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Cataracts in Dogs
Cataract surgery
Anterior capsular cataracts in Norwegian Elkhound
Cataracts on detached retinas of Jack Russell
Cataracts in Puppies
Cataracts
Cataracts surgery
also see Eye problems
also see CIKS
also see Cushing's
also see Distichiasis
also see Vision - How Dogs See
Cataract surgeryQuestion: Dear dr. mike;
first i would like to thank you for your previous advice. I think my dog is
still alive because of it. (it was some six months ago
and i don't believe that problem relates to the current one.)My dog, king tut, a black poodle now almost 14 years old, has cataracts. I
have read your very helpful output on the subject and cleared him
for the qualifications you specify. notably the retina has been evaluated
and is functioning. and the other conditions you mention are met.
i have consulted my usual vet as well as a veterinary opthalmologist .
i believe he could benefit from the operation since he clearly has a problem seeing.
so what i wonder is : whether to do both eyes simultaneously or do each
separately. the opthamologist informs me that to do both at once is
considerably cheaper . this is not my main consideration however and i will
cheerfully pay more if it is safer or better for tut. also there is the
question of whether to do an ocular implant as I believe is done with
people. again i am perfectly willing to do whatever is best but have heard
differing opinions on whether it is best for dogs. ( i don't see how any
unblurred vision is possible without a lens but who am I to say?)
,many thanks for your opinion.. also his walk is unstable but i believe
this can be attributed to the fact that he can't see but his usual vet
is doing further tests about this. is this instability common with
blindness?
again many thanks, frances
Answer: Frances-
Some dogs react adversely to cataract surgery. In our practice experience it has been about
10% or so of the patients who have had cataract surgery. Due to this, I tend to think that it is
better to do the procedures separately when both eyes must be operated on. I am not sure that
my logic is right on this one, but I think that if complications do occur it would be easier to deal
with them in one eye at a time and that this would make it less likely for a complication in one
eye to lead to problems in the second eye due to the increased need to handle the unaffected
eye while treating the affected one. However, if there is a significant difference in cost and doing
both cataract surgeries at one time would make it much more likely that both could be done,
because of cost savings, I think that I'd go ahead and opt to have both done at once and take
my chances.I am presently very confused about the issue of whether or not to use implants. I do think that
vision has to be much better with the implants and for that reason I would tend to advocate
considering them. I have been to one lecture on ophthalmology in which the presenting
ophthalmologist was convinced that implanting lenses increased the complication rate and one
lecture in which the ophthalmologist said that when a preliminary review of the situation for an
individual patient did not show any complicating factors in advance, that implanting lenses
actually reduced the long term complication rate. To be honest I think that both speakers were
probably right. If every dog receives a lens the complication rate is probably higher. If the
ophthalmologist makes a choice in whether to implant a lens or not based on the condition of
the eye at the time of surgery, the complication rate may be lower with implanted lenses,
because the higher risk patients are weeded out prior to surgery. So right now I am just telling
my clients to follow the ophthalmologist's advice based on his or her evaluation of their pet.I hope that this is still helpful to you.
Mike Richards, DVM
10/12/2001
Anterior capsular cataracts in Norwegian Elkhound
Question: Dr. Mike:
This weekend I had my female 13 month old Norwegian Elkhound looked at an
eye clinic. The diagnosis was bilateral anterior suture
cataracts (triangular in shape) marked also on the CERF page was the
"Inter". box. They were very, very busy and I did not get a good
explanation. Are these cataracts apt to rapidly change and lead to blindness
or the need for cataract surgery? Also are they definitely inherited? Both
parents, all grandparents and great-grandparents have been CERF certified
and passed their examinations on more than 1 occasion. I've never
experienced this problem before in breeding the mother or this line. She
has not had any trauma to the eyes but was fed an esbilac formula for about
2 weeks to supplement mothers milk when she got colicky on her real mothers
milk. If possibly inherited by what way i.e. recessive, autosomal, etc...?
A 6 month revisit with an ophthalmologist was recommended.Thank You, R
Answer: R-
Some puppies and kittens who are fed commercial milk replacement products
have developed cataracts, so this possibility has to be considered. Most
commonly these are posterior capsule or equatorial cataracts but other
types of cataracts have been seen with this problem. The fact that the
Esbilac (tm) was used to supplement the mother's milk production and the
relatively short duration of time it was used make this less likely but the
bilateral nature of the cataracts is somewhat supportive of the diagnosis.The lens sort of resembles a round pillow, having convex surfaces on both
sides. It is held in place behind the iris in a vertical orientation, so
that one convex surface is towards to front of the eye (anterior side of
the capsule) and the other surface is towards the back of the eye
(posterior capsule). In some of the breeds in which there is definite
evidence of heritability for cataracts there are specific orientations for
the types of cataracts that are inherited. Doberman pinschers, for example,
have posterior capsule cataracts as an inherited defect. In some breeds the
cataracts may be either anterior or posterior capsular cataracts. I can't
recall if there is a breed with primarily anterior capsular cataracts.The ophthalmologist may be able to tell you if there is a known method of
inheritance for cataracts in Norwegian elkhounds and if so, where the
cataracts usually occur in the breed. This could help determine the
likelihood that this problem is inherited. When information is not
available for a particular breed, ophthalmologists tend to be conservative
in their recommendations about breeding and usually suggest not breeding an
affected dog.Our experience with anterior capsular cataracts that look like those you
are describing is that they don't usually progress much or progress very
slowly. I am not sure if this is true in general. The ophthalmologist in
our area usually asks people to come back once or twice to check for
progression of the cataracts so it seems like there must be some patients
who do develop more extensive problems from these cataracts, though.The exact inheritance mechanism of cataracts in most dog breeds is not
known. The breeds in which the inheritance has been worked out include
dobermans, cocker spaniels, German shepherds, samoyeds, miniature
schnauzers and West Highland White terriers. There may be others that I am
not aware of. I am on the road and do not have access to all my books and I
just got a new ophthalmology book this week. When I get home, I'll check to
see if there is new information on Norwegian elkhounds.Mike Richards, DVM
5/1/2001
Cataracts on detached retinas in Jack Russell
Question: I have a Jack Russell Terrier, Sammy (appox. 6 years of age). Adopted him
two years ago - he was blind. (Detached retinas). He started to form
cataracts in both eyes. The right eye started to form earlier than the left.
He has been on AK-CIDE for the past year (a pred. eyedrop). He also was
recently diagnosed with diabetes insipidus and we are getting ready to switch
him to another eyedrop because of this. He is on Chlorothizaide (sp?) for
this. Both eyes have the typical white/bluish cast of a cataract - see
attached photo. Tonight when I was giving medicine to the dogs, I noticed
that the cataract in the right is gone. I am seeing his pupil as it would
appear pre-cataract. Can you give me any information on how/why this would
happen? Is this a normal scenario for untreated cataracts? His
opthamologist has opt! ed not to operate at this point since the dog is blind
(because of the detached retinas) anyhow. I am a little mystified by the
"disappearance of the cataract" and will call the vet tomorrow.Ro
Answer: Ro-
My guess it that the lens of the eye (containing the cataract) has luxated, or moved from its normal
position. It is probably best to remove the lens, if this has happened. It is possible to use medications
to keep the pupil small, helping to keep the lens behind the pupil, where it won't cause problems, but
this rarely works well long term and Sammy is pretty young for a Jack Russell. Sometimes cataracts
are resorbed when the interior of the lens liquefies and the capsule leaks. In a dog that had normal
vision prior to the formation of cataracts this can result in the return of vision but since Sammy
couldn't see before the cataracts, this won't benefit him much, if it has occurred. In some cases the
leakage of lens contents will cause severe inflammation in the eye and can even produce secondary
glaucoma, so it isn't always a good thing when resorption of the lens occurs. You made a good
choice to have Sammy re-examined by your vet. Hopefully, there has not been inflammation in the
eye, regardless of the cause of the problem.Mike Richards, DVM
12/27/2000
Q: Dear Dr. Mike:
Upon talking to an ophthalmologist, it is my understanding that, in order for
a puppy to have cataracts, both parents must be carriers. Is this correct?Thank you,
Cathy
A: Cathy-
The answer to your question depends on the cause of the cataracts and the
breed the cataracts are occurring in.There are hereditary cataracts. In some breeds, the mode of transmission has
not been worked out, based on the sources I have. At the present time
genetic information is changing very rapidly and it is probable that the
information I have is not completely up to date. For dogs in which the mode
of transmission has been worked out, the breeds with cataracts caused by
dominant genes (meaning that only one parent has to transmit the gene for
the disease) are:beagles and Chesapeake Bay retrievers
Breeds with recessive genes leading to cataracts (both parents must pass on
the recessive gene to the affected offspring) are:American cocker spaniel, Boston bull terrier, German shepherd, golden
retriever, miniature schnauzer, old English sheepdog, Staffordshire bull
terrier, Welsh springer spaniel, Afghan hound, Irish setter, Siberian husky
and standard poodle.This information is from Dr. Peiffer's book "Small Animal Ophthalmology: A
Problem Oriented Approach".There are a lot of non-genetic causes of cataracts, including trauma,
feeding orphaned puppies milk-replacing formulas, chronic inflammation,
toxins, vitamin B deficiency, diabetes and normal aging changes.If you have more information on the type of cataract you are concerned about
and breed it is associated with I would be glad to see if I can find a
specific mode of inheritance for you.Mike Richards, DVM
4/5/99
Q: dear Dr. Mike
We have an 8 yr old shepard-collie mixed breed diagnosed with diabetes
in june 98 who has rapidly developed progressive clouding of the lens of
both eyes. My question is whether there is anything we can do to prevent
further progression. She has significant visual impairment already and will become
completely blind in the next few months at this rate. Our vet has confirmed that she has
cataracts. I have read in a veterinary text that most dogs with diabetes
develop cataracts. She started on insulin immediately and was stabilized by August with
sugars @ 5-18 mmol/l venous samples( I am a doctor). She is asymptomatic. She
also has osteoarthritis in her hips and had a left THR last year. She was on
occasionally on Stilbestrol on the advice of our vet for about a
year at age 5 for intermittent leaking of urine. I
don't think this would affect the lens of the eye.
She is not obese. She is on Humulin ge Lente insulin 15 units twice
daily. I was wondering if this may be an autoimmune response to human insulin, but
she is not insulin resistant. Would vitamin A or any other supplement help ?
We are giving her cod liver oil to help her dry skin. Do we have to
accept that she is going to become blind? Thank-you very much.
Michele (Ontario)
A: Michele-
I do not know of anything that will help to correct the cataracts once they
have started. While it seems logical that strict control of the diabetes
might arrest the progress of the cataracts that hasn't been our clinical
experience, either. Most veterinary ophthalmologists are comfortable
removing cataracts from diabetic patients once the diabetes is well
regulated, though. That would probably be the best choice at this time, if
that is possible for you to arrange (your vet can refer you to a veterinary
ophthalmologist).Mike Richards, DVM
In the past, veterinarians waited for near blindness in both eyes before attempting cataract surgery. I am not sure of the reasoning behind this, but feel that it had a lot to do with the success rate of the surgery. In the past (prior to 1969), the success rate for cataract surgery was generally believed to be poor. Consequently, if the dog had any vision at all, its chances were just as good with or without surgery for long term vision. At this time, it is felt that the long term success rate is 90% or better for cataract surgery, if the patient is carefully selected. A cataract can be a source of visual problems in other areas of the eye if it is left alone -leakage of proteins from the lens can lead to inflammation in the eye, which can lead to glaucoma, which makes removal of the lens (cataract) much less likely to succeed. So currently, the recommendation is to remove the affected lens as soon as significant visual deficit is present. However, there are some criteria for deciding if your dog is a good surgical candidate that you might want to consider:
1. You must be willing to spend a significant amount of money AND provide a significant amount of aftercare!
2. Any inflammation present in the eye must be controlled PRIOR to surgery.
3. The retina should be evaluated prior to surgery to make sure it is functioning - the surgery may not be justified if your dog will not be able to see when it is over.
4. No other disease can be present in the eye.
5. Your dog must be cooperative about being handled and medicated. If not, the outcome of the surgery is seriously jeopardized. Be honest with yourself about this.
6. Your dog should be in good health. If your dog and you are good candidates for this surgery, it is worthwhile.
Mike Richards, DVM
Last edited 01/31/05