Esophageal Diverticula in Dogs

Esophageal diverticula is characterized by large, pouch-like sacs on the esophageal wall. Pulsion diverticula is a pushing outward of the wall. This occurs as a consequence of increased pressure from within the esophagus, as seen with obstruction or failure of the esophageal muscles to move food through. Traction diverticula occurs secondary to inflammation, where fibrosis and contraction pull the wall of the esophagus out into a pouch. Diverticula most commonly occurs at the inlet to the esophagus or near the diaphragm, with food being taken into the mouth and getting caught in a pouch as it travels down the esophagus towards the stomach. Organ systems affected include the gastrointestinal, musculoskeletal, and respiratory. Although no genetic basis has been proven, it may be congenital (present at birth), or acquired. There is no specific breed or gender predisposition for this disease.

The condition or disease described in this medical article can affect both dogs and cats. If you would like to learn more about how this disease affects cats, please visit this page in the PetMD health library.

Symptoms and Types

Regurgitation following eating, difficult swallowing, lack of appetite, coughing Weight loss, respiratory distress (aspiration pneumonia)

Causes

Pulsion Diverticulum Embryonic developmental disorders of the esophageal wall Esophageal foreign body or failure of the muscles to move food through Traction Diverticulum Inflammatory process associated with the trachea, lungs, lymph nodes, or lining of the stomach; causes fibrous tissue formation around the esophagus

Diagnosis

Your veterinarian will conduct an esophagram, or an esophagoscopy to examine the diverticula in order to determine whether there is a related mass. An X-ray of the chest area, and a fluoroscopal examination to evaluate the movement of food through the esophagus will give your doctor a better idea of where the diverticula is placed in the esophageal wall. An injection of a radiocontrasting agent into the esophageal passage may be used to improve visibility on an X-ray so that an exact determination can be made, as the substance flows down the esophagus, filling the pouches as is does.

Treatment

If the diverticulum is small and is not causing significant clinical signs, your veterinarian may only recommend a change in diet for you dog. A soft, bland diet, given frequently and followed by copious liquids, will most likely travel through the esophagus to the stomach unhindered. If the diverticulum is large, or is associated with significant clinical signs, surgical resection will probably be recommended. The potential for food being drawn into the lungs, and leading to aspiration pneumonia makes the importance of dietary management key to avoiding fatal complications. Aggressive care will be called for if aspiration pneumonia is present. Fluid therapy, antibiotics, and nutrition via tube will be necessary. Your veterinarian will prescribe medications for your dog on the basis of the diagnosis.

Living and Management

Your doctor will want to monitor your dog for evidence and prevention of infection or aspiration pneumonia. You will need to maintain a positive nutritional balance throughout the disease process. Patients with diverticula and impaction (i.e., food material that is packed tightly) are predisposed to perforation, fistula, stricture, and postoperative rupturing of the incision. For this reason, your veterinarian will want to revisit your dog on a regular schedule. Prognosis is guarded in patients with large diverticula and overt clinical signs.

Synovial Sarcoma in Dogs

Synovial sarcomas are soft tissue sarcomas – malignant cancers – that arise from the precursor cells outside the synovial membrane of the joints and bursa (the fluid-filled, sac-like cavity between joints that helps to facilitate movement). The synovial membrane itself is the layer of soft tissue that lines the surfaces within the joints.

Precursor cells have the ability to differentiate into one or two closely related  forms: epithelial cells (skin cells) or fibroblastic (connective tissue) cells. Therefore, the tumor may have cancer resembling both cancers of the skin and of the connective tissue.

Synovial sarcomas are aggressive and highly locally invasive, spreading in greater than 40 percent of cases. They most often spread to the elbow, knee, and shoulder blade regions.  They are more common in large-breed rather than small-breed dogs.

Symptoms and Types

Limping Slowly progressive lameness Palpable mass Weight loss No appetite (anorexia)

Causes

Unknown

Diagnosis

You will need to give a thorough history of your dog’s health and onset of symptoms. Your veterinarian will then perform a complete physical exam and order standard laboratory tests, including a biochemical profile, a complete blood count, a urinalysis and an electrolyte panel to rule out other non-cancerous causes for your dog’s symptoms.

Visual diagnostic techniques will show abnormalities around the affected joints. X-rays of the mass will show that the tumor is involved in both the bone and the joint. To obtain a definitive diagnosis, a biopsy of the soft and bony tissue of the tumor is necessary for histologic evaluation (microscopic analysis of the tissue sample). Using fine-needle aspirates (removal of fluid), the regional lymph nodes (i.e., the lymph nodes of the groin, armpits) should also be sampled and tested for evidence of metastasis (spread).

Treatment

The invasiveness of this type of sarcoma makes amputation (if possible) of the affected limb the treatment of choice. When appropriate, the patient should be treated with supportive chemotherapy. Pain medication will also be prescribed and administered as necessary.

Living and Management

After surgery, you should expect your dog to feel sore. Your veterinarian will give you pain medication for your dog to help minimize discomfort, and you will need to set up a place in the house where your dog can rest comfortably and quietly, away from other pets, active children, and busy entryways. Trips outdoors for bladder and bowel relief should be kept short and easy for your dog to handle during the recovery period. Use pain medications with caution and follow all directions carefully; one of the most preventable accidents with pets is overdose of medication.

Your veterinarian will schedule follow-up appointments with you for your dog every two to three months for the first year after diagnosis of the synovial sarcoma. After the first year your dog may be seen by your veterinarian every six months for follow-up exams, and to affirm that the cancer has not recurred. X-rays should be taken at each visit to check for local recurrence and to confirm that the cancer has not spread to the lungs.

Dilacerated Mandibular First Molar in Dogs

The abnormal development and formation of the mandibular tooth, a molar located three teeth away from the midline of the jaw, is an oral health issue seen primarily in small breed dogs. The mandibular tooth is one of the first permanent teeth to develop a calcified crown, and one of the largest.

There is no gender or particular breed predilection, but small breed dogs are at risk due to the small amount of space in the jaw for the molar to grow into. Therefore, it is generally recommended that small breed dogs be given a full evaluation of the mandibular first molars as they are growing in. 

Symptoms and Types

The defect will appear at the neck of the madibular tooth, often with gum evidence that the gum is receding. There may even be extensive bone loss near the root and possible exposure of pulp inside of the tooh. X-rays may reveal discontinuity between the roots and crown and/or presence of pulpal stones in the canal or chamber of the tooth.

Causes

One of the possible causes for this developmental problem is a mechanical challenge (lack of space) in the mouths of small dogs that impede proper crown-root development. Invagination, a folding in of the enamel and/or cement of the tooth, sometimes occurs at the neck of the tooth, often with some degree of gingival recession (receding of gums) at the site.

Diagnosis

Your veterinarian will perform a thorough physical and oral exam on your dog, taking into account the background history of symptoms, if there have been any. Dens-in-dente, an anomaly of development resulting from the deepening of enamel into the dental papilla (the cells involved in the developing tooth), typically begins at the crown and often extends to the root before the calcification of the dental tissues takes place. Traumatic damage to the tooth, possibly from aggressive deciduous tooth (i.e., baby tooth) extraction, may be linked to a loss of dental integrity.

If your veterinarian finds that the tooth is too damaged to remain, an assessment of the remaining mandibular bone will be an important prior to an extraction attempt. The diagnostic evaluation will include taking a dental X-ray to evaluate the extent of the changes, particularly at the roots.

Treatment

Treatment for a dilacerated mandibular first molar will begin with the appropriate pre-operative antimicrobial and pain management therapy as it is indicated. In most cases, there will be indications of a non-vital pulp in the tooth, indicated by a wide canal, periapical (apex of the root), and bone loss. Extraction of the tooth is typically warranted. However, this should not be an aggressive procedure. Care should be taken, as osteolysis (the active resorption or dissolution of bone tissue) could result in a compromised mandible (lower jaw). Your veterinarian may consider the use of bone-promoting material after the extraction.

Although rare, an endodontic procedure may be attempted to save the tooth in cases with minimal pathological changes. There is also a possibility stones in the tooth chamber could complicate canal access.

Living and Management

Your veterinarian will prescribe pain medication to help mitigate the amount of pain your dog is in, and to facilitate normal eating. After the initial care, your veterinarian will want to recheck your dog’s teeth at least once to be sure there is no infection and that the healing is on schedule. The prognosis is guarded for maintaining the tooth. However, an affected dog’s long term health is fair to good if a tooth extraction is performed.

What Is Bloat in Dogs?

Bloat is a condition in which food or gas stretches your dog’s stomach, causing abdominal pain. While it is more common in large breed or deep-chested dogs, any breed can develop bloat. Depending on the severity, bloat can be fatal if not treated within an hour or two.  

The stomach is located in the upper abdomen and normally contains a small amount of gas, food, liquid, and mucus. When a dog eats, food enters the stomach from the esophagus, then is broken down by digestive enzymes. From the stomach, the food moves into the small intestine and down the gastrointestinal tract. 

When bloat occurs, your dog’s stomach begins to expand, or distend, and cuts off blood flow to the abdomen as well as the stomach itself. This may cause injury (even death) of the stomach wall and, without treatment, eventually other organs. Bloat can also put pressure on the diaphragm, a thin muscle that separates the chest from the abdomen, leading to trouble breathing.  

In severe cases of bloat, a dog’s stomach twists and fills with gas. This is called gastric dilatation and volvulus (GDV) and is considered one of the most painful, severe emergencies in veterinary medicine. This degree of bloat cuts off blood flow to the stomach and the lower half of the body, making it impossible for food to pass into the intestine. In extreme cases of GDV, a dog’s stomach can rupture, and the spleen can also be injured. 

This is a very serious health emergency and, if untreated, a dog with GDV will die within hours. 

Is Bloat in Dogs Curable?

All cases of bloat require immediate medical attention to determine the severity. If bloat is treated immediately, it is often curable.

Simple bloat, where the dog’s stomach has not twisted, can sometimes be managed without medication, but may require fluids or other treatments.

Other degrees of bloat, including GDV, can also be curable if diagnosed in the early stages. These conditions are usually treated with immediate surgery.

Symptoms of Bloat in Dogs

Bloat is a very uncomfortable, often painful, health crisis for dogs. As a result, a dog with bloat may: 

Dry-heave (also called retching) without vomiting any food. Sometimes a dog might spit out white foam when trying to vomit, which is usually mucus from the esophagus or stomach.

Have abdominal distention (this might not be visible in the early stages of bloat)

Experience sudden anxiety, pacing, an inability to get comfortable or constantly moving around the room/house.

Be guarding their belly or looking back at their belly

Position themselves in downward facing dog pose, where the dog’s back half is up and upper half is down

Pant and drool

Collapse

Have a racing heartbeat (tachycardia)

Have pale gums

Causes of Bloat in Dogs

It’s unknown why bloat and GDV occur in dogs, but there are suspected risk factors that can increase the chance of bloat.  

While bloat can occur in any dog, risks factors that increase the chances of bloat in dogs are:

Ingesting large amounts of food or water too quickly

Weighing more than 99 pounds increases the risk by about 20% 

Age (Older dogs are at a higher risk)

Being deep chested 

Exercise immediately after eating. 

Eating from an elevated food bowl

Having a close relative that was diagnosed with bloat

Eating dry food with fat or oil listed in the first 4 ingredients

How Vets Diagnose Bloat in Dogs

A veterinarian may suspect bloat and/or GDV by simply seeing a dog’s distressed behavior and physical appearance, but they typically also perform tests to confirm the diagnosis. 

Blood Test

The vet may perform a blood test to get a picture of your dog’s overall health.  

Abdominal X-rays

These are taken to confirm the diagnosis and to determine the severity of bloat. An x-ray can indicate if a dog has simple bloat, where the stomach appears very distended and round and is usually full of food or gas.  X-rays also show if bloat has progressed to GDV and the stomach appears very distended and has what looks like a bubble on top of the already swollen stomach.  

Treatment for Bloat in Dogs

Treatment of simple bloat can be quite straightforward. Dogs are usually hospitalized to receive large amounts of intravenous fluids and sometimes medicine. They’re also walked often to stimulate movement of the gastrointestinal tract to help move the gas and food quickly through the body.

A dog with GDV requires more intense care that typically includes: 

Intravenous fluids with electrolytes to aggressively treat shock and improve circulation to vital organs.

Pain medications and often antibiotics to treat discomfort, shock and any death of tissues from the loss of circulation.

A procedure to decompress the stomach by removing gas from the stomach to allow blood flow to the lower half of the body. In some instances, this helps untwist the stomach.  

Electrocardiogram (ECG) to monitor for any heart abnormalities which frequently due to toxins from decreased circulation. 

Surgery is performed as soon as the dog is as stable as possible. Depending on the severity of bloat, a vet may have to untwist the dog’s stomach and/or spleen, and remove any part of the stomach wall that may have died due to loss of blood flow. The vet will also stitch the stomach to the body wall in a procedure called a gastropexy. This significantly reduces the risk of rotation of the stomach in the future.  

Recovery and Management of Bloat in Dogs

After proper diagnosis, dogs with simple bloat tend to bounce back into their normal lives and routines 1 to 2 days after receiving fluids and taking frequent walks. 

Following GDV surgery, a dog will remain in the hospital until pain is controlled, blood tests indicate normal enzyme levels, and the dog is eating and drinking well on their own. Length of time in the hospital depends on the dog’s health history and severity of bloat, and may be anywhere from 1 to 2 days, to up to 7 or more.

Regardless of the type of bloat or treatment a dog experienced, vets suggest the same steps to lower the risk of bloat in the future:

Never leave large bags or bins of food accessible to your dog to avoid overeating. 

Do not use raised food bowls unless advised by your veterinarian (some pets require a raised food bowl due to a medical condition)

Wait at least 1 hour after a meal or drinking a large amount of water for any exercise or playtime.

Feed small meals a few times throughout the day instead of 1 or 2 large meals

Avoid gorging on water when drinking

Discuss preventative surgery with your veterinarian for breeds at higher risk of bloat. This can often be performed during your pet’s spay or neuter procedure.

Bloat in Dogs FAQs

What foods cause bloat in dogs?

There are no proven diets that cause food bloat in dogs. It is believed that diets where fat or oils are listed in the top 4 ingredients put dogs at a higher risk of food bloat. More importantly, large amounts of food or water in one sitting have been shown to substantially increase bloat risk.

What are the first signs of bloat in a dog?

Symptoms of bloat usually occur without warning and progress quickly. A dog may pant, pace or drool or appear to be dry-heaving (attempting to vomit) without being able to be throw up. Anxiety and abdominal distention are also common symptoms. In severe cases, dogs may collapse or have an elevated heart rate and/or pale gums. 
 

How do vets treat bloat in dogs?

Dogs with simple bloat are generally hospitalized to receive intravenous fluids, medicine to help the stomach empty and frequent walks to stimulate bowel movements. Dogs with GDV require surgery to untwist the stomach. 

Does dry food cause bloat in dogs?

Dry food can cause bloat in dogs especially if eaten in large amounts at one time or if a dog exercises quickly after eating. However, a canned or human food can also cause bloat and rotation of the stomach.

How do you treat bloat in dogs at home?

If a vet determines a dog with simple mild bloat can be treated at home, the owner will be advised to withhold food for 12 to 24 hours, take the dog on frequent walks, and limit water intake to small amounts several times daily.

Can drinking too much water cause bloat in dogs?

Drinking large amounts of water at one time, especially if followed by exercise, is a risk factor of bloat and GDV. It is best to offer small to moderate amounts of water and limit drinking 30 minutes prior to any heavy exercise. Small bowls of water around the house can curb a dog from guzzling too much water at once. 

WRITTEN BY

Katie Grzyb, DVM

Veterinarian

Dr. Katie Grzyb received her Doctorate of Veterinary Medicine from Ross University in 2009. She continued her clinical training at…

Myocarditis in Dogs

Myocarditis is the inflammation of the heart’s muscular wall (or myocardium), often caused by infectious agents. That is, bacterial, viral, rikettsial, fungal, and protozoal agents directly affecting the heart or reaching the heart from other body parts can lead to myocarditis.

Clinical symptoms depend on the type of infection and extent of lesions, but in severe cases, heart failure may result.

Symptoms and Types

The inflammation itself may be focal or diffused throughout the myocardium. Other symptoms associated with myocarditis include:

Arrhythmias (abnormal heart rhythm) Cough Exercise intolerance Difficult breathing Weakness Collapse Fever Other symptoms related to infections may also be present

Causes

Although viral, bacterial, rikettsial, funal, and protozoal infections are the most common cause of myocaditis, drug toxicity to the heart can also be a factor.

Diagnosis

You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms. The veterinarian will then conduct a complete physical examination, paying close attention to the dog’s cardiovascular system. Various laboratory tests — such as complete blood count (CBC), blood culture biochemistry profile, and urinalysis — will be used to isolate and identify the causative organism. The abnormalities revealed by these tests, however, will depend on the affected organ.

Your veterinarian will also perform an echocardiogram (EKG) on the dog to evaluate the extent of myocardial damage and abnormal accumulation of fluid around the heart. In addition to evaluating the abnormalities related to heart dysfunction, EKG findings help in differentiating the location of the lesions within heart. Thoracic X-rays, meanwhile, help evaluate the heart size, whether fluids are located in the lungs, and other such abnormalities.

Other more specific testing include pathological exams of fluid samples taken from around the heart.

Treatment

Dogs with severe myocarditis, congestive heart failure (CHF), or severe heart rhythm problems may need to be hospitalized for intensive care and treatment. If specific causative organism is identified, infection will be treated with suitable medicine, such as antibiotics to fight off bacterial infections. There are also medications to correct heart rhythym issues, should the dog be suffering from them. In some patients, a pacemaker may need to be implanted.

Living and Management

The overall prognosis for myocarditis depends on the extent and severity of disease. Dogs with CHF as a result of myocarditis, for example, have very poor prognosis, while those with milder forms of the disease respond well to treatment.

You will need to visit your veterinarian regularly for follow-up evaluation and frequent laboratory testing will be conducted to monitor progress and response to treatment. Limiting your dog’s activity is important for recovery, as well as setting aside a quiet place for it to rest, away from household activity, children, and other pets.

Certain diet restrictions may be recommended, especially those concerning your dog’s salt intake.

What is Eye Ulcer in Dogs?

An eye ulcer, also medically termed corneal ulcer, or ulcerative keratitis in dogs, is a condition where the outer layer of the eye (the cornea) erodes, causing a divot or dent.  

This divot can be superficial (on the surface), or it can affect the deeper layers of the eye. Eye ulcers lead to pain, redness of the eye, eye discharge, blinking frequently or holding the eye closed, and sometimes swelling. This is a common condition and is diagnosed most often in brachycephalic (flat-nosed) dog breeds but can easily affect any breed of dog.   

Symptoms of Eye Ulcer in Dogs

Symptoms of eye ulcers in dogs range from mild to severe depending on the cause and severity of the erosion.  

Symptoms in order of severity include: 

Blinking the eye more often 

Excessive tearing 

Redness of the eye  

Swelling of the eyelid or skin around the affected eye 

Pawing at the eye or rubbing their face on the ground 

Elevated third eyelid (third eyelid is located in the inside corner of the eye) 

Holding the eye completely shut 

Yellow/green/bloody eye discharge (in severe cases) 

Hole (perforation) in the outer layer of the eye/rupture of the eye (in severe cases) 

Blindness in affected eye (in severe cases) 

Decreased appetite 

Lethargy or hiding behavior 

Causes of Eye Ulcer in Dogs

Anything that disrupts any part of the normal outer layer of the eye (cornea) can cause an ulcer, including if it affects the normal corneal structure, function, or physiology. Causes of eye ulcers in dogs are most commonly trauma, foreign body injury, or chemical burns.   

These are some of the multiple causes of ulcerative keratitis in dogs: 

Trauma: scratches from another animal; running into tree branches, plants, or bushes; self-inflicted trauma from rubbing their own face 

Foreign body: sand, dirt, or other foreign material can enter the eye and get stuck behind the eyelids, causing repeated damage to the cornea 

Chemical irritation/burns: shampoos, topical medications, or household cleaning products getting into the eye 

Bacterial infections 

Viral infections 

Secondary to conformation/congenital issues of the eye: such as abnormal eyelash growth (distichia), eyelid masses or tumors, or entropion (rolling in of the lower eyelid) 

Secondary to chronic dry eye: called keratoconjunctivitis sicca 

Secondary to neurologic issues: that do not allow the eyes to blink appropriately 

Secondary to certain endocrine diseases: such as diabetes mellitus, Cushing’s disease, and hypothyroidism 

Secondary to inherited conditions: such as epithelial dystrophy, seen most commonly in Boxers, King Charles Cavaliers, Beagles, Cocker Spaniels, Afghan Hounds, and Alaskan Malamutes 

How Veterinarians Diagnose Eye Ulcer in Dogs

Your veterinarian will want to perform some eye tests to find the cause of the ulceration and to decide on a course of action for treatment. The most important part of diagnosing and treating eye ulcers in dogs is to figure out if the erosion is simple or complicated.   

A simple (uncomplicated) eye ulcer only involves the most superficial (surface) layer of the cornea and usually heals within 7-10 days without progression into the deeper corneal layers.  

A complicated eye ulcer extends into the deeper layers of the cornea and can become infected or even start “melting” the deeper layers because of severe inflammation (swelling) and microorganism invasion.  

There are three types of complicated ulcers:  

Persistent corneal ulcers: This includes superficial ulcers with an elevated outer rim making it more difficult for the cornea to heal itself. They often heal with longer courses of therapy over several weeks to months. They sometimes require surgery to correct the problem if they worsen or do not heal with the right therapy. 

Corneal foreign bodies: Objects can penetrate superficially or can penetrate the deeper layers of the cornea. The deeper the foreign body goes the faster and more intense inflammation occurs. Often these foreign bodies require careful removal by a veterinarian and aggressive therapy to heal. Surgery is sometimes necessary. 

Stromal ulcers: These affect the deepest layer of the cornea, which is the wall between the outer layer of the eye and the fluid contained within the front chamber of the eye. They require aggressive medical and surgical management which may include melting ulcers (descemetoceles), and cat claw lacerations (cuts) or perforations (holes) to treat. These ulcers are often infected, severely inflamed, and painful. 

Your vet will perform a thorough examination of the eye itself to assess for any foreign objects, obvious lacerations or abnormal eyelashes, and masses prior to any diagnostic testing.   

Sometimes obvious lacerations or divots are noted in the eye with or without inflammation around the affected ulceration. Often, superficial erosions are not visible without special equipment.   

Diagnostic testing that is usually performed by your veterinarian may include: 

Fluorescein stain: A drop of this special yellow to green tinged dye is placed in your dog’s eye. The dye will adhere to the ulcerated tissue unless the ulcer is deep; then usually just the affected rim around the eroded area will uptake the dye. Small eye ulcers may require certain ophthalmic filter equipment to diagnose while other larger ulcers are often obvious when illuminated after fluorescein staining. 

Schirmer tear testing: This is a simple, noninvasive test to measure tear production and to diagnose chronic dry eye in dogs. This is a common cause of corneal ulceration if no other obvious foreign material or objects are found to be causing the ulcer.   

Intraocular pressures (tonometry): This is a simple, noninvasive test that helps to find the pressure behind the eye. If the corneal ulcer is deep or extensive, then this test may not be performed to avoid rupture of the eye itself. Often medical issues such as glaucoma or uveitis are diagnosed as a primary or secondary issue with deep or chronic corneal ulcers. 

Bacterial culture: This involves taking a sample of cells from the cornea which are then allowed to incubate and checked for growth of bacterial cells. A culture helps to direct antibiotic therapy in melting, chronic, non-healing, and deep eye ulcers. 

Cytology: This involves taking a small sample of cells from the cornea to assess under a microscope. A cytology can help direct the correct therapy in chronic, non-healing, or deep eye ulcers.   

Treatment of Eye Ulcer in Dogs

Treatment of eye ulcers in dogs depends on the type of corneal ulcer and the severity of the ulcer itself. Therapy is divided into two types: medical and surgical therapies. 

Medical Therapy for Eye Ulcer in Dogs

A therapy common for simple eye ulcers including broad-spectrum, topical antibiotics, and often topical pain medication. Sometimes systemic pain medication is added depending on the comfort level of the dog.  

Contact lenses are sometimes used to protect the outer layer of the eye while uncomplicated ulcers are healing. Most of these simple ulcers heal with therapy within 3-7 days. It is important to continue watching even simple ulcers closely and follow up with your veterinarian for recommended recheck appointments to ensure that the ulcer is not getting deeper or becoming infected.   

Complicated eye ulcers often require more potent topical antibiotics up to every 2-4 hours depending on the diagnosis. Oral antibiotics and pain medications are also often required for systemic therapy and comfort control. These types of ulcers are watched very closely with frequent veterinary exams to ensure that the ulcer does not worsen during therapy. These can progress to deep ulcers, which require surgical intervention.   

Simple, superficial foreign objects can sometimes be easily removed from the cornea with ophthalmic irrigation (a sterile cleansing solution used to flush the eye), while deeper foreign bodies often need gentle removal under general anesthesia by a veterinarian. Remaining lacerations or ulcerations can be thoroughly treated after removal with aggressive medical therapy. 

Indolent (non-healing) ulcers often require keratotomy or burr debridement, which uses a specific burring instrument (cutting tool) to remove the dead cells from the ulcer. It also stimulates blood vessels’ invasion into the ulcer for healing. Most of these ulcers heal about 2-3 weeks after this procedure.   

Surgical Therapy for Eye Ulcer in Dogs

Surgical intervention is necessary when an eye ulcer is deep, complicated, melting, or is chronic and no longer responding to medical therapy. 

Conjunctival (eye tissue) grafts are the most common surgery performed. This is where conjunctival tissue is transposed over the affected ulcer and is used to provide support and blood supply during healing. In some cases, a third eyelid flap and a temporary surgical closing of the eyelids (tarsorrhaphy) are used for ulcers caused by some congenital (present at birth) or neurologic (nervous system) issues. This acts as a bandage to protect the eye during healing.   

Some chronic or deeper ulcers can cause secondary inflammation in the eye, or uveitis, which requires more aggressive anti-inflammatory therapy using systemic non-steroidal anti-inflammatory medications and additional systemic analgesics.  

Elizabethan collars or pet cones are a necessity during healing from all eye ulcers. They eliminate the possibility of self-trauma caused by rubbing or pawing and protect your dog during healing. This collar must always remain on until it is deemed safe for removal by your veterinarian. Removing the collar too soon can lead to trauma and complicate current corneal ulcerations. 

Recovery and Management of Eye Ulcer in Dogs

Most simple eye ulcers are rechecked by a veterinarian in 5-7 days to assess healing. Most of these ulcers heal during this time with the right therapy. Prognosis is usually excellent for full recovery.  

Deeper or more complicated ulcers are checked more often, usually 1-2 days after diagnosis, to make certain that they are showing signs of improvement and not worsening. Sometimes, a pet may be hospitalized to perform frequent treatments every 2-4 hours. Medications are changed or extended based on bacterial culture and cytology results.   

For melting, deep stromal, or complicated eye ulcers, referral to a veterinary ophthalmologist (eye doctor) is usually recommended for treatment and surgical intervention. Conjunctival grafts are usually left in place for 2-3 months. Complicated ulcers are monitored closely by a veterinarian for several weeks after surgery or therapy to assess for tear production, which may require medical management for short periods of time or permanently in some cases. 

Any underlying medical conditions or congenital abnormalities must be diagnosed and correctly treated to avoid chronic eye ulcers or frequent development of corneal ulcers in the future. 

Eye Ulcer in Dogs FAQs

What is the cornea?

The cornea is the clear cell membranous outer layer of the eye and is made up of three cell layers. The most outer layer is called the epithelium, the thick middle layer is the stroma, and the thinnest, innermost layer is the endothelium (otherwise known as Descemet’s membrane).

Can a corneal abrasion (scrape) progress to become a corneal ulcer?

Yes. Erosion of the outer layer of the eye, the corneal epithelium, is called a corneal abrasion or erosion. When this erosion gets deeper and affects the middle layer or inner layer of the eye, a corneal ulceration occurs. This usually happens from self-trauma (rubbing the face or eyes), bacterial infection, or chronic/progressive inflammation.

What is an indolent corneal ulcer?

Indolent corneal ulcers are ulcers affecting the superficial layer of the cornea that do not heal within 7 days. Often this type of ulcer will seem to be improving when therapy starts, but then it deteriorates with no obvious cause. Often, these ulcers require keratectomy (laser eye surgery) to remove the unhealthy layers and allow therapy and healing.

Featured Image: iStock.com/Todorean Gabriel

WRITTEN BY

Katie Grzyb, DVM

Veterinarian

Dr. Katie Grzyb received her Doctorate of Veterinary Medicine from Ross University in 2009. She continued her clinical training at…