What Is Proptosis in Dogs?
Proptosis in dogs refers to the sudden displacement of a dog’s eye from its socket, with the eyelids unable to retract the eye back into place. It is deemed a medical emergency due to the eye’s susceptibility to infection and the immediate risk of blindness once it is exposed to dryness. This condition is predominantly observed in short-nosed breeds, known as brachycephalic breeds, such as Pugs and French Bulldogs, whose eyes naturally protrude more from the sockets compared to other breeds. Nonetheless, proptosis can occur in any dog following head trauma.
Symptoms and Types
- Eye protruding outward from the eye socket
- Whining, pawing at the eye, restlessness, or attempts to bite
- Severely red eye
- Dry cornea, possibly with an ulcer
- Ruptured eye muscles
- Potential rupture of the optic nerve
- Possible presence of blood inside the eye
- Potential eye rupture, indicated by a hole, deflation, or leakage
Causes
The primary reason for proptosis in dogs often stems from trauma, typically as a result of being hit by a car or engaging in a dog fight. Such incidents can lead to head injuries, including skull fractures. Dogs that have experienced proptosis previously are more prone to a recurrence, as the eye muscles responsible for holding the eye in place may have been weakened.
Brachycephalic breeds, known for their short noses and bulging eyes, are particularly susceptible to proptosis. Moreover, excessive physical pressure on the neck or head, such as through scruffing or the use of a choke collar, can trigger proptosis in short-nosed dogs.
Diagnosis
If your dog experiences proptosis, it’s crucial to promptly seek veterinary assistance. The sooner your dog receives medical attention, the higher the likelihood of preserving the eye.
Upon examination, your veterinarian will assess your dog’s protruding eye and conduct eye tests to evaluate the extent of the damage and any underlying injuries, depending on the cause of the proptosis. The assessment typically involves examining light reflexes, eye pressure, and searching for signs of corneal injury.
In cases where proptosis stems from trauma, your vet may suggest additional diagnostic procedures like skull and chest X-rays, blood tests, CT scans, or MRIs to detect potential serious injuries associated with the incident.
Treatment
When determining the most suitable approach for treating proptosis in dogs, it’s essential to take the prognosis into account. Dogs with a more favorable prognosis for retaining vision post-surgery typically include short-nosed dogs with minimal trauma, those exhibiting normal eye reflexes, and those receiving immediate treatment.
However, if a dog presents with a ruptured eye, internal bleeding within the eye, rupture of three or more eye muscles, or nerve damage, there is a heightened risk of chronic pain and blindness even after surgery. In such cases, your veterinarian might advise surgically removing the affected eye for the dog’s well-being.
Globe Replacement of Eye
When a veterinarian advises the replacement of the eye, the procedure is known as either globe replacement or temporary tarsorrhaphy. Depending on the surgeon’s preference, the dog will either be fully anesthetized or heavily sedated during the surgery. The area around the surgical site is shaved and prepared surgically, and the eye is delicately repositioned back into its socket. Subsequently, the eyelids are sutured together to firmly secure the eye in its correct position.
Options for Eye Removal
In situations where the surgeon suggests removing the eye, there are two alternatives.
Enucleation
Enucleation involves the removal of the eye while the patient is under anesthesia. The surgeon then sutures the eyelid closed. This procedure usually offers rapid relief from pain post-surgery. However, for the dog’s lifetime, the eye will appear closed, and the surrounding area will appear sunken.
Prosthetic Eye
If the pet owner opts for a prosthetic eye, they must seek a referral to a veterinary ophthalmologist. While the pet is under anesthesia, the veterinary ophthalmologist removes the internal contents of the eye and inserts a prosthesis, resembling a black ball, into the remaining eye socket.
Although the prosthetic eye doesn’t restore vision, it maintains the appearance of an eye, allowing the eyelids to open and close. Following the procedure, the eye may appear dark or cloudy. Despite relieving the pain associated with proptosis, ongoing eye care, such as administering eye drops, might be necessary. Additional surgery may also be required to properly position the artificial eye.
Recovery and Management
For both types of eye removal surgery, the surgeon might prescribe an anti-inflammatory pain reliever and optional antibiotics. It’s important to ensure your dog wears an e-cone or recovery collar throughout the entire recovery period to prevent any disturbance of the delicate stitches during healing. When walking your dog in the future, use a harness instead of a collar to minimize the risk of proptosis recurring.
After surgery, you may observe some swelling, bruising, and the seeping of red-tinged fluid at the incision site, which should diminish within a few days. However, if you notice increased redness, swelling, bleeding, cloudy discharge, or heightened pain, contact your veterinarian promptly.
Recovery for Eye Repositioning or Prosthesis Placement
Following the repositioning or replacement of the eye, your dog may require frequent administration of eye drops. These drops may include those to keep the eye dilated, antibiotic drops, and, if needed, drops for glaucoma. Anticipate a follow-up appointment in a few days, with another scheduled in two to three weeks for the removal of stitches.
Recovery for Enucleation
After the eye is removed, there is no need for administering any eye drops. Plan for a follow-up appointment in 10-14 days for the removal of stitches.
Prevention
Brachycephalic dog owners must remain vigilant to prevent their pets from encountering certain situations: head injuries, dog fights, and pressure on the neck (like scruffing, tight hugging, or the use of choke collars). It’s essential for these dogs to wear a harness during walks, not a collar.
For all dogs, irrespective of breed, pet owners should take measures to avoid dog fights, head or eye injuries, and excessive pressure from choke collars.
Proptosis in Dogs FAQs
Is it possible for a dog to survive with proptosis?
Although a dog could technically survive with proptosis, the condition is highly painful, resulting in a poor quality of life for the animal.
Can a dog's proptosis resolve without treatment?
Since the eyelids fold back and obstruct the eye from returning to its socket, proptosis never resolves spontaneously. Urgent surgery is necessary to correct this condition in dogs with proptosis.