Cavernous sinus syndrome in a holstein bull

A 13‐month‐old Holstein bull was presented for right‐sided exophthalmos. Ophthalmologic examination noted that the animal was visual in both eyes, but that the right pupil was persistently dilated and very sluggish to constrict when stimulated with a bright light and that normal ocular motility was absent. Fundic examination of the right eye was normal as was a complete ophthalmologic examination of the left eye. Radiographs at presentation did not reveal the presence of sinusitis or other skull abnormalities. Initial treatment comprised intravenous antibiotics and anti‐inflammatories for orbital inflammation over a 14‐day period. There was no perceptible change in the appearance or neuro‐ophthalmologic examination of the right eye during hospitalization. The animal was discharged to the owner's care, but 3 weeks later was found recumbent with unilateral strabismus of the left eye and a fixed right pupil. Due to the inability to rise and rapid deterioration, humane euthanasia was performed, and a full postmortem examination, preceded by a MRI , was performed that identified abscesses extending bilaterally through the round foramina obliterating the cavernous sinus region, as well as abscessation of the right mandible, right trigeminal neuritis, right‐sided sinusitis, and right‐sided otitis media. Cavernous sinus syndrome should be considered in cattle with a combination of exophthalmos and neuro‐ophthalmologic abnormalities involving cranial nerves III , IV , V , and VI , whose branches are located within the cavernous sinus.