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Keratoconjunctivitis Sicca in Dogs

Keratoconjunctivitis Sicca (KCS) in Dogs: Causes, Symptoms, Diagnoses, and Treatment

Keratoconjunctivitis sicca (KCS) in dogs is a chronic, dry inflammation of the eyes caused by qualitative or quantitative tear problems. Keratoconjuncticvitis sicca is known as dry eyes or KCS. 

KCS in dogs is caused by genetics, congenital disorders, infectious diseases, gland removal or damage, chronic eyelid diseases and inflammation, neurogenic causes, drug side effects, radiation, immune-mediated diseases, and systemic diseases. 

Brachycephalic dog breeds, like Pugs, Bulldogs, and Boston Terriers, are prone to keratoconjunctivitis sicca. 

Dog dry eye symptoms include redness, corneal cloudiness, eye discharge, crusts, excessive blinking, corneal ulcers, and pawing. 

Dry eyes in dogs are diagnosed using specialized ophthalmic tests. The treatment for keratoconjunctivitis sicca dog is medical, surgical, or both. Artificial tears and tear stimulants are essential for managing KCS in dogs.

What is Keratoconjunctivitis Sicca in Dogs?

Keratoconjunctivitis sicca in dogs is a chronic eye disease caused by reduced tear quality or quantity. Dog tear film comprises water, oil, and mucus. 

The water portion of the tear film is produced in the lacrimal glands. Keratoconjunctivitis sicca occurs when the lacrimal glands do not make enough or quality tears. 

Keratoconjunctivitis sicca is the medical term for dog dry eyes. The condition is painful and leads to blindness in untreated and severe cases. 

Keratoconjunctivitis sicca in dogs is prevalent in brachycephalic dog breeds, such as Pugs, Bulldogs, Pekingese, and Japanese Chin. Brachycephalic dog breeds have large and prominent eyes prone to dryness. 

How common is Keratoconjunctivitis Sicca in Dogs?

Keratoconjunctivitis sicca is very common in dogs. KCS in dogs is between 0.3% and 1.52% annually, says a study, “The Tear Film in the Dog,” published in Comparative Ophthalmology Research in 1996. 

Keratoconjunctivitis (KCS) is rare in cats. Its symptoms include painful, red, and irritated eyes, associated with other eye conditions.

Is Keratoconjunctivitis Sicca a Common Dog Autoimmune Disease?

Yes, keratoconjunctivitis sicca is a common dog autoimmune disease. Immune-mediated KCS is when the immune system attacks, inflames and destroys the lacrimal glands. The condition is bilateral or affects both eyes. 

Autoimmune disease “is a widely primarily accepted cause of KCS,” according to the study “Immune-Mediated Keratoconjunctivitis Sicca in Dogs: Current Perspectives on Management,” published in Veterinary Medicine in 2015. 

Breeds such as Cavalier King Charles Spaniels, English Bulldogs, Pugs, Lhasa Apsos, Boston Terriers, English Springer Spaniels, American Cocker Spaniels, and West Highland Terriers are predisposed to KCS, which is caused by dog autoimmune disease.

What are the Causes of Keratoconjunctivitis Sicca in Dogs?

The causes of keratoconjunctivitis sicca in dogs are listed below. 

  • Genetics: Brachycephalic breeds are predisposed to dry eyes due to low tear quality, and certain Terriers and Spaniels are prone to KCS due to low tear quantity. 
  • Congenital Disorders: Congenital disorders causing dry eyes in dogs are sporadic. Small and absent lacrimal glands are two congenital disorders causing dry eye in dogs. 
  • Infectious Diseases: Keratoconjunctivitis sicca is triggered by infectious diseases, including canine distemper and leishmaniosis. 
  • Gland Removal or Damage: Dry eye in dogs occurs when the third eyelid gland is damaged or removed. Gland removal was a treatment for cherry eye in dogs in the past but is not practiced today because it causes dry eye. 
  • Chronic Eyelid Diseases or Inflammation: Eyelids rubbing on the corneal surface cause Keratoconjunctivitis sicca. The number one cause of dry eye in dogs is entropion or an inward-growing eyelid. The inward-growing eyelid irritates the eye for an extended period and causes dry eye.
  • Neurogenic Causes: Neurogenic KCS is caused by neurological damage of unknown cause and is prevalent in middle-aged female dogs. 
  • Drug Side Effects: Dry eye is a temporary or permanent side effect of medication—Atropin and general anesthesia cause temporary KCS, and sulfonamides cause permanent KCS. 
  • Radiation: Prolonged radiation exposure to the head causes keratoconjunctivitis in some dogs. 
  • Immune-mediated Diseases: Immune-mediated KCS occurs when the immune system attacks the lacrimal gland’s tissue, reducing tear production. 
  • Systemic Diseases: Systemic diseases causing dry eyes in dogs are diabetes mellitus, hypothyroidism, and Cushing’s disease. 
  • Idiopathic: Idiopathic means of unknown or undetermined origin, and in many cases, the cause of KCS in dogs is undiscernable. 

Is Keratoconjunctivitis Sicca in Dogs Hereditary?

Yes, keratoconjunctivitis sicca in dogs is hereditary. Certain dog breeds are prone to dry eyes, indicating a genetic component. 

Hereditary alacrima (reduced or absent tear production) is seen in Bedlington Terriers, English Cocker Spaniels, Yorkshire Terriers, and Cavalier King Charles Spaniels. 

Brachycephalic breeds are prone to KCS due to unusual facial anatomy. The incidence of dry eyes in short-nosed, flat-faced dogs like Boston Terriers and English Bulldogs indicates a congenital predisposition to KCS.

Can Dry Eyes in Dogs Come on Suddenly?

Yes, dry eyes in dogs can come on suddenly. Dogs are born with dry eyes, and others develop keratoconjunctivitis later in life. 

The underlying cause of KCS determines whether it is sudden or gradual.  For example, KCS occurs suddenly when triggered by a dog’s immune system change or gradually due to long-term use of certain medications. 

How is Keratoconjunctivitis Sicca Different from Conjunctivitis in Dogs?

Keratoconjunctivitis sicca is different from conjunctivitis in etiology and causes. KCS is a specific type of inflammation of the cornea and conjunctiva. Conjunctivitis is a general inflammation of the conjunctiva. 

KCS is caused by inadequate tear production, while conjunctivitis has various triggers, including allergies, infections, and trauma. 

Keratoconjunctivitis sicca is more severe and occurs suddenly or gradually. Some dogs with KCS require lifelong medication use. Dog conjunctivitis is more acute, developing, and healing quickly with proper treatment.  

What are the Symptoms of Dry Eyes in Dogs?

The symptoms of dry eye in dogs are listed below. 

  • Eye Redness: Eye redness is a sign of inflammation. Keratoconjunctivitis, a type of inflammation in dogs, manifests with red whites of the eyes (sclera). 
  • Corneal Cloudiness: Healthy dogs have crystal and transparent corneas, while dogs with keratoconjunctivitis sicca have hazy corneas covered with a milky-like layer.
  • Eye Discharge: Dogs with KCS experience low tear quality, with oil and mucus dominating the tear film. The oil and mucus form discharge from the dog’s eyes. 
  • Eye Crusts: The keratoconjunctivitis sicca eye discharge forms a crust when exposed to the air. The crust settles in the inner corner of the dog's eyes.
  • Excessive Blinking: Dogs with keratoconjunctivitis sicca open and close their eyelids rapidly to distribute moisture and relieve pain.   
  • Corneal Ulcers: Corneal ulcers are crater-like defects in the eye's surface. Dogs with KCS develop ulcers due to constant irritation and damage. 
  • Excessive Eye Pawing: Eye pawing is one of the common symptoms of dry eyes in dogs—the dog paws at its eyes to relieve the itchiness and provide comfort. 

What does Dry Eyes in Dogs look like?

Dry eyes in dogs look like inflamed, red eyes, covered with eye discharge and crusts on the corners. The eyeballs are hazy and lose their natural glow. The whites are visibly inflamed, and the eyelids are swollen. 

Does Drinking water help manage Dry Eyes Symptoms in Dogs?

No, drinking water does not help manage dry eye symptoms in dogs. Dry eyes develop when the tear glands do not produce enough tears, and in some dogs, they are caused by reduced tear quality. 

Drinking water supports hydration, but water consumption does not directly affect tear production and quality. 

How do Veterinarians Diagnose Keratoconjunctivitis Sicca in Dogs?

Veterinarians diagnose keratoconjunctivitis sicca in dogs based on clinical manifestations and test results. The vet starts with a complete body examination and takes the dog’s detailed history. 

The vet performs an eye examination based on the initial findings of the examination. Blood cell counts, biochemistry panels, ultrasound, and x-rays are performed to determine the underlying cause of dry eyes in dogs. 

What are the Tests done to diagnose KCS in Dogs?

The tests done to diagnose keratoconjunctivitis sicca in dogs are Schirmer tear test (STT), tear film break-up time (TBUT), and fluorescein staining. 

The Schirmer tear test is the cornerstone for diagnosing KCS. The test is done with a scaled filter paper placed inside the lower eyelid. A healthy eye produces between 12 and 25 mm of tears per minute. Values below 12 mm/min indicate dry eye. 

The tear film break-up time measures how fast tears evaporate from the eye's surface. It is defined as the time-lapse between a blink and the emergence of a dry spot. Properly hydrated eyes have a TBUT of over 20 seconds. 

Fluorescein staining is done to check for ulcers. The vet drops a fluorescent stain on the eye's surface, and the emergence of a green spot indicates the presence of an ulcer. 

How serious are Keratoconjunctivitis Sicca Dogs?

Keratoconjunctivitis sicca dogs are very serious. KCS is not a life-threatening condition but affects the dog’s quality of life. 

Dry eyes are uncomfortable and painful. Advanced cases of KCS manifest with vision deficits, which distress the dog. Dry eyes are sometimes a symptom of a more severe underlying condition that requires vet attention. 

Can Dry Eyes on Dogs Cause Blindness?

Yes, dry eyes on dogs can cause blindness. KCS is a chronic and progressive condition that, if neglected, results in blindness. 

Dry inflammation of the eye triggers damage. The early signs of damage are easy to miss, and the inflammation progresses. Untreated KCS in dogs causes irreversible damage and vision loss or blindness. 

Can Dogs Die from Dry Eyes?

No, dogs cannot die from dry eyes. KCS progress and, left untreated, culminate in permanent eye damage. Severe forms result in vision loss. 

Keratoconjunctivitis sicca is not fatal despite the potential vision impairment. Dogs with vision problems caused by KCS have reduced quality of life.  

What are the Treatments for Keratoconjunctivitis Sicca in Dogs?

The treatments for keratoconjunctivitis sicca in dogs are listed below. 

  • Tear Stimulants: Tear stimulants, or lacrostimulants, are medications that promote tear production. Cyclosporine and tacrolimus are the standard choices available as eye drops and ointments. Lacrostimulants are easy to use but not always effective. 
  • Tear Replacements: Tear replacements or artificial tears come as drops or ointments and are recommended for dogs that do not respond to lacrostimulants. Dry eye medication for dogs must be applied several times a day. 
  • Surgery: Surgical correction is required for KCS, which is caused by eyelid problems and cherry eye. Dogs with dry eye complications, like corneal ulcers, need surgeries as part of the KCS dog treatment. 
  • Additional Therapy: Additional therapy treats the underlying cause in KCS cases with an established trigger. The treatment depends on the cause. 

How long does it take for KCS in Dogs to heal?

It takes between six and eight weeks for KCS in dogs to heal. The recovery period is shorter or extended depending on the underlying cause and the treatment option. 

Dogs receiving tacrolimus or cyclosporine to stimulate tear production see results in six to eight weeks. Dogs unresponsive to the treatment benefit from higher doses, but the recovery period is prolonged. 

Milder and non-complicated cases of keratoconjunctivitis sicca in dogs take less than eight weeks to heal in some cases. 

Can Keratoconjunctivitis Sicca be cured at home?

No, keratoconjunctivitis sicca cannot be cured at home. Dry eyes in dogs are not treatable with at-home remedies. Natural remedies, like CBD oil or coconut oil, help manage KCS. 

Coconut oil is shown to have anti-inflammatory, antiseptic, antibacterial, and moisturizing properties. Virgin coconut oil is safe to be used as an ocular rewetting agent,” according to a 2015 study on rabbits, “A Pilot Study: The Efficacy of Virgin Coconut Oil as Ocular Rewetting Agent on Rabbit Eyes,” published in eCAM

Using virgin coconut oil reduces eye dryness and eases the symptoms, but it is not a cure for keratoconjunctivitis sicca in dogs. 

How can CBD Oil help treat Keratoconjunctivitis Sicca in Dogs?

CBD oil can help keratoconjunctivitis sicca in dogs by modulating the immune system and reducing inflammation. 

CBD (cannabidiol) has the ability to modulate the immune system, which is helpful for immune-mediated dry eye in dogs. CBD reduces inflammation, which is significant in dry eyes. 

Cannabidiol is a natural compound extracted from the hemp version of the cannabis plant. CBD for pets is safe for dogs of all ages and combined with traditional treatments. 

How can Boosting a Dog's immune System help prevent Keratoconjunctivitis Sicca in Dogs?

Boosting a dog’s immune system can help prevent keratoconjunctivitis sicca in the ways listed below. 

  • General Wellness: Dogs with a boosted immune system experience better health, reducing the risk of systemic diseases that trigger KCS. 
  • Fighting off Infections: A healthy immune system responds to pathogens strongly and prevents infectious diseases causing KCS in dogs. 
  • Autoimmune Support: A dog immune system boost benefits dogs susceptible to autoimmune conditions. 

What is the KCS Prognosis?

The KCS prognosis is good. KCS is a manageable condition when caught early and treated correctly. Early treatment prevents corneal damage and ensures vision preservation. 

The prognosis is guarded for dogs with advanced KCS. Corneas with Irreversible damage cause vision deficits, and the severity of the damage determines the extent of the impairment.