CORNEAL ULCERS

Definition

The cornea is the transparent, shiny membrane which makes up the front of the
eyeball. Think of it as a clear window.  To understand a corneal ulcer,
you must first understand how the cornea is constructed.

The cornea is comprised of three layers. The most superficial layer is the
epithelium.  This layer is comprised of many very thin layers of
cells.  Below the epithelium is the stroma, and the deepest layer is
Descemetís membrane.  Because all of these layers of the cornea are clear,
it is not possible to see them without special stains which colour particular
cells and highlight them when looked at with a microscope. 

An erosion of few layers of the epithelium is called a corneal erosion or a
corneal abrasion.  A corneal ulcer is an erosion through the entire epithelium

and into the stroma.  If the erosion goes through the epithelium
and stroma to the level of Descemet's membrane, a descemetocele exists.
If Descemet's membrane ruptures, the liquid inside the eyeball leaks out, the
eye collapses and irreparable damage can occur.

Mechanism of occurance

There are several causes for corneal ulcers in dogs.  The most common is
trauma.  An ulcer may result from blunt trauma, such as a dog rubbing its
eye on the carpet, or due to a laceration, such as a cat scratch.  The
second most common cause is chemical burn of the cornea.  This may happen
when irritating shampoo gets in the eye.

Less common causes of corneal ulcers include bacterial infections, viral infections,
and other diseases.   These may originate in the eye or develop secondary to disease

elsewhere in the body.  Examples of other diseases include Epithelial Dystrophy (a
weakening of the cornea which can be  inherited in breeds such as the Boxer),

Keratoconjunctivitis Sicca (drying of the cornea due to abnormal tear
formation), which occurs in breeds such as the West Highland White Terrier and
diseases of the endocrine system (diabetes mellitus, hyperadrenocorticism, and
hypothyroidism).

The Andys Veterinary Clinics

The Andys Veterinary Clinic, Loresho, Nairobi

The Andys Veterinary Clinic, Ngong Road, Nairobi

The Andys Veterinary Clinic, Nyali, Mombasa

Euthanasia and Grief Management

Sometimes, after receiving a terminal diagnosis for a pet, the "waiting" time is the most painful time. Grief is a daily bittersweet experience and it is common for people, after receiving a terminal diagnosis, to experience a wide range of emotions. While grief is often considered to be something one experiences after the loss of a pet, it can also be experienced during this window of time during terminal illness.

Dealing with the loss of a pet is never easy. When dealing with euthanasia, or sudden loss due to an emergency illness or injury, the decisions that must be made and ultimate loss of the pet bring up a lot of conflicting and difficult emotions. When children are involved, special considerations must be made to help them understand what is going on and how to deal with pet loss and grief.

The five stages of grief include:-

1. Denial - This can't be happening to me/my pet!
2. Anger - Why me? This isn't fair!
3. Bargaining - If I could just have more time, find the best cure, do something to change the outcome.
4. Depression - The grief and sadness can be overwhelming.
5. Acceptance - My pet is now in a better place.

Guilt is often another component of this process; could the illness have been prevented or diagnosed earlier for a better outcome? Have all diagnostics and treatment plans been evaluated?
When faced with losing a beloved pet, it is wise and yes, very difficult, to not "mourn the living". If pain and other physical discomforts can be controlled with medications, our pets are much better equipped to "live in the moment", unaware of all that worries us.


Signs of grief in children - warning signs Children may take longer to grieve and "get over" the loss than adults. A short time of depression, acting out, or gloominess can be expected, and should go away. Longer periods or abnormal activity following loss should be addressed. Warning signs of severe or prolonged grief will vary significantly with the variables of child's age, relationship with the pet, emotional maturity, circumstances involved with the death, and so on.

General guidelines for recognizing grief in children:

• Not interested in usual activities, withdrawing from friends and family
• Eating considerably less than usual
• Reverting to pre-potty training or bed wetting
• Afraid of being alone or going to sleep, nightmares
• Preoccupied with thoughts of death

Talking about the death with the child is a good first step.

Moving forward - time to heal

• Remembering the deceased pet It is important never to belittle or ignore the child's relationship with the deceased pet. To say that it was "just a dog or cat, and we can get a new one tomorrow" does not address the child's grief or teach the child the importance of the human-animal bond. Children often have imaginaryfriends that warrant conversations and emotions - pets are real - they warrant true feelings and emotions too! It does not matter how small or "insignificant" the pet may seem to adults.
• Closure
  Having a burial, memorial, or similar ceremony helps to reinforce the importance of the pet's life and mark the death event. Children should be allowed to participate in whatever way is appropriate - helping mark the grave site, decorate the urn of ashes, or draw pictures of happy times together with the pet - whatever activity fits with the closure ceremony and allows the child to say good-bye in their own way.
• Getting a new pet
  This is a very personal choice. Children should not be rushed into getting another pet to help them "get over" the deceased pet. One pet does not replace another, and getting a new pet too soon may only cause the child to resent (even mistreat) the new pet. Only once the child can speak openly about the deceased pet and shows interest in a new pet should the subject of a new pet be discussed.

 

Livestock/Pet Insurance

Kenya has come of age. Many insurance companies are now willing to offer insurance packages for both livestock and pets. This is quite encouraging as the profession is getting attention as a stakeholder in the provision of professional advise.

Cruciate Ligament Rupture in a Boerboel Male

The Andys Veterinary Clinic Loresho Branch operated on a male boerboel who had a rupture of the left hindleg cranial cruciate ligament. The surgery went well and the dog is recuperating.

Welcome to The Andys Veterinary Clinic Blog

This is to inform the veterinary fraternity and the public that we at The Andys are happy to interact and exchange ideas in this noble field. There are many areas where we can assist each other and we believe together we can achieve more.