Dr. Kristen Fischer, veterinary ophthalmologist, is back to discuss the challenges and techniques for applying eye medications to pets when treating corneal ulcers, dry eye, or other eye diseases. She shares practical tips for large dogs, small dogs, and cats, as well as methods for handling more fearful or aggressive animals safely. The episode emphasizes the importance of patience, positive reinforcement, and the use of tools like muzzles and E-collars. Real-life examples, such as a Shih Tzu with dry eye disease, illustrate how owners can successfully administer eye drops. Dr. Fischer recommends pet owner communicating with veterinarians for personalized advice and exploring creative solutions to ensure pets receive the necessary treatment.
Table of Contents
Introduction to Eye Medications
Dr. Lancellotti: Welcome, everyone, to today’s episode of Your Vet Wants You To Know. Today, we’re going to do a quick little follow up episode on how to apply eye medications. Dr. Kristen Fischer, a veterinary ophthalmologist, joined us to talk about corneal ulcers. One of the main treatments that we use for corneal ulcers is topical antibiotics. Dr. Fischer is joining us to tell us a little bit about how to make application of topical eye medications as easy as possible, because we know it’s not always easy. Welcome back to the show, Dr. Fischer!
[00:01:35] Dr. Fischer: Thank you so much for having me. It is not easy, most of the time, to get those eye drops in. You would not believe how many clients (when we’re in the exam room) look at us with their mouth hanging open and her jaw on the floor going, “how did you do that? I would chase my animal around for 20 minutes, trying to pin them down to do this. How did you do it so easily? So there are definitely some tricks of the trade, which we will share today, that will help figure out how to best medicate your pet, if you end up in the position where you need to do eye drops or eye ointment.
[00:02:11] Dr. Lancellotti: Awesome! This is going to be so helpful. I feel like topical eye medications are just as tricky for your clients as doing ear cleanings are for my clients. So I think this is going to be really helpful, to walk people through and guide them on something that (you and I are familiar with and know how to approach, but to someone who’s never done this before, it) can seem really daunting and overwhelming.
Giving Eye Drops to Dogs Can be Hard!
Dr. Lancellotti: When we talk about animals that need a topical eye medication, are there any particular pets that come to your mind who maybe struggled a little bit in the beginning, but with the right guidance and coaching, the owner was able to successfully accomplish this?
[00:02:49] Dr. Fischer: Yeah. This happens on almost a daily basis, but I recall a specific little Shih Tsu named Beau who was really naughty. When you think about the face of a Shih Tzu, they have no nose to grab onto. I joke and say “they don’t have a handle (because on a Dachshund, they’ve got a handle and can hold their little nose still).” Shih Tzus don’t have anything to grab onto (nor do pugs, or any of those little smushy-faced fellows). So, ulcers are one of the many reasons that we need to do eye drops, but usually with an ulcer, the good news is that you do it for a short period of time and then you don’t have to do it anymore. This particular little dog was diagnosed with dry eye disease, which is something that needs ‘twice a day’ drops forever. They need it twice a day, every day, for the rest of their life. Sometimes, in the beginning, they need more frequent eye medications to get it under control. There are several diseases like that (glaucoma, for example) that end up being lifelong diseases which needs long term meds. So those owners came in for their first exam, we prescribed the medication, and then they came back for the recheck and were just exhausted and defeated. They said, “He’s trying to bite us. He’s running away from us. He’s hiding under the bed and we can’t do this. We need a different medication.” And I said, “Well, unfortunately, this is the best thing for him. He weighs 11 pounds and you weigh more than that. You can teach him how to do this. You’re going to have to do it, so let’s just figure it out.” So we taught them some tips on how to administer eye medication and it changed the game. I said, “Let’s try this, do the best you can, and let’s see you back in a couple weeks.” When they came back in, they were so proud of how successful they have been. Now, he comes to them and begs for the drops, because when he gets the drops, he gets a treat. If they forget to do the eye drops, it’s totally changed- from him trying to bite them, to him actually coming and reminding them when he’s due for his eyedrops. He’s just feeling confident, and being able to master the beast without being afraid is key. Now certainly, they’ve got to be safe. If the dog is really trying hurt them, that’s a whole different ballgame. But I think that for them, it was just learning some tips and maneuvers so that they could figure out how to do it successfully.
[00:05:15] Dr. Lancellotti: You brought up some really good points there. First of all, I love when owners come back in proud that they’ve been able to do something at home really well. It’s so satisfying. Secondly, I love that you mentioned safety.
How to Give Eye Drops to Big Dogs
Dr. Lancellotti: So let’s start with (generally) nice dogs, who may just be irritated, annoyed, or confused as to what the owner is trying to accomplish.
[00:05:36] Dr. Fischer: Right. For the dogs who are just avoiding you doing the eye medication (who just don’t like it), there are a couple of different tips. Now let’s first talk about big dogs. If you’ve got a Labrador, St. Bernard, or a Great Dane who needs eye medication, and they’re just big (who may weigh more than you do) and you’ve got to figure out how you’re going to do this, the best thing you can do is back them into a corner and have them sit on your feet with their head facing away. So you’re standing behind them, they’re looking away from you, and you’ve got them backed in the corner so that they can’t back up. And they’re not going forward because you’ve got your arm up under their neck, like you’re giving them a little hug from behind. Then, what I do is put my eyedrop in my dominant hand and I come from the top. If you come straight at their face, they’re gonna back away or turn their head. So if they don’t really realize what you’re doing, they tend to do better. If you’ve got them from behind and you tilt their chin up towards the sky, then you can use the heel of your hand to pull their skin up, above their eye, and put that drop in from the top. A lot of times, it’s helpful to have another pair of hands. You can hold on to them and somebody else can do that. But if you’re by yourself, you live alone, and you’ve got this big unruly beast that you’re trying to give medication to, that’s the easiest way. Sometimes, you can even go into the bathroom or the laundry room, so that even if they do get away from you, they’re not like tearing off at the stairs or out the doggy door or whatever. So I would just confine yourself. Also, use lots of positive reinforcement. I also recommend that if it’s a twice a day medication, do it at feeding time, and don’t feed them until after they’ve had their eyedrops (for motivation). “Alright, you got your eyedrop, now here’s your breakfast. Good job.” You know? Dogs are very good at picking up on that kind of stuff. So that’s my biggest tip for large dogs.
How to Give Eye Drops to Small Dogs
Dr. Fischer: For small dogs, my biggest tip is to pick them up off the ground. Get those four little feet off the ground and put them up on a non-slip surface that’s closer to your kind of working level. Usually, I recommend the countertop, the dryer, or even the bed. Put them on a non-slip surface and do the same thing. Put their rear end towards you, their nose away from you, lift up their chin with your non-dominant hand, and apply the drops from the top with your dominant hand. The same thing applies for ointment. Ointment is a little harder because you’re trying to squeeze a little bit out of the tube without touching the little metal tip to the eyeball. Sometimes with ointment, you can put a little bit on your finger and roll their lower lid down to get it in their eye. But with picking them up off the ground so that they can’t run away, you’ve got that upper hand.
How to Give Eye Drops to Cats
[00:08:29] Dr. Fischer: My tip, for cats who don’t want eye drops, and little dogs who are squirming up on your countertop, is going to be the same. I would recommend putting a towel on that surface, putting your animal in the middle of that towel, rear end towards your belly, head facing away, and wrap them up like a little burrito. You just take one side over the top (like you’re swaddling a baby) and the other side over so that they’re cocooned in there, which makes them feel secure. Then, you can tilt their chin up and come from the top that way, as well. But half of the time, once you lift them up onto the counter, they spend the first couple of seconds trying to figure out why they’re on the counter, and you can probably already get your eye drops done.
[00:09:10] Dr. Lancellotti: Yeah, that’s a great suggestion. And for someone tall like me, it’s a really helpful tool to get those little dogs up and off of the floor, so that you have a little bit more control when you’re working with them, rather than trying to squirm around with them on the ground. I love the positive reinforcement. Cooperative care is a great way of training your animal to be engaged, and to allow the treatments that you want to administer. There’s an episode that I did earlier on ear treatments and cooperative care, but the same concepts of cooperative care apply to eye medications, as well. It’s just making sure that the animal is okay with every step of the process, and a lot of that involves those positive reinforcements with treats, favorite toys, or whatever it is that animal really likes. Just make sure that they are being rewarded for allowing you to do what you want with them. Wrapping the cat in the burrito is fantastic. And in our clinic, we call those “purritos” instead of just burritos. Those are all really helpful tools. For those who want to see this in action, we’re going to have some videos up on the website, so that you can check that out and see the process of actually getting those eye medications into the animal’s eyes.
Using a Muzzle When Giving Eye Medications to Dogs
[00:10:27] Dr. Lancellotti: Let’s talk about our dogs that may be more fearful and may use aggression. What are some ways that you would recommend that owners approach these animals, and this technique, in order to help keep everybody safe?
[00:10:40] Dr. Fischer: Well, if you have a truly aggressive animal (it really depends on the case obviously, and the owner’s ability to handle the pet), the nylon muzzles can be very helpful. They are actually quite calming for some of those fearful pets. It gives them something to think about. And you can purchase those nylon muzzles at pet stores. Your veterinarian may even have some recommendations. You can buy them online. They also make those basket muzzles that are made out of rubber, which have a little bit more of an opening for them to breathe and pant. With the nylon muzzles, they can still breathe too, but they seem to be a little less restrictive. If you can safely get those on, then it will allow you to be able to get the medications in safely, using the tips we spoke about before.
Using Anti-anxiety Medications to Help Give Eye Drops
Dr. Fischer: I also think that anxiety medications can help, so you can ask your veterinarian, if you’re having trouble with that. Sedating your animal or using medications to try to help reduce the fear and anxiety can be quite helpful. A lot of times, it’s not enough medication for your dog to not be themselves, it’s just enough to help them cooperate. So I would certainly speak with your family veterinarian about options, if you’re really struggling to get medications in safely.
I have also had some pets that owners are just unable to medicate for safety reasons. Sometimes, that involves them taking the animal to the veterinarian once or twice a day for medication, or hiring somebody who can come in and help them do it (if they live alone, and they can’t by themselves). Sometimes, we just have to get creative with our treatments. That’s a conversation, if you’re struggling with that, to have with your family veterinarian, to try to come up with some possible solutions.
But I would agree that medications can help ease the process, and a lot of times, that’s a short term solution until your dog gets more used to it. Even the aggressive dogs can actually have a positive experience with our medications eventually, once they get over that initial fear.
[00:12:52] Dr. Lancellotti: You just unloaded so many good gems in there. I love that. And I am 100 percent on board with all of these things, including using some of these anti-anxiety medications that we have. I’ve mentioned my dog, Russell Sprout -he’s the mascot for Your Vet Wants You To Know- he’s not like the nicest dog, especially when we’re doing things that he doesn’t really like. He’s a great snuggler, he’s playful, and he loves my family and me (and his select group of people), but at the vet’s office and for certain things that we have to do to him, he’s not thrilled. When he first started getting ear infections, we did use anti-anxiety medication, so that he would not bite my husband and me, when we were first starting to do ear cleanings. But once we trained him, and he got more comfortable with it, now we can do those ear cleanings without having to do any sort of anti-anxiety medications. The same thing goes for eye medications. You may need them in the beginning, while you’re working on establishing that positive association with the treatments, but then once the animal learns, “Okay, nothing bad’s happening. I get a little something in my eye, but then I get this wonderful treat,” you should be able to eventually phase out these medications and accomplish it on your own.
Tips for Using a Muzzle for Your Dog
Dr. Lancellotti: You mentioned the muzzles- there are so many different types out there, especially for our smoosh-faced dogs like French bulldogs, English bulldogs, Pekingese, Shih Tzus, etc, there are muzzles specifically designed to go over the face and allow those animals to breathe, but they fit differently than the ones for dogs with longer snouts. So make sure that you’re asking your family veterinarian or your veterinary ophthalmologist what type of muzzle they would recommend, and just work on creating that positive association with the muzzle too. Something good should happen. This is why I like those basket muzzles that you mentioned. They’re easy to get treats through, so you can work on that training process while keeping everybody who’s involved nice and safe. Excellent suggestions, Dr. Fischer. I love that!
[00:14:55] Dr. Fischer: I’ve even seen people actually put a little bit of peanut butter inside of that basket muzzle. So the dog’s got the muzzle on, licking the peanut butter, thinking about what’s in the muzzle, and then it’s over. Then they start to see that muzzle and they’re like, “Oh, goody.”
Creative Tips for Putting Eye Drops in Pets' Eyes
Dr. Fischer: It’s not easy. It’s a challenge. If your pet’s eye is hurting, then they really may not want you to mess with them. But they will get used to it, and that’s the thing that’s sometimes hard. If we have one of these really infected ulcers, sometimes I send patients home with three or four different eye drops that they have to get hourly (for several hours) to try to stop the infection and save the eye. They get tired of it pretty quickly, but it’s that or potentially losing the eye. Some people just try to sneak up on their pet when they’re sleeping. Sometimes, that works too, but then you only have certain opportunities for that.
Also, if you wanted to practice eye medications with your own pet, you can use just over the counter artificial tear, unmedicated saline drops that you would use for lubrication. If you want to practice at home, to try to see how your pet would handle something like that, then this would be a safe way to start out.
[00:16:07] Dr. Lancellotti: I love taking a proactive approach, that’s fantastic. You talked about pain as being part of what’s going on with their eyes. Sometimes, your veterinarian can recommend a pain medication that also has some anti-anxiety properties to it. So if you make them feel better and decrease their stress level, that’s going to help accomplish putting in these topical eye medications. Honestly, I think veterinarians are some of the most ingenious and creative people out there, particularly zoo veterinarians. You have to think; what sort of available tools do we have that are going to help in our specific situation? So as a pet owner, if you are struggling with putting eye medications in, it’s important to have a conversation with your family veterinarian or your ophthalmologist (or whomever is prescribing those medications) and let them know, “Okay this is what I’m doing at home. This is where I’m struggling.” Find out what sort of things you can do to make this a little bit easier or more successful. Because a lot of times, we’ve heard it before. We can get a little bit creative and come up with some solutions, but it just depends on what you’re struggling with. Don’t be afraid to reach out and have that conversation -have an open line of communication- so that they can make individual recommendations for your specific pet.
You Can Give Eye Drops to Your Pet!
Dr. Lancellotti: Dr. Fischer, do you have any big takeaways that you want to share with our pet owners about putting in eye medications?
[00:17:35] Dr. Fischer: Well, when you mentioned tools, it made me think about something I mentioned in the corneal ulcer episode. A lot of times, if you’re treating something that’s a painful condition for the eye, or if it’s a post-eye surgery or something like that, your pet might have been sent home with a hard plastic protective E-collar. That can be a helpful tool, as well. So you can use that E-collar to manipulate them and keep their head towards the sky, by tilting them up with their own E-collar, and then coming from the top with the drops. For aggressive or little nippy smaller breed dogs, that can be very helpful. A lot of times, we say that it’s easier to take the cone off, so that you can manipulate their head a little bit better. But for dogs who are bitey, sometimes we’ll leave that cone, and you just grab the edge and maneuver their head in any which direction. That will help you aim and get the drops in.
Sometimes, when you’re practicing and you’re learning, you’re going to waste some eyedrops. So if you’re like, “I sometimes go through six drops trying to get the one in the eyeball,” that’s okay. You can always get more of those if you need them. So I guess my biggest takeaway is that most of the time, if we’re prescribing these medications, they are for a reason and important to help your pets manage whatever disease process is going on.
If you are struggling, there are a lot of different tips and tricks that we’ve highlighted here. You can certainly reference this. But speak with your veterinarian. Sometimes, they can even demonstrate. You don’t know how many times a day that I’ll have have my technicians go into exam rooms and show owners how to administer eye drops. We may tell you that this dog needs this medication four times a day, and you leave there and go, “Okay, I can do this,” but then you get home and you can’t do it. You don’t know how. Nobody ever showed you how. Don’t be embarrassed. Don’t be ashamed that you can’t do it. We are certainly prepared to help you learn how to do this. Especially, for those conditions that require long term treatment. Unless your dog is just extremely fearful, and it’s an unsafe situation with aggression, I believe that even the most avoidant of pets can learn how to have eyedrops administered on a regular basis, with just a little bit of patience and creativity.
[00:19:55] Dr. Lancellotti: Are you saying that old dogs can learn new tricks?
[00:19:59] Dr. Fischer: Of course they can!
[00:20:03] Dr. Lancellotti: Well, this is so helpful. It’s definitely something that I’m going to share with my clients, in terms of being able to get that done at home. Thank you so much for sharing your time and expertise with us, Dr. Fischer. I really appreciate it.
[00:20:14] Dr. Fischer: Oh, you’re so welcome. I feel like this is going to be a great resource for my clients too. When we show them, we can also send them here and have them listen to what I’ve already told them several times before.
[00:20:28] Dr. Lancellotti: Awesome! Repetition really is key. There’s so much information that we give pet owners during the exam, and during their time in the hospital, that it’s just impossible to remember everything. So the fact that we have a resource now, for people to listen to all of that information again, is going to be so helpful for so many people. So thank you very much.
[00:20:49] Dr. Fischer: I agree. You’re welcome.
[00:20:51] Dr. Lancellotti: And to everyone out there listening, I look forward to your next visit with Your Vet Wants You to Know.
