Decreased Tear Production in Dogs

Ian Herring, DVM, MS, DACVO, Virginia–Maryland College of Veterinary Medicine

ArticleLast Updated May 20172 min readPeer Reviewed
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TREATMENT FOR IDIOPATHIC/IMMUNE-MEDIATED KCS

Treatment

Application

Topical ophthalmic cyclosporine (1%-2% solution, 0.2% ointment), tacrolimus (0.03%)

Apply to affected eye(s) q12h; lifelong therapy required

Topical lacrimomimetic PRN (ie, artificial tears; products containing sodium hyaluronate may be particularly beneficial)

Apply until signs resolve (usually unnecessary when STT >8 mm/min)

Topical ophthalmic broad-spectrum antibiotic (eg, neomycin, polymyxin B, gramicidin solution)

Apply to affected eye(s) q8h for 10-14 days or until corneal ulceration (if present) is healed

Topical mucolytic medication (2.5%-5%

N

-

acetylcysteine)

Apply q6-8h if copious mucopurulent discharge is present

Warm compress to eyelids, periocular hair trimming, facial cleaning

Apply as warranted

TREATMENT FOR KCS SECONDARY TO RISK FACTORS

Treatment

Application

Discontinue lacrimotoxic medication if suspected in KCS pathogenesis

N/A

Topical ophthalmic cyclosporine or tacrolimus can be attempted (see

Table 1

) but is generally ineffective in these cases

Apply to affected eye(s) q12h

Topical lacrimomimetic PRN (ie, artificial tears; products containing sodium hyaluronate may be particularly beneficial)

Apply until signs resolve (usually unnecessary when STT >8 mm/min)

Topical ophthalmic broad-spectrum antibiotic(eg, neomycin, polymyxin B, gramicidin solution)

Apply to affected eye(s) q8h for 10-14 days or until corneal ulceration (if present) is healed

Topical mucolytic medication (2.5%-5%

N

-

acetylcysteine)

Apply q6-8hif copious mucopurulent discharge is present

Warm compress to eyelids, periocular hair trimming, facial cleaning

Apply as warranted

TREATMENT FOR CONGENITAL ALACRIMA

Treatment

Application

Topical lacrimomimetic PRN (ie, artificial tears; products containing sodium hyaluronate may be particularly beneficial)

Apply until signs resolve (usually unnecessary when STT >8 mm/min)

Topical ophthalmic broad-spectrum antibiotic (eg, neomycin, polymyxin B, gramicidin solution)

Apply to affected eye(s) q8h for 10-14 days or until corneal ulceration (if present) is healed

Topical mucolytic medication (2.5%-5%

N

-

acetylcysteine)

Apply q6-8h if copious mucopurulent discharge is present

Warm compress to eyelids, periocular hair trimming, facial cleaning

Apply as warranted

TREATMENT FOR NEUROGENIC KCS

Treatment

Application

Topical ophthalmic 0.2% pilocarpine q6-8h or 2% oral pilocarpine

Initial oral dose, 2 drops/20 pounds (10 kg) body weight q12h; increase 1 drop at a time to effect or until systemic toxicity (eg, salivation, vomiting, diarrhea) is evident

Topical lacrimomimetic PRN (ie, artificial tears; products containing sodium hyaluronate may be particularly beneficial)

Apply until signs resolve (usually unnecessary when STT >8 mm/min)

Topical ophthalmic broad-spectrum antibiotic(eg, neomycin, polymyxin B, gramicidin solution)

Apply to affected eye(s) q8h for 10-14 days or until corneal ulceration (if present) is healed

Topical mucolytic medication (2.5%-5%

N

-

acetylcysteine)

Apply q6-8h if copious mucopurulent discharge is present

Monitor for blepharospasm

N/A

*Spontaneous resolution may occur; therapy can be discontinued after resolution.

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