Incidence of KCS is First Opinion Practice

Supplied by Intervet/Schering-Plough Animal Health
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The incidence of
KCS is quoted as
1:22 (4.6%)
Keratoconjunctivitis sicca (KCS) is painful disease
which leads to permanent blindness. Recent studies1
have shown the incidence of KCS to be 1:22 or 4.6% of
the UK dog population, rising to 8.3% of predisposed
breeds. However, this figure is often questioned as the
diagnosis rate is lower in most practices.
During recent months, 20 practices have participated in an
Early Diagnosis Programme, measuring tear production
with a Schirmer Tear Test (STT). 1010 dogs, which had
not been previously diagnosed with KCS, were tested.
Is that correct in practice?
Method
Total dogs tested
Owners of predisposed breeds received a personalised
mailing, either as a letter or Chameleon* postcard, offering
them a free Schirmer Tear Test (STT). Some practices also
elected to test all breeds at routine consultations such as
vaccination. Schirmer Tear Tests were generally performed
by nursing staff after they had received training. The
diagnosis was made by a veterinary surgeon.
A diagnosis of KCS was made in 98 dogs. This is 9.7% of the
tested population – a figure that correlates well with existing
literature.
The results make interesting reading.
Confirmed KCS
Normal tear production
Suspect readings
150 dogs (14.9%) had suspect STT readings and should
be closely monitored, ideally re-testing after 4 weeks.
Monitoring these cases is essential, so that prompt
treatment with Optimmune can be started if needed - giving
the best prognosis longterm3.
75.4%
9.7%
Positive 5-9mm/min
14.9%
Critical <5mm/min
Interpreting STT
A diagnosis of KCS was made in dogs with STT readings below
10mm/min. Readings between 10-14mm/min were classed as
suspect. Readings ≥15mm/min are considered normal.
*Chameleon is an online personalised printing service available to Intervet/ScheringPlough Animal Health small animal vaccine customers.
STT readings from confirmed KCS cases
61.2%
Of confirmed cases, 38 dogs (38.8%) were classed as
CRITICAL, with STT readings <5mm/min.
38.8%
17 dogs (17.3%) had STT readings of 0mm/min in one or
both eyes – almost one dog for each participating practice.
Why were these dogs previously undiagnosed?
Why treat with Optimmune and not artificial tears?
Early diagnosis and treatment with Optimmune gives the best prognosis for KCS;
1. Only Optimmune treats the underlying disease process
therefore it is important these dogs are detected promptly. However, this study
Optimmune contains the powerful immunomodulator ciclosporin, which controls the
suggests that many existing cases are not being recognised.
underlying autoimmune process, preserving lacrimal tissue
Possible explanations include:
2. Only Optimmune maintains tear quality
KCS has a varied presentation
Natural tears are complex and multifunctional and cannot be replicated. Optimmune
s Not all cases have the classic
has a direct lacrimomimetic effect, increasing natural tear production with defensive5,
‘textbook’ appearance – some look
nutritional and lubricating properties. Artificial tears only provide lubrication without
surprisingly normal despite severely
the other functions vital for ocular health.
reduced tear production.
3. Only Optimmune increases the quantity of natural tears
Optimmune stimulates constant production of natural tears for continual supply. It
More STT should be routinely
also enables the eye to respond to increased needs, e.g. foreign body, rather than
performed
waiting for the next application of artificial tears which are commonly not applied
s In many cases, especially early in
frequently enough.
the course of the disease, diagnosis
requires clinical suspicion and a
Still not convinced?
Schirmer Tear Test
s Specialist ophthalmologists
For the chance to win one of 70 Samsung NV3
recommend regular testing of
7.2 mega pixel digital cameras, complete a
predisposed breeds, and all sore
Schirmer Tear Test Challenge**. Simply record
eyes*
All these dogs have KCS
the Schirmer Tear Test result from 50 dogs
not previously diagnosed with KCS, and see
how many confirmed and suspect cases you
*
“All sore eyes should have a Schirmer Tear Test,
whether or not there is corneal change”
discover. Contact your local Intervet/ScheringPlough Territory Manager or call 01908 685685
to receive the official entry form.
Claudia Hartley
BVSc CertVOphthal DipECVO MRCVS,
European Specialist in Veterinary Ophthalmology
For more information regarding KCS, Optimmune and support in implementing an
Early Diagnosis Programme, please contact your local Intervet/Schering-Plough
* A STT should not be performed if a descemetocoele is present as there is a risk of perforation.
Animal Health Territory Manager or call 01908 685685.
References:
1. Pierce V & Williams D, 2006, Determination of Schirmer Tear Test values in 1000 dogs. BSAVA Abstract 2006.
2. Intervet/Schering-Plough Animal Health Practice Study 2009.
3. Sansom J and Smitherman P, 1994, Long-Term Study on Efficacy of Cyclosporine Ophthalmic Ointment in the Treatment of Chronic Keratoconjunctivitis Sicca in the Dog, Veterinary Applications in Ophthalmic Disease. Minutes of ESVO-ECVO meeting.
4. Sanchez F et al, 2007, Canine KCS: disease trend in a review of 229 cases JSAP Vol48 p211-217.
5. Fuller RJ, 1994, Characterisation of Tears Induced by Cyclosporine, Veterinary Applications in Ophthalmic Disease. Minutes of ESVO-ECVO meeting.
** All entries should be on the official Schirmer Tear Test Recording card, available from your local territory manager or by calling 01908 685685. Photographs supplied by the Animal Health Trust.
Presentation: Optimmune® is a white petrolatum based ointment containing 0.2% w/w ciclosporin A. Uses: Keratoconjunctivitis sicca and chronic superficial keratitis. Contra-indications, warnings: Do not administer to pregnant bitches.
Mild irritation in the first few days of therapy has been seen. If such irritation persists, treatment should be discontinued. Do not use where viral or fungal infection of the eye is suspected. Wear gloves when applying ointment and wash hands after use.
Pharmaceutical precautions: Store below 25ºC. Any contents remaining one month after the date on which the container was first opened should be discarded. Legal category POM-V Packaging quantities: 3.5g tubes. For full information see data sheet.
Marketing Authorisation Holder: Schering-Plough Animal Health Ltd. ® registered trademark.
Intervet/Schering-Plough Animal Health, Walton Manor, Walton, Milton Keynes MK7 7AJ