A corneal ulcer is an abrasion to the top layer of tissue lining the cornea which is the clear part of the eye. Corneal Ulcers are the third most common eye problem in dogs. Many ulcers are caused by trauma from foreign objects like foxtails and seed hulls from grass and weeds that can lodge under the eyelid. Scratches resulting from rough play between new puppies and kittens is also a common cause. Occasionally, bathing and grooming can result in an ulcer. Applying an eye lubricant prior to bathing and grooming helps protect the eyes from shampoo and hair. Genetic conditions involving extra eyelashes (Ectopic cilia), inadequate tear production (Dry Eye), and rolled in eyelids (Entropion) also irritate the cornea and can result in ulcers. Certain breeds suffer more than others. Breeds with pushed-in noses, and those with big, round eyes that can’t blink very well like Pekinese, Pugs and Shitzu’s are predisposed. Blinking spread the tears over the cornea, which keeps it moist and helps prevent ulcer formation. These breeds tend to get dried-out eyes which are prone to ulcers. Squinting and tearing are common signs and occur because ulcers are quite painful. The eye contains more nerves than any other body part relative to its size which is why the pain is so severe.

WHAT YOUR VET CAN DO
* Diagnosis is confirmed by staining the eye with a dye that causes the ulcerated (abraded) corneal tissue to turn a greenish color. With proper treatment, most ulcers heal in three to five days. Medication generally consists of a topical lubricant and a topical antibiotic. Both are usually applied at four to six hour intervals. The eye is restained a few days later to be sure the ulcer has healed. Ulcers that do not heal promptly (within seven days) should immediately be referred to an eye specialist to prevent corneal perforation.

COMPLEMENTARY TREATMENTS
HOMEOPATHIC REMEDIES
To relieve pain and inflammation of the eye, Aconitum napellus 30c (monkshood) may be helpful. Give the dog two whole or three crushed pellets. Allow no food for one hour before or one hour after the treatment. Wait 30 days, reassess the dog’s condition, then repeat the treatment if necessary.

Yours dog’s eyes should normally be clear, bright, and free of discharge. Red eyes in a dog can signal problems requiring treatment from eye drops to emergency surgery. Conjunctivitis is the most common eye problem in dogs and is defined as an inflammation of the white membranes lining the inside of the eyelids. It leads to red, swollen, itchy, watery eyes. Being able to recognize the signs of an eye problem or injury are the best ways to prevent permanent eye damage and insure visual integrity.

SYMPTOMS
* Red eyes.
* Mucousy or watery eye discharge.
* Thick yellowish-green eye discharge.
* Swollen eyes.
* Pawing and/or rubbing eyes.

CAUSES

1. Allergies are a major cause of conjunctivitis in dogs. Dogs overly sensitive to pollen, dust and mold often rub and paw at their eyes continuously.
2. Bacteria commonly causes conjunctivitis along with a thick yellowish-green eye discharge.
3. Unvaccinated puppies with distemper virus usually get conjunctivitis.
4. Inherited Eye Diseases involving the eyelids and eyelashes irritate the eye and may result in conjunctivitis.
      a. Entropion is a condition in which the eyelids roll inward which causes the eyelashes to contact the surface of the eye. This condition usually involves both eyes and is quite painful. In addition to conjunctivitis, partial or complete loss of vision can result if left untreated. Squinting and tearing are the most common signs. Surgical correction involves removal of a narrow strip of skin and muscle from the eyelid. Stitches are then used to evert the eyelid so that it lies in a normal position. The Sharpei, English Bulldog and Chow Chow are the breeds most prone.
     b. Eyelash Disease is a group of conditions in which eyelashes or hairs injure the eye.

* Trichiasis is a condition in which normal hairs lie on and irritate the eye. This is common in Pekingese. The long hairs on their face and in the folds of their nose irritate the eyes and cause conjunctivitis. Prevention requires regular trimming of these hairs.

* Ectopic Cilia are abnormal hairs found on the inside of the eyelid. These are quite painful. Surgical freezing is necessary to remove these offensive hairs.
* Distichiasis occurs when an eyelash occurs at an abnormal position along the eye or eyelid which irritates the eye.

WARNING

In addition to eyelid and eyelash disease, cataracts and diseases of the retina are also inherited. They can easily go undetected until quite advanced. Most are quite painful and blindness is not an uncommon consequence. A Canine Eye Registration Foundation (CERF) examination is an eye exam that can only be performed by a certified veterinary eye specialist. It is used to detect inherited eye diseases and can be given at a young age. Responsible breeders should not breed any dog or cat who fails a CERF Exam. Potential owners should ask whether or not the parents received and passed the CERF Exam. Neutering or spaying animals with these hereditary conditions insures that the problem will not be passed on to future generations.

COMPLEMENTARY TREATMENTS

HERBAL REMEDIES
For red, itchy eyes, use raspberry leaf tea as an eyewash, or put a drop of cod liver oil in the affected eye three to four times a day. Two to three drops of raw cucumber juice applied 3 to 4 times a day also helps soothe irritated, red eyes.

HERBAL CONJUNCTIVITIS EYEWASH
Mix one cup of Rosemary with ½ cup of Thyme. Add four cups of water and boil for 15 minutes. Strain and cool. Use a cotton ball soaked in the solution to bathe the eyes and clean secretions every four to six hours or as needed.

Looking carefully at a dog’s head can give you a good general indication of his or her overall health status and temperament. First of all, dogs eyes should be clear and bright. They should also be free of tears and the nostrils should be clean. Runny eyes, a nasal discharge and sneezing may indicate a respiratory problem or an allergy. The ears normally smell and look clean. They should not be filled with debris, scarred or malformed. When you open the mouth white teeth with pink gums and a fresh breath are all signs of good dental hygiene. Healthy skin and haircoats shine. The fur should not be matted or soiled or have signs of fleas. Bald areas without hair and dry flaky skin can reflect a variety of problems.

The inside lining of the ear is normally smooth with a small amount of wax buildup. Many problems can cause the ears to be irritated, inflamed and/or infected. Any of these causes left untreated can lead to more complicated problems, including middle and inner ear damage and hearing loss. Most cats let you know that their ears are uncomfortable by scratching, shaking and/or tilting their heads.

CAUSES
Ear mites are most common in ear problems adult cats and puppies. These microscopic mites have hairs on their body that irritate the ears. They are also responsible for the itching and the dark brown, coffee-like residue. Mites live primarily within the ear canal. They can also live outside of the ear and on other parts of the cats body, they do not infest your home.

* Trauma to the ear from foreign materials like plant seeds or over-aggressive cleaning can also cause pain and inflammation of the ears.
* Flea allergies can occasionally involve the ears.
* Allergic reactions to pollen, mold, and dust are not common in ears. Ear infections associated with allergies often recur until the underlying cause of the allergy is determined and treated.

SYMPTOMS
* Scratch ears often.
* Shake or tilt head.
* Odor and/or discharge from ears.

WHAT YOUR VET CAN DO
* Diagnosis involves examining a sample of the ear discharge under the microscope. This is called a Cytology and will identify the problem. The most effective treatment will be determined according to whether mites, yeast or bacteria are present.
* Ear mites can also live outside of the ear, on other parts of your cat’s body. Flea control products can help to manage this problem.
* Instead of using eardrops to treat mite infections, you can now purchase a new topical treatment called Revolution (selamectin), applied onto the skin at 30 day intervals, which controls fleas, ticks, heartworms, intestinal worms and ear mites for cats and dogs.
* To prevent ear problems, check your cat’s ears regularly. Only use products recommended by your vet to clean your cat’s ears, and never clean any deeper than you can see.
* Long-term and/or recurrent ear infections may require a culture to pinpoint the exact agent responsible and the medication best suited to eliminate the infection.

NOTE: An otoscope is designed and illuminated to allow complete visualization of the ear canal

HEMATOMA (BLOODCLOT) OF THE EAR
* Hematomas usually occur as a result of self-inflicted trauma to the ear. Many cats vigorously Itch their ears because of a persistent underlying ear mite problem. A blood vessel in the earflap ruptures which causes bleeding into the earflap tissue. Treatment usually requires surgical
removal of blood clots and drainage of blood under anesthesia. Hematomas tend to recur until the underlying problem is eliminated because the cats continue to traumatize their ears by itching. Many ears scar down into an abnormal appearance.

TREATMENT
Milbemycin, is the active ingredient in Sentinel, a tablet given monthly to prevent heartworms, fleas, intestinal worms, and ear mites in cats. Selamectin is the active ingredient in Revolution, approved in cats, a monthly product that kills ear mites and walking dandruff mites, and prevents heartworms and fleas. New monthly flea preventative products have replaced ear drops to treat ear mites.

COMPLEMENTARY EAR TREATMENTS
Yeast Infections: Mixing equal parts of white vinegar and water (50:50) makes a good ear cleaning solution for yeast.
Bacterial Ear Infections: Garlic can be added to the diet only occasionally, continual high doses can cause anemia:
* Garlic has antibacterial and antifungal effects.

HERBALEAR REMEDIES
* Mullein (Verbascom thapsus)
* Mucilage or Sapenins have a demilucent effect.
* Use topically for bacterial ear infections.
* Calendula makes an effective ear cleaning solution: Mix one teaspoon of Calendula with ½ teaspoon sea salt and one cup of water.
* Calendula Oil is soothing to red inflamed ears. Apply two drops into ears once daily.
* To eliminate ear mites, Yellow Duck (Rumex crispus) two drops every 3rd day for three to six weeks.

HOMEOPATHIC EAR REMEDIES
For red, irritated ears try Pulsatilla (6c Windflower) one pellet every third day for two weeks. Withhold food ten minutes before and after treatment. Sepia officinalis (30C) two whole or three crushed pellets by mouth twice a day for three days then once a week, until the ears are healed. Helpful with itching and head shaking.

VESTIBULAR (MIDDLE EAR) DISEASE
Long-term and/or recurrent ear infections can spread to involve the middle ear. The middle ear houses nerves, called Vestibular nerves, which are responsible for balance and equilibrium. If these nerves are irritated, cats can lose their balance, tilt their heads, stagger and often fall over. This is called Vestibular Disease. Some cases are associated with ear infections and rarely brain tumors are responsible but the cause in most cases is unknown or idiopathic. The term Idiopathic Vestibular Disease is used in these cases.

DIAGNOSIS
X-rays are initially used to evaluate the middle ear. The bone housing the middle ear is called the Tympanic bulla and is located within the brain. The series of x-rays taken in this case, is respectively called a “Bulla Series”. A CAT scan or MRI are more sensitive imaging techniques that may be necessary to allow visualization of this area of the brain if the x-rays are inconclusive.

Typically, most cases of Idiopathic Vestibular Syndrome occur for some as of yet unknown reason in the spring and fall. Cats suddenly tilt their heads and begin staggering, for no apparent reason. Cats generally improve within 72 hours and symptoms usually resolve in a couple weeks. Occasionally the head tilt persists.

EYE TUMORS
Seventy-five percent of eye tumors in the cat are malignant, aggressive forms of cancer (in dogs the ratio is reversed, 75 percent of tumors are benign and do not spread or become life-threatening). An Iris melanoma is the most common type of tumor affecting cat’s eyes. Older cats may develop a visible brown or black spot on the iris of their eye. The Iris is the colored part of the eye. The spots may be single or multiple and are pigmented cells called Melanocytes that have overgrown. Examination involves the use of a slit-lamp biomicroscope, which determines whether or not the tumor is cancerous. If the pigmented area on the iris is flat, the lesion is referred to as an Ins Melanosis. This is considered to be pre-cancerous and is rechecked at six-month intervals.

IRIS MELANOMA / GLAUCOMA
Iris melanoma is also called Melanosis and/or Melanocytoma. Iris melanoma is the term used if the pigmented area on the iris is raised. This is a cancerous lesion. Treatment involves using a diode laser to destroy the cancer cells. Without treatment, Iris melanoma is generally result in Glaucoma. Glaucoma occurs because the cancer cells spread and obstruct the drainage angle of the eye, which is where the fluid within the eye normally drains. Since fluid can not drain from the eye, it builds up within the eye which increases pressure within the eye and causes Glaucoma. In dogs, Glaucoma rapidly results in blindness due to irreversible damage to the retina.

The only sign of Glaucoma in cats may be a slight difference in the size of the pupils which are the dark central area of the eye. Surgical removal of the eye, which is called Enucleation, is often necessary in advanced cases of Ins Melanoma. This alleviates the pain of Glaucoma and removes the cancerous mass.
RETINAL DEGENERATION
Retinal Degeneration is an inherited condition in Abyssinian cats. It occurs between four to six years of age and results in blindness. A dietary deficiency of the amino acid Taurine can also occur in cats fed primarily dog food which results in Nutritional Retinal Degeneration. This condition was first described in 1975 and was called Feline Central Retinal Degeneration (FCRD). Commercial cat foods are now fortified with Taurine to prevent this problem.

Feline Asthma is a chronic respiratory disease characterized by sudden episodes of breathing difficulty. Episodes are most often triggered by allergies or stress, which cause constriction of the airways. This leads to breathing difficulty, coughing and wheezing. A low-grade, chronic cough may be the only sign but an acute crisis can occur at any time that is potentially a life-threatening event. Affected cats are usually between 2 and 8 years of age. Siamese breeds and females may be more susceptible.

CAUSES
The most common causes are allergies to inhaled substances called allergens in the environment. Pollen, mold, and dust are incriminated outside. Tobacco smoke, perfumes, dusty cat litter, and powdered carpet deodorizers are the most common culprits inside. Other causes include stress, i.e., new pet moves into home as well as lung parasites including lungworms and heartworms. Bacterial infections often complicate these cases; secondary bacterial pneumonias are not uncommon in asthmatic cats or people.

SIGNS
1. Hairball-like coughing often with difficulty breathing. This hairball cough does not bring up any hairballs.
2. Wheezing.
3. Shortness of breath.
4. Breathing may be slow and deliberate, too fast and shallow.
5. Cats may breathe with their mouth open to help move air through their lungs. Cats normally breathe with a closed mouth.

DIAGNOSIS
Diagnosis is confirmed by chest x-rays, which allow differentiation from other diseases with similar signs, such as Bronchitis, Heartworm Disease, and Pneumonia. Fluid and mucous samples from the airway may be collected and microscopically examined to help pinpoint the exact cause.

TREATMENT
True asthma usually responds quickly to a combination of medications geared to open the airway and block the allergic reaction. Severe cases often also require oxygen therapy. Antibiotics are indicated if bacterial infections such as Pneumonia are present.

In an emergency:
* An injection of Epinephrine (adrenalin) reverses an asthmatic crisis in 15 minutes.
* Terbutaline is an airway dilator – when given by injection, it will open airways within 30 minutes.
* Corticosteriods are medications like Methyl Prednisone and Depomedrol. They act within 48 hours of injection and last 10 to 14 days. This is a viable alternative for some owners, unable to give pills to their cat. Cats, unlike humans, are relatively resistant to the side effects of steroids; therefore this is suitable for long-term management in certain cases.

LONG TERM MANAGEMENT OF ASTHMA

Long-term management of Asthma involves:
1. Removing allergens from environment
a. Use an air purifier, electrostatic air filter.
b. Use dust free, scent free cat litter.
c. Avoid odor-controlling sprays.
d. Reduce stress, don’t smoke.
2. Various medications are used to open the airways (Bronchodilators) and decrease the allergic reaction (Corticosteroids) similar to those used for Human Asthma.
a. Airway Dilators include:
i. Terbutaline (Brethine), and
ii. Theophylline (Theo-dur).
These medications decrease airway constriction and allow air to pass in and out of the lungs more easily. Terbutaline is available as an inhalant for humans and certain vets have devised methods to use this as an inhalant for cats.
b. Cyproheptadine is a medication that decreases the chemical serotonin, which has been shown to be involved in airway constriction. It is often used along with steroids and/or in cats unable to take steroids. Side effects include increased appetite and sedation.
c. Zamflurkast (Accolate) – This is a new human asthma medication used to decrease the dose of steroids necessary to manage asthma. In cats, this is considered experimental but initial reports have been good.
d. Cyclosporine – A - This medication is used in human organ transplant patients to modulate the immune response and is quite expensive. Recently, trials have been used in feline asthmatic cases unresponsive to other therapies.
e. Anti-Interleukin-5 Antibody is an anti-cancer medication still in the experimental stages for use in asthmatic felines.

COMPLEMENTARY TREATMENTS

Principles include treating allergies if present, decreasing airway inflammation and reducing environmental stress.
* Hypoallergenic Diets may relieve asthmatic signs associated with dietary allergies.
* Fish Oil: Flaxseed Oil.
* Antioxidants: Vitamins C & E
* Vitamin B6
* Vitamin B12
* Acupuncture has been effective in certain cases.

MOUTH INFECTIONS

FELINE STOMATITIS/LPGS
Feline Stomatitis is also called Lymphocyte Plasmacytic Gingivitis Stomatitis (LPGS). LPGS is a severe disease of the oral cavity in certain cats. These cats develop an allergic reaction to the plaque around their teeth. This response causes severe inflammation at the junction where the tooth meets the gum line.

CAUSE
The actual cause is unknown. These cats are negative for Feline Leukemia and Immunodeficiency Virus and the diet is not a factor. Calici Virus has been found but its significance is not known. Certain purebreds including Abyssinians, Persians, Himalayans, Burmese, Siamese and Somali are prone.

SYMPTOMS
* Bad breath.
* Difficulty chewing hard food (may only eat soft food).
* Decreased appetite.
* Weight loss may occur.
* Excess salivation.

WHAT YOU AND YOUR VET CAN DO

Oral examination reveals red, swollen, severely irritated gum tissue that surrounds all or most of the teeth. The upper and lower check teeth are most often affected. Ulcers of the gums, tongue, lips and/or the roof of the mouth are also often present.

DIAGNOSIS
Diagnosis is confirmed with a biopsy of the gum tissue. A piece of gum tissue is removed and examined under the microscope to determine the exact problem.

TREATMENT

Currently, many therapies have been tried but are only effective temporarily. The only treatment that resolves the majority (over 70 percent) of these cases for the long-term is quite radical and involves removal of all teeth behind the canine teeth.

Owners must brush teeth daily and rinse with 0.2 percent chlorhexidine oral solution. If cats are positive for Feline Immunodeficiency Virus, certain medications may provide temporary relief. These include:

1. AZT – 2.5 mg per pound given by mouth twice daily for 21 days.
2. Interferon (Roferon) given orally.

Bovine Lactoferin (20mg per pound of body weight) applied topically to gums and Carbon Dioxide laser therapy may decrease pain inflammation of gum tissue.

EYE INFECTIONS IN KITTENS
(CONJUNCTIVITIS NEONATORUM)

Conjunctivitis Neonatorum is an inflammatory condition of the conjunctiva, the white tissue lining the eyelids that occurs due to Herpes Virus infection in kittens. The virus enters the eye through the eyelids before they have opened. Prompt intervention prevents rupture of the cornea and permanent scarring of the eye. Treatment involves opening the eyes and applying appropriate medication.

EYELIDS AND DRY EYE
The eyelids serve many important functions. They protect the cornea, the clear outer portion of the eye, and the eye itself from trauma. They keep light out and determine the size and shape of the opening of the eye. The eyelids also produce and spread tears over the eye. Tears supply the cornea with oxygen and nutrients; therefore they are essential to keep the cornea healthy. If the cornea is deprived of oxygen and food because of a lack of tear film, destructive changes occur quickly, leading to a condition called Dry Eye. Dry Eye is also called Keratoconjunctivitis sicca. The cornea can become pigmented, scarred, and ulcerated. Partial vision loss can also result. The eyes of cats with Dry Eye burn and sting all the time just like ours do on a windy day. Diagnosis is made by a tear test that measures how many tears the eye produces in one minute. In this case, low levels of tear production are detected.

CAUSES OF DRY EYE
1. The eyelids of newborn kittens and puppies normally open between 10 and 14 days of age. If the eyelids open too early, tears are not yet produced. Dry Eye will result unless topical eye lubricants are applied three to four times daily until tear production begins.
2. Surgical correction of the lazy eyelid prevents further damage and rupture of the eye.
3. Certain breeds including Persians, Himalayans, Burmese, and Exotic Shorthairs have very large protruding eyes, which are subject to trauma, in addition, many also have an inherited eyelid disorder called Lagophthalmos. The “lazy eyelid” or lids do not close properly and therefore can not spread the tears adequately. This increases the risk of Dry Eye and secondary Corneal Ulcers.
4. Many of these same cats also have mild Entropion of their lower eyelids. Entropion is also an inherited condition in which the eyelid tissue turns inward. This causes further irritation to the eye.
5. Chronic Herpes Virus eye infections in cats can result in Dry Eye.

TREATMENT FOR DRY EYE
* The drug Pilocarpine and the anti-cancer drug Interferon effectively stimulate tear production in certain cats.
* A surgical procedure called a Parotid Duct Transposition (PDT) is a worthwhile consideration for cases that do not respond to medication.
* With consistent therapy, most cases of Dry Eye carry a good prognosis, but without treatment, recurrent corneal ulcers, bacterial infections, and even blindness can result.

INHERITED EYE PROBLEMS

1. ENTROPION
Entropion is a hereditary condition in which the eyelids roll inward which causes the eyelashes to contact the surface of the eye. This condition usually involves both eyes and is quite painful. In addition to conjunctivitis, partial or complete loss of vision can result if left untreated. Squinting and tearing are the most common signs. Persians and Himalayans seem to be at increased risk. Surgical correction involves removal of a narrow strip of skin and muscle from the eyelid. Stitches are then used to avert the eyelid so that it lies in a normal position.

2. EYELASH DISEASE
Eyelash Disease is a group of conditions in which eyelashes or hairs injure the eye.
* Trichiasis is a condition in which normal hairs lie on and irritate the eye. This is common in Persian cats. The facial hairs on the side of the eye nearest the nose can irritate the eyes and cause conjunctivitis. Prevention requires regular trimming of these hairs.

METHOD TO DETECT INHERITED EYE PROBLEMS

CERF EXAM
In addition to hereditary eyelid and eyelash diseases, several disorders of the cornea and retina are also inherited in cats. They can easily go undetected until quite advanced. CERF Exam is a method to detect Inherited Eye Problems. Most are quite painful and blindness is not an uncommon consequence. A Canine Eye Registration Foundation (CERF) examination is an eye exam that can only be performed by a certified veterinary eye specialist. It is used to detect inherited eye diseases in dogs and cats and can be given at a young age. Responsible breeders should not breed any dog or cat who fails a CERF Exam. Potential owners should ask whether or not the parents received and passed the CERF Exam. Neutering or spaying animals with these hereditary conditions insures that the problem will not be passed on to future generations.

Squamous Cell Carcinoma is the most common type of oral cancer in cats.

SIGNS
Drooling and lack of appetite usually occur after tumor has been present several months. Oral examination reveals a red, raised swollen area of gum tissue that may or may not be ulcerated.
CAUSES
The true cause is unknown but experts speculate that the meticulous grooming behavior of cats makes them particularly prone. Carcinogens from the environment land on the cat’s coat and enter the mouth when the cat grooms himself. These carcinogens cause the cells lining the mouth to begin to divide uncontrollably. The result may be a tumor. A tumor is defined as the uncontrollable overgrowth of cells. In this case, the squamous cells of the mouth are affected. For clarification, benign tumors, like a mole, are not harmful. Malignant tumors are cancerous. They can be spread to other areas of the body and can be fatal.

DIAGNOSIS
A biopsy is the procedure used to determine whether or not a tumor is cancerous. A tiny piece of tissue is removed and microscopically examined to confirm the exact type of tumor. This type of tumor is cancerous but usually remains in the mouth. Occasionally advanced cases that are left untreated, do spread. The best treatment is complete surgical removal, which is an effective cure. A cure may not be possible for advanced cases because the masses grow to a large size, which may prevent complete surgical removal. When removal is incomplete, this type of cancer comes back. Supportive therapy would then include pain management and feeding protocols.

PREVENTION
Dental checkups annually or every six months, in middle to older aged cats, allows early detection of several dental problems, including cancer.