EDMOND —
Q: My little dog Holly is a mixed-breed angel that we love beyond belief. She is probably part Shih Tzu. She came from the shelter and is an indoor only dog. She is six to seven years old and has started having a chronic discharge in both her eyes. We have put eye drops that my pediatrician gave us for our son and it is better for a while. The dry stuff on her eyelids is very hard to get off, but I try to clean them every day. She can see fine, but has recently started rubbing her eyes with her paws. What could this be and should we be concerned?
A: Holly may have an allergy to something in the air that is making her paw at her eyes. I am assuming you do not let her ride in the car with her face out in the wind. This is very bad on a dog’s eyes. The wind dries the eyes and foreign objects suspended in the air can do a great deal of damage if it hits an eye. Cut grass, bugs and dust are top of the list.
Assuming this is not the case, and at her age, one of the most common problems that develop in dogs over five years of age is dry eye or keratoconjunctivitis sicca (KCS). Her breed is one that is on the list of high risks for developing KCS. Both the Lhasa Apso and Shih Tzu have a higher incidence of developing it and she sounds like she might be part of one or both breeds. They tend to have protruding eyeballs that have a large surface area for exposure.
Other signs that occur commonly with KCS are a dull or lack-luster surface of the cornea. Redness of the eye, the thick discharge you are describing which may be yellow to greenish especially in the morning. It dries more as the day progresses and becomes more painful. Eventually if untreated, KCS can actually have an adverse effect on vision due to scar tissue and the formation of brown pigment.
Tears are normally secreted into the eye and provide lubrication, moisture and oxygen to the eye surface. Without this lubrication the cornea may develop ulcers that can progress to scar tissue. As you might guess this is very painful. The key is that the discharge is very persistent and is very hard to clean from the eyelids.
Blood vessels will form on the surface of the cornea to try to bring nutrient to heal the cornea. With time, a brownish pigment may form on the cornea, blocking vision and resulting in the extreme, in blindness.
Your veterinarian can carefully check Holly’s eyes for tear production, with what is called a Schirmer Tear Test. A piece of special paper held in the corner of the eye will register tear production over one minute by a dye in the paper moving up an area marked in millimeters. Another test will be performed on the eye to measure the ocular pressure, and finally a drop of fluorescein stain will be placed in each eye. If there is an area that appears green from the stain, there is an ulcer on the cornea. This is important in the selection of treatment by your doctor.
Other tests to look at diseases that can also cause dry eye will be done. Hypothyroidism tops the list, and usually starts to appear at three to five years of age. Infections, especially viral infections can cause KCS. Unfortunately other things such as prescription drugs used to treat her other problems may result in KSC. Drugs that contain sulfa and the anti-inflammatory drug EtoGesic can cause KCS, especially if given long term.
The good news is that KCS is treatable with a cyclosporine containing drug that requires a drop in each eye every twelve to twenty four hours. Some come as an ointment that requires about ? inch be placed across the cornea every twelve hours. 80-90% of animals respond to this treatment although the medication may cost a dollar or two a day. Artificial tears used more frequently may allow for more comfort, and if an infection is present certainly a course of antibiotics directly into the eye and taken orally may be helpful. If it is truly KCS, and antibiotics do permanently relieve her eye problem, it may be a simple conjunctivitis which would be good news for you and her.
Surgery to reroute her salivary duct from the mouth to the eye can lubricate the eye. This is done primarily for those that are refractile to the medication. Artificial tears six to eight times a day can also help if other treatments are not effective. As young as Holly is, if your veterinarian does diagnose KCS, treatment should protect her eyes and long term should be a comfortable and effective solution to prevent blindness for her.
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Dry eyes — A common problem in some dog breeds
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