OldDog Haven - Senior Dog Vet Advice

Your Old Dog's Eyes: Dry Eyes

Terri L. McCalla, DVM, MS, diplomate ACVO (American College of VeterinaryOphthalmologists), Animal Eye Care, Bellingham, Washington

Terri McCalla Old dogs can get dry eyes, just like older people can. The most common cause of dry eye in dogs is autoimmune disease, where the body's immune system attacks the tear glands, causing them to not work well. Dry eyes can be the result of not enough tears, or because the quality of the tears is poor. If tear quality is poor, the tears do not stick to the eyes for as long as they should, and they slide off the eye prematurely, leaving dry spots. In other words, eyes can still be dry even if the tear glands are producing plenty of tears!

The technical term for dry eye is keratoconjunctivitis sicca (KCS), which means dry, inflamed cornea and conjunctiva. I prefer to simplify things and just call it dry eye.

What are the signs of dry eye? The most common one is lots of thick, sticky discharge from the eye(s), especially in the morning. The discharge can be grey or clear, but can also be green or yellow if secondary bacterial infection has occurred. The eyes often are red, due to thickened, inflamed conjunctiva. In severe cases, the eyes are cloudy due to scar tissue forming on the surface of the cornea. In very severe cases, vision is impaired and can even be lost due to severe corneal scarring. Dry eye is also uncomfortable for the patient.

Diagnosis of dry eye can be difficult, especially if tear volume is normal. A general veterinary practitioner can perform a tear test (called a Schirmer tear test, or STT) to measure the amount of tears being made. However, if the dog's dry eye is due to poor tear quality, a STT will not diagnose the problem and a veterinary ophthalmologist needs to examine the patient.

Dry eye is most commonly treated with tacrolimus or cyclosporine drops or ointment. These drugs are technically antibiotics, but they are used to suppress the immune system's attack of the tear glands. They stimulate tear production, improve tear quality, and also reduce corneal scar tissue. If a dog is blind from dry eye, these medications often help to partially reverse scarring, improving vision (assuming that nothing else is wrong with the eyes). Tacrolimus and cyclosporine are used most commonly in humans to treat diseases other than dry eyes; both oral and injectable forms of these drugs are used to treat transplant patients to help prevent the immune system from attacking and rejecting the new organ. When treating dry eye in dogs, the drugs are diluted in strength and usually need to be compounded by a pharmacist because they are not available in a brand name form for eye use other than 0.2% cyclosporine ointment (Optimmune). In my experience, tacrolimus works better than cyclosporine in treating dry eyes in dogs. It is important to understand that LIFETIME treatment is needed, along with regular eye exams to ensure that the correct dosage of medication is being used.

Keeping Your Old Friends Fit

Michelle Schmidtke, DVM

It doesn't seem fair. As they acquire the old dog patina of wisdom and serenity, their bodies are declining.

Dogs are considered geriatric approximately after the age of nine. Many factors affect their longevity; some we have control over, others are determined by genetics.

I want to discuss "the fat dog dilemma." As a veterinarian, I have cared for many dogs throughout their entire lifespan. My clients often ask me what they can do to help their aging companion live better, longer.

I can't emphasize it enough: Keep him slim, keep him slim, and keep him slim&ldots;

And everyone has their own idea of what "slim" or ideal maximum weight is and isn't. I have a model provided by Hill's (Science Diet) that my clients feel so they can acquaint themselves with the features of a slim dog. "You can feel his ribs and he's all tucked up?" they ask in amazement.

It's really very simple. Three things are involved in obesity: too much food, too many calories, and too little exercise. I'd like to share with you the many explanations (excuses) I've heard over the years. In parentheses, I've added my own thoughts:

* "He's not fat, doc!" (Owner is, well, quite large.)

* "He eats next to nothing, doc." (And he does next to nothing and he visits the neighbors for some more nothing.)

* "He just gets into everything, I can't control him." (Hmm, so he opens the refrigerator and cupboards and helps himself?)

* "I can't control him." (Aren't we the ones with opposable thumbs?)

* "He won't eat that diet food." (Oh yes, he will if you practice some tough love.)

* "All he eats are those little sausages and chicken breasts." (All you give him are those little sausages and chicken breast; what a smart dog to train you so well.)

* "He must have some hormone problem." (Unlikely, although occasionally hypothyroidism may influence weight.)

* "He just wants to lay around on the couch." (Apparently, so do you.)

Remember, keeping your old dog slim is good for both of you.

May 2005 March 2006

Pictured is Fred, who was placed by OldDog Haven when his family moved to New York and didn't take him with them. Fairly obese when he arrived, Fred suffered from arthritis and had no stamina. With a proper diet, Fred slimmed down considerably, but had trouble with his hind legs until he died 18 months after finding his final refuge.

The Ten Most Important Tips for Keeping Your Older Dog Healthy

1. Establish a relationship with the best veterinarian you can find. For most older dogs, it is advisable to make an appointment with a vet every six months. Your vet should be someone whom you trust and with whom you feel very comfortable.

2. Become informed about the conditions common to older dogs and the therapies used. Be alert to symptoms, bring them to your vet's attention promptly, and discuss treatment options.

3. Feed your older dog the best food you can afford. Consider feeding a home-prepared diet of two small meals daily rather than one large meal.

4. Don't overfeed your dog. Obesity will create health problems and shorten his or her life.

5. Consider the use of dietary supplements such as glucosamine / chondroitin for arthritis.

6. Give your senior dog adequate exercise, but adjust it to his or her changing abilities.

7. Attend to your dog's dental health. Brush her teeth daily and have them cleaned professionally whenever your vet advises it.

8. Tell your vet you wish to have your dog vaccinated only once every three years, as currently advised by the major veterinary colleges.

9. Be diligent in controlling fleas and ticks, and keep your dog and his environment scrupulously clean.

10. Make your senior dog as much a part of your life as possible, and do all you can to keep him interested, active, happy and comfortable.

(Of course, these ten tips also apply in large part to young dogs, too.)

And number 11: Give generous doses of LOVE.

No copyright on #11 ... so pass it on!

Your Old Dog ’s Eyes: The Lens

Terri L. McCalla, DVM, MS, diplomate ACVO (American College of VeterinaryOphthalmologists), Animal Eye Care, Bellingham, Washington

While dog eyes are in many respects similar to human eyes, there are some differences too.

It is very common for geriatric dogs to have bluish-colored pupils, instead of the pupils being black. This haziness of the pupil is often mistaken as being caused by a cataract, although it usually is not. A cataract is any white opacity of the lens through which light will not pass. Older dogs with bluish-colored pupils have nuclear sclerosis, which is a normal aging change of the lens that every old dog will have. Every older person also has nuclear sclerosis; in people this results in difficulty with near vision —we need reading glasses. This is because in order to focus up close, the lens needs to change its shape and become rounder. When the lens is sclerotic, it is not as flexible and cannot change its shape as well, leaving us with a loss of near-vision. Dogs don't read, so they do not miss their up-close vision as much as we do.

Think of the lens as the reverse of a jelly doughnut —hard on the inside (the nucleus) and soft on the outside (the cortex). The lens grows throughout life and adds new layers on the outside. The oldest lens tissue is in the inside —the nucleus. As the animal ages, the nucleus hardens (becomes sclerotic) and tak es on a bluish grey hazy “cast ”, first evident at around 6 years of age and increasing with age. Animals can see through this haze very well, assuming the rest of their eyes are healthy. Nuclear sclerosis is often mistaken for a cataract, even by general practitioner veterinarians. Slit lamp biomicroscopy performed by a veterinary ophthalmologist can differentiate between the two conditions.

Nuclear sclerosis does not require treatment of any kind. Eyes with nuclear sclerosis can also develop cataracts, however —the two conditions are not exclusive to each other. If one of your dog's eyes seems cloudier than the other one, then it probably does have some degree of cataract, because if the only condition present was nuclear sclerosis, then both eyes would "match" in the color and haziness of the pupils. Also remember that the amount of haziness that you see varies, depending on the pupil size; if the pupil is small (in bright light), then the iris is hiding most of the lens and you can't see the nuclear sclerosis. If the pupil is big (in dimmer light and also when the animal is excited), then you can see more of the nuclear sclerosis.

There is a picture of a dog's eye with nuclear sclerosis on my website -- scroll down to the section called "What is Not a Cataract?". This article also discusses what a cataract looks like. If you wish to read about cataracts and cataract surgery, please read the two articles on my website.

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