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Quality of Life After Vision Loss

Clinician's Brief (Capsule)

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Sudden acquired retinal degeneration syndrome (SARDS) in dogs is an acute disorder of unknown cause, characterized by sudden vision loss in ophthalmoscopically normal eyes. Blindness is usually permanent. Persistence of simultaneous clinical signs (eg, polyuria, polydipsia, polyphagia, weight gain) may represent more difficult management issues than blindness. This survey study evaluated long-term outcomes in dogs (n = 100) with SARDS using data from owner questionnaires.

Mean age at diagnosis was 8.2 ± 2.2 years (range, 4–16 years). Younger age at diagnosis was significantly associated with higher owner-perceived partial vision and quality of life (QOL). Most dogs had one or more concurrent systemic signs, and while most persisted, only polyphagia increased in severity over time. Visual improvement was not detected in any of the 22 dogs in which medical treatment was attempted.

Owners reported that dogs were more cautious, played less, slept more, and had more signs of depression following SARDS diagnosis. However, 37% of owners felt their relationship with their dog improved after diagnosis, and 76% ranked QOL as moderate to excellent. Only about half of owners made special provisions for their dogs (eg, baby gates, kennels, ramps, carpeted pathways, auditory and verbal cues).

Only 10 dogs were euthanized because of SARDS. Most owners (95%) said they would discourage euthanasia, and because euthanasia may be an indirect assessment of QOL, this suggests that dogs with SARDS likely maintain good QOL.

Commentary

It is incredibly difficult to make a truly objective assessment of our pet’s QOL, so we must rely on subjective data. It is heartening to learn from this study that most clients believe that their dogs have a good to excellent QOL and would not recommend euthanasia after SARDS diagnosis. However, this conclusion may make it even easier for clinicians to write SARDS off as a benign condition unworthy of a complete and proper diagnosis. Instead, this study should underscore the importance of a proper ophthalmoscopic and electroretinographic diagnosis of SARDS since the diagnosis of a disease other than SARDS (eg, optic neuritis, encephalitis, CNS neoplasia) carries the potential for far greater impacts on both QOL and prognosis/life expectancy. We should not just make the assumption that sudden blindness automatically leads to a diagnosis of SARDS.—Caryn E. Plummer, DVM, DACVO

Source

Long-term outcome of sudden acquired retinal degeneration syndrome in dogs. Stuckey JA, Pearce JW, Giuliano EA. JAVMA 243:1425-1431, 2013.

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