Vet. 21:1064-1069. Andrew S.E. 1999. Hyphema. I. Pathophysiologic considerations. Com hemorrhages throughout the body and non-clotting blood, Kuhn S.E. & Hendrix D.V.H. 2013. Unilateral subconjunctival and retrobul- two animals, a dog and a cat. Lesions included multifocal- bar hemorrhage secondary to brodifacoum toxicity in a dog. Case Re- ports in Veterinary Medicine:1-6. including the blood within the eye. Interestingly, it is con Miller P.E. 2008. Ocular emergencies, p.419-426. In: Maggs D.J., Miller P.E. or not. Clotted blood in the anterior chamber is often seen th sidered valuable to establish whether the blood is clotted & Ofri R. (Eds), Slatter’s Fundamentals of Veterinary Ophthalmology. 4 - ed. Saunders Elsevier, St Louis. morrhage caused by coagulation disorders is unclotted Moreland R.E. 2009. The necropsy procedure, p.21-67. In: Ibid. (Ed.), Co- when the cause is anterior uveitis or trauma, whereas he lor Atlas of Small Animal Necropsy. Remsoft Publishing, London. Njaa B.L. & Wilcock B.P. 2012. The ear and eye, p.1153-1244. In: Zachary but(Townsend it is rarely et mentioned al. 2009). Hyphemain texts that has discuss been clinical documented signs J. & McGavin D. (Eds), Pathologic Basis of Veterinary Disease. 5th ed. El- ofwith this toxicity. This rodenticide may be because exposure ocular (Trbolova lesions are 2009), un- sevier Mosby, St Louis. common relative to other signs, or because they are usually mild in comparison to the more life-threatening hemorrha- Animal Ophthalmology Secrets. Hanley & Belfus, Philadelphia. Powell C.C. 2002. Ocular hemorrhage, p.214-221. In: Riis R.C. (Ed.), Small ge that typically occurs (Kuhn & Hendrix 2013). Sorrell M.S., Taylor K.H. & Fish R.E. 2008. Secondary acute anterior uvei-

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State University (ISU) under CNPq supervisionsponsored a of12-month Dr. Joseph sandwich S. Haynes. scholarship Both ins- Practice. 4th ed. W.B. Saunders, Philadelphia. for the first author at the Department of Veterinary Pathology of the Iowa gan R.V., Bright R.M. & Swartout M.S. (Eds), Handbook of Small Animal

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