“Sophie” is a 10 year old female spayed French Bulldog. She presented to Carroll County Animal Hospital for a several month history excessive yellow/green discharge, and redness of both eyes. She sometimes squints and rubs her eyes. She is up to date on vaccinations, deworming, and heartworm prevention. She is eating and drinking normally and is not vomiting and does not have diarrhea. EXAMINATION:
“Sophie” has an increased body condition score, and a normal body temperature, respiratory rate, and heart rate. She has thick white/yellow discharge dried around both eyes and new discharge covering her eyes. The conjunctiva (tissue around her eyes, under eyelids) is red and swollen. Her corneas (outside surface of eye) are slightly cloudy but she is visual in both eyes. The remainder of her physical exam is within normal limits.DIAGNOSTIC TESTS:
Interocular Pressure Test.
To determine the cause of Sophie’s eye problems, she had a complete eye work-up: These tests, or similar tests are also performed in human medicine to diagnose eye problems.
Fundic Exam: An exam of the nerve and blood vessels in the back of the eye. This exam was normal.
Interocular Pressures: This is a measure of the pressure within the eye. An increased pressure can indicate certain diseases. This test was normal in Sophie.
Schirmer Tear Test.
Schirmer’s Tear Test: This test measures the amount of tears being produced in each eye. Because tears are important in lubricating the eyes, decreased tear production is a common cause of increased discharge, inflammation, and discomfort in the eyes of dogs. Sophie’s tear tests were very low in both eyes. DISCUSSION:
“Sophie” was diagnosed with Keratoconjuctivitis Sicca (KCS), or Dry eye. This is a common condition in dogs that leads to an increase in thick discharge in the affected eye, and swelling of the cornea and surrounding tissues.
There are two major contributors to tear production in dogs: the Lacrimal gland and the 3rd eyelid. These two areas form tears in two parts, 1) Fatty/mucous part 2) Water part. Both parts of the tears are required for normal tears and normal lubrication of the eyes.
Dry eye affects the eyes ability to produce the water portion of the tear. As a result, production of the fatty part is increased in an attempt to compensate, creating the classic thick fatty/mucous discharge around Sophie’s eye.
There are numerous causes for dry eye including: Diseases such as Distemper, hypothyroidism (low thyroid), and certain medications. However, the most common cause in dogs is immune mediated. With immune mediated disease, the body’s immune system attacks the cells that produce the water portion of the tears, and destroys them. Without these cells, the fatty portion of the tears start being overproduced.
Without treatment, chronic inflammation and dry eye can lead to serious problems, including an increase in intraocular pressure, scratches and wounds to the cornea, and chronic pain and discomfort. TREATMENT:
There are many medications used in the treatment of dry eye in dogs. Each case is unique with regard to cause, severity and response to treatment. For this reason, each patient’s medication regimen will vary.
“Sophie” was started on the following medications. All of these medications (or those with similar actions) are common in the treatment of dry eye.
Artificial Tears: Moisturizing drops to replace the water portion of the tears
Hyaluronan Drops: Long acting lubricating drops to help supply the water portion of the tears
Cyclosporine Drops: Immune suppressing drops. These drops help protect the tear glands that have not already been destroyed by the immune system.
Antibiotic Drops: Because of the severe inflammation associated with dry eye, secondary infections and scratches or ulcerations of the cornea are common. For this reason, Sophie was started on a short course of antibiotics to address this infection. CONCLUSION:
Thanks to Sophie’s perceptive owners, she was diagnosed and started on appropriate therapy for her condition. Today she is doing much better, and while her condition cannot be cured, it can be managed effectively to keep her eyes healthy and comfortable.
If your pet develops any unusual behaviors or symptoms, please call our office right away. We are open normal business hours, 7 days a week! (770) 832-2475