Monday, December 22, 2014

Ectropion in Dogs

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Ectropion is eversion or rolling outward of the eyelid margin, resulting in exposure of the palpebral conjunctiva, which is the delicate membrane that lines the eyelid. It most commonly affects the lower central eyelid.


Causes




  • Breed-associated alterations in facial conformation and eyelid support
  • Marked weight loss or muscle mass loss involving the head and orbit (eye socket)
  • Tragic facial expression in hypothyroid dogs
  • Scarring of the eyelids secondary to injury (chemical, thermal, or traumatic)
  • Surgical overcorrection of entropion, which is turning inward of the eyelid
  • Chronic inflammation
  • Fatigue (may be observed after strenuous exercise or when drowsy)

    Predisposing Factors

    Developmental ectropion may occur as a breed characteristic in the St. Bernard, bloodhound, mastiff, English and American cocker spaniel, English bulldog, basset hound, and Newfoundland, and is recognized in dogs less than a year old.

    Acquired ectropion may be found in other breeds, and these dogs are often older.

    What to Watch For 

  • Chronic redness of the lower conjunctiva
  • Mucoid discharge from the eyes
  • Visible eversion of the lower eyelid with exposure of the palpebral conjunctiva and third eyelid

    Diagnosis 

    Generally, the diagnosis is made by visual inspection of the eye. In older animals, a baseline complete blood count, biochemical profile and urinalysis are recommended in order to rule out other or associated disorders.

    In dogs with profound muscle wasting or poor muscle tone, additional diagnostics may be warranted to pursue neuromuscular disorders. Fluorescein staining is helpful in confirming corneal ulcers secondary to exposure and drying. 

    Treatment

    Supportive care and good ocular and facial hygiene is usually sufficient for most mild cases. Intermittent/physiologic fatigue-related ectropion need not be treated.

    If necessary, treatment may include:

  • Lubricating eye drops and ointments to reduce corneal drying caused by exposure
  • Surgical therapy when chronic, persistent medical management is required, when secondary changes involving the cornea or conjunctiva are severe, or to improve the cosmetic appearance of the dog. 

    Ectropion associated with hypothyroidism and masticatory myositis (inflammation of the muscles of the head) often responds to appropriate medical therapy for the underlying condition. 

    Home Care

    Administer all medication as directed by your veterinarian and return for follow-up as directed. If surgery was performed, use an Elizabethan collar to prevent self-trauma.

    Ectropion may become more severe as the dog ages.
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