Retinal Hemorrhage in Dogs

Retinal hemorrhage is a disorder in which bleeding occurs in the retina itself, or in the cavities in front of or behind the retina. This can be caused by disorders including physical trauma, high blood pressure, diabetes, and congenital predisposition, and the treatment plans can be as varied as the reasons. If you see bleeding in your pet’s eye, contact the veterinarian as soon as possible for testing and treatment. Some vision-saving treatments are only effective if the underlying disorder is caught early.

When the retina or the cavities directly in front of or behind the retina bleed, this is known as a retinal hemorrhage and can be a symptom of several disorders and diseases.

Hemorrhage caused by chronic disorders such as hypertension is more likely to cause progressive vision loss, whereas bleeding due to trauma is more likely to produce acute vision loss.

• Acute or progressive vision loss
• Asymmetrical pupil size
• Bleeding inside the eyes
• Bleeding from the eyes
• Dilated pupils
• Enlarged eyes
• Greenish, shiny reflection of the eyes
• Ocular discharge
• Red eyes

Types 

Several disorders that can be predisposed by breed can lead to retinal hemorrhage as well. Dog breeds predisposed to retinal detachment that may lead to hemorrhage:

• American Cocker Spaniel
• Bedlington Terrier
• English Springer Spaniel 
• Miniature Schnauzer

There are dog breeds prone to “collie eye”, a congenital disease that causes parts of the eye to develop improperly. The blood vessels feeding the retina are called the choroid, and may be inadequately formed in dogs with this disorder:

• Australian Shepherd
• Border Collie
• Collie
• Lancashire Heeler
• Nova Scotia Duck Tolling Retriever
• Shetland Sheepdog

The pressure from glaucoma can also cause the blood vessels in the eye to rupture. These dog breeds are prone to developing glaucoma:

• Bassett Hound
• Beagle
• Chow Chow
• Cocker Spaniel
• Dalmatian
• Poodle
• Siberian Husky
• Terrier breeds

Retinal hemorrhage is when blood pools behind, in front of, or in the retina itself. This disorder can have a large variety of causes, including physical trauma, genetic predisposition, and infections, and should always be evaluated by a veterinary professional. In addition, retinal hemorrhage is listed as a possible symptom or complication in a number of disorders, including:

• Blastomycosis
• Choking injuries
• Cushing’s disease
• Decreased vitamin K levels
• Hemophilia
• High blood pressure
• Hyperviscosity syndrome
• Leukemia
• Liver disease
• Rocky Mountain spotted fever
• Septicemia
• Surgery in or around the eye
• Tumors

When you bring your dog into your veterinarian, the appointment will start with a thorough physical exam. The head will be checked for trauma, and blood pressure and arterial health will be evaluated. Standard tests will be run to check for underlying conditions including urinalysis, biochemical profile, and a complete blood count. These tests help to determine if there is a primary cause, such as high blood pressure, diabetes, toxins, or trauma that needs to be addressed in the treatment plan.

Although your doctor may choose to do the ophthalmic exam,  it is more often referred to a veterinary ophthalmologist for evaluation of the eyes and surrounding tissues. This will likely include tests to assess your pet’s visual acuity such as tossing a cotton ball towards your pet to see how it reacts and a pupillary light reflex test to see if the pupils are constricting properly when exposed to light. The ophthalmological tests will also gauge the health of the structures that support the eye, such as the tissues that surround the eye, the eyelids, and the cranial nerves.

The treatment involved with a retinal hemorrhage will be dependant on what underlying cause is present. In many cases, the treatment of the underlying condition is sufficient to solve the problem and prevent further bleeds. These treatments could comprise a number of remedies depending on the cause of the bleed, such as supplementing the diet with vitamin K if it is deficient, medications prescribed for disorders such as high blood pressure, and adjusting the diet in animals that have developed imbalances in sugar and protein levels.

In severe damage to the retina or to the blood vessels that feed into the area, surgical options such as retinal reattachment may be available to your pet’s vision during the early stages, but may become less viable as time goes on. Laser surgery is often utilized for working with the eyes and the nerves and blood vessels connected with the eyes as the vessels can be small and fragile.

Regular eye examinations and blood pressure monitoring will generally be required after any sort of damage that causes bleeding within the eyes. Beyond that, the prognosis of this disorder is varied, depending on the origin of the bleed. Some dogs recover completely just by treating the underlying condition, and some conditions are not conducive to treatment, and the patient may lose some or all of their vision. Fortunately, dogs usually adapt quickly to both partial and total blindness and can lead an enjoyable and satisfying life with just a few considerations, such as training using voice commands and putting up barriers near danger areas such as stairs or pools.