How do I know if my pet (E.G. Dog or Cat) has a painful eye and what to do
How Do I Know if my Pet e.g. Dog or Cat has a Sore Eye?
As most pets will have 2 eyes (and it is relatively rare to have both eyes painful at the same time) you can use symmetry between the two eyes to gauge if one eye is 'sore'. If there is a difference in symmetry between the two eyes, then this should be investigated. There are 3 classic signs of eye pain that will disturb the normal symmetry: -
Lid spasm - there will be more blinks and the lid opening will be smaller compared to the 'normal' eye. The eye will be 'favoured'
Increased tear production - (assuming your pet can produce more tears) leading to 'runny eyes' or more visible wetting of the hair near the nose or around the eye
Photophobia - the affected eye will be more likely to close when viewed with a light compared to the 'normal' eye
What are the Most Common Reasons for a Dog's eye to be Sore / Painful?
The most common reasons for eye pain involve pathology associated with the outer aspect of the globe and lids, especially the front transparent area (the cornea). The next most common reasons involve pathology 'inside' the eye itself
Common pathological reasons associated with the outer aspect of the globe and lids are: -
A 'defect', erosion or ulcer associated with the cornea
The cornea has become dry because not enough tears are being produced naturally. It is very common for there to also be an associated abnormal mucoid or mucoid-yellow discharge
There is infection between the lids or there is infection associated the cornea
There is a foreign body within the lids or the cornea
There has been some form of trauma to the eye, between the lids the cornea
Common pathological reasons associated with the 'internal' eye are: -
Glaucoma occurs when there is an abnormal build-up of the water (aqueous humour). This 'extra' fluid occurs because of an abnormal reduction in the fluid leaving the eye. This causes the pressure (intra-ocular pressure - IOP) to become too high. This can cause obvious 'eye' pain or a 'dull, debilitating headache'. Glaucoma is most commonly associated with a pupil that is bigger than the 'normal' eye and the pupil doesn't become smaller (constrict) when bright light is directed at the affected eye(s). It is often harder to see 'inside' the eye due to the normally transparent cornea becoming cloudy. The blood vessels associated with the outside 'white of the eye' are often more prominent. In addition, many breeds of dog are known to suffer from glaucoma
Uveitis occurs when there is a prolem inside the eye and the eye has become inflamed. There are 3 structures inside the eye that from the uveal tract (iris, ciliary body and choroid). Inflammation of one or any part or parts of the uveal tract is termed uveitis. Uveitis is most commonly associated with a pupil that is smaller than the normal eye and this pupil doesn't dilate when the pet is placed in the dark. It is often harder to see 'inside' the eye due to the normally transparent cornea becoming cloudy. The blood vessels associated with the outside 'white of the eye' are often more prominent.
In addition to eye pain (lid spasm, +/- eye watering and photophobia) what are the most common clinical signs associated with the causes of the eye pain?
The cornea loses transparency (becomes cloudy) either at a specific area, or across the whole of the cornea
There can be abnormal coloured discharge
The blood vessels on the outer aspect of the eye (over the white sclera) become more prominent
WHAT TO DO: -
RULE #1 -
1. If your pet has a sore/painful eye and the front part of the eye is 'cloudy' (at all) then a visit to a vet should be scheduled immediately. This is a priority where a few hours can make a significant difference to the outcome for the affected eye(s)
2. If your normal vet team are closed or are unavailable then I recommend a trip to a 24/7 or Emergency Veterinary Facility
3. This vet visit will shorten the time-frame that your pet is in pain and reduce the severity of that pain. It will increase the chances for a good final outcome. It is likely to 'save' you money in the long-run and lessen the requirement for surgical intervention
4. Should a pet require surgical intervention, some of PetVision's surgical fees are listed below. A more complete guide is available at petvision.com.au
PetVISION SURGICAL FEES
Typical Total surgical costs at PetVISION during a normal working day, depends on the: procedure; complexity and therefore the surgical time. Surgical success rates at PetVision are >95%
Each procedure has a 'base price' and then a weight factor is applied. The weight factor is 10x a pet's weight in kg e.g. for a 22kg dog this would be 10x 22 = $220
Surgical base prices are as follows for some of the more common procedures: -
$1400 + weight factor for procedures < 30mins using magnification e.g. superficail ulcer treatment; cherry eye; simple lid mass resection and lid reconstruction
$2500 + weidht factor for procedures > 30mins and < 60mins using magnification e.g. keratecotmy and conjunctival pedicle grafts; more complicated lid prodecures
$3000 + weight factor for procedures > 60mins and < 90mins using magnification e.g. keratecotmy and corneo-conjunctival transposition (CCT); more complicated lid prodecures
Cataract surgery (at 1 eye) base price is $3400 + weight factor. Cataract surgery has a 75% long term success rate
Sometimes, regrettably, eye removal is the best option for a pet. The base price for eye removal is $1200 + weight factor
RULE #2
If your pet has a sore/painful eye and it is impossible for you to visit a vet then the following things can help in certain circumstances: -
Giving paracetamol by mouth is safe to dogs, BUT IS TOXIC to cats and MUST NOT be given
Bathing the eye with a dilute iodine solution is safe in both dogs and cats
PARACETAMOL - only given to Dogs
Paracetamol can be given safely, by mouth, to dogs to help reduce any discomfort. The correct dose is 10mg/kg every (q) 12h (2x per day). There are several available preparations of paracetamol, all require a different treatment amount due to the variance in concentration of the active ingredient - paracetamol. Paracetmol is commonly available as either a tablet or in liquid form i.e. 500mg tablets and oral solutions with the following concentrations of paracetamol: 24mg/mL; 48mg/mL or 50mg/mL
Check which paracetamol preparation you have
You need to know your dog's weight in kg. To convert a known weight in pounds to kg the following formula can be used as 2.2 pounds = 1kg, DIVIDE the 'pound' weight by 2.2 to convert into kg. You need to know your dog's weigh in kg to use the following treatment advice
For 500mg tablets, the amount of tablet you need to give is calculated by: dog's weight (kg) divided by 50, therefore a 50kg dog receives 50/50 = 1 tablet, by mouth, every 12 hours and a 25kg dog receives 25/50 = 1/2 paracetamol 500mg tablet, by mouth, every 12 hours
For 24mg/mL liquid, the amount of liquid you need to give is calculated by: dog's weight (kg) divided by 2.4, therefore a 2.4kg dog receives 2.4/2.4 = 1mL of liquid, by mouth, every 12 hours and a 4.8kg dog receives 4.8/2.4 = 2mL of 24mg/mL paracetamol solution, by mouth, every 12 hours
For 48mg/mL liquid, the amount of liquid you need to give is calculated by: dog's weight (kg) divided by 4.8, therefore a 4.8kg dog receives 4.8/4.8 = 1mL of liquid, by mouth, every 12 hours and a 9.6kg dog receives 9.6/4.8 = 2mL of 48mg/mL paracetamol solution, by mouth, every 12 hours
For 50mg/mL liquid, the amount of liquid you need to give is calculated by: dog's weight (kg) divided by 5, therefore a 5.0kg dog receives 5.0/5 = 1mL of liquid, by mouth, every 12 hours and a 10kg dog receives 10/5 = 2mL of 50mg/mL paracetamol solution, by mouth, every 12 hours
IODINE BATHING e.g. BETADINE / POVIDONE IODINE SOLUTION
An owner or 'holder' must not risk getting bitten if undertaking the following treatment and procedure advice. The make-up and administration is solely the responsibility of the person in charge of the decision making. This advice is intended for an emergency situation only, where it isn't possible to visit a qualified veterinary professional : -
Check that you have an iodine solution. DO NOT USE IODINE SCRUB (which contains a soaping agent that is an irritant to the eye)
Check the concentration of iodine the iodine preparation. This will either be 10% w/v or 1%
If you have the 10% iodine solution, take 1 teaspoon of this preparation and add 9 teaspoons of cold water to make a 1% solution
Once you have a 1% solution take a teaspoon of this preparation and add 19 teaspoons of cold water to make a 0.05% solution. This can safely be used on the eye itself and the surrounding skin, if necessary
Place the solution in a Zip-loc bag and seal. Then take a needle that has been sterilised by burning the point with a match and pierce the bag at the bottom. Gently squeeze the bag to get the 0.05% solution to exit from the hole. Initially 'flush' the eye with several drops at once, but finish with a single drop to remain in contact with the eye. Repeat this hourly for the first 6 hours and then every 2 hours until you can see a vet
I hope the above information proves to be both useful and practical, Doc Guy aka 'The Eye Guy' :)
Dr Guy Clare MA BVSc CertVOphthal
Dr Guy has over 20 years experience in solely treating pets (dogs and cats) eyes. Pets are brought from all over Queensland and interstate for his expert opinion and management. Routine appointments are scheduled Monday to Friday. In addition he is available for, emergency cases outside of normal hours. All cases need to have been assessed by a veterinary surgeon prior to arrival for an appointment. Referral from a veterinary surgeon can be either following written or verbal communication. Verbal referral can be made at T: 1300 EYE GUY (T: 1300 393 489). PetVision is on the web, please visit the Pet Vision website.
Dr Guy Clare is a UK Qualified veterinary ophthalmic surgeon (holding the Royal College of Veterinary Surgeons Certificate in Veterinary Ophthalmology - CertVOphthal). Prior to emigrating to Australia in 2009 he lectured in Ophthalmology at Liverpool University Veterinary School and ran a private ophthalmic clinic. In Australia he is recognised as a Consultant Practitioner in Veterinary Ophthalmology. He is based at PetVision on the Sunshine Coast in SE Queensland. PetVision is unique, dealing only with pet eye diseases, and is a veterinary husband and wife team. Dr Yvonne is in charge of patient anaesthetic protocol and anaesthetic delivery. It is very common for eye diseases to occur in older patients and brachycephalic breeds. Careful anaesthesia forms a vital component to PetVision practice successes.