Unilateral Exophthalmos due to Retrobulbar Coenurus cerebralis Cyst in a Sheep.
A sheep was presented with complaint of exophthalmos since last two months. Clinical examination revealed blindness of left eye due to chronic exposure keratitis and lagophthalmos. It was decided to surgically exenterate the left eye by transpalpebral approach. During surgery a cyst was recovered at retrobulbar region. Laboratory investigation confirmed it as a Coenurus cerebralis cyst. Animal recovered after surgery.
Keywords: Coenurus cerebralis, cyst; exophthalmos; retrobulbar
Exophthalmos is an abnormal protrusion of eye from its orbit. In ruminants reported causes of exophthalmos are polioencephalomalacia, lymphosarcoma, gedoelstiasis and hypovitaminosis A (Itamar et al., 2008).
In goats, non-cerebral Coenurus cysts have been called Coenurus gaigeri and in sheep they have been called Coenurus skrjabini Sharma and Chauhan, 2006; Schuster et al., 2010). Christodoulopoulos et al. (2015) concluded that non cerebral coenurus cysts in goats has a low prevalence. Coenurus cerebralis is the larval stage of Taenia multiceps, an intestinal cestode of wild and domestic canids (the definitive host) (Sharma and Chauhan 2006). Coenurus cerebralis is commonly located in cerebrum of sheeps, goats, cattle and humans. It constitutes a major health problem in sheeps and goats worldwide, with significant economic loss. Main causes for exophthalmoses include orbital abscess, orbital cellulitis, orbital cyst, eosinophilic myositis, lacrimal gland disease, foreign body granuloma, haematoma and trauma (Boydell 1991). A case of exophthalmos caused by a retrobulbar Coenurus cerebralis cyst in a sheep is presented here.
(1.) Assistant Professor and Corresponding author.
(2.) Assistant Professor
(3.) Assistant Professor and Head
(a) - Brand of Intas Animal Health, Ahmedabad
(b) - Brand of Zydus Animal Health Ltd, Ahmedabad
(c) - Brand of Indian Immunological Ltd, Hyderabad
History and Observations
A sheep was presented with complaint of enlargement and blindness of left eye since two months. Size of the eye had increasing gradually. Feed and water intake were normal. Clinical examination revealed severe exophthalmos, perocular swelling and chronic exposure keratitis of left eye (Fig. 1). Cornea of the animal was opaque and necrosed. Palpebral reflex was sluggish. Left eye was blind and there was a lagophthalmos. Rectal temperature was normal and animal was active. The sheep was kept on Meloxicam (Melonex (a)) @ 0.3 mg/kg b.wt IM and Enrofloxacin (Enrodac (b)) @ 5 mg/kg b.wt IM for seven days. But, there was no improvement in size of globe. It was finally decided to surgically exenterate the left eye.
Treatment and Discussion
Left eye was aseptically prepared for surgery. Preoperatively, Enrofloxacin @ 5 mg/kg b.wt IM was administered. Sheep was restrained in lateral recumbency and sedated with Xylazine Hcl (Xylaxin (c)) @ 0.2mg/kg b.wt. IM. Left eye was desensitised with 2% Lignocaine Hcl (Wocaine (d) 2%) using peterson's, auriculo-palpebral and supraorbital nerve blocks. Tarsorrhaphy was performed by suturing the eye lids of left eye by simple continuous suture pattern with Silk No.2. Exenteration of left eye was performed by transpalpebral approach (Fig. 2). During the exenteration, a cystic sac was identified at the retrobulbar region and it was carefully recovered for laboratory investigation (Fig. 3). Bleeding was arrested and wound edges were apposed by simple
continuous suture pattern with Silk No.2. Small gap was left at lateral canthus for insertion of sterile roller gauze soaked with Povidone iodine (Cipladine (e)). Sheep was kept on Enrofloxacin (b) @ 5mg/kg b.wt. IM and Meloxicam (a) @ 0.3mg/kg b.wt IM for another seven days. Dressing of the surgical wound was carried on alternate days. Animal recovered uneventfully. The cyst was submitted for identification and based on the morphological characters, the cyst was identified as Coenurus cerebralis.
Jain and Shah (1982) described that the subcutaneous location was an uncommon site for Coenuri in sheep when compared to the brain and spinal cord. Non-cerebral coenurosis was first described in sheep (Benkovskij, 1899) and then in goats (Gaiger, 1907). Gharagozlou et al. (2003) described pulmonary coenurosis in goats. Christodoulopoulos et al. (2012) reported that the locations of coenurus cysts in sheep were the
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triceps brachii muscle, diaphragm, infraspinatus muscle of shoulder, muscles of thigh and abdomen and omentum. Kheirandish et al. (2012) documented that cerebral coenurosis occured principally in sheep whilst extra cerebral coenurosis was more common in caprines.
In the present case, coenurus cyst was located at retrobulbar region of left eye, identified during exenteration which had caused exophthalmos. Chronic exophthalmos caused exposure keratitis and the eye was blind. Sheep did not evince pain on palpation and onset and progression of condition was slow. Itamar et al. (2008) documented that exophthalmos frequently caused greater evaporation of precorneal tear film and exposure keratitis. They also reported that retrobulbar abscess might be distinguished from other causes of exophthalmos on the basis of its acute onset, pain and often pyrexia. In humans, ocular coenurosis resulted in endophthalmy, retinal damage and blindness (Ibechukwu and Onwukeme, 1991 and Ing et al. 1998). Human ocular coenurosis was reported in vitreous, anterior chamber or subconjunctival tissues (Ibechukwu and Onwukeme 1991; Manschot 1976; Williams and Templeton 1971). However, Holmberg et al. (2007) and O'Reilly et al. (2002) mentioned that the orbital coenurosis due to T. serialis larvae in a pet rabbit and chinchilla. Haridy et al. (2014) reported Coenurus cerebralis cyst in the orbit of a ewe and performed enucleation of eye and they observed a cyst filled with translucent sandy fluid in periorbital fat, after cutting the retractor bulbar muscles.
Ibechukwu and Onwukeme (1991) documented that the larvae of T. multiceps entered the eye by way of
the ciliary arteries or direct inoculation of larva to the conjunctiva. Coenurus cyst in sheep is a metacestode larval stage of Taenia multiceps. The sheep would be infected through ingestion of Taenia multiceps eggs. Each egg contained an oncosphere that hatched and activated in small intestine. The oncosphere would penetrate the intestinal mucosa and carried via blood to brain, spinal cord or other tissues where each oncosphere developed into metacestode larval stage. The cysts often persisted throughout the life of an animal. The life cycle would be completed when the final host, dog or wild canid, ate an infected part of sheep (Taylor et al., 2007).
The cerebral coenuri in sheep could reach 95 cm in size and could contain up to 700 scolices (Boev et al., 1964; Schuster et al., 2010). Christo-doulopoulos et al. (2012) stated that Coenurus cysts found in their study were of small size and contained few scoleces in comparison to cyst size and number of scoleces reported for cerebral coenuri. In the present case it was found that morphologically, the cyst was fluid filled sac covered with a thin transparent membrane and contained numerous invaginated scolices (Fig. 4). The scolices were separated from cyst, processed and examined under microscope. An anterior cone shaped rostellum surrounded with two layers of hooks and four rounded suckers were observed (Fig. 5) (Soulsby, 1982; Bowman, 2009).
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M. Naveen (1), B.S. Pradeep (2) and Ravi Raidurg (3)
Department of Veterinary Surgery and Radiology
Karnatkaka Veterinary, Animal and Fisheries University (KVAFSU) Vinobanagar
Shivamogga - 577204 (Karnataka)
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|Author:||Naveen, M.; Pradeep, B.S.; Raidurg, Ravi|
|Date:||Jul 1, 2016|
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