Cataracts in Dogs and cats

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In this episode, Dr. Kristen Fischer, board certified veterinary ophthalmologist, discusses the importance of early diagnosis, the different causes, and treatments of cataracts in pets. Genetic predisposition and diabetes are the common causes of cataracts in dogs, whereas inflammation causes cataracts in cats. Early detection and treatment are essential and can be achieved by routine eye exams conducted by a veterinarian. Surgery is the only effective treatment available, which has a success rate of around 90%. In cases where surgery isn’t possible, maintaining comfort for the pet is key. The positive impact of this treatment in pets is highlighted through a special story about a rescue dog named Ethel. 

Table of Contents

Welcome Dr. Kristen Fischer, veterinary ophthalmologist!

Dr Fischer on a horse with her daughter on another horse

Dr. Lancellotti: Welcome, everyone, to today’s episode of Your Vet Wants You To Know. Today, we’re going to be talking about cataracts, and I have a very special guest with me, Dr. Kristen Fischer. Dr. Fischer is a guide within the ophthalmology group of VetHive, which is a community for veterinary professionals, where we learn and help to teach each other about our cases and how we can be better veterinarians. I am very excited for her to come on. She’s got a ton of information about cataracts. Welcome and thank you for joining us today, Dr. Fischer.

[00:01:35] Dr. Fischer: Thanks for having me. I’m excited to share my knowledge. I love talking about this with clients, pet owners, veterinarians and anybody who will listen, so I’m excited to share here.

[00:01:47] Dr. Lancellotti: Excellent. Why don’t you tell our listeners a little bit about your background? How did you get into veterinary ophthalmology and what’s your story, in terms of your journey through veterinary medicine?

[00:01:56] Dr. Fischer: I knew, for my whole entire life, that I wanted to be a veterinarian. I don’t think, as a child, I even knew that veterinary ophthalmology was a thing, but even when I was three years old, I never wanted to be anything other than a veterinarian. And throughout vet school, I was exposed to all the different specialties and I actually wanted to be an equine surgeon. Somehow, along the course of my training, in my fourth year of veterinary school, I was on my ophthalmology rotation and I discovered ophthalmology again and I just fell in love with it. I loved that I was restoring vision to blind animals. I loved that I could still see anything that had an eyeball, which is really cool. There was anything from sea turtles to lions to horses, but primarily dogs and cats. I loved that none of the disease processes that I was having to manage were imminently life threatening, and it just really turned out to be the perfect fit for me. After veterinary school at the University of Tennessee, I headed out to Colorado for an internship and continued to learn about ophthalmology out there, before heading back to Tennessee (which is actually where I’m from) to complete my ophthalmology residency, which I finished and became a board certified veterinary ophthalmologist in 2012. And since that time, I’ve been in the state of South Carolina with my family, with a practice called Animal Eye Care of the Low Country. We have two full time locations and three satellite offices where I just love practicing ophthalmology. I’m still just as passionate about it as I was when I started. I have also since worked with lots of rescue organizations, zoos, and raptor rehabilitation centers. I’m a specialty guide through the VetHive community, so I get to continue to educate veterinarians. Recently, I also started a teleconsulting business that is geared towards helping family veterinarians treat pets in their own clinic, when referral to a specialist is not an option. I love to educate whenever I can, and that’s pretty much how I got where I am now.

[00:04:11] Dr. Lancellotti: I’m so excited for you to come on and teach pet owners, today. I’m really thankful because I know that you do such a great job within VetHive and, it’s just so helpful to have someone with so much knowledge coming on and sharing it in a way that people can understand.

[00:04:24] Dr. Fischer: Well, I love to do it. When they’re training new staff members, my staff always says, “follow Dr. Fischer around because you’ll get a lot of information when you just hear her talk to clients.” So that’s what I like to do.

Veterinary Ophthalmologists Treat Any Animal with Eyes!

[00:04:37] Dr. Lancellotti: You mentioned the Raptor Rehabilitation Center. Tell me a little bit about working with raptors.

[00:04:42] Dr. Fischer: Well, I’m actually quite terrified of birds, which is kind of funny because I spend a lot of time helping with the Raptor Rehabilitation Center. When raptors are properly restrained by people who know what they’re doing, I find them extremely fascinating. They have really cool eyes. They actually have bone in the sclera (white part of the eye), which is very different than mammals. There’s a large Center for Birds of Prey Avian Conservation Center in our area, and you actually can’t release birds that have significant vision issues. So it’s really important, especially for raptors, to have good vision in both eyes. Prior to release of these raptors that have come in from traumas or illness, they need to ensure that their vision is going to be adequate to be able to hunt in the wild. They have me come out there a lot to assess these birds, to try to help identify causes of specific issues, and help figure out how to best treat those, but then also to assess vision, for the potential for re release into the environment. So that’s really rewarding.

[00:05:48] Dr. Lancellotti: For the pet owners who are listening, who may not understand that raptor doesn’t mean a dinosaur from Jurassic Park, what type of raptors are you talking about?

[00:05:59] We actually see a lot of hawks and eagles in this area. They are federally protected, so you have to be really careful about what you do and how you treat these guys. Also, we see a lot of shorebirds in my area (because I’m near the beach) and a lot of owls. But specifically, the hawks and the eagles really require excellent vision, so they actually have to have normal vision from both eyes to be re released. For owls, they actually have to have really good vision from at least one eye before they can be re released. So we’re talking about the wild birds that you see flying around when you’re out and about, hiking, driving, or exploring outside.

[00:06:45] Dr. Lancellotti: That’s really cool. And I love that you still get a chance to work with horses (because they also have eyes), and that you spent some time riding horses. Is that correct?

[00:06:54] Dr. Fischer: I do. I started riding horses when I was 5, and that’s part of how I continued to grow my interest in veterinary medicine, and why I wanted to be an equine surgeon for so many years. I competed for years, riding all throughout college, and then it became more of a hobby and continued to be something that I just really enjoy to do. It’s something that my daughter (who just turned 10) loves to do, so we try to get out on the weekends (or whenever we can) and ride together. That’s just a fun passion that we get to share together.

Ethel's Cataract Surgery

[00:07:28] Dr. Lancellotti: You mentioned you worked with rescue organizations. You’ve got a special story about a specific rescue pup that you just worked with. Why don’t you tell our listeners about her?

[00:07:38] Dr. Fischer: Yes. So I would love to tell you guys about Ethel. She is just the most adorable little scruffy terrier. She’s around 25 lbs, and she is a 9 year-old mixed breed that presented to us for evaluation for cataracts. She entered into a rescue organization and was really struggling to adjust to that because she was blind. She was very timid and reserved, but you could still just tell that she had the sweetest little soul, and her cataracts just made her look like such an old lady. So she came for evaluation for possible cataract surgery and we determined that we would be able to do that. The rescue organization raised the funds, we performed cataract surgery, and it was very successful. It was one of those cool opportunities that I get to see, day in and day out, where a patient or a rescue dog like Ethel comes in and they’re timid, fearful, and they’re feeling their way around or bumping into everything as they come in because they just can’t see. And when she walked out of the hospital that afternoon, her tail was up and wagging and her confidence had returned. She turned into this happy, outgoing, confident dog. She’s recently just been adopted, so she’s found a new home with owners that are dedicated to making sure that she continues to have excellent vision longterm. I really think it has just been great to restore her vision so that she could be able to see her environment and get around, but also so that she can adjust better into her new home. She’s going to be able to see who her new owners are and explore her environment, and I think it’s really been life changing for her. As an added bonus, it took years off of her appearance. She doesn’t look like a little old lady anymore. Now she looks like a young pup.

[00:09:30] Dr. Lancellotti: How satisfying and cool is that, that you can do that surgery, and by the time they’re awake and leaving the hospital, you see a totally different dog, in terms of their personality. That’s so awesome.

[00:09:43] Dr. Fischer: It’s one of my favorite things. We have clients that sit up front when they come back to pick their dog up from surgery, and they sit there with their phone camera recording to see their dog come up, and it’s just so cool to see how different they are. People come in all of the time saying, “You gave me my dog back and now they’re able to play, and they’re chasing lizards on the back porch and all the things that they weren’t able to do before.” Dogs can have an excellent quality of life if they can’t see, and there are plenty of conditions that we can’t fix, but this is one of the things that when we can, it can just be so rewarding.

[00:10:17] Dr. Lancellotti: Oh, that’s so wonderful. You’re bringing tears to my eyes with these happy stories. That’s so nice.

Ethel, before (left) and after (right) cataract surgery to restore her vision.

Understanding Cataracts in Dogs and Cats

Dr. Lancellotti: So let’s talk a little bit about cataracts. What exactly are they and how are they different from a normal eye?

[00:10:30] Dr. Fischer: The lens is the part of the eye that develops a cataract, and a cataract is actually just when that lens turns white or becomes opaque, so you just can’t see through it anymore. The lens is a spherical structure that sits in the middle of your eyeball, and it’s suspended there right behind your pupil. Its entire job is to focus light in the eye, like the lens of a camera. That way, the light is focused and falls into place on the retina (very back of the eye), and then that information is sent to your brain and interpreted as vision. When that lens becomes opaque or cloudy and you can’t get light through there to perform that focusing mechanism, then it interferes with vision. The lens is shaped like an M&M or a Skittle. It sits right behind your pupil, and it’s got a little capsule around it, like the candy shell. The cataract can actually be a white spot anywhere inside of that lens. A normal lens is crystal clear, and when you get older, the lens actually gets a little bit hazier. That is just a normal aging process called nuclear sclerosis or lenticular sclerosis. That’s the same thing that happens to us, when we get older and we need reading glasses. So if you look at your dog or your cat (or horse), and you notice that their eyes are getting a little hazier, but they still seem to see just fine, it could just be that aging change. But a cataract is when it actually is opaque or turns white, and then you can’t see through it.

[00:12:09] Dr. Lancellotti: And that’s something that if the owner’s not sure, in terms of vision changes, the veterinarian can help to determine if it’s just nuclear sclerosis or a cataract.

[00:12:18] Dr. Fischer: Sometimes, it can actually be hard to tell that without specialized equipment, so a lot of family veterinarians will send you to a specialist or an ophthalmologist if they aren’t sure. Some cataracts progress to be extremely vision limiting, like in Ethel’s case, and some cataracts actually don’t ever really progress and are insignificant in the grand scheme of things. Your vet may not be able to predict that for you, and that’s where a veterinary ophthalmologist or specialist may be helpful in a situation like that.

Cloudy lens from cataracts in a dog eye
Cataract in a dog eye. The lens is opaque and cloudy.

Causes of Cataracts in Dogs and Cats

[00:12:49] Dr. Lancellotti: Why do cataracts occur?

[00:12:50] Dr. Fischer: There are so many different causes of cataracts. It’s a really long list. The most common cause of cataracts is actually a genetic or inherited predisposition, meaning that your pet was just born destined to develop cataracts- it’s just in their DNA. They got the genes from their mom and their dad, and there’s nothing that you can do differently to prevent or change that. In that scenario, it can develop at any age. We tend to think of people getting cataracts when they’re older, but dogs with genetic cataracts often will develop those at a young age, depending on the breed. Some develop them younger than others. They don’t actually even have to be a purebred dog to develop genetic cataracts because they can happen in mixed breed dogs, as well. Cataracts are just genetically very common, so even in the mixed breed dogs, there’s a possibility.

Genetic Cataracts in Different Dog Breeds

Cataract in the eye of a golden retriever with genetic cataracts in dogs
Cataract in the eye of a golden retriever with genetic cataracts

[00:13:45] Dr. Lancellotti: Is there a certain breed where you see the genetic cataracts more common?

[00:13:49] Dr. Fischer: We see genetic cataracts in a lot of the really common breeds- golden retrievers and Labradors. We also see them in Boston Terriers, Schnauzers, Cocker Spaniels, and poodles. But there have been genetic cataracts reported in so many different breeds of dog that it’s really hard to list them all.

[00:14:12] Dr. Lancellotti: So it’s more in relation to the animal’s family and the genes that have been passed on over generations.

[00:14:19] Dr. Fischer: Yes, it is. And unfortunately, in most pets, there’s not really a good blood test for that, to find out if they’re going to go on to develop something like that. The reason it’s been so hard to get this out of the gene pool is because a lot of these dogs don’t develop their genetic cataracts until they’re older. So if they are breeding pets, they have already bred before they have a chance to develop their genetic problem. That’s why it’s so prevalent in the pet population.

Cataracts in Dogs and Diabetes

[00:14:48] Dr. Lancellotti: What about other diseases that may put the pet at risk for developing cataracts, if they don’t have this genetic predisposition?

[00:14:58] Dr. Fischer: That’s a good question. The second most common cause of cataracts, in dogs at least, is actually diabetes. Diabetes is an endocrine disease where your blood glucose is actually well above the normal range, and it’s a problem with the animal’s ability to produce its own insulin to regulate the blood sugar. And insulin is a hormone that actually helps keep your blood sugar level in a normal range. So if you have a problem doing that, then your blood sugar stays really high, and that can actually lead to really significant cataract formation. In fact, most dogs with diabetes will develop blinding cataracts within the 1-2 years. And those cataracts can come on really quickly. We think about our grandparents and great grandparents, or whoever it is that we know of who’s had cataract surgery, and generally, they’re older people. They can still see okay, but they’re going to have cataract surgery because their cataracts progress slowly over time. But in some pets, the cataracts can progress really rapidly- almost overnight. In a diabetic patient, that is something that we are always concerned about because when that blood sugar is really out of whack, these cataracts can come on super quickly. It’s not uncommon for people to say, “they were seeing fine on Friday and by Saturday evening they were running into the wall.”

[00:16:23] Dr. Lancellotti: And that must be very upsetting, not only for the pet owner, but for the pet as well, who has no understanding of what’s going on. All of a sudden, they can’t see where they are in their surroundings.

[00:16:34] Dr. Fischer: It can be very stressful. I would say that it’s probably truly harder on the pet owner than it is on the pet just because they can’t really comprehend what’s happening completely. But it just breaks the owner’s hearts to see their beloved pet getting stuck in the corner or running into things. And it can be dangerous! We have pets that fall off of balconies, into pools, and wander off and can’t find their way home. It can be really hard for them to adjust, especially when they lose vision really suddenly.

[00:17:06] Dr. Lancellotti: Yeah. So any sudden vision change should be considered an emergency and should be evaluated as quickly as possible.

[00:17:12] Dr. Fischer: Yes, I would certainly agree with that.

Congenital Cataracts in Dogs

[00:17:15] Dr. Lancellotti: How about some other causes of cataracts? Let’s talk a little bit about some of the things that may not be as common as the genetic predisposition or diabetes.

[00:17:24] Dr. Fischer: Okay. Some pets are actually born with (congenital) cataracts. A congenital disease is something that you’re born with, but they’re not necessarily genetic. Some of them are, but that would be if your pet was born with cataracts from the beginning. And that may be something that a breeder or your family vet will pick up on at a very young age.

Cataracts in Cats

Dr. Fischer:  The most common cause of cataracts (in cats) is actually inflammation inside of the eyes (uveitis). Over time, uveitis causes cataract development. That’s why we see cataracts primarily (at least in clinical practice) in dog patients, especially the surgical type of cataracts. But we do certainly see cataracts forming in cats and dogs, secondary to this inflammatory disease. The inflammation in the eye can be caused by a whole host of different secondary issues, which sometimes warrants additional testing to try to find the underlying cause of that.

Traumatic cataract in a dog eye
Traumatic cataract in a dog eye.

Cataracts and Problems in Other Parts of the Eye

[00:18:28] Dr. Lancellotti: What about if there are problems in other parts of the eye? Are there certain types of cataracts that are formed because of problems with other structures in the eye?

[00:18:38] Dr. Fischer: The retina is actually a structure in the back of the eye that is made up of a bunch of different layers. It’s what I would call the processing center within the eye. When light comes into the eye and goes through the lens, it focuses back on the retina. When it hits the retina, that information then travels from the retina to your brain. Then, your brain interprets that as vision. So I would consider the retina one of the most important structures inside of the eye, as far as vision goes. There are several disease processes that can affect the retina, but there’s a genetic disease called progressive retinal atrophy. It affects several different breeds of dogs and can actually affect cats. And in the very end stage of this retinal problem, where the retina degenerates over time, dogs and cats will often develop cataracts. The biggest concern is that it’s not just a lens problem. With most of these other issues, it’s just a lens problem, so if you can make that lens clear again, then you can actually improve vision. But if the retina is not working properly, making that lens clear again may not help improve their vision at all, so it can be really important to identify something like that before considering something like cataract surgery.

There are other things like trauma. If your dog has a penetrating injury to the eye and touches the lens, that can certainly cause it. Then, there’s nutritional deficiencies. If a pet is born in a dumpster, and they have to scrounge for food, and they don’t actually get normal nutrition at a young age, that can affect the development of the lens, which can sometimes lead to cataracts. So there are lots of different causes but we touched on the main ones for sure.

Testing for Cataracts in Dogs and Cats

Dr. Fischer performing an eye exam on a dog with cataracts

[00:20:33] Dr. Lancellotti:  Because there’s so many different causes, and because we want to make sure that the problem is just with the lens (and not other parts of the eye), veterinarians are usually going to recommend some different types of testing. What do you talk to pet owners about, in terms of figuring out what the underlying cause is, and what the next steps are, in terms of treatment?

[00:21:09] Dr. Fischer: As far as testing goes, a basic eye exam is something that your family veterinarian will do when your pet comes in to see them for any eye problem, but especially if there’s a problem with vision or if you suspect cataracts. In a basic eye exam, your family veterinarian is going to be trying to evaluate vision- how well your pet can see. They’re going to start that with something called a menace response. This is when you move your hand very slowly toward the eye (and you try not to make any air move or any sound or anything with that). You don’t want to touch the animal, but you gently come toward their eye in a non threatening manner. But if your pet sees the hand coming towards their eye, they will blink in response to that. So that is a menace response, and that’s one of the ways that we evaluate vision. We can also do it by just watching the pet navigate around the room. We will also use bright lights, shining into their eyes directly, to see if the pupil is moving. So when you shine a bright light in the eye, the pupil should constrict, and when there’s not light, the pupil will dilate. We want to make sure that there is an appropriate response in your pet because that can help indicate if the eye is otherwise healthy.

There are other tests that we do to evaluate if your pet is making enough tears on the surface of their eye. Are they lubricating the surface of their eye well enough? We can check the pressure in the eye (tonometry), looking for things like Glaucoma, or things that could affect vision or our ability to restore vision. Then, because we talked about cataracts having a lot of potential underlying causes, you should do a really good physical exam on your pet, and maybe do some blood work to make sure they don’t have something like diabetes creeping in, so that you can figure out if there’s anything else that needs to be addressed. Prior to something like surgery for cataracts, there are tests that an ophthalmologist would do to evaluate the health of the eye, to be certain that if we go through that process, we’re really going to have a successful outcome.

[00:23:14] Dr. Lancellotti: So it sounds like the family veterinarian can do most of the initial evaluation- making sure that there’s not diabetes, getting that under control if it is present, before sending the pet over to see a specialist, so that they can get a really good evaluation and talk about next steps, in terms of treatment.

[00:23:32] Dr. Fischer: Yes, that’s exactly true. There are plenty of family veterinarians that just really don’t like to deal with eye problems. And that’s okay! If your veterinarian does not feel comfortable making the diagnosis or doing the testing, or if they don’t have some of these tests available in their clinic, that’s okay. But then, they would probably recommend following up with a specialist to get a better handle on what’s going on.

Treatment Options for Cataracts in Dogs and Cats

[00:23:55] Dr. Lancellotti: What are some of the options that pet owners have, in terms of treating cataracts? Can you talk a little bit about some of the benefits and risks to each treatment that’s available?

[00:24:06] Dr. Fischer: Sure. I guess I’ll start with saying that not all cataracts progress to vision loss. Some of them are really small and they don’t ever change. There are actually certain types of cataracts that form in certain breeds that are pretty classically insignificant. They’re just small, and they don’t really limit the vision, so we don’t really do anything about that. But there are some that we can tell that (even early on) are going to progress to vision decline. Unfortunately, if a cataract does progress to vision loss, and if it causes significant blindness, the only way to fix that would be something called phacoemulsification or cataract surgery.

There are not any medications or eye drops that actually work to dissolve cataracts or prevent cataracts from forming. I can say that with confidence. There are a lot of things that you may come across on the market (or on the internet) that claim to dissolve cataracts, but there is nothing that has been scientifically proven to do that.

Immature cataract in a dog eye

How Cataract Surgery is Performed in Dogs

Dr. Fischer: Basically, this surgery is very similar to what happens in people. If you know anybody who’s had cataract surgery, it’s pretty much the same thing. I tell owners all of the time that the biggest difference between cataract surgery in your dog and you is that this does require anesthesia, because no matter how sweet your pet is, they will not sit still long enough for me to do surgery inside of their eyeball.

We actually make a little incision into the eye, and then we make a little hole in that capsule, allowing us to get rid of that cloudy lens and essentially throw it in the garbage. Then, we put a new artificial lens in place to clear the window and restore vision. We use this machine to use a high frequency ultrasound, energy, to break up that cataract, liquefy it, dissolve it, and slurp it out of there. And then we put that artificial lens in place. As soon as they wake up from anesthesia, the lights are back on and they can see again, so it can be really rewarding.

Cataract Surgery in Cats

[00:27:25] Dr. Lancellotti: That’s awesome. I love that. You also do this surgery in cats?

[00:27:30] Dr. Fischer: We do. I mentioned before that cats don’t usually get genetic cataracts or diabetic cataracts actually, but sometimes, they develop cataracts secondary to inflammation in the eyes. Because of the inflammation inside of the eye, that can actually increase the risk of complications after cataract surgery, so we don’t do a lot of cataract surgery in cats just because of the reason that they develop the cataracts to begin with. But I have done cataract surgery in several cats who have traumatic or nutritional cataracts, or even what we don’t really know, but there’s no sign of inflammation, and we presume that maybe it was a genetic or congenital thing. And I’ve had a really great success rate with cats and cataract surgery, so it’s not off the table. But I would say that by and large, the most common pet that ends up having cataract surgery would be a dog.

Hypermature cataract in a dog eye with inflammation

Cataract Surgery Restores Vision in 90% of Pets

[00:28:21] Dr. Lancellotti: You mentioned success. Do you have an overall success rate that you give owners, when you talk about doing this procedure, and whether or not they’re going to get their vision back?

[00:28:31] Dr. Fischer: I do. One of the things that I tell owners all of the time is that your pet has a 100 percent chance of staying blind if we don’t try. There is no way to make it better if we don’t try with surgery. But it is really important to know that even though we usually quote success rates of 90 percent or greater for longterm vision that there are still potential risks with surgery. So in general, cataract surgery is very successful and we do usually quote success rates around 90%. But that still implies about a 10 percent chance that they could develop a complication after cataract surgery that could result in them losing their vision again.

All of the tests that we do before surgery are geared at making sure that they are the best candidate for surgery that they can be, and if we find something on that pre surgical testing that tells us otherwise, then we certainly talk about how that would affect that particular pet’s success with surgery. In general, if they are a good candidate for surgery, then most of the time they do really great. Occasionally, they can lose vision because of diseases after surgery, like detaching their retina or developing glaucoma (elevated pressure inside of the eye). But generally, I tell owners, “they have 100 percent chance of staying the way that they are if we don’t intervene,” and for most of those people, it’s worth the risk to go for it.

[00:29:54] Dr. Lancellotti: Yeah, that’s a great success rate, in terms of being able to change an animal’s quality of life dramatically.

Managing Dogs and Cats with Cataracts

[00:29:54] Dr. Lancellotti: Yeah, that’s a great success rate, in terms of being able to change an animal’s quality of life dramatically. But I know that there are some animals who are not going to be good candidates for surgery, either because of the underlying disease process, or maybe they have other things that put them at higher risk for anesthesia. And maybe some owners might not be able to afford the surgery. Can you talk a little bit about those animals where surgery may not be an option?

[00:30:22] Dr. Fischer: Of course. It is important to know that pets can have an excellent quality of life without vision. I think they have a little bit more fun if they can see, because they can go investigate the noises and chase the ball and all of that stuff, but they do not have the same emotional attachment to their vision as we do. They don’t think, “Oh, I’m never going to get to see the sunset again.” They really do adjust so well to vision loss because their environment is already relatively safe, protected and small. They don’t have to drive or read email, they just really need to be able to navigate their environment safely. Their sense of smell, their hearing, and the fact that they stay within the confinement of your home, usually makes it really easy for them to adjust.

In the chance that we can’t restore vision, the most important goal is to be sure that the eyes do not become a source of discomfort or pain. So a cataract itself is not inherently painful, but especially in scenarios where it progresses really rapidly, or it’s been there for a really long time, it can cause inflammation in the eye. So in really chronic cataracts, we see that pets can develop glaucoma, which can be quite painful, and they can also detach the retina (which is a permanently blinding issue, but it’s not necessarily painful). The lens can actually break free from the little attachments that it has inside of the eye and it can move around inside of the eye (lens luxation). When the little ligaments that hold the lens in place start to break down over time, then the lens can start to wiggle about inside of the eye and that can cause discomfort as well.

The most important thing, if your pet has cataracts and cataract surgery is not going to be an option for them, would be for you to just monitor them for signs of discomfort- things like squinting or holding the eye closed, discharge from the eyes, whether it’s tearing or a more mucous-like discharge. If the whites of the eyes are more red, or if you notice just any significant change in appearance of those eyes, those would be a reason to have your family veterinarian evaluate your pet to figure out if they’re comfortable or not. Most of the time, we’re able to achieve comfort, even in cases where we can’t do cataract surgery, but that is always going to be our goal.

Key Takeaways about Cataracts in Dogs and Cats

[00:32:52] Dr. Lancellotti: And so what are some of the big takeaway points that you’d like pet owners to remember?

[00:32:56] Dr. Fischer: It’s important to know that not all cataracts progress, will be blinding, or will require surgery. But if they do progress, there’s something that you can potentially do about that. Having your pet evaluated by your family veterinarian, and then potentially by a specialist veterinary ophthalmologist is going to be the best way to figure that out. Then, if cataracts progress quickly, ophthalmologists will consider those almost surgical emergencies, because when that happens, it can result in those secondary issues like inflammation in the eye, glaucoma, and other things that can actually prevent us from being able to restore vision successfully. So if you are concerned at all about your pet’s vision or the cloudiness that’s in their eyes, I would not wait until their appointment 10 months from now to bring it up. I would probably go ahead and try to have your family veterinarian evaluate your pet to try to figure out what’s going on.

[00:33:54] Dr. Lancellotti:  Dr. Fischer, I want you to talk a little bit about your consulting service, for those people who may not have a veterinary ophthalmologist in their region.

[00:34:29] Dr. Fischer: Of course. I started this teleconsulting business called OpthoVet Consulting, but it’s geared towards helping your family veterinarian manage your pet in your location (in their clinic), to provide specialty guided care for pets that may not have the ability to see a specialist. There is no substitute for being seen by a veterinary ophthalmologist. But if you have an issue, or if your family veterinarian is evaluating your pet and they’re not exactly sure what’s going on or what to do, and if you’re not sure if you want to go be evaluated by an ophthalmologist, I could potentially be a resource for them, to help guide them in making that decision.

I started this consulting business because I spoke with a lot of veterinarians all over the country who have said, “I would love to have my patients seen in a timely manner, but the ophthalmologist in my area has a three month waiting list for new appointments and some things just can’t wait,” or “the closest ophthalmologist to me is six hours away” and there’s no way that my clients will drive that far on a regular basis. So I have a really hard time managing these ophthalmology cases. I created the consulting business to try to help your family veterinarian managed cases, in their own clinic, with specialty guided care, to give the pets that they’re seeing the best possible outcome, whether it’s just until they have a chance to get into an ophthalmologist or if seeing an ophthalmologist is not an option.

Scratching the Itch: ACVO National Service Animal Eye Exam Event

[00:36:10] Dr. Lancellotti: Dr. Fischer, I like to end each episode with a segment that we call Scratching the Itch. This is designed to highlight something, whether it’s a human interest story, a product, or a website that just provides relief or makes you feel good. Hence, scratching the itch. Dr. Fischer, do you have a Scratching the Itch for our listeners today?

[00:36:40] Dr. Fischer: Well, the American College of Veterinary Ophthalmologists (ACVO) is our parent organization for all of the board certified veterinary ophthalmologists in the country. Every May, ophthalmologists all around the world actually volunteer their time and services to provide complimentary eye exams to service animals and working animals through this AVCO/Epicure national service animal eye exam event. Registration for this event actually happens in April, and then in the month of May, we will do free eye exams for them. The goal there is to try to pick up on issues before they really cause a problem because some of these animals really have important jobs. We see police dogs, police horses, military working dogs, guide dogs for the blind, etc. It’s so important that those dogs can see where they’re going so that they can do their job. And then there are mobility assistance dogs who help people with mobility issues navigate their world. We see animals that detect medical conditions. I have a dog that I see every year that is a hypoglycemia detection dog, who went off to college with a student, so that if they were having low blood sugar, they could detect that and alert them. There are also seizure detection dogs. It’s really cool to learn about these animals and what they’re capable of. This past year, we actually did the event and there were over 5200 working animals evaluated by over 270 ophthalmologists across the globe (America, Canada, Hong Kong, and even Puerto Rico).

[00:38:16] Dr. Lancellotti: That’s amazing.

[00:38:17] Dr. Fischer: We just love it. I love giving back in that way, learning about some of these super cool jobs that these animals can have, and being able to provide that service for them.

[00:38:27] Dr. Lancellotti: And so if people want to learn more about that event to either help donate and make that event possible, or maybe get their service animal looked at, where can they go to find more information?

[00:38:37] Dr. Fischer: The website is And there’s actually also a link to that website on the general ACVO website, as well. But if you work with an organization that has service animals, or if you have a certified service animal, I would certainly encourage you to register for this. It’s really cool. And you can find ophthalmologists in your area that are participating and set it up that way.

[00:39:07] Dr. Lancellotti: That’s awesome. I love that you participate in that. What a cool thing to do to give back to the community, but also to be able to work with these dogs that really make such a big difference in the lives of the people that they’re taking care of. Thank you for doing that.

[00:39:21] Dr. Fischer: Oh, you’re welcome. I love it. I love any opportunity to give back and share what I can do, with people who may not be able to find me otherwise.

[00:39:31] Dr. Lancellotti: Well, you certainly gave a lot of information to pet owners, today. I think that it was super helpful for everyone and there are really good places for them to go, in terms of having that conversation with their family veterinarian and potentially seeking out a veterinary ophthalmologist to help their pet. So thank you again for coming on and sharing that information, today.

[00:39:49] Dr. Fischer: You are so welcome. Thank you so much for having me.

[00:39:52] Dr. Lancellotti: And for everyone out there listening, I look forward to your next visit with Your Vet Wants You To Know.

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