Corneal ulcers in dogs and cats

Ulcers of the cornea in dogs and cats is a common occurrence, and a potentially dangerous affliction. 

Any abrasion to the cornea, including an bee sting, rub from a paw, a scratch from a claw or thorn or an invasive infection can abrade the cells on the surface of the dog or cat cornea.  Once the surface cells are disrupted the smooth surface of the cornea becomes rough, infective organisms can invaded the spaces between the cells and the area becomes a source of pain and irritation to the animal.  Dogs and cats with corneal ulcers commonly will have increased tear production, will squint (called blepharospasm) and rub at their eye.  The irritated tissues often become infected.

If infection progresses into the thin cellular layers of the cornea, the ulcer may deepen and widen and eventually break through the membrane at the back of the cornea called Descemet's membrane. In these severe cases, the fluid from the anterior chamber of the eye can escape and the front of the eye collapses. When this occurs, called a descemetocele, the iris will often seal the hole in the cornea.  If the iris tissue adheres to the opening and acts as a plug, the anterior chamber may refill and eventually the ulcer may heal and seal the opening in the cornea. This could take many weeks to occur. In unfortunate cases, the interior of the eye can become infected and eventually the eye may be damaged beyond repair.

Once the cornea is abraded, the entire cornea suffers from swelling (called edema) and the cornea takes on a slight haze.  Then tiny capillaries begin to move over the cornea from the white of the eye (called the sclera) and seek out the damaged tissue. Within days of the abrasion these tiny vessels are on their way to bring healing tissues and fluid to the ulcer.  As specialized corneal cells slide into and fill the defect, the ulcer eventually heals and the surface of the cornea returns to normal.  Then the healing capillaries dry up and go away!

Fluorescein strips are used to demonstrate if there is a break in the corneal surface.  The stained strip is moistened with sterile water and the stain is flushed across the eye.  Any break in the corneal surface takes up the stain and the veterinarian can record the dimensions of the defect.

Treatment For Corneal Ulcers In Dogs and Cats
Most veterinarians will begin treating corneal ulcers in dogs and cats with appropriate antibiotic ointment or drops.  The use of cortisone or cortisone-related medications may not be a good choice to use due to the possibility of delayed healing and a worsening of the ulcer.  It pain is evident, Atropine or other antispasmodic medications may also be dispensed.  The dog or cat's dewclaw, if present, may need to be bandaged to prevent the dewclaw from doing further damage to the irritated cornea as the patient wipes across the offending eye.  Rechecking the eye in five days and then another five days usually demonstrates that proper healing has taken place.  A negative stain uptake upon use of the Fluorescein stain will indicate if additional treatment is needed.

Some breeds of dogs, notoriously Boxers and Boston Terriers, often have very unresponsive corneal healing activity.  These cases of poorly healing corneal ulceration need to be monitored closely and special selection of adjunctive medications, such as topical Vitamin E and other medications, may need to be tried to stimulate corneal epithelium regeneration.

Third eyelid flap surgery
Occasionally when a corneal ulcer fails to heal or when a very deep or wide ulcer is present a third eyelid flap procedure is performed.  Under general anesthesia the patient's Nictitating Membrane...also spelled Nictating Membrane... (called the third eyelid) that originates in the medial corner of the eye opening and under the lower lid, is pulled up and over the cornea.  It is sutured to the inside of the upper eyelid, thus forming a protective and nourishing layer of tissue over the damaged cornea.  Medications can still be applied to the eye between the eyelids, but the surface of the cornea will not be exposed and cannot be visualized while the third eyelid flap is in place.  The sutures are removed in 10 to 28 days and the corneal healing is assessed.  This procedure is commonly done and be very helpful in generating a healing response in severely damaged corneas.

 

Comments

[myra williamson]

my boston (PUP) had a run in with a cat, and got a scratch on his eye, cornea and lid, and to complicate matters, he already has implants for cateracts since the age of 18 mons. The vet did the third lid stich , and I am putting drops and ointment in 3 times a day and pills 2 times a day. The eye when I saw it ,wasn,t all the way thew the membrain and looked fairly clear. Do you think his emplants will have a baring on him healing? I am very concerned,he is almost 5yrs now. I can not affort to take him back to the doctor that did his eyes before , as I am now diabled and as it is this is costing me much more than I really can afford but I love my Baby, thanks

[myra williamson]

my boston (PUP) had a run in with a cat, and got a scratch on his eye, cornea and lid, and to complicate matters, he already has implants for cateracts since the age of 18 mons. The vet did the third lid stich , and I am putting drops and ointment in 3 times a day and pills 2 times a day. The eye when I saw it ,wasn,t all the way thew the membrain and looked fairly clear. Do you think his emplants will have a baring on him healing? I am very concerned,he is almost 5yrs now. I can not affort to take him back to the doctor that did his eyes before , as I am now diabled and as it is this is costing me much more than I really can afford but I love my Baby, thanks

[Peterz]

I thought that was a good question and I really don't know the answer, but when I read the article again closely, it does point out your dog's breed (boston) to be a stubborn healer: "Some breeds of dogs, notoriously Boxers and Boston Terriers, often have very unresponsive corneal healing activity. These cases of poorly healing corneal ulceration need to be monitored closely and special selection of adjunctive medications, such as topical Vitamin E and other medications, may need to be tried to stimulate corneal epithelium regeneration." I'd watch it closely - you don't mention if he has discomfort. If he does and he's still scratching you most likely need a 2nd trip to the vet. Maybe a friend or relative can help you get him there? Or maybe if you just call the vet and explain your situation, they'll let you know if anything sounds unusual.

[myra]

thanks for the info. we are still going to the vet and trying different meds. and I am giving him pain drops twice a day and the ulcer is some better but even with medcation drops every hour in the day, this thing is not healing as fast as I want. I am going to get the vitamin e drops. I might have to take him back to the teaching hospital in raliegh nc that did his emplants ( if I can affort it)

[myra]

Oh, can you remember the other meds the article
recomendid?

[Stella keddie]

I am from Pittsburgh, PA. I have a West Highland White Terrior, age 11yrs. He has been diagnosed with a corneal ulcer in his right eye. Actually, I had him to the vet for an exam due to a mucus in his left eye. It was a dry eye condition that became noticable overnight. The right eye was fine, and did not need the cyclosporin as the left eye did. After only 3-4 days, he began squinting both eyes, and was not interested in eating or any activities. I took him back to the vet thinking that part of the problem could be his back legs (arthritis) acting up with the weather getting colder. But, to my surprise, he had developed a corneal ulcer that quickly. The vet put him on Cipro--
antibiodic, and kept a close watch. After approx. a week, the ulcer had gotten deeper and spread larger. The vet then did emergency surgery, as he was concerned that the eye could rupture. He did the suturing of the third eyelid membrane to the upper eyelid to cover the ulcer for support, and to enourage the ulcer to heal. I have faith in the veterinarian, but, I feel so bad for my little dog and worry about his condition. He gets artificial tears in both eyes, the antibiotic in his right eye for the ulcer, and cyclosporin the the left eye for dry eyes. He was on an oral antibiotic, bsut finished it and it was no longer recommended by our vet. My dog eats U/D for a bladder condition-he had bladder stones, and he does have arthritis in his back legs, which usually does not seem to bother him. With the weather change, he had some pain, and was put on Rimadyl, which has helped him greatly. He is his peppy old self at this time---good appitite, and loves to go out in the yard---I actually have to slow him down due to the surgery. He is wearing a cone to protect him from scratching his eye. I recently read an article about Rimadyl being really bad for dogs----------so confusing. Can you shed some light on all of this. Casey has a good strong heart and is playful and loving, loves people and loves to travel in the car, and play with his toys. He is a joy, and i will always give him any care he ever needs. I hope he has some good years left. Can you shed some light on all of this--advice ETC> Sincerely, Stella

[Nicole Domuret]

I found a stray persian. I immediately had him checked out by the vet due to a severe eye infection. It turned out to be a descemetocele from a neglected corneal ulcer. The vet recommended removing the eye. I opted for a topical antibiotic. He has been on antibiotics for 4 days now and the eye doesn't seem to be getting better. I'm not sure how long the process my take. He can't close his eye due to the ulcer. Would that slow the healing process as well? Thanks for your time!

[Stacy Caretti]

I have a bulldog that is being treated for a scratched cornea. We have been treating the eye with antibotics 4 times a day without seeeing much improvement. The sclera of the eye is swollen as well as the tissue on the inside of the eye lids. I understand why the sclera may be red and swollen. But is it normal for the tissueunder the lids to red, swollen, and meaty looking after 4 days of treatment?

[Gael]

I have a maltese, a pup. She is only a few months old. She is being treated for a corneal ulcer. The vet that is treating her did the suturing of the third eyelid membrane to the upper eyelid to cover the ulcer for support, and to encourage the ulcer to heal. This was seven days ago today. She is scheduled for a check up within seven days. Throughout the week she seems fine, but today I noticed that a black build up was forming around her eye. It also seems swollen. I have a feeling that she probably hurt, or scratch the affected area herself. I call the vet's office, and unfortunately he is on vacation because of the holiday. The assistant told me that sometimes this is due to secretion of the stitches done in order to keep the eye close. She also told me to apply some Neosporin. My pup does not seem to be in pain, or to have developed any fever. She is running around and eating fine. Is her condition within the range of "normality" considering her circumstances? Does what the assistant at the vet's office sound about right? Does this sound like an infection? Should I be more concern and rush her to the emergency facility?

I would appreciate your advice.

Gael

My Rottweiler was just diagnosed with a superficial cornea scratch. She is on Atopine drops and ointment. This just happened Sunday night and saw the vet yesterday. She will go back in 5 days. She doesn't want to eat and I am worried about her. All she does is sleep. Is this common?

[amie]

Hi, it's been a lil' over a month since my 6 yr old boxer was given the diagnsis of corneal ulcers. He was diagnosed with one in each eye. It doesn't seem like an injury caused them, more hereditary is what we're told. The vet said he'd prefer if we would take him to a specialist..but because of financial and the far distance it was, we could not. So we opted to try what we could at his vet. He did not give us much hope. However we took him in last week for another check up and his eyes have healed. We did oral antibiotics, ofloxocin 3x a day and atropine also. He went to vet every week for a check up. It has worked. Our vet was so excited he was jumping up and down, he could not believe it. He had never been able to cure this before. He is now on an ointment that is a steroid to clear up the cloudyness and it is working wonderfully. The right eye cleared up quicker than the left, but the right was worse in the beginning..he did, a couple weeks back, graph( i guess is what it's called)the left eye to promote the healing by helping blood vessels reach out to the cornea..it's cost about a thousand $ total(for everything), but it was over time, not all at once..and it was worth every penny because it has worked..it was a weekly cost of about $80-$100. I hope my story gives someone else hope.

[shannon]

my dog had emergency surgery two weeks ago because her eye popped out she is a 10 year old pomeranian but now she has a corneal ulcer how do you have any info on if it will heal or how long it will take.