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Hyphema in Dogs

Hyphema, or blood in the anterior chamber of the eye, is a common condition among dogs. However, hyphema is a clinical sign and not a specific disease.

Symptoms and Types

The symptoms of hyphema are dependent on the extent of bleeding, whether vision has been impaired, and whether your dog has other, underlying systemic diseases.

Common signs that are observed during a physical examination are:

• Blood within the anterior chamber of the eye
• Corneal edema or corneal lesions
• Elevated intraocular pressure (IOP)

Causes

The most common causes of hyphema are:

• Injury or trauma to the eye or head
• Severe retinal detachment
• Hypertension, hyperthyroidism, systemic deficiencies
• Infection by parasites
• Bleeding vessels - vasculitis, uveitis, uveal neoplasia, and lymphoma particularly
• Ocular defects - retinal dysplasia, collie eye anomaly, glaucoma, etc.

Hyphema can also be indicative of various ocular (eye) and systemic deficiencies, some of which may be life threatening. Therefore, its diagnosis and proper treatment is very important.

Diagnosis

Hyphema is diagnosed through hematology and blood biochemistry tests, lab tests, and diagnostic imaging using X-rays and ultrasound tests.

A complete medical history will be taken and a thorough physical examination done to include or exclude possible causes for the condition.

Common diagnostic tests and procedures include:

• Complete blood count with platelet count
• Serum biochemistry to measure serum levels in protein
• Coagulopathy tests to assess blood coagulation functions
• Blood pressure
• Urinalysis to exclude kidney diseases
• Chest and abdominal X-rays
• Ocular ultrasounds (ultrasonography) to investigate the anterior portion of the eye and include/exclude possibilities of retinal detachment, lens displacement, abnormal masses, and vitreal hemorrhage.

Other advanced tests that may be performed include abdominal ultrasounds, X-rays of the head and eye orbit to detect hitherto unknown traumatic injuries, and hormonal tests (assays) of the adrenal glands. To detect bone marrow cancer, a bone marrow aspirate - the liquid found within the bone marrow - may also be done.

Treatment

The objectives of hyphema treatment involve containing the inflammation and removing the underlying causes which contribute to the bleeding in the anterior chamber of the eye.

The common approaches to treatment are:

• The use of corticosteroids as eye drops or ointment to cure inflammation arising out of the bleeding
• Atropine eye drops to dilate the pupil and minimize sticking between the lens and the iris
• Initiation of appropriate treatment for ocular deficiencies like retinal abnormalities (i.e., dysplasia), collie eye anomaly, glaucoma, etc.

Surgery may also be necessary for the correction of traumatic injuries and lesions.

Your dog's activity will need to be restricted if the problem has been caused by a clotting disorder. A clot in a vein or artery can quickly become fatal when vigorous movement encourages the clot to travel to the heart. In cases of clotting, your dog will need to be treated specifically for dissolving the clot. In addition, if hyphema has significantly damaged your dog’s vision, it should not be allowed to go outside without supervision. Regular monitoring of the fluid pressure within the eye is also very important - daily checks for severe diseases, and in less severe cases, every two to three days until the condition has cleared up. To prevent your dog from inflicting further injury or irritation to the eye by scratching at it, you may want to ask your veterinarian for an Elizabethan collar - a wide collar that fits around the neck, preventing the dog from being able to reach its face with its paws.

Unless the ocular structures have suffered irreversible damage, the prognosis is usually good in case of traumas. In case of retinal detachments, secondary glaucoma will eventually develop, and surgical intervention may be necessary for relief of pain.