Help, Cocker Spaniel glaucoma is suspected in my dog, what do I do? Cocker Spaniels have some of the most endearing eyes of any dog breed, yet they have a higher-than-normal propensity to developing glaucoma. At least once a week someone writes to me for information about surgical and nonsurgical options for Cockers with glaucoma. In order to understand why this particular dog breed is more commonly affected with glaucoma, we’re taking a deep dive into the Cocker eye anatomy and why they are overrepresented with this disease.
Cocker Spaniel glaucoma is one of the most common causes of irreversible pain and blindness. Primary glaucoma generally affects both eyes, and according to Cornell University, at least five percent of purebred Cocker Spaniels have glaucoma. Because glaucoma can be incredibly painful to a dog (think severe migraine) and can develop rapidly, surgical and nonsurgical options must be explored in any dog where glaucoma is suspected. Healthy Cocker Spaniel eyes are clear and without heavy discharge, but only a thorough ophthalmoscopic exam can reveal what’s really going on behind those almond-shaped peepers. Acute glaucoma is always a medical emergency. Surgical options for non-emergent glaucoma include removing the entire eye or laser surgery. Non-surgical options include medications to try and keep the eye pressures down.
Most often, Cocker Spaniel parents will notice changes in their dog’s eye(s) including observing the dog pawing or rubbing at the eye, a watery discharge, loss of appetite, seeming lethargic, swelling or bulging of the eyeball, and even blindness. I’ve talked to pet parents whose Cockers had normal eye pressures at the veterinarian’s office but later that day, even within a few hours, the dog went blind. Glaucoma is a disease wherein the intraocular pressure of the eye increases, but there are different types of Cocker Spaniel glaucoma and reasons for it to occur. We’ll explore everything you need to know about glaucoma in Cockers and talk to some experts and dog moms who own Cockers with glaucoma to see how they are handling it and what their vets say.
Cocker Spaniel Glaucoma: What Is It?
When Janelle Edwards visited the University of Tennessee College of Veterinary Medicine with her 7-year-old tri-color Cocker Spaniel, she did so because Bentley was suspected of having acute glaucoma. Glaucoma was a possible diagnosis, and Janelle’s local veterinarian told her Bentley could go completely blind within three years.
“We noticed Bentley’s left eye was a bit cloudy yesterday,” Janelle explained.” Today I took him to the vet as it didn’t look any better, and it’s not looking good, as he has a lot of pressure and it looks to be glaucoma.”
Glaucoma occurs from increased pressure within the dog’s eye that causes degenerative changes in the optic nerve and retina with subsequent blindness. There’s an area in between the cornea and the lens that is filled with aqueous fluid. Caroline Coile, Ph.D writes in the Cocker Spaniel Handbook that aqueous fluid drains from the eye as fast as it is produced. This process allows the eye’s intaocular pressure (IOP) to maintain a proper rate and balance. When the drainage of fluid builds up due to any number of reasons, the IOP goes up, too. Left untreated, elevated intraocular pressure can cause permanent damage, including blindness, in a matter of hours.
There are four levels of glaucoma based on the stage of the disease: Class IV is very early glaucoma and Class I means the eye is enlarged and the eye is blind. A stable intraocular pressure in a normal eye is between 10 and 25 mmHg. There are both primary and secondary types of glaucoma, and a qualified veterinary ophthalmologist can diagnose the type affecting your Cocker Spaniel.
Here’s what Bentley looked like when he was suspected of having glaucoma:
Bentley has primary glaucoma in his left eye,” Janelle told us.” To determine that, they performed gonioscopy to evaluate the drain of the eye and it was abnormal. He has other degenerative issues in both eyes. He was seen by several doctors at UT and will follow up with a recommended specialist in Nashville tomorrow morning. Also, the pressure in Bentley’s eye went down from our doctor’s office to when we left UT which was a huge relief. No talk of losing his eye at this time, but they did say he will probably lose his sight within 3 years-ish. As sad as I am, we are going to live life to the fullest.”
What Causes Glaucoma In Dogs?
Glaucoma develops when the normal flow of fluid from the eye is somehow blocked or impaired. As a result, the filtering mechanism around the iris gets blocked off. According to the veterinary ophthalmologists who examined Bentley, this is generally a hereditary defect.
“During the first few years of life, aqueous humor exits the eye through flow holes in the sheets,” dvm360 notes. “But eventually the flow holes fail to control aqueous fluid outflow adequately, resulting in an elevation in the IOP.” In these cases, dogs will often present with an acute attack of glaucoma. In the beginning, only one eye is usually affected, but both eyes should be evaluated and monitored since progressive angle narrowing and closure can occur.
Affected breeds include the Cocker Spaniel, Basset Hound, Bouvier des Flandres, Springer Spaniel, Beagle, Chow Chow, and Shar-Pei, among others. If it is the Cocker Spaniel glaucoma is hereditary, it is referred to as primary glaucoma. Most dogs with primary glaucoma are diagnosed in early to mid- life, but seniors can develop glaucoma. If something other than genetics causes the issue, this is known as secondary glaucoma.
Some of the causes of secondary glaucoma in dogs include:
- Inflammation of the eye from another disease, such as anterior uveitits
- Dislocation of the lens from its normal position, called lens luxation
- Bleeding due to eye injury, called hyphema
- Tumors of the eye
- Cancer of the eye
- Retinal detachment
I’ve been a Cocker Spaniel mom for almost 30 years and one of my writing specialities is the health and well-being of Cocker Spaniels. I’d estimate at least 90 percent of the Cocker Spaniels I’ve encountered with glaucoma have the primary glaucoma type as in hereditary.
What Are The Signs of Glaucoma In Dogs?
Redness, cloudiness, rubbing or pawing at the eye(s), and even squinting are the typical signs of glaucoma in dogs. Even though Cocker Spaniels are overly represented in the disease, the breed’s symptoms manifest in the same way as other purebred and mixed breed dogs.
My dog’s brother, Ricky, is affected by cataracts and glaucoma. His mom, Sandy Kanitra, says Ricky’s left eye was bulging, the sclera (white part) was reddened, and a goop-like discharge was flowing from the eye. He was also diagnosed with a corneal ulcer, likely from rubbing the affected eye, along with primary subacute advanced glaucoma in both eyes.
Once the dog with suspected glaucoma is examined, intraocular pressure readings are high. The eyeball may appear to bulge because it recedes towards the back of thew dog’s head. Pupils may not respond to light or become overly dilated, as is the case with Ricky. Ultimately, there can also be vision loss, which can be temporary or permanent.
I’ve noticed that many Cocker Spaniels with glaucoma have a “vessel-like” appearance to the eye, like this:
My dog’s other brother, McGee, is a Cocker Spaniel who has dealt with cataracts and glaucoma as well. Because of this, I am extra diligent about eye screenings in my Cocker Spaniel. As of this writing, my dog’s eye pressures have been normal, but he does have early mature cataracts in both eyes (OU). We will continue to monitor them at veterinary visits and seek the services of a veterinary ophthalmologist should the need arise.
Time is of the essence when diagnosing acute glaucoma, so if you notice any sudden changes in your dog’s vision or appearance of their eye, don’t wait. Using a tonometer, a veterinarian can test the dog’s IOP, intraocular pressure. With sudden acute glaucoma, the pupil doesn’t respond well to light, blinking is weak or the dog is unable to blink, the cornea looks swollen and/or cloudy and there could be tearing of the eye, redness, and squinting.
Chronic glaucoma is ongoing and the blink response is generally absent. The pupil does not respond to light, the eye is inflamed and red, the cornea is enlarged, tearing may be present, and corneal vessels are often noticed.
How Is Glaucoma Diagnosed In Dogs?
Cocker mom Elaine Schultz has had three Cocker Spaniels with glaucoma: a registered Cocker puppy and two rescue Cockers. All three started with increased pressures. She recommends having many pressure rechecks with the vet ophthalmologist to stay on top of things. She was prescribed drops for her dogs and was told to never miss a drop.
She’s managed to keep the “good eyes” in her Cockers from going blind due to 100 percent compliance with eye drops. Elaine’s dogs were initially diagnosed with glaucoma with a tonometer instrument. There are several different types of tonometers, but they are all designed to test the intraocular pressure exerted by the fluid in the eye. Most vets use a Tono-Pen for “applanation tonometry” and others use TonoVet for rebound tonometry. Electronic tonometers are expensive and are usually used by specialists such as veterinary ophthalmologists.
Here’s video of an actual veterinary ophthalmologist using a TonoVet tonometer to measure eye pressure readings in a dog:
Taking it one step further, if your Cocker Spaniel is seen by a veterinary ophthalmologist, they will perform a series of tests to completely and accurately assess the eye. Here is a step by step video of those tests, and sometimes your dog’s regular vet can perform many of these. If your Cocker starts to show signs of glaucoma or is diagnosed, I highly recommend you seek the services of a qualified veterinary ophthalmologist.
Once the specialist has accurate intraocular pressure readings and performs an internal eye examination using special instruments, the diagnosis of glaucoma can be ruled in or eliminated. For acute glaucoma cases, most vets will refer their patients to a veterinary ophthalmologist, as is the case with Janelle Edwards and her Cocker Spaniel, Bentley.
Glaucoma is more than an increase in a dog’s intraocular pressure, which is why complete eye examinations are important. Not every canine patient will exhibit the same signs of glaucoma, and some dogs may develop glaucoma due to other issues like luxating lens, trauma to the eye, inflammation, or even a tumor.
How Is Glaucoma Surgically Treated In Dogs?
When Rhonda Roberts took her Cocker Spaniel to the vet for an eye check, her pooch was diagnosed with glaucoma. The eye specialist said glaucoma would “spread” to the good eye, so she wondered about the approximate time span between diagnosis and the spread of glaucoma to the good eye.
She posed this question to Cocker Spaniel parents in my Club Cocker: Wigglebutts Worldwide Facebook group. The responses ran the gamut, but many dogs did wind up having surgery because glaucoma was affecting one of their Cocker’s eyes and it did finally affect the other. Responses to the timespan ran the gamut from days to months and even years. Like people, all dogs are different.
Cocker mom Becky Delashmit reported her Cocker, Lacey, had one eye removed from high pressures as a result of primary glaucoma. A total of 18 months later, the other eye had to be removed. “If I had to do it all over, I would have had the first eye removed sooner,” she shared.
Since glaucoma from elevated intraocular pressure can threaten vision and cause severe pain for the dog, the goal is to lower pressure in the eye. If this cannot be achieved with medications and drops, surgery is inevitable. Surgical options according to Dr. Kristina Vygantas, DACVO, Diplomate, American College of Veterinary Ophthalmologists, include:
|Surgical removal of the eye (enucleation)||The eye is surgically removed under general anesthesia. Once removed, the eye pressures cannot cause pain because the eye has been removed. Most pets recover well and complications are uncommon. This is the most straight-forward option and often seen in many Cocker Spaniels with uncontrolled primary glaucoma due.|
|Intravitreal chemical cycloablation||The eye is injected with a medication that reduces fluid production within the eye. The medication damages the retina, so this option is reserved for dogs with a blind eye(s). Cosmetic results are uncertain, as some eyes shrink dramatically while others do not. This option is often used in dogs who are at risk for being under general anesthesia for long periods of time.|
|Evisceration with intraocular prosthesis||The dog retains the appearance of an eye because the original eye is removed and a prosthetic eye takes its place. The surface of the prosthesis may appear cloudy. Northstar Vets cites an overall success rate of 95 percent. Complications include rejection of the prosthetic eye and corneal ulceration.|
|Laser surgery||Some specialists offer endolaser in which they laser the tissue that produces fluid in the dog’s eye through a small endoscope that is used on the eye after lens removal. Recovery is considered ‘intense’ but some dogs achieve long periods of glaucoma control and are able to eventually come off all medications.|
According to dvm360, some veterinary ophthalmologists may operate to increase the flow of aqueous humor by implanting drainage tube in the eye or decrease the production of the fluid via laser or cryotherapy to partially destroy the ciliary body in the eye.
The folks at Northwest Animal Eye say they are often asked why any procedure or surgery is required for uncontrolled glaucoma in a blind eye. “The reason is that uncontrolled glaucoma is a painful disease whether the eye is visual or not. Though signs of pain are not detectable in some pets with chronic glaucoma, we feel that most are indeed painful based on how they improve after the glaucoma is controlled medically or resolved by surgery.”
Potential complications postoperatively include pressure fluctuations early on in the recovery period and excessive inflammation.
Not all Cocker Spaniel glaucoma cases require surgery, which is why anyone with a Cocker Spaniel should find a qualified veterinary ophthalmologist to call or visit should a problem arise. You may need to travel to a veterinary hospital or university. When Dexter was just a few years old, we took him to a CERF clinic for a complete eye exam. More about that in the next section.
Where to find a veterinary ophthalmologist.
Can Cocker Spaniel Glaucoma Be Treated Non-Surgically?
Yes, canine glaucoma can be treated non-surgically, and this is normally how a vet or vet ophthalmologist will start. Non-surgical treatment options for glaucoma vary but include medications such as various eye drops and close, frequent monitoring of the dog’s eye pressures.
Glaucoma can be very painful and cause a dog to have discomfort, so analgesics to quell pain may be prescribed. In terms of the increased pressure in the eye(s), vets will often prescribe medications to decrease eye fluid production and treat the increased pressure. Sometimes, medication is combined with surgery and dogs will require drops throughout their life.
Most canine eye medications are ointments, drops, or topicals that must be administered several times a day without missing a dose. Sometimes, an IV injection or drainage of fluid from the eye can be performed to rapidly decrease intraocular pressure.
Cocker Mom Lisa Jurcich Kovach’s dog, Sami, was diagnosed with glaucoma. Her IOP was too high to save her left eye. She met with a veterinary ophthalmologist who performed laser surgery. Sami’s vision was good for a while with daily drops, but she developed a cataract on her right eye that cannot be removed since laser surgery was performed twice. Lisa says it has not been an easy process, but they are all learning and Sami is the same sweet, loving girl she always has been but she just can no longer see.
There is no permanent cure for glaucoma other than surgery. Sometimes, glaucoma can be monitored and surgery can be avoided, but the long-term prognosis for many Cocker Spaniels with primary glaucoma in maintaining their vision is poor. Measuring the intraocular pressures of the eye on a regular basis.
Cocker Spaniel glaucoma affected Debbie Zupan Eickhoff’s dog, and she lost vision in one eye but emergency medications restored her vision. She had surgery to replace the lens in that eye and then a shunt was placed. Her Cocker, Abby, was misdiagnosed by the first vet who examined her and lost vision in her eye. She was nine years old when glaucoma developed.
Marlene Ness is a Cocker Spaniel breeder, owner, and handler and says “Glaucoma can be very painful, managed or not. When the eye is removed, you will likely notice a difference in how they are feeling because the pain is gone.”
As an example, and keeping in mind that every dog and every Cocker Spaniel is different, here are some of the medications and supplements prescribed to a few of the Cocker Spaniels whose owners we interviewed:
- Latanopost: One drop in the right eye three times daily, one drop in left eye two times daily.
- Dorzlamide-Timolol: One drop in both eyes three times daily.
- He was also prescribed an antibiotic ointment for the corneal ulcer.
- Dorzolamide-Timolol Solution: One drop in the right eye each day, one drop in the left eye three times daily.
- Pred Acetate: One drop in the left eye three times daily.
- Sodium chloride 5% solution: One drop in the left eye twice daily.
- Fish oil: Give as directed by your primary veterinarian.
Bosco (of Lyle Lieberman):
- Timolol-Maleate ophthalmic solution
- Dorzolamide HCl/Timolol Maleate ophthalmic solution
- Latanoprost ophthalmic solution
Never attempt to treat suspected glaucoma or eye conditions on your own and do not use over-the-counter drops or medications. Always seek the services and advice of your dog’s veterinarian and/or veterinary ophthalmologist.
Back in 2011, Dexter’s eyes were tested at a “CERF” (Canine Eye Registration Foundation) clinic. CERF was founded by a group of concerned, purebred owner/breeders who recognized that the quality of their dogs’ lives was being affected by heritable eye disease. CERF has since become a part of the OFA (Orthopedic Foundation for Animals). Here’s a snapshot of our CERF clinic results from years ago, which needs to be updated at least yearly.
Learn more about OFA and screening for diseases of the canine eye here.
Can I Prevent Cocker Spaniel Glaucoma?
Because genetics are responsible for primary glaucoma in Cocker Spaniels, it cannot be prevented. You can, however, maintain good eye health in your dog and like any disease, slow the progress. These preventatives include:
- Regular eye exams
- Antioxidants and/or nutraceuticals as recommended by a vet
- Wearing a harness to reduce neck pressure on the dog
- Reduce chemical and environmental stressors to your dog
- Feed a healthy diet and provide exercise for overall good health
- Early detection to best manage glaucoma should your dog be diagnosed
There is no magic pill, supplement, or vaccine that can prevent primary glaucoma in dogs.
Cocker Spaniel secondary glaucoma can sometimes be prevented by:
- Having regular eye exams where early problems can be diagnosed and treated (i.e. ulcers, injury, tumors)
- Not allowing your dog to stick his head out the window in a moving vehicle to avoid debris from striking his eye(s)
- Wearing canine goggles (doggles) in situations where eyes can be subject to injury
- Doing your best to prevent canine eye accidents and injuries
Do Dogs With Cataracts Develop Glaucoma?
When we wrote about cataract treatment in dogs, we received questions as to whether a Cocker Spaniel with cataracts will develop glaucoma. The short answer is not always. Cataracts cloud the lens portion of a dog’s eyes and again, Cocker Spaniels have a high-than-average likelihood of developing cataracts.
Like a camera, a dog has a clear lens in his eyes so he can focus. Cataracts are not generally painful but they can impair vision and sometimes lead to vision loss. Cataract formation in Cockers often happens in older age or as a result of diabetes or injury. When you look at the eye, it appears grayish-blue in color, murky, and may even be red or irritated.
Not all dogs who develop cataracts will get glaucoma. Many dogs live long lives with cataracts and without losing their vision. Even dogs who have cataract surgery are not guaranteed 100 percent vision restoration after cataract surgery.
Glaucoma may occur in up to 30 percent of dogs who have cataract surgery and usually within the first 24 hours postoperatively. Glaucoma can also occur later in the dog’s life — even years after surgery.
Dogs who have cataracts and do not have surgery may or may not develop glaucoma. As a dog’s cataracts progress, glaucoma may occur at any time, which is why regular eye exams and pressure checks are important. I ask my Cocker Spaniel’s vet to perform eye exams (tear test, pressure check, etc) at least two to three times a year. Many dogs with age-related cataracts, such as my Cocker Spaniel, can live a normal life with minimal changes.
Monitoring your Cocker Spaniels’ cataracts is important so that any secondary diseases (inflammation from uveitis or glaucoma) can be identified, treated, and managed.
I highly recommend you purchase a copy of my new book, the Dogminder: A Canine Health and Wellness Journal for under $10. You can track visits with your dog’s vet, write down any changes or symptoms, and even include notes and photos of your dog’s eye changes.
Cocker Spaniel Health
For good overall health of your Cocker Spaniel, we recommend the following articles we’ve written: