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10 Oct 2024

All eyes on evidence-based medicine as ‘barbaric’ practice reemerges

Posting of online promotions for surgery to remove the nictitans gland provokes fury among ophthalmology group and professionals who believe it raises serious ethical and welfare questions.

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Lacey Pitcher

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All eyes on evidence-based medicine as ‘barbaric’ practice reemerges

Prolapsed third eyelid gland in an 11-month-old English bulldog. Image from Cherry eye: a re-emerging problem by James Smith.

A veterinary group has voiced its concerns at the apparent re-emergence of a controversial treatment method for the canine condition known as “cherry eye”.

The posting of several online promotions for surgery to remove the nictitans gland has also provoked fury among other professionals who believe it raises serious ethical and welfare questions.

The prolapse of the gland, widely referred to as cherry eye due to its appearance, is more common in some breeds including brachycephalics, due to the conformation of their skulls.

Criticism

Although approaches to treating the problem have been the subject of substantial professional debate, the British Association of Veterinary Ophthalmologists (BrAVO) is leading the latest round of criticism.

In a recent letter to both the BVA and Vet Times, the group said it would “would strongly advise against excising prolapsed tear glands of the third eyelid, especially in brachycephalic breeds, unless there was absolutely no other option”.

It continued: “In a situation where the tear gland must be excised, the owner should be made aware of the potential consequences of the procedure and should give fully informed written consent.”

‘Wildly outdated’

Some individual clinicians who contacted Vet Times also described the practice as “barbaric”, a “mutilation” and “wildly outdated”.

Mike Rhodes, ophthalmology specialist and BrAVO’s senior chair, added: “The excision procedure (typically done consciously following the application of topical local anaesthetic solution) is often carried out at breeder-led fertility clinics when the dogs are very young puppies.

“In our experience, the new owners are not made aware that this has been done to their pet or of the potential future consequences associated with excision of the tear gland, that is, medically refractive keratoconjunctivitis sicca and associated sequelae.”

An article in the Vet Times by James Smith entitled “Cherry eye: a re-emerging problem” (Volume 53, Issue 1, Pages 9-10, 3 January 2023 issue) summarised the surgical techniques available, and although postoperative complications are possible treatment carries a good overall success rate of around 90%.