Jenifer Chatfield  00:00

Hello, I'm Dr Jen, the vet here with Dr Brittany Schlesener, and this is chats with the chatfields.

Voice over 00:13

This episode is brought to you by full bucket veterinary strength supplements, the leader in digestive health for dogs, cats and horses. 

Jenifer Chatfield  00:22

All right, welcome back into the chat room. Everyone we are going to chat today all about pink eye. Does it happen? Is it a thing in dogs? Should you be concerned about it in your dog? And luckily, we're bringing in an expert Joining us today is Dr Brittany Schlesener, also known as Dr Sparkles, and she is a board certified veterinary ophthalmologist currently practicing at fetch specialty and emergency Veterinary Center in Brandon, Florida. And wait for it, she's a fellow Texas ANM veterinarian. So welcome, Dr Brittany. Welcome into the chat room. That's right, she even has it behind her. So I'm very excited. You guys should just know out there chatter boxes, like I have been wanting to do this episode with Dr sparkles, specifically, ever since she gave a lecture to my local group on ophthalmology for local veterinarians, like when to refer yada yada yada. And every single person after that meeting, because I didn't get to go, yours truly, had some other silly thing to do, but every single person I talked to in my local group said that you had the best Optho lecture they had ever had. Like, it was wonderful, yes. And so, I mean, clearly I was like, Well, how, like, how can I make up for missing, like, the best Opto lecture ever. I know I'm going to talk about eyeballs on the podcast, and I'll have her on. It'll be wonderful. So I'm really excited, and so glad that you had time, because I know you're very busy lady, so let like, let's get into it. Could you like, just, just for the folks at home, is is pink eye a thing? Because people tell me, Oh, my dog had pink eye. Is it? Is it a thing? What are we talking about here? That's such

Dr. Brittany Schlesener  02:20

a great question. So pink eye that people traditionally think of as pink eye, and people medicine is like when the eye kind of gets red and there's discharge lots of boogers and and human medicine, it's actually more closely linked with like viral infections, like adenovirus or bacterial infections. And it's not the same as in as an animals. For animals, we don't really use the terminology pink eye at all. You can still get like a pink eye kind of appearance in a dog or a cat, which is where the white part of the eye, which is covered in blood vessels, is just inflamed and red, and the terminology for that is conjunctivitis. And conjunctivitis can be caused from so many different things, and in every animal species, like the most common things are, are very different. So,

Jenifer Chatfield  03:13

yeah, well, so, so I guess, so let's back that up, because I think what happens is pinkeye is a very good descriptor, right? Like, like, you just said, I'm looking at my dog, and the white of the eye, the sclera, is pink, right? Yeah, okay, so I guess I should say we're not wrong, because we're calling it pink eye, right? But that's not actually a medical thing that work that your veterinarian is going to be using, would you say exactly?

Dr. Brittany Schlesener 03:46

I've never had to write Pink eye in a medical record. In the last eight years I've been doing this. So,

Jenifer Chatfield  03:51

okay, all right. Hey, me too. So great, dang. I'm having a good day. I didn't do wrong. All right, okay, so, but, but dogs do get that conjunctivitis, right, that inflammation, and so, like, if I'm looking at a dog, and I kind of want to know, Is this anything, right? Like I'm looking at my dog, how do I know is this anything? That's

Dr. Brittany Schlesener 04:17

a great question. So if it's if the eyes look more red or pink in general, and it's persistent, or they're squinting, or they have eye discharge that's not normal. And so it's something where you should definitely consider getting your pet in with a veterinarian. It doesn't have to be with an ophthalmologist like an eye specialist, because there's just so many different causes. And for dogs versus cats, the most common causes are very, very different, okay, and so, and some of those causes can actually be blinding, and so I want to get into that a little

Jenifer Chatfield  04:54

bit. Yeah, I do too. Um, but first, everyone remain calm just because your dog's eyes are inflamed or. Cat's eyes are inflamed. Doesn't mean they're going blind. I know she just said the word, but everybody remain call, okay, so, so what? So the first thing that comes to mind, so you say, if we see discharge, or, you know, goop from the eye, the corner of the eye usually, um, and we see that the the eye looks kind of inflamed. It's a little bit reddened, redder than usual. What about allergies? Because I know you and I like, we're in Central Florida, yeah. Like, yeah. Can allergies do that? Like, how do I know? Or do I know? Yeah,

Dr. Brittany Schlesener 05:34

you as far as a pet owner, they may not know, which is one of the reasons why they should go see their vet for dogs, autoimmune causes like immune mediated diseases are the most common reason for persistent pink or reddish looking eyes. So for dogs, allergies is one, but you have to rule out all the more severe things like ulcers or high pressures or low tier production, things like that, which would be done tests that would be done by your veterinarian to make sure it's nothing that's too concerning. And most of the time it's not going to be, it's going to be something that you might even resolve on its own. But there's just always a possibility that if there is a pink or red eye, there could be, you know, harmful things. And you want your pet to be comfortable, and you want to make sure your pets, you know, living their best life. So if it's something that's bought, like bothering them, and you're worried about it, it's not wrong to just go into your vet and just make sure everything's okay. And if it is allergies, because there's a lot of allergens in Florida, good luck.

Jenifer Chatfield  06:38

Right? Exactly. I'm like, I, you know, I struggle with that with my own eyeballs, right? Like, I mean, sometimes I wake up and I feel like I must have sand in my eyes. And it's not, it's just that, oh yeah, hey, guess what? It's the fall, right? Yeah, yeah. So, so that that's actually, that's actually really interesting, and this is where I also think, and it's kind of a rabbit trail that we don't need to go down, but I find very useful. Like, if I'm doing relief in a veterinary practice and they say, Hey, you know so and so's on the phone, they're concerned about their dog's eye. It looks a little red. Can they text me a photo? Right? Because it

Dr. Brittany Schlesener 07:19

depends on what your vet's comfortable with. Yeah, for me, I think that photos are really helpful, because when it comes to ophthalmology, the eye specialty, a lot of conditions you can kind of like rule out just by looking at a quick picture of the eye. But you know, it just depends on what your vet feels comfortable with. And when it comes to taking a good picture of the eye, so your vet can actually best help you from a distance. It's usually preferred to be like outside in direct light, because the harsh lights inside can actually cause a lot of shadowing and make it hard for them to see inside. And then not just getting, like a full body picture and then zooming into the eye, because that becomes very pixelated and you can't see the details. And so I usually ask owners if they wanted to send me a photo just to check to go outside with their pet, you know, get they need to go for a walk anyways, and then just try to get a close up photo of the eye, if you'll tolerate it. And and sometimes they'll be like, Well, my pets really squinty. And if they're really squinty, I still need to be able to see their eyes, so try to open it up if you feel comfortable, if you feel safe, to do that. Otherwise, if they're that uncomfortable and they're not letting you open their eye to take a photo, then they probably should be seen anyways.

Jenifer Chatfield  08:37

Yeah, I agree. And I think it's funny, because everybody, everybody sees things differently, because you can only see it the way that you see it, right? And so somebody will call and say, you know, oh Lord, I'm I'm just worried that my dog's gonna lose their eye. It looks terrible. This morning they woke up. It's crusted shut, and it's nasty. And like, oh my gosh, get them right in. I'll work them in. Let's see, because they only have two eyes, right? And eyes and brains worry me. So I'm like, get them in. Like, let me have a look. Because, you know, do I either need to refer them immediately to you, like, that day, Get thee to the vet, immediately to the specialist, or can I stay, you know, do some things at my regular practice, right? Can I do the corneal stain? Can I do the tear test? Could I, could I attempt to check pressures, you know, like, kind of the standard things, right? Or do we have time? And so some folks that dog will come in, and I'll be like, looking at the dog, and I'll be like, is this the right dog? The dog's looking at me with both eyes blinking open clear, like, one little eye booger, like, right in the corner, and I'm like, okay, all right, this non emergency, I appreciate you as an owner. Love it that you're on it, but then I'll have the other person, and they'll be like, Nah, it could probably wait. We could see me drinks and they come in and the dog's eyes like, totally shut. And they probably haven't used that eye in like, a year, and it's just a mess, and they didn't had no urgency about them. That's why I love, I just love technology for these sorts of things. So, yeah, so listen, also, I want to, like, clarify for folks. I don't know that you would make a diagnosis, would you based on the picture, or is it just like the decision?

Dr. Brittany Schlesener 10:23

No, it's just kind of like a helpful decision. I can't diagnose things over a photo because there's just so many variables. The reason why Ophthalmology is super specific is because you use a lot of special tools and microscopic kind of tools that you magnify things, otherwise you'd be missing those details. And I mean, sometimes if they're not able to come in, and a veterinarian needs help, you know, and I'm booked out for three or four weeks, then sometimes I'm like, just text me a photo from, you know, from the primary care veterinarian and and let me know, and I'll try my best to give you some recommendations until your pet owner can come in and see me. So there's definitely ways to try to not have every animal come in every single day, whenever it initially starts happening, and developing a good relationship with any any specialist you know, is really good first step, because the hardest job in the world is to be a primary care vet. You have to be an expert in absolutely everything and be available for everybody. And that's just really hard to do. And so being able to be like, Okay, I'm, you know, this is more specialty level. I need to reach out to somebody that they need to feel comfortable with that. And I want, I want people that are in the community that I work in to feel comfortable, to reach out to me for help if they don't know what to do.

Jenifer Chatfield  11:46

Yeah, I love that. My phone a friend for Opto cases for years was Dr Wolf. So shout out to Dr Wolf. I know he's retired, but he is a listener of the podcast, so I say shout out to him, because he was wonderful. And it would be a phone call either from the E clinic or from a, you know, regular vet. And I would ask, I'd be like, Listen, man, I'm a little concerned, you know, should I have them come to you right now? Is this something that can wait if they're gonna wait while they're waiting for that appointment to see you? What can I do that doesn't make things worse? Yeah, okay, so, so, I guess, so we have kind of the basic steps. If you think that your dog, you wake up in the morning and your dog's eye looks funny, what can you do? What should you do? Allergies are a thing. Pink eyes really not but, but there are some other significant causes for ocular disease in dogs and cats that we're going to get into those kind of specific causes after this quick break. Y'all know, with all the fuss happening in the pet food industry, why not invest in something to help guard against digestive health arrangements in your pet full buckets, probiotics are formulated by veterinarians to support your pets normal digestive health. Your pets gut microbiome is integral to their immune system performance. Why not add full buckets daily dog or daily cat probiotic powder to your pet's daily routine to curate, protect, maintain and strengthen your pets microbiome. Visit full bucket. Help.com today to check out all of their veterinary strength supplements. We're back in the chat room. We're getting to the nitty gritty here, folks. So back again with Dr sparkles. So I do dogs and cats are different, as you alluded to. So I'm kind of curious, you know, kind of what's the most common thing, the most common issue you see with dogs versus cats?

Dr. Brittany Schlesener 13:55

Yeah, that's a great question. So just like I was saying earlier, animals are not people. So pink eye and people is not like really a thing that we see in dogs and cats and so. And that goes to say that cats and dogs are also completely different. And so when their eye is looking irritated or having discharge or it's kind of like a pink or red kind of Hue for dogs, it's more common. There's lots of things, but it's more common to be like an autoimmune disease or immune mediated condition. So what does that mean? That means there's something in the environment, maybe like an allergen, that's irritating them, and there's so many of those things out there, and sometimes it's really hard to kind of target, like figure out what exactly is going on and pinpoint it and treat it. So if your pet has not only eye signs, but also skin issues, they're licking their paws too much. They're getting constant ear infections. There are paw pads smell like Fritos. You know those are might be other signs that they're having allergy that's not only affecting their eyes but affecting the rest of their body.

Jenifer Chatfield  14:58

That's a food aller. G friends right there. Every Frenchie owner just went, Oh yeah, yeah, right, because they've all smelled the Frito feet and and, you know, every cocker spaniel just went, Oh yeah, my ears, yep, yep, yep. But so, but when we're but when we're talking about that. So if we start with kind of the most common things, because for me, what I see in regular practice is I see allergies, you know, just, they're just their eyes are red, and they maybe have a little bit of discharge, but the first thing I do is stain it, right? I do a corneal stain because I don't want an ulcer there, right? And I'm friends, I'm looking at the specialist and taking a risk here that she's going to be like, making a face like, oh, no, don't do that. That's not next. Nope. Okay. So when you take your dog in, or your cat, and you say, look, eye problem, I feel like every you know, general practice veterinarians as a does a corneal stain. Would you? Would you say? Would that be the first thing,

Dr. Brittany Schlesener 16:00

the first three things. So we're Kyle's kind of talking about, like, conjunctivitis by itself, with like, you've ruled out ulcers, you've ruled out eye brushers, things like that, for for dogs. But in terms of, like, how do you get there? How do you get there too? Is it allergies? Is it something else? You have to do the three most important tests, which, you said, a fluorescein stain to make sure there's no ulcer, because if there's a scratch that's going to cause a tissue to be pink, you have to do an eye pressure, which sometimes is a little challenging. But there's different ways to take a pressure where you tap on the eye with different types of tools, and gives you like an estimate of what the pressure is inside the eye to make sure it's not glaucoma, because high pressures in the eye can also cause redness on the outside of the eye, and then a shimmer tear test, which is assessing the amount of tear production that the eye actually has. Because sometimes low tear production can also cause the eyes to be red because they just feel dry and irritated, kind of like standing in the middle of a desert and you're not able to blink like just imagine that it's really uncomfortable,

Jenifer Chatfield  17:03

that's miserable, super awful. Wow, yes,

Dr. Brittany Schlesener 17:07

all things really have to be done in order to kind of get to the diagnosis of allergies, if, or, you know, just just conjunctivitis, if you don't exclude all of the more serious things first. Then, like I said, I know it sounds scary, but there are blinding things that can happen, or painful things that can happen, so we need to make sure that they're being ruled out and addressed before we just, like, start assuming that's allergies.

Jenifer Chatfield  17:32

And then, okay, so let's say, let's say that this dog or cat has had, has, you know, maybe, maybe one or both eyes are a little bit redder than they normally. They just look irritated, inflamed. So I see like bilateral conjunctivitis, minimal ocular discharge, so maybe just a little bit of goops in the eye, open eyes, looking around, you know, normal pupillary light responses, all the things. Corneal stain is negative, so I don't see an ulcer, I don't see a scratch, nothing like that. Tear test, normal pressure testing, like inconclusive, basically. But everything else is fine with the with the pet, right? The ocular Support Unit is intact. As a veterinarian, I see people that will prescribe, in that situation, something to go home, right? So they'll do like drops, like antibiotic drops or antibiotic drops with dexamethasone to go home, right? Okay, so did you just make the ophthalmologist face? Thank you very much, because I see so many regular friends who are doing that. And I was raised up as a veterinarian at Texas A and M and also Dr wolf was sort of my guiding light for Opto for so long that I'm like, I fear steroids in the eye. So can you like, Why? Why do I have this healthy or unhealthy fear of steroids in the eye? It's

Dr. Brittany Schlesener 19:07

a healthy fear. That's a healthy fear. Because what I was saying earlier is, you know, when it comes to an eye specialist, we have magnifying tools, and so sometimes it looks like there's not an ulcer, but there could really be, like a pinpoint one that's really infected, and if you accidentally add steroids on top of that eye, it's going to make it a lot worse, and probably could put them at risk for losing that eye. And so when it comes to, like the combo antibiotic, steroid, like triple antibiotic, or BNP, or, you know, probably back, or whatever they want to call it, I can put on one hand the number of times I have prescribed that medication the last eight years, because it's in theory, people think, oh, yeah, well, there's a little bit of discharge, and it looks like past a little bit. So maybe an antibiotic, and there's some redness, and they're irritated. And so I'll put them on my anti. Inflammatory, because that steroid will help with that together. But unfortunately, the steroid at that concentration going into the eye several times a day can actually lower the immune system and put them at risk for getting infection. And if there is a small infection that's already going on, it's going to make it a lot worse. Okay,

Jenifer Chatfield  20:18

and this, do I remember this, right? Is this when, like, you can have a melting ulcer? Could you induce a melt? Right? You could?

Dr. Brittany Schlesener 20:30

You absolutely could. And there's some variation on, you know, what ophthalmologists kind of think about, a non steroidal, anti inflammatory like diclofenac or Ketorolac, yep. But there's some consistent literature that shows that any type of anti inflammatory could increase the risk of melting corneal ulcer, so I just don't take that risk. If they're previously on some type of anti inflammatory and then they get an ulcer, they're gonna stop that anti inflammatory until they get the ulcer figured out first. It's kind of a list of priorities,

Jenifer Chatfield  21:08

okay, so, so for a dog that sort of has something that we know for sure, like, let's say whatever, all of the boxes are checked to rule out anything of significance. And we know it's allergens. We know it's like seasonal like, allergens in the air. You know, listen, it's not their home, it's not their food, it's not, you know, the air at Lowe's, it's not when they go to the hardware store with their it's none of those things. It's just, I'm alive in the world, and I live in an area where, over seasonal changes, there's allergens in the air, right? Is the dog or cat getting any significant relief from that conjunctivitis? Do you think with an anti inflammatory, whether it's steroidal or non steroidal, or is the risk too great? Like, what's your opinion? What do you know?

Dr. Brittany Schlesener 22:01

That's a great question. Um, the thing about anti inflammatories in an animal that has allergies of some sort, even if it's mild, it's only going to be helpful for a short period of time. There definitely are situations like you're describing animals, like a little bit pink, a little bit of discharge, not squinting. You know those signs of super, super minimal and between risks and benefits there, there might be a higher risk of causing more problem. Okay, so, yeah, well, I

Jenifer Chatfield  22:30

because, I because I know the owners come in and the dog's eye is red, and now listen, the ones where I diagnose, I'm like, Oh, listen, your dog has a giant scrape across their cornea, right? Like, I can help with that, okay? Like, then I can do all the things and, and I love how, in the last few years, there's all of these sort of ancillary treatments to support just an antibiotic ointment in the eye, right? Like, we got all kinds of things to promote healing across the cornea. I can, like, I can do something with that. Or if I say, You know what this is like a eight year old dog. I see sort of a constellation of things happening here as I get the history. I think this dog is diabetic, diabetic. Maybe it's got glaucoma, you know? Maybe it's developing cataracts, ready, etc, other things. But it's really okay. I guess what I'm getting at is it's really okay for me to say, Listen, I know you brought your dog in. It's wonderful. Great. Good job. Gold star. The eyes are fine, right now. They look totally great. I think we're gonna let that go. Maybe a maybe a systemic and histamine or something would be safer and more effective for that dog, for that allergic conjunctivitis or No, not really.

Dr. Brittany Schlesener 23:49

I wish it was anti histamine that you're using regularly and consistently, Sure, definitely Okay, but, like, one time or two times isn't going to make a huge difference. No, but and then some people are in the thought process of using topical anti inflammatories like Pat a day. The problem is is there's not clear research in the veterinary community that shows that antihistamines on the surface of the eye is actually metabolized super well and actually very helpful. And so it's lubricating, which is nice, because if you're irritated and feeling dry, you know, that can help a little bit. But if you're talking about like the eyes are just a little bit goopy, a little bit irritated, you know, certainly causing them significant quality of life issues, then you can re, readdress it, or reassess it. If it's getting worse, you need to come back in. Then maybe you do need to consider type of some type of anti inflammatory therapy, or they're getting new allergy signs on their body. Maybe they need to see a dermatologist and actually figure out what the underlying allergy is. Is my dog has horrible allergies, and her the redness around her eyes is more minimal whenever I'm addressing the rest of her signs. So she gets baths three times a week. When she comes in from plank, she gets baby wipes on her paws, gets her whole face wiped. You're kind of reducing the allergen load, because usually pollens and other things are sticking around the eyes because they're sniffing around, and that's what's causing the chronic irritation. So if you're reducing the allergen load in their environment or on their body, that's going to usually have the greater benefit for them, okay, is, is my favorite thing to use if they then say that again, unscented baby

Jenifer Chatfield  25:44

wipes. Unscented baby wipes. Friends, no, I love that, because what I'm getting at is that, like, owners want to do something. I mean, that's why they sought care of the first place, for what we consider to be like, Come on, man, like this, minimal, but they want care. Great, like, but so it's not like we can't do anything, there are things we can do. Yeah, absolutely. And that that's, that's good to know, because I hadn't thought about that, to be honest, addressing all of those other issues, and that it would, would have a difference. So, so that's wonderful. Okay, so now let's get into kind of the nitty grit. So corneal ulcers happen? We treat those if they don't get out of control, if you probably don't see a lot of them, unless they get out of control, what are kind of the other things you alluded to, the autoimmune diseases.

Dr. Brittany Schlesener 26:30

So for if we rule out the ulcers, like you said, we treated those, we rolled out glaucoma with our tonometer as best we could, then we're getting to other like autoimmune diseases and dogs, more commonly, conjunctivitis is caused from dry eye disease. It's actually really common, and that's where the lacrimal glands that sit kind of in the inner corner or outer corner of the eye are just not producing as much tears, and 70% of the time, their immune system, for some reason, attacks those glands. Doesn't necessarily affect the rest of the body. When I say autoimmune disease, it doesn't mean they're gonna, you know, need to be on systemic treatment. Sometimes it just needs to be an eye drop twice a day. And the great news is, is it super treatable? What you're using is a medication called cyclosporine, or tacrolimus, right on the surface of the eye. And after a couple of months of using it, it'll dampen down the immune system that's kind of going after those glands and improve the tear production, which is really great. And so when you're thinking about dog with like pinkish eyes, and you've rolled out ulcers, you've rolled out glaucoma already, and they're just kind of left with conjunctivitis. It's going to be more commonly a tear film problem in dogs, or like a underlying allergy issue in the environment, which, you know, there's no cure, really, for both of those. And that's kind of a bummer, but, but I have dry eye disease myself, and I can tell you from experience, it's awful. It truly feels like you're standing in a desert with sand in your eyes, and you can't blink. And no, it's just so drying. And so you just, I really think that when it comes to dogs having those boogery eyes, you know, it is a quality of life thing. They probably feel really uncomfortable. And so if you can provide them with something, even just an anti like a immuno modulatory drop, the cyclosporine drop for the dry eye disease, do you feed them twice today? Yeah, yeah. So you can totally give them a drop twice a day, breakfast and dinner. You know, it's not super challenging for that type of treatment.

Jenifer Chatfield  28:43

Yeah. I mean, I 100% agree. But is there, is it wrong? Like, as soon as you say, like, KCS, the thing that pops in my head is a picture of a German shepherd. And I don't know if that's still true or not, that, for some reason I remember this being common in German Shepherds. Is there a breed predilection for KCS?

Dr. Brittany Schlesener 29:04

Uh, yeah. Usually Cocker Spaniels, uh, poodles, um, typically the flat faced dogs like Frenchies and Bulldogs, um, yeah, Frenchies.

Jenifer Chatfield  29:16

Now, listen, you're new. You're new to the chat room. We don't disparage the French. We don't disparage the French Bulldog at all because, because I have one, but,

Dr. Brittany Schlesener 29:26

oh, they're the reason why I have a job,

Jenifer Chatfield  29:30

right? They're supporting all ophthalmologists, no, but I know they are adorable. Thank goodness. Cosette doesn't have any of those sort of autoimmune related issues, or actually, any of the issues that are common in French Bulldogs. She's a well bred frencher, but, but that's interesting. So does that mean that all these doodles that are running around, like, are, you know, they, you know, you could have an issue. It could,

Dr. Brittany Schlesener 29:59

yeah, and. Um. And so the, honestly, the breeds that I have just listed are the ones I most commonly see, and also pugs, pugs as well.

Jenifer Chatfield  30:07

Yeah, the puglets, yes, yeah. Um, okay, so, so that's interesting, but I do love that it's treatable, because I do, like, you know, 25 or 30 years ago, it was like, oh, it's KCS, you know, we just, I mean, we knew what it was and whatever. I just think that treatments were not as affordable and readily available, you know, on the market as they are now. So

Dr. Brittany Schlesener 30:31

the German Shepherd, right? What's that? You know, German Shepherd is that the pre dimension, so they typically get something called Panis, which is also an autoimmune disease, but it's not, it's not KCS. It's a type of autoimmune disease, but it's treated the same way. Yeah. And the reason I'm bringing this up is because sometimes people have larger breed dogs, and it's really hard to give them eye meds, even if, like, I have a little stuffed animal here, show everybody how to give an eye medication, you have to use gravity to your advantage. So you just lift up their chin like that. You don't have to lift up the whole body, but lift up the chin and their eyes just naturally want to open up. And you just, you just drop it in. You just put, take a little eye dropper and drop it in. I know that sounds super easy because, you know he's not wiggling around, but gravity can be really, really helpful. And so even in those situations where you have dogs like German shepherds or, you know, wiggly Frenchies, and it's hard to get drops in, there's new medication options. There's actually these little cyclosporine implants that I can just do, like a quick little couple minute procedure, and I just put it right here underneath the eyelid, and it lasts for like, six months, and so you don't have to do any I meds. Then it just stays there for but it's super you do have to replace them, but yeah, in terms of cost, they're really not that much more expensive to do that little procedure versus cost of the drops that you're having to do twice a day every single day. So,

Jenifer Chatfield  32:00

but that's wonderful, because also I do worry, so, you know, when I have a little shit Sue or something, and I, you know, I diagnose them with some sort of metabolic disease, right, like, like diabetes, or, you know, something like that, and they develop those ophthalmological sequelae. And here now I have an owner who now spends most of their relationship with their dog engaging with them to give them meds. Right? They're either injecting them or they're giving a pill, or they're dropping stuff in their eyes, or they're wiping their eyes, or whatever. And so I do feel like sometimes some of these things, especially if they're long term, like chronic, you know, persistent, lifelong things, they totally impact that relationship between the owner and their and their dog, and not always in a good way. So I just worry about that, you know, with eye stuff, and I feel, I feel like we're gonna see a pet. Are we gonna see a pet? Oh, look,

 Dr. Brittany Schlesener 32:59

her. She's being impacted by this chat because she's not getting attention.

Jenifer Chatfield  33:04

Yes, exactly, right. And so I do worry, and I do think that sometimes why we don't get as good a compliance for these persistent issues as we might otherwise is because they're just like, I just don't want to fight with my my pet anymore. So they were doing so that's a wonderful, like solution. I didn't even know about that. Yeah, yeah, no, it's fairly

Dr. Brittany Schlesener 33:27

new. I am. I love that you're talking about this, because I think that when it comes to owner compliance, you know, if they feel like their relationships being impacted because of this potentially negative interaction, they're not going to want to do it, no. And they have the best they have the best intentions. You know, the owners that I see that they they're bringing their pets in because they care about them, and that's right. Want them to feel good and and feel better and, and so sometimes what I recommend is that they get this extra special treat. So for example, like churros. Or for my cat or my dog really likes, like, freeze dried treats, like vegetables and fruit. I don't know she's special, okay, but she only, she only gets those special, special treats when she gets her medications. Otherwise, she never gets them. And so when I get that bag out, she's like, Oh, I might be getting eye drops, but I'm getting this extra special treat, and so it makes it a lot easier. And she's excited about it, you know, yeah,

Jenifer Chatfield  34:30

like, does she hear the freezer door open? Then all of a sudden, her eyes bug out, like, I'm ready, Mom, I'm ready. I'm ready. As

Dr. Brittany Schlesener 34:38

soon as I get close to the refrigerator, she's like, oh, yeah, that's

Jenifer Chatfield  34:41

right, you have to leverage the high value treat. You must leverage the high value treat. Okay, so, so, so that's, that's wonderful. So, friends, if you have a dog out there that's diagnosed with some sort of autoimmune Opto issue, talk to your vet, get maybe to an ophthalmologist that can do these. Um. Um, you know, what would you call it? It's a cyclosporine it's an implant, or an implant, yeah, yeah. So you get that cyclosporine implant if it's appropriate for your pet, yada yada, all the things, but, yeah, that's wonderful. Wow. That's, I mean, like, winning today. That's fabulous. Okay, so that's, like, autoimmune stuff. And then there's a couple things that float around. And I know this is a little bit a little bit disjointed conversation, but that's okay, because I love having an ophthalmologist on so the other stuff that that we see in general practice, a lot, we'll see diabetic dogs and cats, but I feel like in in cats, and maybe it's because of how they can resolve diabetes with weight loss, like we don't see as much, but in dogs. So I once heard a statistics, a statistic about cataract development in dogs following diagnosis of diabetes, and it's so high. I hate to say it out loud and sound silly, but so how cataracts are common in dogs after they have the onset of diabetes, right? Yeah,

Dr. Brittany Schlesener 36:07

unfortunately, they happen pretty quickly. So there's one paper that shows it's almost 90% of dogs within a first year of being died. Okay,

Jenifer Chatfield  36:17

so my statistic wasn't crazy, like it was a little off. So I had, like, 80% of dogs will develop cataracts within six months of diagnosis of diabetes or something like, that was what I remembered from some lectures. Yeah, yeah. So it's even worse, worse though, 90% within the first year was what one paper said it was. 

Dr. Brittany Schlesener 36:39

It was like a little bit over 85% but, yeah, but that's still a majority, and you have them perfectly regulated, and they're still going to develop potentially blinding cataracts and and owners, I think, you know, they see that their animals visions declining, and then they're bumping into things, and then they might be Falling into the pool, because they live in Florida. What scares them? Because they're like, oh my, because my dogs are framing Am I holding on to too hard? No, you're not. Because animals are so amazing and they have a better sense of hearing and a better sense of smell than we do. You just need a little short period to kind of figure it out. You have to watch them make sure they're not around the pool for a little bit until they sort it out. But dogs are so brilliant, and they even have research studies that show that they can memorize the layout of a maze or your house just don't move the furniture around, and they can still have a very, very good quality of life, even if they can't see and if you're one of those, people that just really, really wants to provide them with vision. Again, cataract surgery is an option, just like it is in human medicine, and so it is something that you can definitely manage, you know, just help them learn their new environment, not being able to see and giving them the support and love that they need. And sometimes that's like, they're not able to find the ball the way that they used to. That's okay, you will, you know, get, get the same ball that they loved, and add a little bit of, like, a scent to it. Now they can find it, you know. Or, or get one of those. I know it sounds funny, but if your dog really likes this ball, get a cat toy that makes chirping noises, because now they can find it. And so there's different ways where you can, like, improve their environmental stimulation and still make sure they're happy, even if you can't afford cataract surgery. Yeah,

Jenifer Chatfield  38:31

I think that's wonderful. We actually had one of our older dogs. She developed cataracts when she was, I think, 12, and we did do bilateral lens replacement for her, and it was amazing. Now, listen, the post op care is not for the faint of heart, though, like those drops are going in every hour, every two hours. I can't remember. It was crazy the so it's just like when a human has cataract surgery, if not, maybe more intense. And so you do have to prepare yourself for that post op, but it's just in the immediate post op period that you have to do it. But it was wonderful for her. She did go from like you're describing, like you throw the ball, and she just sit there and look at you, and she was a Border Collie, and that was not cool. And so, yeah, so I'm really, really pleased that we were able to provide that for her, because she went right back to it, you know. And I think we didn't realize how much vision she had lost over such a period of time until one day to the next, she could see again. It was really amazing. It was it was really amazing. And I, and I would recommend it if there's a way that you can do it, to talk with an ophthalmologist about lens replacement surgery for your dog, just talking about it doesn't commit you to doing it, because it may not be right for. For your pet or your family, but you don't know that until you explore the option. And so I recommend everyone with if their dog develops cataracts, that you go see an ophthalmologist and find out what the options are, because I do think they're there. The other thing, though, is that can't those cataracts? Can't that lens slip and produce glaucoma and then it's uncomfortable, right?

Dr. Brittany Schlesener 40:23

Yeah. So that's a really great point. When it comes to cataracts in general, they're not really supposed to be there. So the immune system in an animal actually formed before the the lens forms. And so what that means is, is that the body doesn't detect, like the lens cataract material, whenever it starts leaking into the body, until it gets detected as foreign material. I'm so sorry. My cat is like screaming at me. I need to let her out of this room. Okay,

Jenifer Chatfield  40:58

we're going to pause for technical support. Well, Dr Brittany lets the cat out, not of the bag, though, just of the office or of the room, because she she couldn't hear herself think over the cat, ever so demanding that kitty

Dr. Brittany Schlesener 41:17

and now my dogs come in.

Jenifer Chatfield  41:18

Oh, that's awesome. We love it. It's life, life of a veterinarian. Okay, so we were talking about the cataract, you know, oh, with the toy, look at that. I love that. Oh, okay, there we are. Friends. Love it. Everyone's welcome in the chat room, even a German Short hair with a to wait. Oh, look. Oh, look, Mom, I'm here. Oh, and who is this? You got to tell us.

Dr. Brittany Schlesener 41:49

This is Belle. She is the allergic mess that has all the treatments like Bellevue spells, yes.

Jenifer Chatfield  41:56

Oh, my God. Love it. I love it. Okay, so, Belle, we were just discussing cataracts and dogs. Did you have anything to contribute? No, we love it. You should never apologize for your pets.

Dr. Brittany Schlesener 42:10

They're so great. I love them. Um, yeah. So when it comes to cataracts, it can cause a lot of secondary issues. So the immune system starts to I see those lens proteins that are leaking out the eye because the cataracts are advancing or advanced very quickly from diabetes development, and that's going to cause inflammation, that can cause kind of the pink looking eyeball appearance as well. And over time, if there's a lot of inflammation, it can cause glaucoma, because thigh itself is almost like a balloon, and there's a constant production of fluid in the eye and drainage. And if, for some reason, the drainage outflow is impacted, for some reason, like inflammatory cells that are being caused that secondary to that cataract, then the pressures in the eye are going to go up. That can also cause the fibers that hold the lens in place to break down and for the lens to shift around, like you suggest, like you talked about, it can also cause bleeding in the eye, or the retina that's in the back of the eye that allows the pet to take in light and see to detach as well, and all of these things are, you know, quite serious I'm talking to you about. And the thing is, is that even so that's without cataract surgery, and it's really rare, it's not super common. But even if the cataracts are there and you don't want to do surgery, it's important to see somebody, because you do need to get them started on some type of eye medication at least twice a day, possibly to try to avoid those painful things from developing.

Jenifer Chatfield  43:47

Yeah, and I think that's the thing too, is that I think every owner, while lens replacement surgery might not be right for their pet for a multitude of reasons, they still don't want their pet to be uncomfortable, right? Like to have like, that migraine headache behind their eye, like 24/7 so no one wants that. And so again, I encourage everybody, well, I do almost every episode, talk to your veterinarian about these things, because it doesn't mean that you're committed, that you're gonna do it. We're not going to judge you. We're just going to share with you the information we have, because we're also interested in making your your pet as comfortable as they can be, and we may have ways to do that that fit more appropriately with your family and with your pet and your lifestyle and but you won't know unless you ask, right? And that is the thing. And if you don't trust that, your veterinarian will have that conversation with you in a meaningful way. Hey, as I always say, get a new one. You should trust your veterinarian, and if you don't, you should get a new one. There's a lot of us get a new one that you trust because. Because, because otherwise, you're just wasting time. Yeah, okay, so, so we have talked about a number of things, and we didn't get through all of it. So I'm just gonna right now, probably boldly, like you should never do, I'm gonna say out loud to the universe that I really hope that Dr sparkles will come back on the podcast, because I feel like we we neglected our feline friends significantly. Today, we were focused on the thing. And honestly, it's just because, like, Yes, Dr Jen, the vet, is tired of hearing people talk about pink eye like it's a thing in dogs, because it's not. So is there any so I hope we'll have you back. We'll talk about more of these issues. And friends, if you have a specific eye issue that you want to us to talk about, send me an email. But is there any one thing, because we're going to kind of wind it up, because everybody doesn't have all day to talk about eyeballs, and I know Dr sparkles has to get back clearly to taking care of Bell and and the the loud kitty, although we didn't hear the cat. No, no, no, we didn't hear kitty. So that's okay. But is there? If there was one or two things that you would want everyone, not just veterinarians, not just pet owners, but everyone to understand about veterinary ophthalmology. You know, What? What? What might that thing be? If you just wish everyone knew, I know I'm kind of putting her on the spot, friends,

Dr. Brittany Schlesener 46:37

that's a great question. Okay, I got it all right. Okay. So unfortunately, when it comes to eyeballs, not a lot of people are comfortable with it, and that's okay, like not every veterinarian had that strong background, and that's okay. And so if they're asking you to go to a specialist, that's just because they care about you too, and they they want the best thing for you and for your pet. And I know that can sometimes be a little bit frustrating, because you can do a vet, and maybe you trust your vet a lot, but the fact that they're like, you know, I've reached the level of, you know, what I my knowledge base and what I know, and I need you to go to see somebody else that is awesome, that's honest there, that somebody you can trust. And I think that's just really, really important, is that you can't expect your veterinarian, even though you love them and you've been with them for 20 years know everything about everything. That's just not possible. And so if they're recommending an ophthalmologist or any, maybe a different specialist in some of their fashion, that that's great, and you should any, I guess, give them some grace and let them, let them not know everything about everything. Well, I think

Jenifer Chatfield  47:43

that's wonderful. And so, yeah, you're you're absolutely right if you trust your veterinarian. Trust them when they say it's time for you to see a specialist. And here's the one I want you to see. Trust them at that point as well, because they are looking out for for you and your pet. And I think that's true. You know, that's, that's a really, I wish other people knew that too. So that's a good one. That is it. Yeah, that's a great one, folks. So, yeah, especially in this day and age there. I mean, there are Veterinary Specialists in so many different fields and and it's true, like the ophthalmologist, the just the tools that you guys have. You know, no regular veterinarian has all those tools. We just don't. They're too expensive. And also we, you know, they only have two eyes, folks, they only have two eyes. So, yeah, so when your veterinarian recommends you go see the the ophthalmologist, please do it and don't. Don't do it like next month or next year, or, you know, do it in the in the time frame that they're recommending. Yeah. So thank you so much for joining us. Dr Britta, yeah. Dr, Brittany Schlesinger from fetch specialty and veterinary hospital in Brandon, Florida, and a proud Aggie vet. Yeah. Thanks so much for joining us today, folks. That's all I have for you. I am. Dr, Jen the vet, and I'll catch all on the next episode. I'm gonna go wipe my eyes.

Voice over 49:27

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Jenifer Chatfield  49:36

pack CE code for this episode is CC, 220092