If you should ever have a question or concern regarding your pet’s ocular health, we can be reached at any time by calling our location nearest you.
The subpalpebral lavage system is used to deliver medication to the horse’s eye safely, easily and efficiently. The system is made from flexible tubing, which is passed through the upper or lower eyelid into the conjunctival cul-de-sac (the space located between the eyelid and the eye). Medication is introduced into the system through a catheter at a distant injection port (usually braided into the mane along the neck) and is slowly delivered to the eye through the tubing (which runs under the halter to the eye). Upon reaching the end of the tubing, medication exits the system and runs onto the surface of the eye.
Topical corticosteroid eye drops reduce inflammation, suppress vascularization (blood vessel formation) and may decrease corneal pigmentation. In many cases, the benefits of corticosteroid eye drops are dramatic and can save vision and promote comfort. However, corticosteroids may have several side effects including delayed corneal healing, increased susceptibility to ocular infection, local irritation, corneal thinning, and corneal mineralization. In rare cases, internal side effects associated with topical administration of corticosteroids have been reported.
We typically prescribe topical corticosteroid medications to control ocular inflammation. We carefully select a particular strength and frequency of corticosteroid, depending on the degree of inflammation at the time of examination.
The topical corticosteroid medication should make your pet feel significantly more comfortable. Besides topical medications, we may consider corticosteriod injections underneath the conjunctival membrane. However, if your pet develops increased squinting, tearing, discharge or starts rubbing at their eye, please stop the medication and call Eye Care for Animals to speak with one of our staff members.
Oral corticosteroid medications are often used to reduce inflammation after eye surgery or to control very severe inflammation. In these cases, corticosteroid pills or injections are very beneficial. However, they may have side effects including increased appetite, thirst, urination, panting and weight gain. Your pet may need to be let outside more frequently throughout the day and may occasionally have uncharacteristic accidents in the house. Occasionally, these medications may result in behavioral changes such as aggressiveness or restlessness. These side effects will resolve as we taper and finally discontinue the medication.
Animals normally produce their own corticosteroids. However, the body will stop making corticosteroids when an external source is supplied. Therefore, when it is time to stop a systemic corticosteroid treatment, it is important to gradually withdraw it so that they body will have time to start producing them again. Abruptly discontinuing a high dose or long-term use of an oral corticosteroid can lead to shock and an emergency situation. Therefore, it is very important to follow the label instructions very closely and to not stop them early unless consulting with your veterinarian first.
Cyclosporine and tacrolimus are topical ophthalmic medications commonly used in the treatment of keratoconjunctivitis sicca a.k.a. dry eye. While there are many causes of dry eye, most dogs suffer from an immune-mediated abnormality that negatively affects the tear glands leading to reduced watery tears.
Several medications are used in the treatment of dry eye in animals. Cyclosporine A is a medication derived from a fungus used as an immune- suppressive agent. It was first used in human medicine to help prevent rejection of transplanted organs. Tacrolimus, a drug closely related to cyclosporine was developed to help prevent corneal transplant rejection in humans. Both are commonly used to treat dry eye in animals. A less-concentrated version of cyclosporine is used to treat dry eye in humans as well.
Cyclosporine and tacrolimus work through several different mechanisms:
1. They stimulate/increase watery tear production by the lacrimal and nictitans glands.
2. They decrease the immune-mediated destruction of the tear glands.
3. They improve the health of the conjunctival cells that secrete mucus, another important component of tears.
To date, few side effects have been noted in association with cyclosporine and tacrolimus. A small percentage of patients have shown some mild eye irritation after administration, but this is generally believed to be due to the base the drug is made in (water, oil, ointment, etc.). If this occurs, let us know and we can try a different medication or formulation of the drug. There have been reports in the human medical literature proposing a link between these medications and a certain type of skin cancer. This has not been proven definitively and it has not been reported in veterinary medicine. While it is prudent to wash your hands after contact with any drugs, there are no additional precautions recommended at this time.
It is important to remember that cyclosporine and tacrolimus cannot cure dry eye. They are used to manage the disease, to maintain corneal health, and provide comfort long-term. Stopping medication will cause the return of clinical signs of KCS; therefore, it is not recommended to discontinue treatment unless directed to do so by your veterinarian. As with people, most pets with dry eye will require medication for life. Depending on the severity of dry eye in your pet’s eyes, our veterinary ophthalmologists may prescribe cyclosporine or tacrolimus in conjunction with other medications.
At Eye Care for Animals, we are proud of the precautions we take to safely administer anesthesia. We feel that our success in doing so is due in part to our commitment to evaluate every patient prior to using an anesthetic and to monitor each patient’s vital signs (i.e., his or her respiration, heart rate, blood pressure, and temperature). Our success in safely using anesthesia is also due to our hospitals’ use of modern anesthetic products and techniques, which we continually update as the medical industry develops newer and safer anesthetic agents. Eye Care for Animals also has a board certified veterinary anesthesiologist on staff who is able to consult and manage anesthesia for high-risk patients.
During the past 20 years, gas anesthetics have been developed, which have proven to be much safer and more effective than intravenous anesthetics. The use of these gas anesthetics in both animals and humans has led to the expansion of conditions considered surgically treatable; we now are able to do surgical and diagnostic procedures that would not have been possible with earlier anesthetic techniques. Additionally, we often utilize ventilators to provide the most accurately calculated mechanical ventilation for each patient.
Today, the gas anesthetic agents, isoﬂurane and sevoﬂurane, are used in both veterinary and human medicine because of their superior qualities. Isoﬂurane and sevoﬂurane are considered superior to previous gas anesthetics because in both agents most of the anesthetic is excreted by the lungs and very little is actually metabolized by the liver and kidneys. Furthermore, isoﬂurane and sevoﬂurane have fewer adverse effects on the heart and the lungs than earlier gas anesthetics.
Like earlier gas anesthetics, patients inhale isoﬂurane and sevoﬂurane by taking normal breaths. Because doctors can easily change the amount of inhaled anesthetic, they can ensure with a high degree of conﬁdence that patients receive only the amount of anesthesia required. Additionally, patients of isoﬂurane and sevoﬂuran recover from the anesthetic agent very rapidly and are able to stand within minutes after administration of the gas has stopped.
Be assured that the health of every patient is our highest concern and we will do everything possible to maintain that health. That said, the administration of any drug or anesthetic agent may give rise to complications. Sedation, tranquilization and/or the administration of anesthetic agents carry a small, but realistic, possibility of side effects, which may include, but are not limited to, respiratory arrest, cardiac arrest and/or death. While your pet is under general anesthesia, we monitor heart rate, respiratory rate, blood pressure, temperature, oxygenation and expiratory carbon dioxide levels. In the event that an emergency arises, our teams are equipped to provide the best possible emergent care.
Caring for a blind pet is a unique and privileged responsibility. If your pet suddenly becomes blind, he or she may be confused by the quick nature of this change. Many pets adapt to their blindness quickly while others need months to adjust.
Vision in cats and dogs is quite different from ours. They have better night vision than we do, but their ability to focus and see fine detail is less developed. In addition, they lack well-developed color vision. In general, our pets are less dependent on vision than we are due to their heightened senses of hearing and smell. Therefore, they tend to compensate and adapt to vision loss much better than people do, as they are more suited to rely on these other senses. Pets that become blind undergo a 1 – 3 month period of adaptation, during which, many changes occur. At first, they will bump into walls, furniture and doors; however, this confusion will improve with time.
Most blind pets readily memorize the layout of their home and yard and can function extremely well with poor or even completely absent vision. It will take time for them to learn how to get around using their other senses. With their owner’s supper, blind pets can continue to live happy lives. In fact, owners often report that their pet’s quality of life was not significantly affected when they became blind. Always remember to provide your pet with lots of love and reassurance while they adapt.
Here are some suggestions to help your pet compensate for vision impairment:
1. Animals adapt to their blindness by memorizing their surroundings. Therefore, it is important that you avoid changing their environment such as moving furniture or your pet’s bedding, food and water bowls. If your pet is placed in a new environment, understand that they will need time to readjust to their new surroundings.
2. One of your most important responsibilities is to provide safety for your animal. Be careful of stairways, open doors, and swimming pools. Pools can be especially dangerous if your pet is allowed outside without supervision. Be sure you have a fenced yard that is safe from harmful objects, plants, and bushes.
3. If you have a doggie door, your pet may experience frustration when trying to find it. One option is to place a small mat that has a different texture to it (such as a straw welcome mat or Astroturf) on each side of the doggie door. This way (with your encouragement), your pet will have a way of learning exactly where their door is. A mat can also help your pet find their way back into the house from the yard.
4. Encourage your pet to use their other senses to compensate for the vision loss. Buy noisy toys or ones that have a recognizable odor. For example, “Kong” toys have a hole in the bottom where smelly treats can be placed, allowing them to concentrate on their sense of smell while playing with it. On this note, balls containing noisemakers such as bells will help your dog fetch and focus on their hearing. Some people elect to get an additional pet to serve as a “seeing eye dog/cat” that will act as a companion and guide which your blind pet can follow around using senses other than vision.
5. Note that suddenly blind dogs occasionally develop behavioral changes such as aggression or depression. Therefore, avoid stressing or scaring blind pets. Instruct family members (especially children) to vocalize the pet’s name and approach them slowly. This fear usually passes with time as the pet learns to adjust to the blindness.
6. If your pet is blind due to cataracts, it is a good idea to observe their eyes daily for any changes that could indicate your pet has developed side effects such as glaucoma or uveitis (inflammation inside the eye). Diseases such as these may be very painful for your pet. Changes to monitor for include; reddening of the whites of the eye, increase in the size of the eye, pawing/rubbing the eye, or a change in position of the cataract. Also, blind pets may have a tendency to bump into objects, thereby injuring their eye or eyelid. Such injuries may be painful and cause excessive tearing, swelling, mucous discharge, squinting and/or rubbing. Be sure to contact your veterinarian if you notice any of the above signs.
7. You can continue to take your blind pet for walks if you make a few minor adjustments. Consider switching from a collar to a harness. In so doing, your pet will feel more secure walking at your side. Be as consistent as possible on your walks; always go out the same door and take the same path. This way, your pet will better adapt to its surroundings and be more prepared for steps, curbs, and turns.
8. Many books are available that provide additional suggestions for how to help blind pets adapt. One book that our clients often find helpful is “Living With Blind Dogs” by Caroline Levin, which can be purchased online.
Blind pets can maintain a very high quality of life as long as you help them compensate by following guidelines such as these.
If you have any questions regarding ocular conditions or treatments, please contact us.