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10/Apr/2024

On Wednesday 3rd April, Dr+Vet was honoured to welcome leading veterinary ophthalmologist Maria Simó for our first webinar on Keratoconjunctivitis Seca (KCS) in dogs. During this virtual event, María Simó shared her knowledge and experience in the diagnosis and treatment of this common but often underestimated eye disease. Today, we can finally announce that the full video, with subtitles in English (and other languages automatically), is available for viewing on our blog and our YouTube channel! Attached to this article, you will find the direct link to the video so you can access it and deepen the knowledge shared by María Simó.

About Maria Simó:

Maria Simó is a renowned veterinary ophthalmologist with a solid background and extensive experience in the field of veterinary ophthalmology. Graduated in Veterinary Medicine from the Autonomous University of Barcelona, María has completed several postgraduate courses and works as an ophthalmologist at the prestigious Instituto Veterinario Oftalmológico (IVO) in Barcelona.

Contenido del Webinar:

Maria Simó talked us through the basics of Keratoconjunctivitis Seca, from diagnostic methods to the most effective treatment options, exploring in detail how to approach this disease in a comprehensive way.

One of the main conclusions of the webinar was the importance of not relying solely on the Schirmer test to diagnose KCS. María Simó emphasised the need for a complete and detailed assessment, as well as the use of additional diagnostic tools for a correct diagnosis, as without all the information, ineffective treatments may be prescribed. She also talked about the importance of referring cases that do not resolve correctly in order to fully evaluate them.

 

We thank all participants for their support.

The webinar on Keratoconjunctivitis Seca with Maria Simó was a great success, and we would like to thank everyone who joined us for this educational event. We hope that this resource will be a valuable source of information for all veterinarians interested in veterinary ophthalmology. Feel free to check out the full video and share it with your colleagues.

Stay tuned to our social media and website for more information on future of Dr+Vet events and educational resources!


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10/Apr/2024

Dr+Vet presents its new Guide to the Diagnosis and Management of Keratoconjunctivitis Seca in Companion Pets

We are pleased to announce the launch of our latest initiative: the Guide to the Diagnosis and Management of Keratoconjunctivitis Seca (KCS) in Companion Animals. This guide has been designed to provide veterinarians with a tool to address this common ocular pathology in pets.

KCS, also known as dry eye, is a disease that affects the ocular health of animals, causing discomfort and, in severe cases, permanent damage to the cornea and conjunctiva. To help veterinary professionals diagnose and treat this condition effectively, our guide covers a wide range of topics, from the pathophysiology of the disease to treatment options and recommendations for clinical management.

Some of the guide’s topics include:

  • A detailed description of the disease and its impact on the ocular health of animals.
  • Explanation of the different types of KCS and their clinical features.
  • Diagnostic methods.
  • Treatment options, from artificial tears to more advanced therapies.

At Dr+Vet, we want to assist in everyday clinical practice by providing valuable resources to help veterinarians provide the best possible care for their furry patients.

The Keratoconjunctivitis Sicca Diagnosis and Management Guide is now available for free download on our website – don’t miss this opportunity to improve your knowledge and skills in managing your patients’ ocular health!

Click here to download: Dr+Vet. Guide for KCS for veterinarians


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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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14/Dec/2023

Keratoconjunctivitis sicca (KCS) is a condition of the ocular surface (cornea and conjunctiva) secondary to a deficiency of one of the phases of the tear film and has a prevalence in dogs of 0.4%, according to the IVO.

Qualitative QCS is characterized by a pathological decrease of lipid or mucoid components in the tear film. This leads to tear hyperosmolarity due to increased evaporation. It is more common in brachiocephalic breeds and in cases of lagophthalmos.

In this study, conducted in collaboration with the Instituto Veterinario Oftalmologico (IVO), a comprehensive evaluation of different therapeutic approaches for qualitative QCS was performed.

Ten dogs were selected, including five brachiocephalic breeds, with a two-month follow-up. The selected patients had blepharospasm, epiphora, increased serous secretions compared to normal, or a combination of these symptoms at the first visit and, in order to be included in the present study, had to have Schirmer’s test (STT-1) values above 10 mm/min.

Cases with corneal ulcer and those under treatment that could interfere with the diagnostic tests were excluded. A series of diagnostic tests were performed, such as Schirmer’s test (STT-1), fluorescein test, break-up time (TBUT), lissamine green test, impression cytology (CIC) and OSA-VET®.

The selected treatment included the use of topical moisturizers and lubricants as tear replacements. In addition, Dr+Vet’s Lacrimalis food supplement, rich in omega-3 fatty acids, lactoferrin, vitamins C and E, Zinc and Copper, was implemented.

The results indicated significant improvements in print cytology, interferometry and tear film breakup time. There was a slight reduction in tear production, possibly attributed to decreased compensatory reflex due to hyperosmolarity.

Conclusions

This clinical case comparison underscores the importance of a multidisciplinary approach in the management of qualitative QCS. The combination of topical moisturizers and lubricants with the supplement Lacrimalis offers a promising perspective in the management of this condition.

The clinical case comparison performed by the IVO provides a valuable contribution to the approach to qualitative QCS in dogs. We thank Drs. Maria Simó and Francisco Simó for their collaboration in this first approach to the use of nutraceuticals in ocular diseases in dogs.

You can consult the comparative of clinical cases here (in spanish): COMPARATIVA DE 10 CASOS CLÍNICOS EN PERROS CON KCS CUALITATIVA


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09/Mar/2023

Dr+Vet launches a new formulation of LACRIMALIS with a higher concentration of fatty acids, EPA and DHA called LACRIMALIS+

As we have previously explained on the blog through the article “Key Points of Keratoconjunctivitis Sicca”, this is one of the most common ocular pathologies in the daily clinic of small animals. Let’s do a brief review and expansion of what was already discussed in the previous article:

What is keratoconjunctivitis sicca?

Keratoconjunctivitis Sicca (KCS) 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.

What layers or phases make up the tear film?

– Mucinic layer: the innermost layer, it modifies the surface tension of the tear so that it adheres and distributes correctly on the surface of the cornea. Mucin is produced and secreted mainly in conjunctival goblet cells.

– Aqueous layer: the intermediate and by far the most abundant. It moisturizes the ocular surface and essential nutrients and oxygen for the metabolism of the cornea diffuse through it. It also has a physical effect by washing away corneal debris and foreign bodies. The aqueous portion is produced and secreted in the main and accessory lacrimal glands.

– Lipid layer: the outermost layer, it protects the aqueous layer from evaporation, allowing it to remain on the eye longer. In addition, it also increases the surface tension of the tear, preventing overflow (epiphora) along the eyelid edge and lubricates the eyelids. Produced and secreted mainly by the meibomian glands.

How are KCS classified?

The basic and most widespread classification is the following:

– Qualitative: due to pathological decrease in the lipid or mucoid components of the tear film, which makes it difficult for the tear to remain on the cornea, either due to excess evaporation or difficulty in adhering. It is usually due to damage or inflammation in the meibomian glands or goblet cells of the conjunctiva.

– Quantitative: due to pathological decrease in the aqueous component of the tear film. There may be different origins, the most common being localized and chronic immune-mediated inflammation of the lacrimal gland. It is the most common type of KCS, although most tend to progress to mixed KCS (quantitative and qualitative) over time.

How does LACRIMALIS+ intervene in the improvement of the clinical signs of KCS?

LACRIMALIS+ is a food supplement based on natural products that helps improve the clinical signs of dry eye by increasing the quantity and quality of tears.

Its formula rich in Omega 3 fatty acids helps modify the lipid profile of the tears, making them of better quality and thus reducing their evaporation. In addition, Omega 3 also provides an antioxidant and anti-inflammatory effect on the meibomian glands and the ocular surface.

LACRIMALIS+ is also enriched with Lactoferrin, a component naturally present in tears and which gives it anti-inflammatory, antimicrobial and antifungal properties.

Finally, its precise combination of minerals, such as zinc or copper, and vitamins C and E give it an antioxidant effect that enhances that of Omega 3 fatty acids.

What differentiates LACRIMALIS+ from the previous LACRIMALIS?

The main change in the formulation of LACRIMALIS concerns the source of Omega 3 fatty acids. In LACRIMALIS+ we have added purer sources of EPA and DHA. The liquid version is supplemented with a high proportion of fish oil, which contains EPA and DHA naturally and directly, also maintaining the contribution of alpha-linolenic acid already present in LACRIMALIS. As for the tablet version, EPA and DHA are provided pure to guarantee a much higher proportion.


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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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