Treatment of canine KCS may include the following medications:
- Cyclosporine or tacrolimus eye drops or ointment. These medications decrease the immune system's destruction of the eye's tear gland tissue.
- Antibiotic drops or ointment. Secondary eye infections are common in dogs with KCS and may need to be treated with topical antibiotics.
- Steroid drops or ointment. ...
- Artificial tear drops or ointment. ...
What to do if your dog has KCS?
Some dogs with KCS do not respond to medical treatment because they either do not have lacrimal glands or because their lacrimal glands have atrophied and are no longer capable of producing tears. These dogs may be candidates for either a parotid duct transposition or a labial salivary gland graft.
How do you treat KCS in dogs eyes?
Both are easily placed in the eyes once or twice daily. These drugs are very safe and most pets improve dramatically with their consistent use. Pilocarpine (brand name Isopto-Carpine®) is useful in treating cases of neurogenic KCS. Tear film replacement is often used in combination with a tear production stimulant.
What kind of ointment can I give my Dog for KCS?
Different formulations for topical use of CsA have been developed as eyedrops or ophthalmic ointment, and several clinical trials have demonstrated their therapeutic effects. In one study (Herrera et al, 1994), 373 dogs with KCS were treated using 2% CsA oily solution (corn oil).
What can I give my Dog for neurogenic KCS?
These drugs are very safe and most pets improve dramatically with their consistent use. Pilocarpine (brand name Isopto-Carpine®) is useful in treating cases of neurogenic KCS. Tear film replacement is often used in combination with a tear production stimulant.
Can KCS be cured?
Once a patient has KCS, medical therapy will alleviate the signs but will not often cure the disease. Affected dogs and cats usually need to be treated for life. Fortunately, most pets can be maintained on eye drops once or twice daily..
Is KCS painful for dogs?
KCS can progress to be a very uncomfortable and painful condition for patients and it is important to carry out a STT as part of the ophthalmic examination. There are various causes of KCS and factors influencing its development, however the most commonly seen cause in canine patient is immune-mediated.
Can KCS cause blindness?
Keratoconjunctivitis sicca (KCS), commonly referred to as canine Dry Eye,1 can lead to blindness if not treated properly.
How do you test for KCS?
Several important diagnostic tests are involved in diagnosis of KCS. The most important test involves looking at the corneal surface cells and tear film with an instrument called a biomicroscope. Paper test strips called Schirmer Tear Test strips may also be utilized to quantify tear production from both eyes.
Is there a substitute for tacrolimus for dogs?
Cyclosporine has been the standard drug for years, although topical ophthalmic tacrolimus can be more effective and, as a result, may be appropriate for animals who do not respond to cyclosporine. Animals with dry eye will need to receive treatment for the rest of their lives.
What is cyclosporine eye drops used for in dogs?
Cyclosporine ophthalmic ointment (brand names Optimmune®, Restasis®) is an immunosuppressant used in the treatment of eye diseases suspected to be immune-related, including keratoconjunctivitis sicca (KCS) in dogs, and other inflammatory conditions of the eye.
What causes KCS?
The most common cause of KCS is immune mediated inflammation of the lacrimal gland. Other causes are congenital alacrima, drug toxicity from sulfonamides or etodolac, neurogenic loss of parasympathetic tone, third eyelid excision and metabolic diseases (diabetes mellitus, hypothyroidism, canine distemper).
Can you use human dry eye drops on dogs?
Also, medication for humans, including eye drops, are generally not the same for dogs. You should never treat your dog with human medication without consulting a pet care specialist first. Using the wrong eye drops could cause significant pain, damage, and blindness.
What is tacrolimus eye drops for dogs?
Tacrolimus ophthalmic is an immunosuppressive agent used to treat keratoconjunctivitis sicca (KCS), also known as dry eye. It can also be used for other immune mediated eye conditions such as chronic superficial keratitis (CSK). It is not commercially produced and must be specially compounded by a pharmacy.
How does cyclosporine eye drops work?
Ophthalmic cyclosporine is used to increase tear production in people with dry eye disease. Cyclosporine is in a class of medications called immunomodulators. It works by decreasing swelling in the eye to allow for tear production.
Can puppies KCS?
Keratoconjunctivitis sicca (KCS), is a relatively common condition in dogs, although the diagnosis is often overlooked. This article provides guidance on the pathophysiology, causes, diagnosis, and medical and surgical treatment for this condition.
Can I put artificial tears in my dog's eyes?
Just like humans, pets can have “sleep” in the morning and have mucus discharge after being exposed to wind, dirt and pollen. Your pet will be more comfortable if the mucus is removed. If the discharge is in the eye, you can use eye wash or artificial tears to remove it.
How to diagnose dry eye in dogs?
Quantitative dry eye is diagnosed by performing a Schirmer tear test (STT). For many decades tear production in dogs had been considered normal over 15mm/min, but most recent studies have shown most dogs in the mid to high 20’s. The most common cause of KCS is immune mediated inflammation of the lacrimal gland. Other causes are congenital alacrima, drug toxicity from sulfonamides or etodolac, neurogenic loss of parasympathetic tone, third eyelid excision and metabolic diseases (diabetes mellitus, hypothyroidism, canine distemper). Tear break up time (TBUT) is used to diagnose Qualitative tear deficiency and it should be greater than 20 seconds.
Is Medvet Columbus in a clinical trial?
Currently MedVet Columbus is participating in a KCS clinical trial for a novel quantitative dry eye therapy. For more information please visit our clinical trial website at www.medvetforpets.com/clinical-studies/. Participation in clinical studies, a collaborative environment, appointment availability, and a highly trained Anesthesia department with a team of board certified anesthesiologists, sets MedVet Ophthalmology apart from other ophthalmic private practices.
What causes KCS?
Immune-mediated diseases that damage the tear producing glands. This is the most common cause of KCS and is poorly understood. The body's immune system attacks the cells that produce a portion of the tear film resulting in decreased production. This is thought to be an inherited disorder.
What is the procedure to correct a dog's eye?
If you are unable to administer your dog's eye medications, we will discuss the possibility of surgical correction. While this is not an option for all dogs, we will help determine if this is a possibility for your pet. Surgical correction involves repositioning the salivary duct so that it secretes saliva onto the eyes. This surgery is usually performed by a board-certified veterinary surgeon or ophthalmologist. This procedure has significant risk of complication so it should not be pursued unless all other treatments have failed.
How often should I replace my dog's cornea?
Most dogs will receive tear replacement every two to six hours, depending on need and severity of condition. Some dogs will require topical antibiotics or anti-inflammatory medications to treat underlying infection and inflammation.
How to help a dog with tear film?
Some dogs will require topical antibiotics or anti-inflammatory medications to treat underlying infection and inflammation. Gently cleaning the eyes several times a day with a warm, wet washcloth will help your dog feel better and may help stimulate tear film production.
Can a dog's corneal scarring be reversed?
If the condition is diagnosed late in the course of the disease and if extensive corneal scarring has developed, the pet may not respond fully or regain its vision. Once corneal scarring has developed, there is little that can be done to reverse it.
Is it safe to put isoptocarpine in your eyes?
Both are easily placed in the eyes once or twice daily. These drugs are very safe and most pets improve dramatically with their consistent use. Pilocarpine (brand name Isopto-Carpine®) is useful in treating cases of neurogenic KCS. Tear film replacement is often used in combination with a tear production stimulant.
Is KCS better for dogs?
With today's tear stimulating drugs, the prognosis for dogs diagnosed with KCS has never been better. Dry eye requires lifelong medical care. With diligent attention and monitoring, most dogs are able to enjoy a pain-free life. If the condition is diagnosed late in the course of the disease and if extensive corneal scarring has developed, ...
What is the best treatment for KCS?
The best treatment for KCS is a lacrimogenic agent . Cyclosporine is a widely used lacrimogenic agent and is the active ingredient in Optimmune ointment. When treating KCS, cyclosporine is generally used twice daily and it is often compounded as a 1 or 2% drop or ointment. Tacrolimus, another lacrimogenic agent, is often compounded as a 0.02 or 0.03% drop or ointment and is generally used twice daily. Both tacrolimus and cyclosporine are T-helper cell suppressors, however, tacrolimus is more potent than cyclosporine and has some mast cell stabilizing properties. Because of its mast cell stabilizing effects, tacrolimus is often used in people and dogs with ocular allergies.
What is the treatment for qualitative tear film deficiency?
The treatment for qualitative tear film deficiency is either cyclosporine or tacrolimus once to twice daily. A test called a tear break up time can be performed to diagnose qualitative tear film deficiency.
How to do a tear breakup test on a dog?
You carefully observe the tear film under a broad beam of cobalt blue illumination while gently holding the dog with the eyelids spread apart so he can’t blink. The TBUT is recorded as the number of seconds that elapse between the last blink and the appearance of the first dry spot in the tear film. A TBUT under 10 seconds in a dog is considered abnormal.
What is the most common eye disease in dogs?
KCS in dogs can cause ocular discharge, pain, corneal scarring and ulceration. In fact, one of the most common causes of a corneal ulcer in the dog is KCS.
What causes KCS in the third eyelid?
Trauma – Any accident that damages the lacrimal and third eyelid glands (or the nerves supplying these structures) could result in KCS. Distemper virus – This viral infection can temporarily or permanently damage the lacrimal and third eyelid glands.
What is the lacrimal system of a dog?
Nasal puncta. The lacrimal system/apparatus of a dog. An abnormality in any of these components can lead to keratoconjunctivitis sicca. As this disease is so common in dogs (affecting ~1% of canine population), veterinarians have identified potential causes of KCS, including: Idiopathic – Idiopathic is the fancy medical way ...
What is the most common eye disorder in dogs?
Keratoconjunctivitis si cca or dry eye is one of the most common eye disorders affecting dogs. Diagnosing KCS is relatively straightforward. Initial treatment commonly involves several eye medications. Unfortunately, some patients don’t respond to medical management, and these patients may undergo an intricate surgery to improve eye lubrication.
Why do you need an antibiotic for a corneal infection?
An ophthalmic antibiotic may be needed if a patient develops a secondary bacterial infection. Similarly, a veterinarian may prescribe an ophthalmic drug called acetylcysteine to help remove excess mucus and further protect the cornea.
What is a dry eye in dogs?
Keratoconjunctivitis, more commonly called dry eye, is a common ophthalmic disease dogs. This week I’ve dedicated some time to share information about this important condition. Happy reading!
Can pet parents administer eye drops?
Of course, some pet parents simply can’t administer the necessary eye medications. In these situations, a surgical procedure called a parotid duct transposition can be performed. The parotid duct carries saliva from the parotid salivary gland to the mouth.
WHAT IS KERATOCONJUNCTIVITIS SICCA (DRY EYE)?
The tear film consists of 3 layers: A superficial lipid (oily) layer which decreases evaporation, a middle aqueous layer which contributes 90% of the tear film, and a deep mucin layer which facilitates spreading of the tears over the cornea.
HOW LONG IS TREATMENT NECESSARY?
Usually 4-6 weeks is required before any improvement in tear production is noted although the above treatment should result in marked improvement of the clinical signs.
Keratoconjunctivitis sicca in dogs
This article discusses keratoconjunctivitis sicca (KCS), factors that may contribute towards KCS and how we might treat/manage it. KCS is often characterised by uncomfortable eyes accompanied with mucopurulent discharge and a general dry appearance to the cornea.
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What is KCS in dogs?
Canine keratoconjunctivitis sicca (KCS) is a common disease characterized by chronic inflammation of the lacrimal gland, conjunctiva and cornea which leads to a qualitative and quantitative modification of the precorne al tear film (PTF). The condition is usually defined as a diminution of tear production.
What does a dog with KCS look like?
The hallmark of the disease is the presence of mucoid ocular discharge. These eyes look like undergoing bacterial conjunctivitis and this is the reason for the misdiagnosis.
What is severe KCS?
In humans, severe KCS is associated with Sjögren's syndrome, a condition characterized by autoimmune reactions in the lacrimal and salivary glands. Serologic and histopathologic studies in dogs revealed similar findings to those characteristic of human autoimmune KCS. Sjögren's syndrome in man is often associated with polyglandular autoimmune ...
How long does it take for KCS to reappear?
The patient improves while treated but the clinical signs reappear days or weeks after the discontinuation of the treatment.
What causes a reduction in tear production in dogs?
Different causes can produce a reduction in tear production. Canine Distemper virus, sulfonamide toxicity, long term using of atropine and facial nerve injury are some of them. However, the etiology of canine KCS can often not be determined.
What is the test for dry eye in dogs?
The diagnosis is easily confirmed by using the Schirmer tear test (STT). The STT, a quick and easy test, should be performed as a routine part of the ophthalmic examination in any dog, but it must be used in every dog of a predisposed breed with conjunctivitis, even with no other clinical signs of dry eye.
Is KCS a misdiagnosed disease?
Finally, KCS is a common but misdiagnosed disease. Diagnosis can be made using the Schirmer tear test but initial clinical changes can be present even with normal values of STT. Therapeutic response will be better as earlier the diagnosis can be done.
What is the role of T-helper cells in KCS?
T- suppressor cells normally predominate, but in immune-mediated KCS, T-helper cells become the prevalent T lymphocytes. It is believed that by inhibiting T-helper cells in KCS, CsA allows T-suppressor cells to sustain normal lacrimal function.
What is tacrolimus and Csa?
CsA is a derivative of the fungus Tolypocladium inflatum whereas tacrolimus is a macrolide antibiotic produced by Streptomyces tsukubaensis . Both CsA and tacrolimus are T cell activation inhibitors initially developed for their systemic use in preventing graft rejection after organ transplantation. The mechanism of action of CsA and tacrolimus is similar in that T cell proliferation and activation are altered by the inhibition of interleukin-2 (IL-2) gene expression in CD 4+ helper lymphocytes. IL-2 transcription blockage leads to impaired T-helper and T-cytotoxic proliferation. In addition to reduction of IL-2 release from lymphocytes, these drugs interfere with IL-2 receptors on lymphocyte surfaces. CsA and tacrolimus have also been reported to reduce eosinophil production, block mast cell degranulation and suppress tumor necrosis factor cells. Additional therapeutic effects may be achieved via CsA and tacrolimus’ anti-inflammatory effects, stimulatory effect on lacrimal glands, proliferative effect on mucin-producing conjunctival goblet cells, and inhibitory effect on lacrimal cell apoptosis. Despite similar mechanisms of action between CsA and tacrolimus, tacrolimus has been demonstrated to be 10 to 100 times more potent than CsA in its ability to inhibit cytotoxic T lymphocytes and production of IL-2, IL-3 and gamma interferon in vitro.
Is tacrolimus effective for dogs?
In addition, tacrolimus was also effective in some dogs in which treatment with CsA had failed.
Can dogs take tacrolimus?
In addition, high toxicity with systemic administration has precluded the use of tacrolimus in dogs for most situations in veterinary medicine and concerns regarding the carcinogenic potential of tacrolimus applied to the skin have recently been raised.
Is cyclosporine A good for dogs?
While topical Cyclosporine A (CsA) is approved for use, well-documented to be effective, and currently the treatment of choice for dogs with immune-mediated KCS, other similar drugs are beginning to emerge as effective therapeutic alternatives.
Does tacrolimus help with KCS?
Topical CsA has been reported to improve tear production in 71-86% of dogs with KCS. In the study reported by Berdoulay et al, 83% of dogs with presumed immune-mediated KCS were successfully treated with topical 0.02% tacrolimus based upon an increase in tear production of > 5 mm/min. Thus, the study by Berdoulay et al concluded that topical tacrolimus may represent an alternative treatment for canine KCS patients receiving CsA when irritation prevents the use of CsA (the primary side effect of topical CsA administration is ocular irritation) or when there is an inadequate response to CsA. In addition, combining tacrolimus with CsA in cases refractory to each administered alone may help improve overall response as tacrolimus has been shown to act synergistically with CsA in suppressing the proliferation of T cells in vitro.
