Corneal ulcer (ulcerative keratitis). Corneal ulcer in dogs and cats

Any cat owner knows that his pet, when awake, is always on the hunt. Cats love to hunt and can chase their tail or any other object that moves for hours. If the wind blows the leaves off the trees in your garden, then the chance that your cat will chase them is close to 100% - as this is their natural instinct. However, these hunting trips often force cats to make their way through bushes and bushes, through forests and fields. When your cat sneaks through thickets, she can damage the cornea in front of her eyes - but why is the cornea often injured, and not other parts of the cat's eyes?

Why is the cornea injured?

The cornea is upper layer the cat's eye, which, due to its position, is more vulnerable to injury than any other part of the eye. However, in addition to corneal scratches, there are many other causes that can lead to injury:

Fight with another cat or animal
Ingrown eyelashes
Foreign body in the eye
Chemicals that can get into the eyes
Heat radiation and smoke can also damage the cornea of a cat's eye.
Viruses and bacteria can lead to eye infection and inflammation of the cornea
Decreased tear production can cause corneal damage

Which cats are most susceptible to corneal ulcers?

All of the above causes can lead to corneal ulceration in cats. But some breeds, namely the Himalayan, Burmese and Persian, are most susceptible to corneal injury, as they have flat faces and prominent eyes. However, corneal damage becomes chronic more frequently in older cats.

Corneal ulcer symptoms

This condition is very painful and causes the cat to rub its eyes, which can lead to further complications. The main symptoms are:

Increasing the production of tear fluid
Colored discharge from an injured eye
Blurred eye
Eye redness
The cat may begin to squint with the injured eye.

Diagnosis and treatment

As mentioned earlier, this is very disease state which makes the life of a cat completely unbearable. Without treatment, a corneal ulcer can lead to blindness, so it's important to have your pet examined by a veterinarian as soon as possible. The veterinarian will be able to determine if there is an ulcer on the cornea. The veterinarian may use:

Fluorescent fluids, which can stain and show any corneal ulcer, if present.
A special test with which he will measure the production of tear fluid.
Special tests to help detect bacterial or viral cause corneal damage.

Once corneal ulceration is confirmed, the following procedures may be recommended:

Antibiotic eye drops or ointments to prevent infection
Painkillers
Protective collar to prevent chafing and additional damage to the eye
Treating the root causes of corneal ulcers

Critical value for complete cure ulcers have a passage full course an antibiotic ointment that your veterinarian will prescribe for your cat.

Can a corneal ulcer be prevented?

Unfortunately, since there are many causes of corneal damage in cats, effective way prevent injury no. However, a good approach is to periodically check your cat's eyes from time to time. If you notice any of these symptoms of the disease, contact your veterinarian as soon as possible. Timely treatment provide fast recovery cat and prevent the extreme discomfort that accompanies any damage to the cornea.

Chronic corneal ulceration in older cats

As cats age, they become more prone to corneal damage, which can become chronic. You should seek advice from a veterinarian on how to care for old cat, which may require long-term use eye drops. It is important to carefully monitor the injured eye so that the disease does not spread to the other eye.

Even novice breeders are well aware that only a really healthy animal can have clear, clean and shiny eyes. If some dubious exudate appears on them, the eyes fade and become cloudy, you need to urgently show the pet to the veterinarian. The fact is that ophthalmic diseases and a corneal ulcer in a cat, in particular, lead to extremely backfire, often ending in complete blindness of the animal.

The cornea is a kind of membrane that covers the front of the eyeball and plays, among other things, a protective role. Ophthalmologists compare this organ to "clean window glass". But how is it that an ulcer suddenly forms on this “glass”? To answer this question, it is necessary to know (at least in in general terms), how the cornea is arranged.

It is formed by three layers at once, each of which is formed by ... special, "specialized" skin cells. At the very top, however, lies the most common epithelium. Its transparency is explained by the extremely small thickness of this layer. Below the epithelium is the stroma. This is a kind of “backbone” of the cornea, on which the latter rests. Underneath is a layer called Dessemet's membrane. Since all these areas are very thin, they can only be seen under a microscope, and only after preliminary coloring.

Perhaps the most common and rather severe the cause of the ulcer is the germination of the corneal epithelium to other layers. At severe ulcers even the stroma is severely affected, which is fraught with serious consequences, up to the complete loss of vision. So, as a result of such phenomena, the stromal tissue seeps in abundance interstitial fluid, as a result of which the cornea becomes cloudy, the visual acuity of the animal drops dramatically.

If the ulcer passes through the stroma and reaches the Dessemet's membrane, the so-called descemetocele(photo above). This pathology can be compared with a hernia on the camera. In cases where Dessemet's membrane ruptures, fluid enters directly into the eyeball. The result is complete and irreversible loss of vision. Even worse is a perforated corneal ulcer, when it comes down to it being necessary. complete removal eyeball.

Predisposing factors

There are several reasons for the development of corneal ulcers in animals. Most often to blame eye injury. In particular, the cat itself can “plant” its eye when washing (especially if its claw is split), a stubble of grass can stick into the cornea. The second most common cause is corneal chemical burn.. This can happen when components get into the eyes household chemicals, fertilizers, other chemicals. However, in some cases, there is no need to talk about an “ulcer” here: especially aggressive chemicals “simply” burn out the eye of a cat. So keep chemicals away from your pets (and kids)! What other causes of the development of the disease exist?

Read also: What to do if worms in cats in the feces?

Despite the generally accepted view, viral, bacterial and fungal infections quite rarely cause the development of corneal ulcers in cats. However, this possibility should not be completely ruled out. In addition, today experts believe that an infectious corneal ulcer is almost never a primary disease. Much more often - this is just a consequence of skidding pathogenic microflora from the focus of inflammation already present in the body of the animal.

Clinical picture and diagnosis

Corneal ulcer - pathology is very painful. The animal, as a result, will constantly rub its eyes with its paws, while plaintively and hoarsely “howling”. Since any movement of the eye, including blinking, also leads to a strong pain reaction, the cat tries to sit, constantly closing its eyes. When you need to look somewhere, he does it sideways, while looking like an old pirate. Besides, ulcer formations on the cornea are almost always accompanied by the release of a significant amount of exudate, so that abundant crusts quickly form in the corners of the eye of a sick animal.

How can a veterinarian know that he is dealing with a corneal ulcer? Once again, we repeat that you cannot see any of the corneal layers with the naked eye. Accordingly, the diagnosis of "corneal ulcer" is also "by eye" is never made. They are discovered pre-staining the surface of the eyeball with fluorescent paint. It is applied in the form of a finely dispersed solution. The meaning of the technique is that this dye, subject to irradiation with a UV lamp, begins to glow brightly. Accordingly, it is much easier to notice any defects in the cornea.

However, this applies only to the most pronounced ulcers. Small ones sometimes have to be identified using special filters and magnifying devices. But diagnostic methods only visual detection is not limited. If the ulcer is chronic or very deep, samples are taken to microscopic examination and cytology.

Therapeutic methods

Therapy depends on the form and severity of the disease. So, given the existing descemetocele, it will be much longer, more expensive, and no one will give you a special guarantee of a cure. In mild cases, subject to timely treatment, small lesions can heal within a week. To prevent bacterial contamination of ulcerative surfaces, antibiotics and other antimicrobials. AT without fail are used sedatives(we have already indicated that the pathology is very painful).

Please note that antibiotics and painkillers applied to the cornea in the form of a drop remain effective for a maximum of four to five hours (then the medicine is simply washed off). Therefore, it is necessary to “dig” your pet more often. If you do not have the opportunity to put medicine in your cat's eyes every hour, it is better to use ointments. They are washed off much worse, and therefore the effectiveness of the applied drug remains much longer.

We have already mentioned that in cats with a corneal ulcer, any movement causes pain for the eyelids, which is why the animals constantly sit with their eyes closed tightly. To alleviate this condition, experts prescribe atropine. Please note that this drug, although it relieves pain and muscle spasm, greatly expands the pupil. This means that during the treatment period the animal becomes a kind of "vampire", extremely sensitive to any light. It must also be remembered that the pupil, even after the end of treatment, returns to its normal state not immediately, but after a few days.

Read also: Diarrhea with blood in a kitten: causes, diagnosis, treatment

To obtain top scores antibiotics should be used every four to six hours. On the other hand, with the additional appointment of atropine (to relieve spasm eye muscles), it must be administered no more than twice a day (usually once every two days).

If a ulcerative lesion already deep enough, and there is also a suspicion of descemetocele, all measures must be taken to accelerate healing. It must be taken into account that for some reason cats are not enthusiastic about blindfolds, and therefore it is necessary to prevent eye licking in other ways. AT severe cases you have to not only put a surgical collar on the cat, but even sew up the eyelids for two or three days!

Worst of all, when the edges of the ulcer accumulate a large number of dead cells, which stops the normal healing process. In such cases, a surgical operation is indicated, during which the specialist will remove these tissues. Of course, this is done surgical intervention exclusively under general anesthesia. Fortunately, non-surgical treatment is more common in practice, but nice results it shows only in those cases when the owners turned to the veterinarian in time!

A word about complications

Can the lung ophthalmic disease(for example, serous conjunctivitis), "mutate" into a corneal ulcer? Yes. That is why, for any eye problems, you should immediately show your pet to an experienced veterinarian. Unfortunately, such a development of events is especially likely in cases where the owners are trying to “treat” their pet on their own. As a rule, this does not lead to anything good. Moreover, even in situations where the cat is treated by a veterinarian, the animal must visit him with preventive purposes not only during the immediate therapeutic period, but also after (at least once a week, for two weeks). If a specialist regularly monitors the condition of your pet, he will be able to notice threatening signs in time.

How likely are side effects to develop? Such a possibility exists, but still the cases are relatively rare. Unfortunately, at corneal ulcer side effects are not always obvious - the cat is already ill in the early days, so sometimes warning signs skip even experienced breeders. You should be alerted, for example, by a clearly deteriorating condition of the animal immediately after taking the drugs. In this case, its use should be stopped immediately and your veterinarian should be contacted immediately.

Red stripes along the borders of ulceration - what is it?

Normally, the cornea does not contain blood vessels. Nutrients and oxygen enter it by diffusion. Unfortunately, the appearance of blood vessels indicates either an aggravation of the ulceration process, or the formation of a descemetocele. Vessels in this case begin to grow from the sclera to the focus of ulceration.

The cornea is the outer spherical shell of the eye. Normally, it is glossy, transparent, devoid of blood vessels, and feeds on the components of the tear. It is through the cornea that we clearly see the iris and pupil. playing important role in the very process of vision, the cornea serves as a barrier to microorganisms, viruses, and many drugs. Being the outer structure of the eye, it is subject to injury and environmental influences.

Cat cornea - glossy, transparent, spherical

Animal cornea consists of 4 layers. From outer to inner, these are epithelium, stroma, Descemet's membrane, and endothelium. The transparency of the cornea is due to the fact that there are no vessels and little water in it. This result is achieved due to the work of endothelial cells, which are pumps that pump out fluid.

Layers of the cornea, where A - epithelium, B - stroma, C - Descemet's membrane, D - Endothelium

Corneal injuries are classified according to the depth of damage:

So, for example, damage to only the superficial epithelial layer is called erosion cornea. It can be compared to an abrasion on the skin: it is superficial, very painful, heals quickly, does not leave noticeable scars. Corneal erosions respond well to therapeutic treatment and, if they are not complicated, heal in a few days. Separately allocated chronic erosion. In dogs and cats they are caused different reasons and are treated differently.

Damage to the epithelium and less than 50% of the stroma is called superficial ulcer cornea. They are also very painful, they regenerate more slowly than erosions, and a slight turbidity may remain in their place. Therapeutic treatment is also great effect in the treatment of superficial corneal ulcers. Such defects can heal up to 14 days.

Damage to the epithelium and more than 50% of the stroma is called deep ulcer cornea. These ulcers are less painful because the deep layers of the stroma do not nerve endings. However, the defect will be stained with fluorescein. Most deep corneal ulcers require surgical treatment. If the situation worsens, a deep ulcer becomes even deeper, which greatly increases the risk of perforation of the eyeball and leads to the need for surgery.

Damage to the epithelium and the entire thickness of the stroma up to the Descemet's membrane is called descemetocele. This is a very dangerous type of ulcer because the risk of perforation is extremely high. Often no descemetocele is caused pain and are not stained with fluorescein dye, which can confuse the clinician. In the event of a descemetocele, surgery cornea, as therapy is powerless. Surgical treatment is represented by a variety of techniques, but the most popular are transplantation of a donor cornea, own cornea, and a conjunctival flap. The first two techniques return almost perfect transparency to the cornea. A proper conjunctival flap will provide translucency while maintaining visual function. However, the choice of technique largely depends on the specific clinical case.

The center of the ulcer does not stain with fluorescein, since the Descemet's membrane is immune to it. This is confusing to many clinicians.

Descemetocele may be accompanied by corneal perforation. All cases of descemetocele and corneal perforation are urgent and require urgent surgical treatment.

The causes of erosions and ulcers of the cornea can be injuries, chemical burns, foreign bodies in the conjunctiva, inversion of the eyelids, dry eye syndrome, degenerative changes, viral, fungal and bacterial infections. Chronic corneal erosions in dogs and cats stand out separately. They are caused by different causes and fundamentally differently treated. They will be discussed in another article.

The clinical picture of damage to the cornea looks like this: the animal covers its eye, lacrimation, photophobia, and whitish mucus are observed. The eye itself is red (conjunctival vascular injection), the cornea at the site of damage is cloudy white or reddish white. Severe pain is present.

With deep damage, clouding of the cornea increases (due to edema), redness of the eyeball and discharge from it persist, but pain may be less pronounced.

Corneal ulcer in a dog rare disease. It appears and progresses after deformation of the upper ball of epithelial cells.

Reasons for progression include:

Mechanical deformation of the outer shell by getting into the eyes of a foreign object (dirt, dust, pieces of glass), contaminated harmful microbes. The combination of microscopic deformation and extraneous flora is the reason for the activation of the inflammatory period;
Education chemical burn after interacting with chemical elements, which led to deformation of the integrity of the entire upper layer;
Twisting the eyelid towards the eyeball, during which cells are regularly damaged by eyelashes. Microorganisms enter the wounds, which provoke damage to the outer shell;
infections viral etiology, which results in purulent inflammation. Dead microorganisms destroy protein particles;
Hereditary and congenital anomalies eyeball.

At the first stage of the development of the disease, the problem with the outer shell is asymptomatic, but after a while it causes a lot of pain and inconvenience. At this stage, the owner of the dog clearly understands that something is bothering him.

Creeping corneal ulcer in a dog

Creeping ulcer in dogs is manifested in acute form. Often occurs as a result of trauma, accompanied by cutting pain, lacrimation, the eyelids begin to spasm. Photophobia may appear, the vessels overflow with blood, the eyes begin to swell.

The outer shell is covered with pus with a yellowish tint, which quickly spreads throughout the eye, an ulcer develops. The inflamed wound has distinct edges, the bottom is covered gray coating. Often there is inflammation of the iris of the eye. AT rare cases- perforated wound. The outcome is the appearance of scars of varying intensity, oncological disease lymphatic tissue, clear clouding of the cornea. Emergency help- 0.25% solution of Chloramphenicol. Go to the vet immediately.

Perforated corneal ulcer in a dog

If you don't start on time drug treatment, toxins and microorganisms located in the cavity between the posterior surface of the eyelids can cause deformation of the cornea, which will cause an increase in the depth and area of the wound. In this case, the dog will be treated for a long time, and this will not always lead to a full recovery. visual function- the transparent outer shell of the eye will be covered with a yellowish film.

With the development perforated ulcer clinical picture will become unpredictable. Most dangerous option- falling out of the eyeball, which will lead to complete blindness and even loss of the eye. Due to the development of purulent infectious processes the animal may die.

Now in all leading clinics, innovative surgical treatment is carried out, which leads to the restoration of the cornea.

Symptoms of the disease

Clinical symptoms manifest themselves as follows:

Blurring of the outer shell of the eye. Provokes the process of cellular infiltration and its premature decay. Turbidity classification:

Gray color with a haze indicates the accumulation of white blood cells;
The formation of circles indicates increased concentration white blood cells;
Yellow haze means the presence of pus;

Superficial formation of new blood vessels. An excessive amount of them passes to the outer shell, they begin to branch intensively and occupy the entire area of the eyeball;
Inflammation of blood vessels provokes them strong filling blood;
The accumulation of eyelid fluid provokes inflammation of the tunica albuginea.

The iris can provoke a narrowing of the pupil, sharp pain on the rays of light, spasm of the eyelids (the dog will constantly squint).

Corneal Ulcer Treatment in Dogs

The disease involves several stages of treatment: therapeutic, medical and surgical. Usage conservative therapy justified when the disease has just begun to develop. Veterinarian recommends an appointment antibacterial agents With local action that drip into the damaged and healthy eye. For treatment, the active substances of Tobrex, Iris (drops) and Tetracycline, Optimmun (ointment) are prescribed.

The owners should remember that the treatment is carried out under the strict supervision of a doctor and according to the prescribed scheme. It is forbidden to change or adjust the dose of drugs on your own. If it is not possible to drip eyes or apply ointment on your own, you should contact your veterinarian.

Why do drops need to be used so often (every 240 minutes)? The outer shell must be kept as hydrated as possible, and this is done through contact with tears. This leads to premature washing off of active substances and further spread of ulcers. The use of drops according to the prescribed scheme accelerates the achievement of a clinical result.

However, this rule does not apply to pharmacological agents that contain a plant alkaloid. Drops or ointments are often prescribed to treat eye diseases, they quickly reduce itching and spasms. When a plant alkaloid gets into the eyes, the pupils expand sharply, and the animal practically goes blind, so you can use it 2 times in 24 hours.

Ulcers are forbidden to heal steroid hormones that are successfully used in the treatment of other inflammations. Active substances, upon contact with the affected shell, they begin to act with backfire, and ulcers begin to develop at a double rate.

With an advanced form of the disease, veterinarians insist on surgical intervention. Depending on the type and technique of execution, there are several types of operations:

Cutting the lining of the eye. The operation is simple, during its implementation, the outer shell of the eye is cut and it is aligned. The dog gets a dose local anesthetic, the incision site is additionally processed. In 99% of cases, after the interventions, full recovery visual activity;
Removal of part of the cornea of the eye. Surgery for a corneal ulcer in a dog is complex and traumatic; a laser beam is used to perform it. They eliminate all injured areas of the outer shell. The dog falls asleep for the duration of exposure, but after the operation, vision returns in 99 percent of cases. The operation is performed by a veterinarian, which guarantees the result in 100% of cases.

After the intervention, the operated eye is covered with optical glass, which prevents possible relapses.

Surgical treatment of a corneal ulcer is often performed using the technique of undercutting the affected area. To do this, the zone is removed from the outer shell of the affected eye a few millimeters from its base. The elimination of the zone is carried out without deformation of the nutrient vessels and should be proportional to the healthy area.

The place for fixing the zone on the outer shell is prepared according to the norms of ophthalmic veterinary medicine. The zone is attached to the cornea with a suture material used for ophthalmic exposure. After the end of the procedure, the site of the lesion is temporarily isolated for further regeneration of tissues and blood vessels. For two weeks, drug treatment is prescribed, the stitches are removed under local anesthesia.

Before surgery, tests are performed (blood, feces and urine), cardiological therapy (reflection of the heartbeat and electrocardiography), which should confirm the absence of contraindications for the introduction of anesthesia or general anesthetic. After surgical intervention therapy should be continued in the form of an effective and restorative treatment.

Price

To the treatment of wounds on the outside eye shell it is necessary to start immediately, since it can significantly increase in size, filling the entire cavity, this will significantly affect the price of surgery. The cost for the operation can range from 1500 to 20 thousand rubles. The price does not include anesthesia, all necessary medicines for rehabilitation. Also, the price will increase if the eyes are affected by concomitant diseases or the infection has touched other areas on the face.

At conservative treatment and after surgery, the owner must provide his dog complete care and peace, as these are the basic rules for a speedy recovery.

Corneal ulcer - serious illness. It can lead to various complications, loss of vision and death, so the pathology must be treated in the early stages and follow the doctor's recommendations.

Diagnostic procedures

To put correct diagnosis, the veterinarian should conduct the following examinations: An external examination of the eyeball is carried out with a flashlight, a microscope with maximum magnification and a slit lamp. In this case, the blinking frequency, the reaction to a change in lighting, and the hypersensitivity of the apple are calculated.

Staining with fluorescent dye. The affected area will clearly appear and glow with a light green tint. Schirmer's test, sampling of the ocular enveloping substance and staining with other dyes.

Preventive measures

Look at the behavior of the dog. Beware of walking in dangerous areas and dry grass, contact with aggressive dogs, games with which can lead to injury to the eyeball.

Keep an eye on your dog's eyes. If you find red spots or hemorrhages, tears from one or two eyes begin to flow in the dog, pus is released, if in the morning the dog cannot open its eyes on its own due to the formation of crusts, it is better to immediately contact the clinic. Let it be classic inflammation, then it is better to eliminate its manifestations at the first stage than to treat later from wounds formed on outer shell eyes.

Follow the vaccination calendar because most infectious diseases are the root cause inflammatory response on the eye shell, which can develop into a wound. If you follow all the rules, your dog will not get sick, and will delight with his cheerful and kind games. If you find any of the symptoms, you should contact your veterinarian.

Chronic or non-healing corneal ulcers common among dogs and cats and is a serious problem for both pet owners and veterinary ophthalmologists.

In dogs given type corneal ulcers also called " boxers ulcer».

Chronic non-healing corneal ulcer occurs due to the fact that the connection of the upper epithelial layer of the cornea with the lower layer, the stroma, is disrupted.

Clinical features of chronic corneal ulcers in dogs and cats

Such corneal ulcers in dogs usually superficial and not very painful, although in area they can occupy almost the entire surface of the cornea. The edges of the ulcer are torn and uneven. When stained with a special dye fluorescein, fluorescein penetrates along the edge of the ulcer under the corneal epithelium. The epithelium is easily removed from the surface of the ulcer cotton swab.

Part chronic non-healing ulcers cornea are "creeping". Such ulcers move along the surface of the cornea due to the fact that one edge of the ulcer epithelizes (heals), while the other one progresses.

Ophthalmology for dogs: photo 1.
Boxer with a chronic non-healing corneal ulcer in his right eye and
with corneal scarring and pigmentary keratitis after a corneal ulcer in the left eye

Ophthalmology for dogs: photo 2. The right eye of the same boxer-
chronic non-healing ulcer stained with fluorescein

Ophthalmology for dogs: photo 3.
The left eye of the same boxer - scars on the cornea after
chronic non-healing ulcer, pigmentary keratitis

Ophthalmology for cats: photo 1.
Chronic non-healing corneal ulcer stained with fluorescein
in a cat with rhinotracheitis

What breeds of dogs and cats have chronic corneal ulcers?

Veterinary ophthalmologists register chronic non-healing corneal ulcers in dogs different breeds. Most common in Boxers, Pit Bull Terriers, American Staffordshire Terriers, french bulldogs sometimes in poodles and dogs of other breeds.

In cats chronic corneal ulcers occur in all breeds, most commonly in British shorthair cats.

How do veterinary ophthalmologists treat chronic corneal ulcers?

Professional Veterinary ophthalmologists offer two main lines of treatment for chronic non-healing corneal ulcers in dogs.

It's lengthy therapeutic treatment in combination with several types of mechanical treatment of the surface of the ulcer and radical surgical method treatment - superficial keratectomy with tarsorrhaphy.

Despite the fact that superficial keratectomy is a microsurgical operation, it is the therapeutic management of patients with non-healing corneal ulcers that is the most complex and jewelery business, which not everyone knows. veterinary ophthalmologists Moscow.

Chronic non-healing corneal ulcer in dogs is therapeutically treated for a long time, 2-3, and sometimes 4 months. But in this case the animal is not exposed surgical operation and general anesthesia.

Cats with chronic non-healing corneal ulcers often occur against the background of infection. Usually it is a herpes virus infection. Veterinary ophthalmologists also perform surgical or therapeutic treatment of chronic non-healing corneal ulcers in cats. If the ulcer occurs against the background of an infection, an antiviral or antibacterial systemic treatment depending on the pathogen.

Corneal ulcer - features of cats

In cats, there is one feature - a complication of any damage to the cornea, including a chronic non-healing corneal ulcer, is corneal sequestration, so the tactics of treating chronic non-healing corneal ulcers have their own characteristics.

If your pet has discharge from the eyes different nature, if the color of the eye changes, if the eye squints - contact a specialist immediately - veterinarian ophthalmologist. These signs may indicate the occurrence of an ulcerative process of the cornea.

"Konni" is a veterinary clinic with home visits of veterinarians. Remember, help is near!