Corneal Ulcer in Bulldogs and French Bulldogs
Corneal Ulcer in Bulldogs and French Bulldogs is very common, it is concidered the #1 eye problem in bulldogs. It is diagnosed in every phase of the aging process, more often in mature adults and senior bulldogs but also in bulldog puppies.
While trauma is the main cause of corneal ulcers in most breeds, it is NOT so in bulldogs
Due to their squashed skull, excessive skin folds, bulgy eyes, tear production deficiencies, and eyelid problems, the brachycephalic breeds such as the English bulldogs and French bulldog chances of suffering from corneal ulcers are much HIGHER than in most other dog breeds.
Corneal Ulcer in Bulldogs and French Bulldogs ANATOMY
Your bulldog cornea is transparent windshield-like that is stretched over your bulldog eye. Because of its transparency, you might find it easier to observe your bulldog cornea by looking at it from the side (i.e., profile position).
The cornea is the part of the eye that we place eye drops on
BULLDOG CORNEA: LIGHT & IMAGE:
Bulldog and French bulldog cornea transparency allow light to enter the eye and travel through the inner eye chambers and lens. The cornea allows the light to travel to the back of the eye where the retina and optic nerve are situated and where the light is translated into an image.
BULLDOG CORNEA EYESIGHT:
Any reduction of corneal transparency will impede the light’s ability to reach the nerves placed in the back of the eye, thus immediately affecting your bulldog eyesight.
BULLDOG CORNEA: 3 X LAYERS
The bulldog cornea is made from three specialized layers
- EPITHELIAL: the first layer outermost corneal layer
- STROMAL: the second layer sandwiched in between the superficial epithelial and the posterior deep descement layer
- DESCEMET & ENDOTHLUM: the deepest most posterior layer
BULLDOG CORENA TEARS:
The bulldog cornea is bathed and “lubricated” with tears, the tears film helps provide nutrients and oxygen to the cornea.
Corneal Ulcer in Bulldogs and French Bulldogs TYPES
BULLDOG EPITHELIAL CORNEAL ULCER
The bulldog epithelial corneal ulcer is the most common type, the least serious, and usually the one that heals quickly with proper treatment
BULLDOG STROMAL CORNEAL ULCER
A Bulldog Stromal Corneal Ulcer is deeper and easier to see, its usually cloudy looking
BULLDOG DESCEMET CORNEAL ULCER
bulldog Descemtocele ulcer is the deepest one and the most serious, without urgent care it could perforate and your bulldog could lose its sight permanently
Corneal Ulcer in Bulldogs and French Bulldogs CAUSE
For most breeds, trauma is the #1 cause, NOT SO FOR BULLDOGS
In contrast to other breeds, the most common causes of bulldog corneal ulcers are:
BULLDOG CORNEAL ULCER: ENTROPION
Inward inversion of the eyelids due to the breed of excess facial skinfold, the lid and eyelashes rub, irritate and injures the corneal
BULLDOG CORNEAL ULCER: TEAR PRODUCTION
Bulldog KCS is an Immune-mediated condition common in the breed that affects tear production. Lack of tear will void the corneal from essential nutrients, oxygen, and lubrication which brings on chronic corneal disease and ulceration.
BULLDOG CORNEAL ULCER: ABNORMAL EYELASHES
Abnormal eyelash growth such as distichiasis, trichiasis, and ectopic cilia that encounter and rub the cornea cause repeated injury.
CORNEAL ULCER IN BULLDOG: TRAUMA
- Running into a rose bush
- Cat scratch
- A chemical injury such as soap or shampoo
- Accidently rubbing the eye due to allergies such as bulldog food allergy and atopic dermatitis
- Rubbing the eyes due to bulldog skinfold dermatitis
BULLDOG CORNEAL ULCER: CHERRY EYE
Cherry eye is common in French bulldog and English bulldog puppies. A large, protruded cherry eye could rub the cornea and also affect tear production
FRENCH BULLDOG CORNEAL ULCER: EXPOSURE KERATITIS
Due to their flat squashed skull, their eyes bulge out and the eyelid fails to completely close leading to abnormal corneal exposure and tear film problems.
ENGLISH BULLDOG CORNEAL ULCER: OTHER
- HORMONAL: Endocrines diseases such as diabetes, hypothyroid, and Cushing’s
- VIRAL & BACTERIA
- CORNEAL DYSTROPHY
- FACIAL NERVE PARALYSIS: will stop blinking thus creating tear film problems
Corneal Ulcer in Bulldogs and French Bulldogs PRESENTATION
BULLDOG CORNEAL ULCER: SEVERE PAIN
Pain typically is manifested by:
- Blinking & Squinting
- Tearing & Discharge
- Rubbing & Pawing
- Shut often swollen eyelids (closed eye)
- Other: change in appetite and other behavioral abnormalities associated with PAIN
Bulldog and French bulldog corneal ulcers can be very painful
BULLDOG CORNEAL ULCER DISCOLORATION
White, opaque, vascular, pigmented, red, hemorrhagic
BULLDOG CORNEAL ULCER WOUND/PUNCTURE
Visible “hole”, puncture, concave lesion
Corneal Ulcer in Bulldogs and French Bulldogs DIAGNOSIS
BULLDOG CORNEAL ULCER: DR. EXAM:
Visual examination looking for:
1. BULLDOG CORNEAL PAIN:
Evidence of ocular discomfort, squinting, abnormal blinking,
2. BULLDOG ITCHING & DERMATITIS:
Evidence of skin irritation that can trigger rubbing & pawing, redness, skinfold dermatitis, otitis
3. BULLDOG ENTROPION:
Evidence of underlying traumatic causes such as abnormal eyelids
4. BULLDOG ABNORMAL EYELASHES:
Usually requires a magnifier and special lamination
5. OTHER BULLDOG OCULAR DISEASES:
Looking for evidence of ocular disease such as glaucoma and uveitis including ocular discoloration & bulging consistent. The diagnosis will require tonometry (measurement of the intraocular pressure)
BULLDOG CORNEAL ULCER STAINING
Using a special corneal stain and ultraviolet light we can detect ulcers that might be difficult to deduct on an exam.
The fluorescein stain test is the most common bulldog cornea ulcer test performed
BULLDOG CORNEAL ULCER SCHIMER TEAR TEST
A tear production test should be done on any bulldog presented with a cornea ulcer
BULLDOG CORNEA ULCER CULTURE & CYTOLOGY
A deep more advanced corneal ulcer or non-healing one will require a sample for culture and cytology.
Corneal Ulcer in Bulldogs and French Bulldogs TREATMENT
Treatment depends on the type of ulcer and the underlining cause
BULLDOG CORNEAL ULCER TOPICAL TREATMENT
1. BULLDOG CORNEAL ULCER TOPICAL ANTIBIOTIC:
ophthalmic antibacterial ointment or drops placed a few times daily
2. BULLDOG CORNEA ULCER TOPICAL SMASM & PAIN RELIEF:
Ophthalmic atropine drops or ointment can help with ocular pain and discomfort
3. BULLDOG CORNEAL ULCER LUBRICATION & TEAR PRODUCTION
Drops or preferably ointment should be used for excessive exposure, saline, hyaluronic acid topical ophthalmic are examples
BULLDOG DRY EYE TOPICALS: lifelong drops/ointment to help maintain adequate tear production
4. BULLDOG CORNEAL ULCER SERUM & PRP
Autologous serum eye drops and PRP (platelet Rich Plasma) can also help heal cornea ulcers
5. BULLDOG CORNEAL ULCER SKINFOLD ANTISEPTIC WIPES
It is important to recognize the cause & effect of itch and painful nasal or facial bulldog skinfold dermatitis and bulldog corneal ulcers. The proximity of the infected folds to the eyes means that an itch, pawing, rubbing of the infected skinfold can lead to an accidentally injured cornea
Preventic care of your bulldog skinfold dermatitis can prevent a more serious and costly corneal injury. Using Dr. Kraemer’s V4B Antiseptic Bully Skinfold XL wipes is the ideal preventive and maintenance therapeutic remedy for this common bulldog condition
6. BULLDOG CORNEA ULCER SYSTEMIC RX
PAIN RELIEF: Oral NSAID anti-inflammatory and pain relief might be needed especially for bulldogs with deep stromal and descemetocele corneal ulcers
ANTIBIOTICS: oral antibiotics are not necessary for superficial ulcers but often are subscribed to deep stromal and/or descemetocele corneal ulcers
7. BULLDOG CORNEA ULCER SURGERY
GRID KERATECTOMY: Surgery might be necessary for indolent ulcers to help remove detached or poorly healing corneal epithelium
CORNEAL GRAFT: might be necessary for corneal descemetocele
ENTROPION SURGERY: is urgently needed when the corneal ulcer is caused by your bulldog’s inward eyelid rotation
TEMPORARY ENTROPION SURGERY: for bulldogs suffering from rotating eyelids (entropion) due to spasmatic pain or as an emergency relief till permanent entropion can be scheduled. This procedure can be done in an emergency set up in seconds and without anesthesia (or if needed mild sedation)
ABNORMAL EYELASH SURGERY: to help remove an eyelash(s) that are growing in the wrong direction or inside the eyelid. It is usually done with liquid nitrogen freezing (cryo freezing)
BULLDOG CHRRY EYE SURGERY: some cheery eyes can also rub the corneal and create an injury. Bulldog cherry eye can also impede tear production, thus dry eye.
Bulldog and French Bulldog Corneal Ulcer TIPS & WARNINGS
BULLDOG CORNEAL ULCERS TIPS
Bulldog ulcer tip #1 RESTRAIN: place a buster collar to prevent any further injury
Bulldog ulcer tip #2 R/C EXAM: r/c exams are critical to confirm healing, they usually involved a cornea negative staining
Bulldog ulcer tip #3 OPHTHALMOLOGIST: referral to a specialist might be required for a nonhealing corneal ulcer or a severe deep, melting, or perforating one.
Bulldog ulcer tip #4 STEROID: after the ulcer healed (negative stain) we often use topical ophthalmic steroids to help reduce the overgrown corneal blood vessels common to some healing ulcers.
Topical steroids are also used for bulldog dry eyes.
BULLDOG CORNEAL ULCERS WARNINGS
Bulldog ulcer wanring#1 ATROPINE: in addition to relaxing the spasm the atropine ophthalmic drops will also dilate your bulldog pupils, thus you need to keep your bulldog away from bright light.
Bulldog ulcer warning #2 STEROID: Ophthalmic topical steroids are often used for various ocular conditions. It should only be used after the ulcer healed, it should NEVER be used on a live active corneal ulcer since it inhibits healing and could cause serious complications.
If your bulldog seems worse (squinting, blinking, discolored cornea, etc.) after applying any topical ophthalmic that contains a steroid (look for words like “pred”, “dex”, “hydro”) immediately discontinue and see your vet as soon as possible
Bulldog ulcer warning #3 EMERGENCY: Corneal ulcers are an emergency, any time your bulldog is squinting or the cornea seems discolored, vascular or opaque see a veterinarian right away.
An Ounce Of PREVENTION Is Worth A Pound Of CURE
*This guide was compiled courtesy of Dr. Kraemer, a “must-read” manual for any current or future bully owner