Peer-reviewed veterinary case report
Long-lasting ear meds may cause dry eye in dogs
By Bercovitz, Genia R et al.·Published in Journal of the American Veterinary Medical Association·2022·College of Veterinary Medicine, United States·View original on PubMed →
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Original publication title: Long-lasting otic medications may be a rare cause of neurogenic keratoconjunctivitis sicca in dogs.
- Species:
- dog
Plain-English summary
A group of 29 dogs developed eye problems, specifically neurogenic keratoconjunctivitis sicca (nKCS), shortly after receiving ear medications that contained terbinafine and florfenicol. Owners noticed symptoms like dry eyes and reduced tear production, confirmed by a tear test. Most dogs showed improvement, with 24 out of 29 returning to normal tear production within about three months. However, some dogs developed corneal ulcers, which could delay recovery. Overall, the prognosis for these dogs was good, with many regaining normal eye function within a year.
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Abstract
OBJECTIVE: To characterize the clinical course and long-term prognosis of a suspected novel cause of neurogenic keratoconjunctivitis sicca (nKCS) secondary to florfenicol, terbinafine hydrochloride, mometasone furoate (Claro and Neptra) or florfenicol, terbinafine, betamethasone acetate (Osurnia). ANIMALS: 29 client-owned dogs. PROCEDURES: Online survey and word-of-mouth recruitment were conducted to identify dogs that developed clinical signs of nKCS after application of otitis externa medication containing terbinafine and florfenicol. A retrospective analysis of medical records of dogs meeting inclusion criteria was then conducted. Included dogs had onset of clinical signs of nKCS within 1 day after application of otitis externa medications containing terbinafine and florfenicol and had documentation of low Schirmer tear test value (< 15 mm/min) of affected eyes. RESULTS: 29 dogs with medical records available for review met the inclusion criteria. Documented return of clinically normal tear production was identified in 24 of 29 dogs, with a median time from application of ear medication to documented return of clinically normal tear production of 86 days (range, 19 to 482 days). A corneal ulcer was diagnosed in 68% (20/29). Multivariable Cox regression analysis showed being referred to an ophthalmologist (P = .03) and having a deep ulcer (P = .02) were associated with a longer time to documentation of Schirmer tear test ≥ 15 mm/min. CLINICAL RELEVANCE: Dogs that developed nKCS within 1 day after application of otitis externa medications containing terbinafine and florfenicol had a good prognosis for return of normal tear production within 1 year.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36350754/