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Timely treatment of Dry Eye Condition

Life without vision is unimaginable. A simple looking redness in your dog’s eye can lead to permanent blindness in your pooch. Here’s more on this eye disorder.

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Before treatment (Dry Eye): loss of
vision, corneal ulcerations, redness
and mucous discharge.

Keratoconjunctivitis Sicca (KCS) is a disorder of the tear glands that results in insufficient aqueous tear production and may lead to permanent blindness in your pet. It is also known as ‘Dry Eye Condition’.
Susceptible breeds
Dry eye is prevalent in some breeds of dogs like Lhasa Apso, English Bulldog, American Cocker Spaniel, English Springer Spaniel, Pekingese, Pug, Chinese Shar Pei, Yorkshire Terrier, Shih Tzu, Miniature Schnauzer, German Shepherd, Doberman Pinscher and Boston Terrier.
Causes of KCS
There are multiple causes of KCS. Most common cause is the body’s own immune system causing abnormal inflammation of a lymph node or gland. Some other causes include tear secretory disorders that are mostly congenital (genetic) in origin. Certain drugs/anaesthetics can produce either temporary or permanent KCS. Removal of third eyelid to correct a disease problem can increase the risk of a dog developing KCS, since tear-production is associated partially with the third eyelid. The most common viral disease in dogs, canine distemper virus, is often associated with KCS. Systemic metabolic diseases associated with the development of KCS include hypothyroidism, diabetes mellitus, hyperadrenocorticism (Cushing’s Disease), atopy and dysautonomia. Damage to facial nerve, either due to disease or trauma, can result in KCS by decreasing the amount of tear film produced.
Diagnosis of KCS
Your dog will not develop this condition overnight. He will surely give you alarm. Dogs may have red/irritated/itchy eyes and may have a thick ocular mucoid discharge that can range from off-white to green in colour. The third eyelid is protruded, and the cornea is no longer shiny in appearance. In advanced cases, it may lead to potential vision loss.
Dry eyes need to be differentiated from different eye disorders. Schirmer Tear Test (STT), fluorescein staining of the cornea, and evaluation of the intraocular pressures are routine tests performed by a vet to diagnose if dog is suffering with eye problem. The Schirmer Tear Test is designed to measure amount of tear produced by the eye. It is a painless and very simple procedure. Schirmer Tear Test strips are available in pet clinics. This strip is a piece of paper with small scale on it. Vet will hold this strip touching to dog’s eye for a minute so that the tear production can be quantified, based on mm/min.

Dot Health

After treatment with Cyclosporine Ophthalmic Ointment: normal vision, no ulcers, no redness/inflammation and no discharge from eye

Interpretations of
Schirmer Tear Test
Normal: ≥ 15 mm/min
Early KCS: 11-14 mm/min
Mild/moderate KCS: 6-10 mm/min
Severe KCS: ≤ 5 mm/min
Fluorescein is a bright yellow/orange stain that is used to detect corneal ulceration. In dogs with KCS chronic irritation to eye may lead to corneal ulceration. Tonometer can be used to measure pressure in eye.

Treatment of KCS
After confirmation of KCS in dog, it can be treated very effectively by using topical ophthalmic preparations. All therapies to treat Dry Eye Condition are very economical. It is the responsibility of the pet parent to remain alert and check if your dog is showing any symptom of developing this condition.
(Dr Bipin Sonar, Medical Services, SAVA Healthcare Limited, Pune.)

OTITIS Causes, Treatment & Management

Otitis externa and otitis media are two common ear problems in pooches. Here are the causes, symptoms and treatment for these ear problems.

Otitis externa is defined as an acute or chronic inflammation of the epithelium of the external ear canal which Otitismay also involve the pinna. The condition is characterised by erythema and increased discharges or desquamation of the epithelium with varying degrees of pain or pruritus. Contributing predisposing and primary factors for otitis externa must be evaluated or the condition is likely to become chronic, ultimately resulting in an end-stage ear with surgery the only viable option.
Otitis externa often results when a change in the normal environment of the ear canal causes the glands lining the canal to enlarge and produce excessive wax. Gradually, the outer skin (epidermis) and the inner skin (dermis) produce excessive fibrous tissue (fibrosis) and the canal becomes narrowed. It is normally a secondary symptom of another underlying disease, such as an infection.
While, otitis media is defined as inflammation of the middle ear and is an important perpetuating cause of otitis externa. Otitis media typically occurs as an extension of otitis externa, causing a ruptured membrane (tympanum) that separates the external ear and the middle ear.
Otitis externa and otitis media affect dogs and cats of any age and breed. As responsible pet parents, we can protect our canines from these ear problems.

Symptoms to look out for!

  • Pain
  • Head shaking
  • Scratching/itching at the external ear flaps
  • Bad odour
  • Redness and Swelling of the external ear canal
  • Scaling skin or obstruction of the ear canal
  • Tilting the head
  • Anorexia
  • Un-coordination and
  • Occasional vomiting

Causes of otitis
Foreign bodies: Plant material, dirt, sand, dried medicaments, cross-lodged hairs can cause otitis.  Diagnosis is more complicated if bilateral or if the condition has progressed with the appearance of a purulent discharge which may be confused with a primary bacterial disorder.
Ear tumours and polyps: Patients with ear canal tumours or polyps will present with unilateral otitis externa and possibly otitis media. Common tumours include sebaceous gland adenomas and adenocarcinomas, ceruminous gland adenomas and adenocarcinomas, carcinomas of undetermined origin, and squamous cell carcinomas. All masses within the ear canal should be surgically removed as soon as possible and positively diagnosed by biopsy.
Bacterial: Cytology is very important to estimate numbers of organisms. More common pathogens include Staphylococcus intermedius, Pseudomonas aeruginosa, Enterococcus spp, and Proteus spp. ‘Swimmer’s Ear’ can be a problem in dogs resulting from a combination of water retention, epidermal maceration and secondary infection with Pseudomonas spp.
Mycotic infections: In otitis, fungal organisms isolated are candida spp and rarely dermatophytes.

Diagnosis of otitis
Techniques like otoscopy, pneumotoscopy, bulla radiographs, otic endoscopy and magnetic resonance imaging (MRI) may be used to identify the accumulation of fluid or soft tissue growth in the middle ear. Otitis media was diagnosed in over 80 percent of these ears with chronic otitis.
Vets also need to know the history of the pet and will conduct a complete physical examination as well as otic examination (pinna, otoscopic examination of the external ear canal). Gram negative bacteria  is indicated by purulent, pale yellow, thick, tenacious, sweet smelling exudates while gram positive bacteria  is indicated by  light brown, creamy exudates. Ear mites  symptoms include dark brown to black crumbly exudates while those for yeasts include dark brown sweet smelling exudates.
Vet will perform a cytological examination, bacterial culture and sensitivity and additional diagnostic, testing like skin scrapings, fungal cultures, thyroid evaluation, allergy testing (skin or serum testing for inhaled allergens), ear canal biopsy, CT scan and hemogram and serum biochemistry profile.

Treating otitis
Treatment for otitis externa and otitis media usually involves outpatient care, unless the inflammation or infection has moved into the inner ear. In most cases of otitis externa, a topical therapy following a complete cleansing of the external ear is an effective resolution to the problem.
The topical therapy may consist of antibacterial, corticosteroid, anti-yeast, and antiseptic drops. In severe cases of otitis externa and otitis media – where the presence of infectious organisms has been confirmed – oral antibiotics and antifungal may be prescribed. Corticosteroids may also be used to reduce the animal’s pain and swelling.
Systemic antibiotics are prescribed for severe, chronic, or recurrent bacterial otitis externa and for all cases of otitis media. While, systemic antifungal agent Ketoconazole at 5-10 mg/kg/day should be considered along with topical therapy for treatment of yeast otitis media for 3-4 weeks, but should be continued until follow-up cytology confirms that the infection is cleared. Also, Zeps surgery can be performed for the correction of otitis media in dog.

Living and management
Follow-up treatments for otitis externa and otitis media involve repeat examinations of the ear discharge and control of any underlying diseases. With the proper therapy, most cases of otitis externa will resolve within three to four weeks, whereas otitis media takes a considerably longer time to treat it and up to six weeks to be resolved. If these conditions persist over long periods of time and are not treated, they may lead to deafness, facial nerve paralysis, otitis interna, and (rarely) meningo-encephalitis. So, take care of your pooch’s ears!
(Dr Vikash Sharma is MVSc & AH (surgery) at Animo Pet Care & Research Center, Patna.)

Dog Health

Canine cataract: symptoms, treatment and care

How cataract occurs?

There is a lens in the eye which has its place behind the pupil. It is transparent and focuses light onto the

Dog Health

Unilateral Cataract

retina. The retina sends the image to the brain, where vision is perceived. Cataract forms when the cells and the protein of the lens begin to deteriorate. The lens gets cloudy and the light cannot be transmitted to the retina. There are many different forms and causes of cataract formation.

What is a cataract?

The word ‘cataract’ literally means ‘to break down.’ This breakdown refers to the disruption of the normal arrangement of the lens fibers or its capsule. This disruption results in the loss of transparency and the resultant reduction in vision is called cataract. When the opacity is very small, it leads to blurred vision called immature cataract. When the entire lens becomes cloudy and there is loss of all functional vision, it is called mature cataract.

Cataracts vis-à-vis nuclear sclerosis

People often confuse cataract with another common problem called nuclear sclerosis. Nuclear sclerosis is a normal change that occurs in the lenses of older dogs. Nuclear sclerosis appears as a slight graying of the lens. The loss of transparency occurs because of compression of the linear fibers in the lens. It usually occurs in both eyes at the same time and occurs in older dogs. This condition does not significantly affect the vision of the dog and treatment is not recommended.

What are the causes of cataract?

There are several causes of cataracts which include:

Genetic: Cataracts in dogs are frequently inherited. Over 40 breeds of dogs are known to be predisposed to cataract e.g. Retrievers, Cocker Spaniels, Terriers, etc.

Trauma: If the lens is punctured or damaged due to automobile accident, penetration of a thorn or stick, a cat scratch, etc usually lead to cataract.

Diabetes: Diabetes mellitus (sugar diabetes) is a systemic disease where regulation of blood sugar (glucose) is not controlled. The lens requires some glucose, but when the levels are too high, cataract can form rapidly.

Old age: As animal becomes geriatric, all his body functions generally become sluggish and hence the eyesight. Age-related cataracts are usually very small and tend to progress very slowly.

Other causes: Nutritional deficiencies early in life, changes in blood calcium, exposure to certain drugs and toxins, exposure to intense microwaves, radiation therapy and electrocution may also alter both nutrition and structure of the lens, resulting in cataract.

How can cataract be diagnosed?

Diagnostic tests are needed to recognize cataracts and exclude other diseases. These tests include:

Complete eye examination: Such an examination includes fluorescein staining of the cornea, schirmer tear test, slit lamp biomicroscopy, etc.

Blood tests: Blood tests are usually done for diabetes and other systemic diseases.

Ocular ultrasound: Ocular ultrasound is performed if the retina cannot be examined because the cataract is too opaque, and if surgery is being considered.

An electroretinogram (ERG): It is also frequently performed prior to cataract surgery in order to evaluate the function of the retina. An ERG is especially important in determining underlying retinal disease masked by the cataracts (if the lens is too opaque for the entire retina to be examined).

How can cataract be treated?

Treatment for canine cataracts includes surgical removal of the lens, which may include one or more of the following:

Cataract surgery : Phacoemulsification is the most common technique used in both humans and animals to remove a cataract. Once the pupils have been dilated and animal is under general anesthesia, a small incision is made through the cornea. The lens is housed in a small bag called the lens capsule. A small tear is made in the front capsule and a circular piece of the capsule is removed. The phacoemulsification instrument uses ultrasonic waves to break apart the lens and then suck it out. Most of the lenses are removed by phacoemulsification, and then the lens capsule (the “bag”) is cleaned of any remaining lens material. Frequently an intraocular lens implant (a prosthetic lens) is then placed into the lens capsule. The lens capsule acts as a bag to hold the implant in place. There are lens implants for both dogs and cats, and these prosthetic lenses return the vision as close to normal as possible.

Extracapsular lens extraction: This is another cataract removal technique. It is used either when a phacoemulsification machine is not available or when a cataract is so hard or old that the phacoemulsification instrument isn’t powerful enough to break up and remove the lens. The surgical procedure requires making a larger incision through the cornea and a larger hole in the lens capsule so that the lens can be removed from the bag as a whole. A lens implant can still frequently be inserted during this type of procedure.

Intracapsular lens extraction: This is another surgical method that involves making a large incision through the cornea and removing the whole lens in its capsule. This procedure is generally used when a cataractous lens has shifted out of position and is no longer held firmly in place inside the eye. Because the lens capsule has been removed, if a lens implant is going to be used, it has to be sewn into place because there is no capsular bag left to hold it in the center of the eye.

Post-operative care of cataract surgery

Regardless of which type of procedure is used to remove a cataractous lens, there are many postoperative medications and important home care instructions to be followed after surgery.

After cataract surgery, the first one to two weeks are the most labour-intensive. The dog must be kept quiet and calm. Usually an Elizabethan collar is used to keep the dog from rubbing or traumatizing the eye. This collar should stay on at all times. Playing, barking and jumping should be discouraged and all pressure around the head should be minimized. Several topical (drops) and oral medications may be used after surgery, such as:

  • anti-inflammatory drops
  • dilating drops
  • antibiotic ophthalmic drops
  • oral anti-inflammatory drugs
  • oral antibiotics

(Dr S S Patil is PhD scholar at Centre of Advanced Studies in Animal Nutrition, Indian Veterinary Research Institute, Izatnagar; Dr KB Kore is PhD scholar at Division of Animal Nutrition, IVRI, Izatnagar; and Dr PP Mirajkar is MVSc scholar at Division of LES, IVRI, Izatnagar)

GID: causes, treatment and prevention

GID is a common disease in dogs. But such problems can be avoided if you vaccinate your pet regularly. Dr. Hitesh Swali gives tips to take care your pet’s health.

Gastrointestinal diseases (GID) often occur in puppies till 6 months of age, although adults can also be affected to a variable percentage. The common symptoms of GID include frequent diarrhoea and vomiting.

It is utmost important to reach the underlying cause for the disease, some of which include:

  • Viral Bacterial
  • Parasitic
  • Diet
  • Environmental

Viral:

Viral Gastroenteritis is the most commonly occurring disease in puppies till 3 months. Of this, Canine Parvo Virus (CPV) and Canine Corona Virus (CCV) are mostly prevalent in puppies. Clinical signs include blood diarrhoea, vomiting, high temperature (103-105oF) and dehydration. This disease lasts for 3-5 days and requires extensive treatment. Treatment?:?Main aim in treating Viral Gastroenteritis is fluid therapy. Dogs suffering from this disease should be fed with lots of clean water. Fluid therapy should be done i/v or s/c to check dehydration. Puppies should be kept in isolation to prevent the disease spreading to other pups. Avoid giving food till diarrhoea and vomiting comes in control. Pups can be given ORS solution to check dehydration. Orally Metronidazole and broad spectrum antibiotics can be given along with anti-emetics such as Metaclopromide according to body weight till your vet can start his treatment.

Prevention?:?CPV and CCV can be prevented by regularly vaccinating the pups. Modified live virus and freeze dried vaccines such as Vanguard-5L, NOBIVAC DHPPiL available in the market should be administered to pups at 6-8 weeks of age after proper deworming has been done. Repeat booster vaccines every 21 days till 3 months of age and thereby annually.

Both male and female dogs should be vaccinated to help pass the passive immunity to the offsprings.

Bacterial:

Bacteria such as Salmonella, E. Coli, Campylobacter are the common bacteria responsible for the diseases in dogs. Characteristic symptoms include vomiting, dysentery with lot of strain during passing stools. Fever is usually mild or absent. This usually happens during travelling or if there is a change in climatic conditions or for puppies who have been exposed to bore well water or have had sea water during picnics. Treatment?:?Usually dogs do respond very well to broad spectrum antibiotics and anti-diarrhoeal. Checking dehydration level is must. Examination of faeces should be done to rule out parasitic involvement.

Prevention?:?Preventing pups from drinking stagnated water is the best way. Pups like to drink water directly from the bathroom which should also be avoided. Carry home water along with you while travelling and during dog shows.

Internal parasites:

The most common round worm is a potential health hazard to humans, you must ensure that the dog is routinely dewormed as they can also act as an intermediate host to certain tape worms, that can pass to humans. In addition to round worms and tape worms, dogs can become infested with more serious intestinal hook worms and whip worms or by microscopic parasites that cause diarrhoea. Treatment?:?Regular deworming for puppies every month till 6 months of age and thereby every 2 months using broad spectrum dewormers such as Drontal plus @1 tablet per 10 kg body weight. Deworming should be done to breeding dogs prior to mating.

Prevention: Regular deworming and examination of stools should be done by the vet at regular intervals. Avoid feeding table scraps and half-cooked meat to pups.

Diet:

Diet plays an important role in the growth of the pup. Any change in diet can lead to lot of Gastroenteritis disorders. Avoid feeding pure milk to puppies. Orphan pups/recovering dogs from chronic diseases should be fed commercially available prescription diet for intestinal disease (for pups Royal Canin-V diet is prescribed).

Environmental:

Dogs and pups are very sensitive to any change in the climate. Owners should take care of pups during summer season and they should give them lots of clean water as summer diarrhoea is very common. Monsoon are the major worry for Bacillary Dysentery/Amoebiosis and Viral Gastroenteritis. Exotic breeds such as St. Bernard, Mastiffs and other giant breeds have lots of problem during summer. If you do spot any of the above symptoms, do contact your veterinarian immediately. Breeds such as Pugs, French Bull dogs, English Bull dogs undergo lot of stress during summers leading to summer diarrhoea and respiratory problems.

(Dr. Hitesh Swali, B.V.Sc & A.H. (Bom) is a veterinary physician and surgeon at Veterinary Dispensary & Antirabic Centre, Mumbai. He can be contacted at 9821120058 or 9821237566.)