Decreased Tear Production in Dogs
Ian Herring, DVM, MS, DACVO, Virginia–Maryland College of Veterinary Medicine
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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