Comprehensive guide to keratoconjunctivitis sicca (KCS) in dogs

Keratoconjunctivitis sicca (KCS), also known as “dry eye,” is a serious eye disease in dogs characterized by inadequate tear production. The disease can cause significant discomfort and, if left untreated, serious complications.

In this article, we will delve deeper into the causes, symptoms, diagnosis, and treatment options for DED in dogs to provide a better understanding and effective treatment of this condition.

Definition and causes of KCS

Keratoconjunctivitis sicca occurs when tear production in the eye is reduced, leading to drying of the cornea and conjunctiva. The main causes of this disease can vary and include idiopathic and immune-mediated causes. Certain breeds, such as the West Highland White Terrier, are genetically more susceptible to KCS.

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Symptoms of KCS

Symptoms of keratoconjunctivitis sicca (KCS), or dry eye in dogs, can vary depending on the severity of the disease. Here are some of the most common signs and symptoms that may be seen in dogs with KCS:

1. Increased blinking (blepharospasm):

• Affected dogs blink more frequently to compensate for the lack of tears and to lubricate the surface of the eye.

2. Rubbing the eyes:

• Dogs with KCS tend to rub their eyes with their paws to relieve the discomfort or itching.

3. Red and sore eyes:

• The eyes may appear red and inflamed, especially the conjunctiva, which covers the white of the eye.

4. Mucous or purulent discharge:

• Slimy, purulent, or thick mucus may collect in the corners of the eyes or adhere to the edge of the eyelid.

5. Dry deposits on the edge of the eyelid:

• Dry, crusty deposits can form on the edge of the eyelid.

6. Changed corneal surface:

• The cornea may appear dull, rough, cracked, or cloudy, and over time, ulcers, edema, and neovascularization (new blood vessels) may form.

7. Increased tears:

• Ironically, in some cases, dogs with DED may exhibit increased tearing as the eyes attempt to compensate for the dryness by producing more tears.

8. Swelling and prolapse of the nictitating membrane:

• The eyelids and surrounding skin may be swollen, and the nictitating membrane (third eyelid) may protrude.

9. Light sensitivity:

• Dogs with KCS may be photophobic and squint their eyes in bright light.

10. Visual Impairment:

In advanced cases, the dog's vision may be impaired.

11. Follicular conjunctivitis:

Inflammation of the conjunctival lymph follicles, causing small, raised, red bumps on the inner surface of the eyelids.

These symptoms can be very uncomfortable for your dog and affect their quality of life. veterinarian as soon as possible to make an accurate diagnosis and begin appropriate treatment.

Treating KCS early can help prevent long-term eye damage and improve your dog's quality of life.

Diagnosis of KCS

Diagnosis of keratoconjunctivitis sicca (KCS) in dogs requires a thorough examination by a veterinarian , preferably a veterinary ophthalmologist. Here are the steps and tests that can be done to diagnose KCS:

1. Anamnese:

• The veterinarian will conduct a thorough medical history to learn more about the dog's symptoms and medical history. Questions about the eye symptoms that have occurred, their duration, and previous eye diseases or injuries are common.

2. General eye exam:

• A visual inspection of the eyes and surrounding structures is performed to identify redness, swelling, discharge, and other noticeable changes.

3. Schirmer tear test (STT):

• This test measures tear production in the eyes and is crucial for diagnosing KCS. A special test paper is placed in the lower edge of the eyelid and the amount of tears absorbed within a certain time is measured.

4. Fluorescein staining:

• A fluorescein test is performed to examine the cornea for ulcers or defects. Fluorescein is a dye that attaches to damaged areas of the cornea and becomes visible under blue light.

5. Tonometry:

• This test measures intraocular pressure to rule out other eye diseases such as glaucoma, which can also show symptoms similar to DED.

6. Biomicroscopy (Slit-Lamp Examination):

• Biomicroscopy allows for a detailed examination of the anterior segments of the eye and can help identify changes in the cornea, conjunctiva, and other structures.

7. Cytology and culture:

• Samples of eye discharge may be collected and examined under a microscope to identify bacterial or fungal infections. In some cases, cultures can be performed to identify specific pathogens.

8. Other specific tests:

• Additional tests may be performed to better understand the cause of DED, such as immune-mediated diseases.

9. Differential diagnosis:

• It is important to rule out other eye diseases that may present with symptoms similar to DED.

10. Treatment plan:

Once diagnosed, an individualized treatment plan is created to relieve symptoms and promote eye health.

Early and accurate diagnosis of DED is crucial for the effective treatment and management of the disease. A regular check-up by a veterinary ophthalmologist is recommended to maintain your dog's eye health and to detect and treat possible eye problems early.

Treatment of KCS

Treatment for keratoconjunctivitis sicca (KCS) in dogs aims to promote tear production and protect and lubricate the ocular surface. Here are the different treatment options and measures that can be taken to relieve symptoms and promote eye health:

1. Medical therapy:

• Tear replacement products: These products help to moisturize and protect the surface of the eye and should be used regularly.
• Ciclosporin A eye ointment: This medication helps stimulate tear production and reduce inflammation.
• Topical Steroids: Steroid-containing eye ointments or drops can help reduce inflammation but should only be used under close veterinary supervision.
• Pilocarpine: Pilocarpine can be administered orally to neurogenically stimulate tear production.

2. Local measures:

• Regular eye washes: Eyes should be rinsed regularly with a sterile saline solution to remove dirt and mucus.
• Antibiotic eye ointments: Secondary bacterial infections may require antibiotic eye ointments.

3. Surgical treatment:

• Transposition of the Parotid Duct: In severe cases of DED where medical therapy is unsuccessful, surgical redirection of the salivary gland into the eye may be performed to lubricate the ocular surface.

4. Management of comorbidities:

• Addressing comorbidities that may affect eye health is critical to the success of DED treatment.

5. Special diet:

• A healthy diet rich in omega-3 fatty acids can help support overall eye health and the immune system.

6. Regular check-ups:

• Regular ophthalmological examinations are important to evaluate the success of the treatment and make adjustments if necessary.

7. Owner education and support:

• Educating dog owners about the condition, treatment plans and the need for regular follow-up care is critical to the dog's well-being.

8. Complementary therapies:

Acupuncture and other complementary therapies can be used in some cases to promote the dog's well-being and relieve symptoms.

Treatment for KCS is usually long-term and requires dedicated care from the dog owner and close collaboration with the veterinarian. With proper treatment and care, many dogs with DED can have a good quality of life and their eye health can be managed effectively.

It is important to remember that each treatment should be individualized to the individual dog, and advice and care from an experienced veterinary ophthalmologist is critical to the success of the treatment.

Surgical treatment of KCS viewed critically:

Surgical treatment of keratoconjunctivitis sicca (KCS) in dogs, particularly transposition of the parotid duct, is a serious step and may be an option when other forms of treatment fail. Here are some critical considerations for surgical treatment of DED:

1. Effectiveness:

• Transposition of the parotid duct can be effective to lubricate the ocular surface by using saliva instead of tears for lubrication. However, the consistency and composition of saliva may differ from that of tears, which may not be ideal.

2. Complications:

• As with any surgery, there are risks, including infection, bleeding, and possible complications from anesthesia. In addition, transposition of the parotid duct can lead to undesirable consequences such as excessive lubrication and resulting discharge.

3. Long-term management:

• After surgery, dogs continue to need regular ophthalmological examinations to evaluate the success of the operation and detect possible complications early. Ongoing drug treatment may also be necessary.

4. Cost:

• Surgical procedures can be expensive, and the cost of the surgery and post-operative care and follow-up can place a financial burden on owners.

5. Life quality:

• While surgical treatment aims to improve the dog's quality of life, recovering from surgery and adapting to the changed conditions can be challenging for both the dog and the owner.

6. Alternative treatment options:

It is important to explore and understand all available treatment options before opting for surgery. In some cases, alternative drug treatments or management strategies may be sufficient to effectively manage the symptoms of DED.

7. Surgeon's experience:

The experience and skill of the surgeon are crucial to the success of the operation. It is advisable to consult an experienced veterinary ophthalmologist and learn about the success rates and possible complications of the operation in their specific practice.

The decision to undergo surgery to treat DED should be carefully considered and discussed with an experienced veterinary ophthalmologist. It is crucial to understand all the pros and cons and make an informed decision that keeps the dog's well-being at the forefront.

Summary KCS

Keratoconjunctivitis sicca (KCS) in dogs, also known as dry eye, is a condition in which tear production is inadequate, leading to inflammation of the cornea and conjunctiva. Susceptible breeds include the Miniature Schnauzer, Pug, Yorkshire Terrier and West Highland Terrier.

Symptoms range from increased blinking and eye rubbing to red, sore eyes and mucous discharge. Diagnosis is made through a thorough ophthalmological examination, the Schirmer tear test, and possibly fluorescein staining to identify corneal defects.

Treatment includes tear substitutes, drug therapies such as ciclosporin A, and in severe cases, surgical procedures such as transposition of the parotid duct. Regular ophthalmological checks and close collaboration with the veterinarian are crucial for managing KCS and promoting the dog's eye health.