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25/Mar/2024

Keratoconjunctivitis Sicca (KCS), also known as “dry eye,” is a common ophthalmic condition in dogs and cats that affects the ocular surface, specifically the cornea and conjunctiva.

This disease results from the deficiency of some of the phases of the tear film, which leads to tear hyperosmolarity and, consequently, a series of ocular complications that can compromise the visual health of the animal.

The structure of the tear

To better understand KCS, it is important to know the three layers that make up the tear film and their functions:

  • Mucinous layer: This layer, the innermost, modifies the surface tension of the tear so that it adheres and distributes properly over the surface of the eye. Mucin is produced and secreted mainly in conjunctival goblet cells.
  • Aqueous layer: The intermediate layer, and the most abundant, hydrates the ocular surface and transports nutrients and oxygen essential for the metabolism of the cornea. It also acts as a flushing mechanism to remove debris and foreign bodies. This watery portion is produced and secreted in the main and accessory lacrimal glands.
  • Lipid layer: The outermost layer protects the aqueous layer from evaporation, allowing the tear to remain in the eye longer. In addition, it increases the surface tension of the tear, preventing overflow over the edge of the eyelid and lubricating the eyelids. This layer is produced and secreted mainly in the meibomian glands.

KCS classification

The KCS can be classified into two main types:

  • Qualitative KCS: It is produced by a pathological decrease in the lipid or mucoid components of the tear film, which makes it difficult for it to remain on the cornea, either due to excess evaporation or difficulty adhering. It is usually due to damage or inflammation in the meibomian glands or goblet cells of the conjunctiva.
  • Quantitative KCS: It is produced by a pathological decrease in the aqueous component of the tear film. It can have various causes, the most common being localized and chronic immune-mediated inflammation of the lacrimal gland. This is the most common form of KCS, and in most cases it progresses to a mixed form (quantitative and qualitative) over time.

What symptoms does it cause?

Symptoms of KCS may include mucosal exudate, conjunctival hyperemia, corneal opacity, neovascularization, corneal edema, and ulceration, among others. The diagnosis of KCS requires a thorough evaluation of the patient’s medical history and specific ophthalmological tests, such as the Schirmer Test, Fluorescein Test, and the Lysamine Green Test.

What treatment is used?

Treatment of KCS may include artificial tears, topical immunosuppressants, and surgical treatments, depending on the severity and underlying cause of the disease. Additionally, supplementation with specific nutraceuticals such as LACRIMALIS+ can help manage this disease, offering natural help to maintain pets’ eye health.

 

If your pet presents symptoms compatible with this disease, go to your trusted veterinarian for correct diagnosis and treatment.


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16/Jan/2024

When our pets get older, just like us, they start to require some special care and also a more exhaustive veterinary follow-up than during the rest of their lives.

From approximately 8 years of age, we recommend an annual visit where the veterinarian can check the weight, general physical condition, perform analytical or other tests if necessary. In these controls can be diagnosed diseases that do not yet have clinical signs and in which early treatment can slow the progression or development of such disease.

In this article we are going to focus on the most common vision defect in geriatric pets: cataracts. One of the most frequent ocular affections we see in the veterinary practice are cataracts. The origin of these cataracts is usually associated with age and degeneration of the crystalline lens due to the increase of its layers and the oxidative damage it suffers during its life. Other causes of cataracts can be diabetes mellitus, blows or trauma, congenital/hereditary or retinal atrophy.

How does a cataract form?
The crystalline lens is a lens formed by several layers located inside the eye, its function is to concentrate light so that it is properly projected on the retina. With the passage of time and the natural aging process, the lens tends to accumulate additional layers. This gradual process of layer accumulation can cause the lens to become denser and less transparent.

How do we detect that our pet has cataracts?
At home we can suspect the presence of cataracts and it will be the veterinarian who will confirm the diagnosis and will be able to tell us what treatment we can offer to our pet. If detected and treated in time, cataracts should not be a problem. At home we will be able to see a certain whitish or bluish opacity (at the beginning) in the crystalline lens. If the cataract is more advanced, we will clearly see the opacity or that the animal is hitting obstacles it may encounter due to the difficulty of vision.

In early stages (A,B), when it is not yet mature, there are still non-surgical treatment options such as dietary supplementation with vitamins and antioxidants to slow the onset of cataracts. Specialized nutritional supplements such as Occulus+ from Dr+Vet could be used to provide vitamins A, C, E and antioxidant minerals to slow the progression of the disease.

Once the cataract has evolved (C), a specialist veterinarian will indicate the best surgical solution, after an exhaustive review of the pet’s health and vision. Cataracts are an operable disease with a high success rate (around 90%). Post-surgical recovery usually takes a few days with anti-inflammatory eye drops and antibiotics until medical discharge.

Phases of cataract

Figure 1. Phases of cataract in dogs: A. Initial phase B. Immature cataract Immature cataract C. Mature cataract (point of surgery).
As the lens becomes less transparent and light can no longer pass through it clearly. In simple terms, the additional layers in the lens alter its original structure causing irreversible damage that affects its ability to focus light properly on the retina.

The Dr+Vet formula: Occulus+
As mentioned above, Dr+Vet offers the nutritional supplement Occulus+ recently reformulated to increase its antioxidant potential with alpha lipoic acid. This product contains abundant vitamins, minerals and antioxidant components that promote overall eye health and help slow disease progression.


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28/Apr/2022

Today we will talk to you about one of the most common eye pathologies in dogs: dry eye disease or Keratoconjunctivitis Sicca.

Keratoconjunctivitis Sicca is an inflammatory disease of the ocular surface (cornea and conjunctiva) secondary to the deficiency of some of the phases of the tear film and which generates tear hyperosmolarity. This hyperosmolarity and increased friction will lead to secondary infections, dehydration and malnutrition of the cornea and conjunctiva and will increase the likelihood of corneal ulcerations. In turn, chronic inflammation of the ocular surface will also end up generating conjunctival hyperemia, hyperkeratinization and thickening of the corneal epithelium, corneal vascularization with increased migration of inflammatory cells and the deposition of pigment, lipids and calcium. The prognosis is usually favorable, although it will depend on the cause of the disease and whether effective treatment is implemented early and individualized for each patient.

There are two main classifications of Keratoconjunctivitis Sicca:

Qualitative: Pathological decrease in the lipid or mucoid components of the tear film. In this case, the lacrimal gland is functional and the hyperosmolarity of the tear is due to an increase in its evaporation. The cause of this type of Keratoconjunctivitis Sicca may be damage or acute/chronic inflammation in the meibomian glands and/or the goblet cells of the conjunctiva, such as in cases of infectious blepharitis, seborrheic dermatitis, etc.
Quantitative: Pathological decrease in the aqueous component of the tear film. In this case, hyperosmolarity is due to reduced secretion of the aqueous component under normal evaporation conditions. This is the most common initial presentation in dogs, although in most cases, a vicious circle is generated in which the other types of components of the tear film are also affected.

The causes of Quantitative Keratoconjunctivitis Sicca are varied, such as infectious diseases, endocrine diseases, systemic immune-mediated/autoimmune diseases, iatrogenic (surgical), etc. although the most common is localized and chronic immune-mediated inflammation of the lacrimal gland (immune-mediated adenitis). There are breeds of dogs and cats that are more predisposed, as we already mentioned in one of our previous posts on our social networks (Instagram and Linkedin), such as brachiocephalic breeds, West Highland White Terriers, Cocker Spaniels and American , etc.

The symptoms that may occur are: very characteristic mucous exudate, conjunctival hyperemia, opaque cornea, with neovascularization, corneal edema and ulceration, etc.

To reach a diagnosis, we will have to be attentive to the patient’s anamnesis and clinical history, perform a general and ophthalmoscopic examination, if we suspect systemic pathologies, general analytical and other complementary tests and followed by ophthalmological tests: Shirmer test, Fluorescein, Lysamine Green Test, TBUT (Tear Break-up Time), Impression Cytology and Osavet Test.

There are various types of systemic and topical medical treatments such as artificial tears (there is a wide variety), topical immunosuppressants, etc. and in most cases they can be applied together. Additionally, if there are secondary problems such as infections or corneal ulcers, these will also need to be treated. There are also surgical procedures such as parathyroid duct transposition, among others.

Another essential asset to help improve the symptoms of Keratoconjunctivitis Sicca, of which studies have already been carried out in dogs and which has others being carried out to demonstrate its effectiveness, will be supplementation with specific nutraceuticals such as Lacrimalis, rich in Omega-Fatty Acids. 3 that will improve the quality, stability and tear secretion, Lactoferrin with anti-inflammatory and antimicrobial properties on the ocular surface and antioxidants such as Vitamins E and C and the minerals Zinc and Copper.

From Dr+Vet Pet Care by Böthmen Pharma, we will present each of the different ophthalmological tests that we have mentioned little by little over the following weeks together with the Veterinary Ophthalmological Institute (IVO) so that you can learn more about them. lose!


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