Section: Veterinary Care
Diagnosis
A complete history and physical examination are important to document the onset and progression of any eye signs and systemic abnormalities.
A thorough ophthalmic examination is indicated. Some retinal hemorrhages are obvious, while others can be difficult to see. Your veterinarian may refer your dog to a veterinary ophthalmologist for further evaluation using specialized instrumentation.
Once retinal hemorrhages are diagnosed in your dog, an extensive search is often required to identify any underlying diseases. Tests to be considered include the following:
Complete blood count (CBC)
Biochemical profile
Urinalysis
Measure of arterial blood pressure
Thyroid hormone assays
Blood clotting tests
Adrenal hormone assays
X-rays of the chest and abdomen
Blood tests for infectious diseases
Ocular ultrasound
Possibly a heart and/or abdominal ultrasound
Treatment
Treatment is usually directed at the underlying cause of the retinal hemorrhage. Depending on the physical condition of the patient, treatment options may include outpatient care or may necessitate hospitalization.
If the retinal hemorrhage is due to high blood pressure, then medications are instituted to lower the blood pressure. As the blood pressure is being controlled, systemic anti-inflammatory medications may be used to try to decrease the damage done to the retina.
Specific therapy for the underlying condition can include the following, depending upon the underlying cause:
Antibiotic and anti-fungal therapy for certain infections
Systemic corticosteroids for immune diseases
Chemotherapy for leukemias and other cancers
Vitamin K therapy and blood transfusions for clotting problems
Intravenous fluids for hyperviscosity and other circulatory disorders
Surgical removal of severely injured eyes or eyes with tumors
Administration of insulin for sugar diabetes
Administration of certain medications for adrenal or thyroid gland diseases
If the retinal hemorrhages are not caused by infectious diseases, then systemic corticosteroids may be administered in an attempt to decrease any inflammation caused by the hemorrhages. It is important to note that the nonsteroidal anti-inflammatory medications (NSAIDs) are not used in this condition because they can alter platelet function and potentially make the hemorrhages worse.
Home Care
Administer all medication as prescribed by your veterinarian. Return for follow up as directed to ensure that the hemorrhages and underlying condition are responding to treatment.
During the recovery period it is important to keep the dog quiet, to avoid placing extensive force around the dog's neck (replace choke collars with harnesses), and to prevent violent shaking of the head so that further bleeding into the retina does not occur.
Small hemorrhages usually disappear within a few weeks to several months. Larger hemorrhages may take months or longer to resolve, and may predispose the eye to retinal detachment.
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