Glaucoma and your diabetic dog

As you can see from the redness in the pic, our dog Parker developed glaucoma.There was a lot of pressure behind one eye and, despite our best efforts working with a canine ophthalmologist, he had to have one eye removed. That was tough news to hear.

Why diabetic dogs are at risk

Diabetic dogs are already prone to cataracts, because high blood sugar causes changes in the lens of the eye. Unfortunately, cataracts can increase the risk of secondary glaucoma.

Here’s how it happens:

• When the lens becomes cloudy and swollen from cataracts, it can block the normal drainage of fluid inside the eye.
• This fluid build-up increases pressure in the eye.
• That pressure damages the optic nerve and surrounding structures, leading to vision loss.

When you go for an eye exam, it’s likely that you experience a strange test where a machine blows a puff of air on your eye. That’s testing the pressure, and it’s typically measured in percentages. 

When Parker’s eyes are healthy, it seems like the percentages are around 18. The problematic eye reached into the 90s, which is extremely high pressure and probably caused him headaches and other pain.

Glaucoma can also develop for other reasons — like genetics or eye trauma — but in diabetic dogs, the link between cataracts and glaucoma is especially strong.

Signs of glaucoma in dogs

Glaucoma is often painful, but dogs may not always show obvious signs right away. Watch closely for:

• Redness in the eye (you can see it in the picture in Parker’s eye at the top of this article)
• Cloudy or bluish cornea
• Squinting, pawing at the eye, or light sensitivity
• Swollen or bulging eye
• Sudden loss of vision (bumping into things, hesitating on stairs)

It can be urgent

Glaucoma can progress very quickly. If you notice these signs, treat it as an emergency and call your veterinarian or a veterinary ophthalmologist. When we saw the redness, we called the clinic and sent a picture of his eye (which is why we happened to have it). They had us come in immediately.

What can be done

Treatment depends on how advanced the glaucoma is and whether vision can be saved. Options include:

• Medications (eye drops or oral drugs) to reduce pressure in the eye. We had, and still have, Parker on a regimen of three different drops 2x daily for his remaining eye.
• Surgery to restore fluid drainage or remove the source of pressure.
• In cases where vision is already lost and the eye is painful, removal of the eye (enucleation) may be the most compassionate choice.

We ended up having Parker’s eye removed. It was a tough, emotional decision to make. But we knew it was the right thing to do and we learned that dogs adapt quickly to having one eye.

Supporting a dog with glaucoma

• Regular eye exams: If your diabetic dog develops cataracts, ask your vet about glaucoma risk and monitoring.
• Prompt action: Quick veterinary attention at the first sign of eye pain or cloudiness can make a difference. We recommend taking pictures as it can be hard to describe.
• Consistency: Keeping blood sugar well-managed may help reduce complications that lead to eye disease.
• Adaptation at home: Dogs with limited vision do best with predictable routines, scent-based toys, and safe, familiar spaces.
  

Our house is an urban infill with four levels. The floors are all hardwood but our stairs are carpeted and we have yoga mats in the slippery areas. We put peel and stick carpet treads at the top of each staircase landing to help Parker, but he is cautious on the stairs. He used to bound up them with vigor but now he takes his time and we mostly carry him down the stairs.

Eye treatments are costly

There’s a sizable difference in the cost of a visit to your vet and a veterinary ophthalmologist. Even a brief follow up visit can be a couple of hundred dollars which pays for their time and advanced equipment. 

The prescription eye drops can be expensive as well. We've opted to continue drops on Parker's remaining eye to avoid another surgery, which adds to the monthly costs of his care.

Both the cataract surgery and eye removal operations were several thousand dollars. A diabetic dog requires blood glucose monitoring before, during and after surgery, which adds to the cost for the anesthesiologist. They will want your dog regulated ahead of surgery.

What we’ve learned

Glaucoma is a difficult diagnosis, especially on top of diabetes, but it doesn’t mean your dog’s life is over. With early detection, prompt treatment, and lots of love, many dogs continue to live happy, fulfilling lives. For us as pet parents, the most important thing is staying watchful for changes in their eyes and behaviour.