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Corneal abrasion treatment? Healing time?

This forum is for dog lovers seeking everyday advice and suggestions on health-related issues. Remember, however, that advice on a public forum simply can't be a substitute for proper medical attention. Only your vet can say assuredly what is best for your dog.

  
Kally

I caught a- squirrel once...
 
 
Barked: Tue May 17, '11 8:17am PST 
Hello all!

My sweet little one, Sophie, (Kally's sister!) was diagnosed with a corneal abrasion. She is a chihuahua/min-pin mix and her little eyes are a little "buggy" smile

This past Friday night, I saw a spot on her eye. I thought it was a piece of dirt as she often has dirt or grass in her eyes that we have to wash or wipe out. This didn't move so Saturday morning I took her in to the vet. She diagnosed her with a corneal abrasion. She said it looked like something "poked" the eye, like a "dot" on her eye, not really a scratch.

She was prescribed an antibiotic ointment for her eye. We administered it 4x on Saturday, 3x Sunday, and are doing it 2x per day until Friday. The spot itself looks MUCH better. If you look closely, you can see a little spot and the vet said it might leave a scar.

Sophie really dislikes the medication. She blinks a lot afterwards. For the first few days, she would squint and blink. We were supposed to try and keep her in "dim light" but she really wants to go outside with her sister. She doesn't avoid the light but we do try to let her outside less.

A vet tech called to check on her yesterday and I let her know she is still blinking/squinting at times, especially after putting the medication in. The vet left a message this morning stating she wants to prescribe something to dilate Sophie's eye. I'm hesitant to do this because we are going out of town tomorrow and it will be more difficult to keep her out of the sun/light. Plus, I don't know if she really "needs" this extra medication?

Sorry for this really long question! I'm just wondering if anyone else has experienced this and how long it took their dog to heal? If they gave any other meds besides an antibiotic ointment? Thank you so much!!
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Leah, CGC

All the Beauty- with none of the- Brains
 
 
Barked: Tue May 17, '11 8:44am PST 
As far as I know there are no long-lasting negative effects of using pupil dialaters and allowing pet to be in sunlight. We reccomend keeping out of sun as much as possible becuase it makes the dogs sensitive to light and therefore they may squint, be uncomfortable or have trouble seeing. HOWEVER some dogs do just fine and never show ill effects.

Are you using a e-collar (elizabethen collar) to prevent pet from scratching at the eye? If you aren't I would becuase self-trauma is the number one reason these do not heal and it will also help to shade the eyes. I guess another way would be to see if dog tolerated cap or hat or sunglasses to shade eyes.

I came up with some info on how long they take to heal and meds that are appropriate - Keep in mind that a corneal abrasion is just before a corneal ulcer IE its a mild form of ulceration:

From CompanionAnimalEyeCenter.com
"Treatment depends on whether there is a corneal abrasion, corneal ulcer, or descemetocele present.

Simple corneal abrasions generally heal within three to five days. Medication is used to prevent bacterial infections (antibiotic ophthalmic drops or ointment) and sometimes to relieve spasm and pain (atropine ophthalmic drops or ointment). Antibiotic drops are only effective for a few minutes so they must be applied frequently; ointments last a bit longer but still require application every 6-8 hours. Atropine generally lasts many hours and is applied less frequently.

If a corneal ulcer or descemetocele is present, measures must be taken to protect the eye and to promote healing. Since dogs do not wear eye patches well, surgery may be required to protect the injury and allow for normal healing. In certain cases, it may be necessary to perform surgery to remove dead or poorly healing layers of corneal tissue, or to perform a corneal graft. Your veterinarian will choose the best surgery to optimize healing for your pet.

Are there any side-effects from the eye medications?

Occasionally a dog will be sensitive to an ophthalmic antibiotic. If your dog seems to be in more pain after the medication is used, discontinue it and contact your veterinarian immediately.

A corneal ulcer is usually painful so the eye is kept shut. Atropine relieves the pain but also dilates the pupil widely. Therefore, the eye is sensitive to light and many dogs will squint or close the eye when exposed to bright light. The effect of atropine may last for several days after the drug is discontinued. Do not be alarmed if the pupil stays dilated for several days.

My dog began to drool excessively and paw at its mouth after I administered the eye medications. Is that a reaction?

No. The tear ducts drain tears from the eyes to the back of the throat. Eye medications may go through the tear ducts and eventually get to the throat where they are tasted. Atropine has a very bitter taste, which may cause drooling, and pawing at the mouth. You are seeing your dog's response to a bad taste, not a drug reaction.

Since a corneal ulcer is painful, can I apply a topical anesthetic to the cornea?

A topical anesthetic is often used to numb the cornea so the diagnostic tests may be performed. However, these drugs often delay healing and should be used with discretion. Atropine is used to reduce your dog's pain and discomfort, if indicated"


or Check out this link:

Corneal ulcer info
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Kally

I caught a- squirrel once...
 
 
Barked: Tue May 17, '11 12:46pm PST 
Thank you so much for all that helpful info!

We have not been using an e-collar... she is pretty good about not scratching at her eye. I watch her pretty closely after I put in the medication, because that is when she tends to want to rub her eye - I'm sure it feels goopy and weird to her.

I ended up scheduling a vet apt. this afternoon to follow up and have her look at the eye again to make sure it is healing properly. I will talk to her about meds for dilation.

Thanks again for your help!
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Kally

I caught a- squirrel once...
 
 
Barked: Wed May 18, '11 6:11am PST 
Just wanted to thank you again for your help yesterday! We took little Sophie to the vet late yesterday afternoon. They said it looks like the abrasion is actually bigger than it was on Saturday - the vet said he couldn't tell if it had gotten "worse" or if dead cells around the abrasion had just "sloughed off" since Saturday and we weren't seeing the full extent Saturday.

He gave her Atropine ointment and... the e-collar. This has been the hardest part! She obviously doesn't like it but has been tolerating it pretty well. I think Mom and Dad are the ones having a hard time seeing her be so uncomfortable! frown We have a follow-up in a week... I'm keeping my fingers crossed that it is healing/healed. He said "worse case" if it was worse or the same next week, he would probably have to sedate her and "scrape" some cells around the abrasion off... this sounds horrible to me but he reassured me it's not that bad.

Thanks again for the support!
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Leah, CGC

All the Beauty- with none of the- Brains
 
 
Barked: Wed May 18, '11 10:10am PST 
Glad you followed up with the vet before you head out of town!

It is not uncommon for the abrasion to get bigger due to dead cells along the border so I hope that is what is happening. Eye stuff is hard because it is so dependent on ensuring that the pet cannot do any self trauma but it is SO SO uncomfortable!

I think you will be surprised how well the atropine works! As for the e-collar -- keep in mind that most dogs need about 24 hours to get use to it then they start to figure out their "new" size.

The eyeball itself has no pain receptors so it will not be painful for Sophie. The usually use a q-tip or similar to lightly rub along the edge of the abrasion to wipe away the dead cells. The sedation is needed because most dogs don't tolerate a person sticking a qtip into their eye - its not like we can ask them to keep their eye open and hold their head still (and honestly I am not sure how many Humans would be ok with this!!). Also it is a pretty precise and sensitive treatment so even slight movement could result in more damage or trauma or inability to get all of the dead cells. In some cases of severe corneal ulcers (think like large ulcerated holes in eyeball) the cornea can rupture with excessive handling or even restraint where pressure is put on face of pet or pets BP increases significantly (stress). A rupture will cause pets eye to become irreversibly damaged with no vision or severe vision loss. This is why ulcers are so scary for pet owners and vets. Your dog is far from this but the added sedation basically takes this concern out of the equation.

To explain why some ulcers are more scary than others you need to understand the anatomy of the eye....

"Anatomy of the Cornea:

The cornea is a transparent membrane at the front of the eyeball and is made up of three layers. The outermost layer is the epithelium, the center layer is the stroma, and the deepest layer is called the Descemet’s membrane. Since all of these layers of the cornea are clear, special stains must be applied to view abrasions with an ophthalmoscope.

Corneal Damage:

There are three levels of damage that can occur to the cornea. A corneal abrasion occurs when there is erosion of a few layers of the epithelium. Damage through the epithelium and into the stroma is known as a corneal ulcer. Erosion through the epithelium and stroma to the Descemet's membrane results in a descemetocele.

If the Descemet's membrane ruptures, the fluid inside the eyeball will leak out, the eye will collapse and irreparable damage can occur."
from Bostonterrierhub.com because of the easy to understand, straight forward description I could not easily write on my own! There is also a diagram of the eye provided at that link!

If a descemetocele is present there are some surgical options to help promote healing and in some cases a board certified optho vet can save some eye function if immediate intervention occurs after a rupture.

This is why when people call the ER with dog/cat eye issues we tell everything to just come in - ignoring any eye issue OR placing medications with steriods into eyes that have not been examined by a vet can result in significantly increased risk of irreversible damage or worsening of condition. One episode of rubbing can set back healing weeks to days so initial injuries can be worsened significantly if rubbing is allowed for even one night until the vet opens again. This is one of the reasons I suggest all pet owners - ESPECIALLY brachycephalic breed owners - keep an e-collar sized appropriately for each pet in the house at all times.

Edited by author Wed May 18, '11 10:11am PST

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