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Cherry eye in dogs, medically is known as prolapse of the nictitating membrane. Usually occurs when the gland of the third eyelid protrudes from its normal position. This condition predominantly affects dogs, particularly those under one year of age. The third eyelid is a crucial component of a dog’s ocular system. Plays a significant role […]
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Welcome to the deep dive. The place
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Welcome to the deep dive. The place
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Welcome to the deep dive. The place where we, you know, we really trying to
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where we, you know, we really trying to
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where we, you know, we really trying to get past those surface level headlines
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get past those surface level headlines
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get past those surface level headlines and into the details that matter.
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and into the details that matter.
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and into the details that matter. >> Today we are digging into something that
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>> Today we are digging into something that
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>> Today we are digging into something that if you're a dog owner is just
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if you're a dog owner is just
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if you're a dog owner is just >> Yeah.
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>> Yeah.
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>> Yeah. >> It's one of the most alarming things you
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>> It's one of the most alarming things you
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>> It's one of the most alarming things you can suddenly see.
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can suddenly see.
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can suddenly see. >> Absolutely. We're talking about that
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>> Absolutely. We're talking about that
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>> Absolutely. We're talking about that moment you look at your dog and see this
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moment you look at your dog and see this
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moment you look at your dog and see this small red fleshy mass just sort of
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small red fleshy mass just sort of
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small red fleshy mass just sort of bulging out from the corner of their
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bulging out from the corner of their
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bulging out from the corner of their eye.
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eye.
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eye. >> It's a condition that almost everyone
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>> It's a condition that almost everyone
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>> It's a condition that almost everyone knows by its nickname, cherry eye. And
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knows by its nickname, cherry eye. And
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knows by its nickname, cherry eye. And that first sight can really send you
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that first sight can really send you
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that first sight can really send you into a panic. Is it a tumor,
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into a panic. Is it a tumor,
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into a panic. Is it a tumor, >> an injury? It's uh it's very visually
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>> an injury? It's uh it's very visually
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>> an injury? It's uh it's very visually jarring.
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jarring.
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jarring. >> It really is. So, our mission for this
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>> It really is. So, our mission for this
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>> It really is. So, our mission for this deep dive is to pull apart the
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deep dive is to pull apart the
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deep dive is to pull apart the veterinary research. We want to
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veterinary research. We want to
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veterinary research. We want to understand what's actually happening
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understand what's actually happening
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understand what's actually happening beneath the surface. Why does cherry
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beneath the surface. Why does cherry
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beneath the surface. Why does cherry happen? Why does it seem to target
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happen? Why does it seem to target
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happen? Why does it seem to target specific breeds? And maybe most
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specific breeds? And maybe most
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specific breeds? And maybe most importantly, what is the absolute gold
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importantly, what is the absolute gold
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importantly, what is the absolute gold standard for treatment?
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standard for treatment?
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standard for treatment? >> Right? We want you to walk away from
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>> Right? We want you to walk away from
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>> Right? We want you to walk away from this with knowledge that's not just
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this with knowledge that's not just
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this with knowledge that's not just interesting, but truly actionable for
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interesting, but truly actionable for
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interesting, but truly actionable for the health of your dog.
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the health of your dog.
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the health of your dog. >> And I think we have to start with the uh
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>> And I think we have to start with the uh
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>> And I think we have to start with the uh the formal medical term because it tells
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the formal medical term because it tells
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the formal medical term because it tells you so much right away.
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you so much right away.
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you so much right away. >> It does. Medically, it's called a
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>> It does. Medically, it's called a
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>> It does. Medically, it's called a prolapse of the nictitating membrane.
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prolapse of the nictitating membrane.
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prolapse of the nictitating membrane. And that word prolapse tells you this
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And that word prolapse tells you this
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And that word prolapse tells you this isn't an infection or a growth. It's a
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isn't an infection or a growth. It's a
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isn't an infection or a growth. It's a structural failure. Something has come
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structural failure. Something has come
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structural failure. Something has come out of place. And one of the most
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out of place. And one of the most
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out of place. And one of the most fascinating things our sources point out
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fascinating things our sources point out
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fascinating things our sources point out is who this affects. It's not a disease
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is who this affects. It's not a disease
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is who this affects. It's not a disease of old age.
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of old age.
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of old age. >> Not at all. It is overwhelmingly a
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>> Not at all. It is overwhelmingly a
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>> Not at all. It is overwhelmingly a problem of the young. We see it
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problem of the young. We see it
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problem of the young. We see it predominantly in dogs that are under one
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predominantly in dogs that are under one
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predominantly in dogs that are under one year of age, sometimes even just a few
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year of age, sometimes even just a few
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year of age, sometimes even just a few months old.
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months old.
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months old. >> Wow. That young.
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>> Wow. That young.
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>> Wow. That young. >> Yeah. And that's often the first big
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>> Yeah. And that's often the first big
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>> Yeah. And that's often the first big clue for a veterinarian. When a young
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clue for a veterinarian. When a young
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clue for a veterinarian. When a young dog presents with this, Cherryey is
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dog presents with this, Cherryey is
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dog presents with this, Cherryey is immediately at the top of the list of
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immediately at the top of the list of
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immediately at the top of the list of possibilities because it points towards
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possibilities because it points towards
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possibilities because it points towards something developmental or hereditary.
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something developmental or hereditary.
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something developmental or hereditary. Okay, so let's unpack that essential
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Okay, so let's unpack that essential
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Okay, so let's unpack that essential anatomy. To really get what's going
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anatomy. To really get what's going
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anatomy. To really get what's going wrong, we first have to understand the
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wrong, we first have to understand the
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wrong, we first have to understand the structure itself. Most people think dogs
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structure itself. Most people think dogs
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structure itself. Most people think dogs just have two eyelids like us,
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just have two eyelids like us,
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just have two eyelids like us, >> right? But they actually have a third
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>> right? But they actually have a third
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>> right? But they actually have a third one, it's a crucial piece of their
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one, it's a crucial piece of their
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one, it's a crucial piece of their ocular system.
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ocular system.
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ocular system. >> And that's the nictitating membrane we
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>> And that's the nictitating membrane we
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>> And that's the nictitating membrane we just mentioned.
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just mentioned.
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just mentioned. >> Exactly. It's technically located at the
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>> Exactly. It's technically located at the
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>> Exactly. It's technically located at the inner corner of the eye, the part
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inner corner of the eye, the part
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inner corner of the eye, the part closest to the nose. And while you might
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closest to the nose. And while you might
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closest to the nose. And while you might not notice it most of the time, it's not
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not notice it most of the time, it's not
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not notice it most of the time, it's not just a flap of tissue. It's built around
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just a flap of tissue. It's built around
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just a flap of tissue. It's built around a T-shaped piece of cartilage that gives
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a T-shaped piece of cartilage that gives
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a T-shaped piece of cartilage that gives it some rigidity.
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it some rigidity.
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it some rigidity. >> So, it's an active part of the eyes
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>> So, it's an active part of the eyes
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>> So, it's an active part of the eyes anatomy. It does something.
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anatomy. It does something.
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anatomy. It does something. >> Oh, absolutely. It has two incredibly
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>> Oh, absolutely. It has two incredibly
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>> Oh, absolutely. It has two incredibly important jobs. First, it's for
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important jobs. First, it's for
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important jobs. First, it's for protection. It can sweep across the
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protection. It can sweep across the
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protection. It can sweep across the cornea like a windshield wiper to shield
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cornea like a windshield wiper to shield
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cornea like a windshield wiper to shield it from dust or a stray branch. It's a
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it from dust or a stray branch. It's a
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it from dust or a stray branch. It's a rapid mechanical barrier.
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rapid mechanical barrier.
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rapid mechanical barrier. >> A built-in shield. That's pretty cool.
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>> A built-in shield. That's pretty cool.
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>> A built-in shield. That's pretty cool. >> It is. But its second job is arguably
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>> It is. But its second job is arguably
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>> It is. But its second job is arguably even more vital for the long-term health
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even more vital for the long-term health
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even more vital for the long-term health of the eye.
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of the eye.
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of the eye. >> And that's where the moisture component
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>> And that's where the moisture component
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>> And that's where the moisture component comes in. Precisely. This third eyelid
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comes in. Precisely. This third eyelid
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comes in. Precisely. This third eyelid houses a very important gland. It's
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houses a very important gland. It's
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houses a very important gland. It's actually responsible for producing um
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actually responsible for producing um
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actually responsible for producing um somewhere between 30 and 40% of the
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somewhere between 30 and 40% of the
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somewhere between 30 and 40% of the dog's total tears.
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dog's total tears.
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dog's total tears. >> 30 to 40%. That's a huge amount.
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>> 30 to 40%. That's a huge amount.
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>> 30 to 40%. That's a huge amount. >> It's massive. And those tears aren't
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>> It's massive. And those tears aren't
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>> It's massive. And those tears aren't just for lubrication. They bring
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just for lubrication. They bring
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just for lubrication. They bring nutrients to the cornea and wash away
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nutrients to the cornea and wash away
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nutrients to the cornea and wash away waste. So when everything is working
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waste. So when everything is working
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waste. So when everything is working correctly, this gland is tucked safely
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correctly, this gland is tucked safely
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correctly, this gland is tucked safely out of sight just doing its job.
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out of sight just doing its job.
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out of sight just doing its job. >> Okay. Okay. So, when we talk about the
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>> Okay. Okay. So, when we talk about the
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>> Okay. Okay. So, when we talk about the prolapse, the cherry eye, what's
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prolapse, the cherry eye, what's
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prolapse, the cherry eye, what's actually happening on a mechanical
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actually happening on a mechanical
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actually happening on a mechanical level?
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level?
3:09
level? >> The word prolapse means the gland has
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>> The word prolapse means the gland has
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>> The word prolapse means the gland has slipped out and literally flipped over
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slipped out and literally flipped over
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slipped out and literally flipped over the top edge of that T-shaped cartilage.
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the top edge of that T-shaped cartilage.
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the top edge of that T-shaped cartilage. It's been pushed out from its normal
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It's been pushed out from its normal
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It's been pushed out from its normal protected position.
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protected position.
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protected position. >> Once it's exposed to the air,
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>> Once it's exposed to the air,
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>> Once it's exposed to the air, >> it immediately becomes irritated and
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>> it immediately becomes irritated and
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>> it immediately becomes irritated and inflamed. That's why it gets that
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inflamed. That's why it gets that
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inflamed. That's why it gets that characteristic red fleshy cherry-like
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characteristic red fleshy cherry-like
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characteristic red fleshy cherry-like appearance. The tissue is not meant to
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appearance. The tissue is not meant to
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appearance. The tissue is not meant to be on the outside. And it's important to
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be on the outside. And it's important to
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be on the outside. And it's important to note this isn't always just a one eye
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note this isn't always just a one eye
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note this isn't always just a one eye problem, is it?
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problem, is it?
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problem, is it? >> That's a great point. The sources are
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>> That's a great point. The sources are
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>> That's a great point. The sources are very clear that while it can happen in
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very clear that while it can happen in
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very clear that while it can happen in just one eye, it's often bilateral,
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just one eye, it's often bilateral,
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just one eye, it's often bilateral, >> meaning it can happen in both.
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>> meaning it can happen in both.
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>> meaning it can happen in both. >> Yes. Either at the same time or more
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>> Yes. Either at the same time or more
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>> Yes. Either at the same time or more commonly, one eye will develop it and
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commonly, one eye will develop it and
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commonly, one eye will develop it and then the other will follow weeks or even
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then the other will follow weeks or even
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then the other will follow weeks or even months later. That really reinforces the
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months later. That really reinforces the
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months later. That really reinforces the idea that this is a systemic structural
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idea that this is a systemic structural
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idea that this is a systemic structural weakness, not just a random event.
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weakness, not just a random event.
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weakness, not just a random event. >> And that brings us to the real relevance
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>> And that brings us to the real relevance
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>> And that brings us to the real relevance for the listener. This isn't just a
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for the listener. This isn't just a
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for the listener. This isn't just a cosmetic issue. It's not just that it
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cosmetic issue. It's not just that it
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cosmetic issue. It's not just that it looks bad. What is the actual risk of
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looks bad. What is the actual risk of
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looks bad. What is the actual risk of leaving that gland exposed?
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leaving that gland exposed?
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leaving that gland exposed? >> The risk is severe. And this is where
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>> The risk is severe. And this is where
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>> The risk is severe. And this is where the urgency comes in. People might hope
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the urgency comes in. People might hope
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the urgency comes in. People might hope it'll just go back in on its own, but
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it'll just go back in on its own, but
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it'll just go back in on its own, but that rarely happens. If that gland stays
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that rarely happens. If that gland stays
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that rarely happens. If that gland stays prolapsed, two bad things start to
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prolapsed, two bad things start to
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prolapsed, two bad things start to occur.
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occur.
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occur. >> Okay?
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>> Okay?
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>> Okay? >> First, the chronic exposure to air and
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>> First, the chronic exposure to air and
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>> First, the chronic exposure to air and contaminants leads to inflammation that
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contaminants leads to inflammation that
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contaminants leads to inflammation that physically damages the delicate
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physically damages the delicate
4:24
physically damages the delicate glandular tissue.
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glandular tissue.
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glandular tissue. Second, that exposure impairs its
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Second, that exposure impairs its
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Second, that exposure impairs its ability to make tears. Over time, the
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ability to make tears. Over time, the
4:32
ability to make tears. Over time, the gland can stop working altogether.
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gland can stop working altogether.
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gland can stop working altogether. >> And if you lose 30 to 40% of your tear
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>> And if you lose 30 to 40% of your tear
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>> And if you lose 30 to 40% of your tear production,
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production,
4:36
production, >> you are headed straight for a condition
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>> you are headed straight for a condition
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>> you are headed straight for a condition called keratau conjunctivitis sika,
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called keratau conjunctivitis sika,
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called keratau conjunctivitis sika, >> also known as dry eye.
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>> also known as dry eye.
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>> also known as dry eye. >> Exactly. KCS or dry eye is a chronic,
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>> Exactly. KCS or dry eye is a chronic,
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>> Exactly. KCS or dry eye is a chronic, progressive, and frankly painful
4:48
progressive, and frankly painful
4:48
progressive, and frankly painful condition. the cornea dries out, which
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condition. the cornea dries out, which
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condition. the cornea dries out, which can lead to ulcers, infection, scarring,
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can lead to ulcers, infection, scarring,
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can lead to ulcers, infection, scarring, and eventually, if it's not managed
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and eventually, if it's not managed
4:54
and eventually, if it's not managed aggressively, it can even lead to
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aggressively, it can even lead to
4:55
aggressively, it can even lead to blindness.
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blindness.
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blindness. >> So, just to be crystal clear, cherry eye
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>> So, just to be crystal clear, cherry eye
4:58
>> So, just to be crystal clear, cherry eye isn't just a weird-looking lump. It's a
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isn't just a weird-looking lump. It's a
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isn't just a weird-looking lump. It's a direct warning sign for a much more
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direct warning sign for a much more
5:02
direct warning sign for a much more serious lifelong disease if it's not
5:04
serious lifelong disease if it's not
5:04
serious lifelong disease if it's not handled correctly.
5:05
handled correctly.
5:05
handled correctly. >> That is the single most important
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>> That is the single most important
5:07
>> That is the single most important takeaway. It is not cosmetic. It's a
5:09
takeaway. It is not cosmetic. It's a
5:09
takeaway. It is not cosmetic. It's a medical emergency for the long-term
5:11
medical emergency for the long-term
5:11
medical emergency for the long-term health of that eye.
5:12
health of that eye.
5:12
health of that eye. >> That really drives home the seriousness.
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>> That really drives home the seriousness.
5:14
>> That really drives home the seriousness. So, okay, let's unpack the why. If this
5:17
So, okay, let's unpack the why. If this
5:17
So, okay, let's unpack the why. If this is a structural failure, what is
5:19
is a structural failure, what is
5:19
is a structural failure, what is actually failing? Why do these ligaments
5:22
actually failing? Why do these ligaments
5:22
actually failing? Why do these ligaments in, say, a six-month-old bulldog just
5:26
in, say, a six-month-old bulldog just
5:26
in, say, a six-month-old bulldog just give out?
5:27
give out?
5:27
give out? >> That's the core question. It takes us
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>> That's the core question. It takes us
5:29
>> That's the core question. It takes us right down to the mechanical level to
5:30
right down to the mechanical level to
5:30
right down to the mechanical level to the ligaments. The gland is meant to be
5:32
the ligaments. The gland is meant to be
5:32
the ligaments. The gland is meant to be held in place by these tiny fibrous
5:35
held in place by these tiny fibrous
5:35
held in place by these tiny fibrous attachments that anchor it deep inside
5:37
attachments that anchor it deep inside
5:37
attachments that anchor it deep inside the eye socket.
5:38
the eye socket.
5:38
the eye socket. >> So, these are like little tethers.
5:40
>> So, these are like little tethers.
5:40
>> So, these are like little tethers. >> A perfect analogy. They're the tedals
5:42
>> A perfect analogy. They're the tedals
5:42
>> A perfect analogy. They're the tedals that keep the gland tucked safely where
5:43
that keep the gland tucked safely where
5:43
that keep the gland tucked safely where it belongs. Cherry eye is what happens
5:46
it belongs. Cherry eye is what happens
5:46
it belongs. Cherry eye is what happens when those tethers are congenally weak
5:48
when those tethers are congenally weak
5:48
when those tethers are congenally weak or too stretched or just poorly attached
5:50
or too stretched or just poorly attached
5:50
or too stretched or just poorly attached from birth.
5:51
from birth.
5:51
from birth. >> And when the anchor fails,
5:52
>> And when the anchor fails,
5:52
>> And when the anchor fails, >> the gland has nothing holding it back.
5:54
>> the gland has nothing holding it back.
5:54
>> the gland has nothing holding it back. It just pops out and flips over the edge
5:56
It just pops out and flips over the edge
5:56
It just pops out and flips over the edge of that cartilage and suddenly you have
5:57
of that cartilage and suddenly you have
5:57
of that cartilage and suddenly you have that red bulge.
5:58
that red bulge.
5:58
that red bulge. >> Which brings us squarely to genetic
6:00
>> Which brings us squarely to genetic
6:00
>> Which brings us squarely to genetic predisposition.
6:01
predisposition.
6:01
predisposition. Because the data is so clear, this is
6:03
Because the data is so clear, this is
6:03
Because the data is so clear, this is not a random occurrence across all dogs.
6:05
not a random occurrence across all dogs.
6:06
not a random occurrence across all dogs. >> Not at all. It's practically built into
6:08
>> Not at all. It's practically built into
6:08
>> Not at all. It's practically built into the blueprint of certain breeds.
6:10
the blueprint of certain breeds.
6:10
the blueprint of certain breeds. Veterinarians immediately think of it as
6:12
Veterinarians immediately think of it as
6:12
Veterinarians immediately think of it as a hereditary condition. The genetic
6:14
a hereditary condition. The genetic
6:14
a hereditary condition. The genetic factors are just uh they're profound.
6:16
factors are just uh they're profound.
6:16
factors are just uh they're profound. >> So, who are the main breeds we're
6:17
>> So, who are the main breeds we're
6:17
>> So, who are the main breeds we're talking about? Which dogs are in the
6:18
talking about? Which dogs are in the
6:18
talking about? Which dogs are in the high-risisk group?
6:19
high-risisk group?
6:19
high-risisk group? >> The sources consistently point to the
6:22
>> The sources consistently point to the
6:22
>> The sources consistently point to the brachyphalic or short-nosed breeds. They
6:24
brachyphalic or short-nosed breeds. They
6:24
brachyphalic or short-nosed breeds. They have the highest incidence by far.
6:26
have the highest incidence by far.
6:26
have the highest incidence by far. >> So, bulldogs,
6:27
>> So, bulldogs,
6:27
>> So, bulldogs, >> English and French bulldogs are probably
6:30
>> English and French bulldogs are probably
6:30
>> English and French bulldogs are probably the poster children for this condition,
6:32
the poster children for this condition,
6:32
the poster children for this condition, but we also see it very, very frequently
6:34
but we also see it very, very frequently
6:34
but we also see it very, very frequently in Cocker Daniels and beagles as well.
6:37
in Cocker Daniels and beagles as well.
6:37
in Cocker Daniels and beagles as well. >> Let's dig into that anatomical link a
6:39
>> Let's dig into that anatomical link a
6:40
>> Let's dig into that anatomical link a bit more, especially with the bulldogs.
6:41
bit more, especially with the bulldogs.
6:41
bit more, especially with the bulldogs. It's not just that their faces are flat,
6:43
It's not just that their faces are flat,
6:43
It's not just that their faces are flat, right? Their whole skull is different.
6:45
right? Their whole skull is different.
6:45
right? Their whole skull is different. How does that specifically lead to this
6:48
How does that specifically lead to this
6:48
How does that specifically lead to this ligament failure?
6:49
ligament failure?
6:49
ligament failure? >> It's all about the architecture of the
6:50
>> It's all about the architecture of the
6:50
>> It's all about the architecture of the skull. Think about the eye socket, the
6:52
skull. Think about the eye socket, the
6:52
skull. Think about the eye socket, the orbit. In a dog with a more traditional
6:55
orbit. In a dog with a more traditional
6:55
orbit. In a dog with a more traditional snout, like a Labrador, the eye sits
6:58
snout, like a Labrador, the eye sits
6:58
snout, like a Labrador, the eye sits deep inside a cone-shaped socket,
7:00
deep inside a cone-shaped socket,
7:00
deep inside a cone-shaped socket, >> which gives it protection,
7:01
>> which gives it protection,
7:01
>> which gives it protection, >> protection, and stable anchor points for
7:03
>> protection, and stable anchor points for
7:03
>> protection, and stable anchor points for all those ligaments. Now, in a bulldog,
7:06
all those ligaments. Now, in a bulldog,
7:06
all those ligaments. Now, in a bulldog, the whole skull is compressed. It's
7:08
the whole skull is compressed. It's
7:08
the whole skull is compressed. It's shorter and wider. This leads to a much
7:10
shorter and wider. This leads to a much
7:10
shorter and wider. This leads to a much shallower eye socket.
7:11
shallower eye socket.
7:11
shallower eye socket. >> So there's just less space and
7:13
>> So there's just less space and
7:13
>> So there's just less space and everything is sort of pushed forward.
7:15
everything is sort of pushed forward.
7:15
everything is sort of pushed forward. >> Precisely. The bony structures where
7:17
>> Precisely. The bony structures where
7:17
>> Precisely. The bony structures where those ligaments are supposed to attach
7:18
those ligaments are supposed to attach
7:18
those ligaments are supposed to attach are in a different position. The
7:20
are in a different position. The
7:20
are in a different position. The ligaments themselves might be shorter,
7:21
ligaments themselves might be shorter,
7:21
ligaments themselves might be shorter, weaker, or just under constant strain
7:24
weaker, or just under constant strain
7:24
weaker, or just under constant strain from day one because of the anatomy.
7:26
from day one because of the anatomy.
7:26
from day one because of the anatomy. >> And you add in the fact that many of
7:28
>> And you add in the fact that many of
7:28
>> And you add in the fact that many of these breeds have those large, slightly
7:30
these breeds have those large, slightly
7:30
these breeds have those large, slightly bulging eyes,
7:31
bulging eyes,
7:31
bulging eyes, >> right? A condition called lagofalmos
7:34
>> right? A condition called lagofalmos
7:34
>> right? A condition called lagofalmos that can put even more forward pressure
7:36
that can put even more forward pressure
7:36
that can put even more forward pressure on the gland. So you have weak anchors
7:38
on the gland. So you have weak anchors
7:38
on the gland. So you have weak anchors and constant pressure pushing from
7:40
and constant pressure pushing from
7:40
and constant pressure pushing from behind. It's a recipe for failure,
7:42
behind. It's a recipe for failure,
7:42
behind. It's a recipe for failure, especially when the puppy is young and
7:44
especially when the puppy is young and
7:44
especially when the puppy is young and its connective tissues are still
7:46
its connective tissues are still
7:46
its connective tissues are still developing.
7:47
developing.
7:47
developing. >> So the structural weakness isn't just
7:48
>> So the structural weakness isn't just
7:48
>> So the structural weakness isn't just bad luck. It's an almost predictable
7:51
bad luck. It's an almost predictable
7:51
bad luck. It's an almost predictable outcome of the breed standard we've
7:53
outcome of the breed standard we've
7:53
outcome of the breed standard we've selected for.
7:54
selected for.
7:54
selected for. >> In many cases, yes, but it's also
7:56
>> In many cases, yes, but it's also
7:56
>> In many cases, yes, but it's also important to look at other contributing
7:57
important to look at other contributing
7:57
important to look at other contributing factors. Heredity is the main driver,
8:00
factors. Heredity is the main driver,
8:00
factors. Heredity is the main driver, but other things can influence when and
8:01
but other things can influence when and
8:02
but other things can influence when and if it happens.
8:02
if it happens.
8:02
if it happens. >> Are we talking about things like
8:04
>> Are we talking about things like
8:04
>> Are we talking about things like inflammation? Primarily think about a
8:06
inflammation? Primarily think about a
8:06
inflammation? Primarily think about a dog that has chronic eye irritation,
8:09
dog that has chronic eye irritation,
8:09
dog that has chronic eye irritation, maybe from allergies or dust. That
8:11
maybe from allergies or dust. That
8:11
maybe from allergies or dust. That constant low-grade inflammation can
8:13
constant low-grade inflammation can
8:13
constant low-grade inflammation can further weaken those already compromised
8:15
further weaken those already compromised
8:15
further weaken those already compromised ligaments.
8:16
ligaments.
8:16
ligaments. >> So, if a dog is already genetically on
8:18
>> So, if a dog is already genetically on
8:18
>> So, if a dog is already genetically on the edge, the chronic irritation is like
8:20
the edge, the chronic irritation is like
8:20
the edge, the chronic irritation is like the little push that sends it over.
8:22
the little push that sends it over.
8:22
the little push that sends it over. >> That's a great way to think about it.
8:23
>> That's a great way to think about it.
8:23
>> That's a great way to think about it. Chronic inflammation releases enzymes
8:25
Chronic inflammation releases enzymes
8:25
Chronic inflammation releases enzymes that can degrade connective tissue over
8:27
that can degrade connective tissue over
8:27
that can degrade connective tissue over time. So, it can absolutely accelerate
8:29
time. So, it can absolutely accelerate
8:29
time. So, it can absolutely accelerate the timeline for a prolapse.
8:31
the timeline for a prolapse.
8:31
the timeline for a prolapse. >> And you mentioned age again. The fact
8:33
>> And you mentioned age again. The fact
8:33
>> And you mentioned age again. The fact that it happens in young dogs is key.
8:35
that it happens in young dogs is key.
8:35
that it happens in young dogs is key. >> Yes, the peak incidence is in dogs under
8:37
>> Yes, the peak incidence is in dogs under
8:37
>> Yes, the peak incidence is in dogs under a year old, which really suggests it
8:40
a year old, which really suggests it
8:40
a year old, which really suggests it happens before those ligaments have a
8:42
happens before those ligaments have a
8:42
happens before those ligaments have a chance to fully mature and strengthen.
8:44
chance to fully mature and strengthen.
8:44
chance to fully mature and strengthen. It's a developmental window of
8:46
It's a developmental window of
8:46
It's a developmental window of vulnerability.
8:47
vulnerability.
8:47
vulnerability. >> It sounds like there's no single
8:48
>> It sounds like there's no single
8:48
>> It sounds like there's no single definitive answer. It's more of a
8:50
definitive answer. It's more of a
8:50
definitive answer. It's more of a perfect storm.
8:51
perfect storm.
8:51
perfect storm. >> It is. The research is still clear that
8:53
>> It is. The research is still clear that
8:53
>> It is. The research is still clear that we don't know exactly why one puppy in a
8:55
we don't know exactly why one puppy in a
8:55
we don't know exactly why one puppy in a litter gets it and another doesn't. But
8:57
litter gets it and another doesn't. But
8:57
litter gets it and another doesn't. But it's this complex mix of genetic
8:59
it's this complex mix of genetic
9:00
it's this complex mix of genetic destiny, anatomical structure, and then
9:03
destiny, anatomical structure, and then
9:03
destiny, anatomical structure, and then potentially some environmental triggers
9:04
potentially some environmental triggers
9:04
potentially some environmental triggers on top of that.
9:06
on top of that.
9:06
on top of that. >> Okay, now let's move to recognition. For
9:08
>> Okay, now let's move to recognition. For
9:08
>> Okay, now let's move to recognition. For a pet owner at home, that primary visual
9:11
a pet owner at home, that primary visual
9:11
a pet owner at home, that primary visual symptom is pretty hard to miss. But
9:13
symptom is pretty hard to miss. But
9:13
symptom is pretty hard to miss. But let's get into the details of what
9:14
let's get into the details of what
9:14
let's get into the details of what they're seeing and just as importantly,
9:16
they're seeing and just as importantly,
9:16
they're seeing and just as importantly, what the dog is feeling,
9:18
what the dog is feeling,
9:18
what the dog is feeling, >> right? So, the main thing you see is
9:19
>> right? So, the main thing you see is
9:19
>> right? So, the main thing you see is that sudden appearance of a reddish or
9:21
that sudden appearance of a reddish or
9:21
that sudden appearance of a reddish or pink round smooth mass popping out of
9:25
pink round smooth mass popping out of
9:26
pink round smooth mass popping out of the inner corner of the eye. It can be
9:28
the inner corner of the eye. It can be
9:28
the inner corner of the eye. It can be the size of a pee or even a small grape.
9:30
the size of a pee or even a small grape.
9:30
the size of a pee or even a small grape. >> I can easily see how someone might think
9:32
>> I can easily see how someone might think
9:32
>> I can easily see how someone might think their dog just got a piece of food or
9:33
their dog just got a piece of food or
9:33
their dog just got a piece of food or something stuck in its eye.
9:34
something stuck in its eye.
9:34
something stuck in its eye. >> That's a very common first thought, but
9:36
>> That's a very common first thought, but
9:36
>> That's a very common first thought, but the key difference is that this is
9:38
the key difference is that this is
9:38
the key difference is that this is attached. It's living tissue. You'll
9:40
attached. It's living tissue. You'll
9:40
attached. It's living tissue. You'll also notice the affected eye might look
9:42
also notice the affected eye might look
9:42
also notice the affected eye might look less open or it might have a general
9:44
less open or it might have a general
9:44
less open or it might have a general bulging appearance. It just changes the
9:46
bulging appearance. It just changes the
9:46
bulging appearance. It just changes the whole expression on their face.
9:48
whole expression on their face.
9:48
whole expression on their face. >> And beyond just seeing the cherry, what
9:50
>> And beyond just seeing the cherry, what
9:50
>> And beyond just seeing the cherry, what are the other physical signs that tell
9:52
are the other physical signs that tell
9:52
are the other physical signs that tell you the dog is in active discomfort.
9:54
you the dog is in active discomfort.
9:54
you the dog is in active discomfort. >> You want to look for excessive tearing.
9:56
>> You want to look for excessive tearing.
9:56
>> You want to look for excessive tearing. The medical term is epifera. The eye is
9:59
The medical term is epifera. The eye is
9:59
The medical term is epifera. The eye is trying to flesh out what it thinks is a
10:01
trying to flesh out what it thinks is a
10:01
trying to flesh out what it thinks is a foreign object.
10:02
foreign object.
10:02
foreign object. >> And does the discharge change over time?
10:04
>> And does the discharge change over time?
10:04
>> And does the discharge change over time? >> It can. Initially, it might be clear and
10:06
>> It can. Initially, it might be clear and
10:06
>> It can. Initially, it might be clear and watery, but as the exposed gland gets
10:09
watery, but as the exposed gland gets
10:09
watery, but as the exposed gland gets more irritated or if a secondary
10:11
more irritated or if a secondary
10:11
more irritated or if a secondary bacterial infection starts to develop,
10:13
bacterial infection starts to develop,
10:13
bacterial infection starts to develop, it can become thicker, more like mucus,
10:16
it can become thicker, more like mucus,
10:16
it can become thicker, more like mucus, sometimes with a yellow or greenish
10:18
sometimes with a yellow or greenish
10:18
sometimes with a yellow or greenish tint.
10:18
tint.
10:18
tint. >> And the dog will try to protect its eye,
10:20
>> And the dog will try to protect its eye,
10:20
>> And the dog will try to protect its eye, I assume.
10:21
I assume.
10:21
I assume. >> Yes, absolutely. You'll often see them
10:23
>> Yes, absolutely. You'll often see them
10:23
>> Yes, absolutely. You'll often see them squinting a lot. That's called
10:24
squinting a lot. That's called
10:24
squinting a lot. That's called blerospasm.
10:26
blerospasm.
10:26
blerospasm. And they could also become really
10:28
And they could also become really
10:28
And they could also become really sensitive to light, a condition called
10:30
sensitive to light, a condition called
10:30
sensitive to light, a condition called phototohobia.
10:31
phototohobia.
10:31
phototohobia. >> So, they might avoid bright rooms or
10:33
>> So, they might avoid bright rooms or
10:33
>> So, they might avoid bright rooms or sunlight. Exactly. That exposed inflamed
10:36
sunlight. Exactly. That exposed inflamed
10:36
sunlight. Exactly. That exposed inflamed gland is very sensitive and bright light
10:39
gland is very sensitive and bright light
10:39
gland is very sensitive and bright light can be painful. So, they'll shy away
10:41
can be painful. So, they'll shy away
10:41
can be painful. So, they'll shy away from it or blink constantly when they're
10:43
from it or blink constantly when they're
10:43
from it or blink constantly when they're outside.
10:44
outside.
10:44
outside. >> Okay. And this is where it gets really
10:45
>> Okay. And this is where it gets really
10:45
>> Okay. And this is where it gets really interesting for me. The behavioral red
10:47
interesting for me. The behavioral red
10:47
interesting for me. The behavioral red flags. The things the dog does that tell
10:50
flags. The things the dog does that tell
10:50
flags. The things the dog does that tell you it's really distressed.
10:51
you it's really distressed.
10:51
you it's really distressed. >> This is so important. The behavior is
10:54
>> This is so important. The behavior is
10:54
>> This is so important. The behavior is the dog trying to tell you it needs
10:56
the dog trying to tell you it needs
10:56
the dog trying to tell you it needs help. The most obvious sign is frequent
10:58
help. The most obvious sign is frequent
10:58
help. The most obvious sign is frequent pawing at the eye. But the most specific
11:01
pawing at the eye. But the most specific
11:01
pawing at the eye. But the most specific and frankly most alarming behavior is
11:04
and frankly most alarming behavior is
11:04
and frankly most alarming behavior is aggressive rubbing.
11:05
aggressive rubbing.
11:05
aggressive rubbing. >> You mean rubbing their face on the
11:06
>> You mean rubbing their face on the
11:06
>> You mean rubbing their face on the carpet or the couch
11:07
carpet or the couch
11:07
carpet or the couch >> or grinding their face into your leg.
11:09
>> or grinding their face into your leg.
11:09
>> or grinding their face into your leg. Yeah. This isn't just a casual itch.
11:11
Yeah. This isn't just a casual itch.
11:11
Yeah. This isn't just a casual itch. It's a vigorous almost frantic rubbing.
11:13
It's a vigorous almost frantic rubbing.
11:13
It's a vigorous almost frantic rubbing. They're trying to relieve that constant
11:15
They're trying to relieve that constant
11:15
They're trying to relieve that constant irritation or maybe even trying to
11:17
irritation or maybe even trying to
11:17
irritation or maybe even trying to physically push the mass back in.
11:19
physically push the mass back in.
11:19
physically push the mass back in. >> And that's incredibly dangerous
11:21
>> And that's incredibly dangerous
11:22
>> And that's incredibly dangerous >> extremely because that rubbing can cause
11:24
>> extremely because that rubbing can cause
11:24
>> extremely because that rubbing can cause serious self-inflicted damage. They can
11:26
serious self-inflicted damage. They can
11:26
serious self-inflicted damage. They can scratch the gland itself or worse they
11:28
scratch the gland itself or worse they
11:28
scratch the gland itself or worse they can cause a corial abrasion or even a
11:31
can cause a corial abrasion or even a
11:31
can cause a corial abrasion or even a deep ulcer on the surface of their eye
11:33
deep ulcer on the surface of their eye
11:33
deep ulcer on the surface of their eye which is a whole separate medical
11:35
which is a whole separate medical
11:35
which is a whole separate medical emergency.
11:36
emergency.
11:36
emergency. >> So seeing that aggressive rubbing is a
11:37
>> So seeing that aggressive rubbing is a
11:38
>> So seeing that aggressive rubbing is a signal that you need to get to the vet
11:39
signal that you need to get to the vet
11:40
signal that you need to get to the vet immediately.
11:40
immediately.
11:40
immediately. >> It's a five alarm fire. It tells you the
11:43
>> It's a five alarm fire. It tells you the
11:43
>> It's a five alarm fire. It tells you the dog is in significant discomfort and is
11:45
dog is in significant discomfort and is
11:45
dog is in significant discomfort and is at high risk of complicating the
11:47
at high risk of complicating the
11:47
at high risk of complicating the situation severely.
11:48
situation severely.
11:48
situation severely. >> Are there any more general signs like
11:51
>> Are there any more general signs like
11:51
>> Are there any more general signs like changes in their overall mood?
11:53
changes in their overall mood?
11:53
changes in their overall mood? >> Sometimes yes. If the pain and
11:55
>> Sometimes yes. If the pain and
11:55
>> Sometimes yes. If the pain and irritation are constant, you might see
11:57
irritation are constant, you might see
11:57
irritation are constant, you might see the dog become a bit lethargic. They
11:59
the dog become a bit lethargic. They
11:59
the dog become a bit lethargic. They might sleep more or show reduced
12:01
might sleep more or show reduced
12:01
might sleep more or show reduced appetite. It's just hard for them to
12:03
appetite. It's just hard for them to
12:03
appetite. It's just hard for them to relax and go about their normal day when
12:05
relax and go about their normal day when
12:05
relax and go about their normal day when their eye is bothering them that much.
12:07
their eye is bothering them that much.
12:07
their eye is bothering them that much. >> So, it's really about connecting the
12:08
>> So, it's really about connecting the
12:08
>> So, it's really about connecting the dots. You see the cherry, you see the
12:09
dots. You see the cherry, you see the
12:09
dots. You see the cherry, you see the discharge, you see the squinting, and
12:11
discharge, you see the squinting, and
12:11
discharge, you see the squinting, and then you see the rubbing. And
12:12
then you see the rubbing. And
12:12
then you see the rubbing. And altogether, that paints a picture of
12:14
altogether, that paints a picture of
12:14
altogether, that paints a picture of acute distress.
12:16
acute distress.
12:16
acute distress. >> Precisely. The rubbing in particular
12:18
>> Precisely. The rubbing in particular
12:18
>> Precisely. The rubbing in particular tells you the level of irritation and
12:20
tells you the level of irritation and
12:20
tells you the level of irritation and the risk of secondary damage. And that
12:23
the risk of secondary damage. And that
12:23
the risk of secondary damage. And that should really light a fire under you to
12:24
should really light a fire under you to
12:24
should really light a fire under you to make that vet appointment.
12:26
make that vet appointment.
12:26
make that vet appointment. >> Okay, so you've made the appointment.
12:28
>> Okay, so you've made the appointment.
12:28
>> Okay, so you've made the appointment. Given how many things can make a dog's
12:30
Given how many things can make a dog's
12:30
Given how many things can make a dog's eye red, how does a veterinarian make a
12:32
eye red, how does a veterinarian make a
12:32
eye red, how does a veterinarian make a definitive diagnosis and rule out other
12:35
definitive diagnosis and rule out other
12:35
definitive diagnosis and rule out other more sinister things?
12:37
more sinister things?
12:37
more sinister things? >> The process always starts with a really
12:39
>> The process always starts with a really
12:39
>> The process always starts with a really thorough physical and specifically an
12:41
thorough physical and specifically an
12:41
thorough physical and specifically an opthomic exam. Now, the visual of a
12:45
opthomic exam. Now, the visual of a
12:45
opthomic exam. Now, the visual of a classic cherry is often what we call
12:47
classic cherry is often what we call
12:47
classic cherry is often what we call pathogammonic, meaning it's so
12:49
pathogammonic, meaning it's so
12:49
pathogammonic, meaning it's so characteristic that it's almost
12:50
characteristic that it's almost
12:50
characteristic that it's almost certainly the diagnosis. But you can't
12:52
certainly the diagnosis. But you can't
12:52
certainly the diagnosis. But you can't just assume.
12:53
just assume.
12:53
just assume. >> You can never just assume. The vet has
12:55
>> You can never just assume. The vet has
12:55
>> You can never just assume. The vet has to confirm it and crucially rule out
12:57
to confirm it and crucially rule out
12:57
to confirm it and crucially rule out other possibilities. And that's where
12:58
other possibilities. And that's where
12:58
other possibilities. And that's where taking a detailed history from the owner
13:00
taking a detailed history from the owner
13:00
taking a detailed history from the owner is so fundamental.
13:02
is so fundamental.
13:02
is so fundamental. >> What kind of questions are they asking?
13:03
>> What kind of questions are they asking?
13:03
>> What kind of questions are they asking? >> They'll want to know the timeline. When
13:05
>> They'll want to know the timeline. When
13:05
>> They'll want to know the timeline. When did it appear? Was it sudden? Does it
13:07
did it appear? Was it sudden? Does it
13:07
did it appear? Was it sudden? Does it seem to get bigger or smaller? And what
13:09
seem to get bigger or smaller? And what
13:09
seem to get bigger or smaller? And what about the discharge? Has it changed?
13:12
about the discharge? Has it changed?
13:12
about the discharge? Has it changed? This history helps the vet distinguish
13:14
This history helps the vet distinguish
13:14
This history helps the vet distinguish it from something like say severe
13:16
it from something like say severe
13:16
it from something like say severe conjunctivitis or even a tumor, which is
13:18
conjunctivitis or even a tumor, which is
13:18
conjunctivitis or even a tumor, which is more of a concern in an older dog. So
13:20
more of a concern in an older dog. So
13:20
more of a concern in an older dog. So once they have the history and the
13:21
once they have the history and the
13:21
once they have the history and the visual, what are the actual diagnostic
13:24
visual, what are the actual diagnostic
13:24
visual, what are the actual diagnostic tools they use to get hard data?
13:25
tools they use to get hard data?
13:25
tools they use to get hard data? >> To get that baseline data and confirm
13:27
>> To get that baseline data and confirm
13:27
>> To get that baseline data and confirm everything, there are a couple of key
13:29
everything, there are a couple of key
13:29
everything, there are a couple of key tests. The single most important one is
13:32
tests. The single most important one is
13:32
tests. The single most important one is called the Shurmer tier test or ST.
13:34
called the Shurmer tier test or ST.
13:34
called the Shurmer tier test or ST. >> Okay. Explain the ST. What is it
13:36
>> Okay. Explain the ST. What is it
13:36
>> Okay. Explain the ST. What is it measuring and how does it work?
13:38
measuring and how does it work?
13:38
measuring and how does it work? >> The ST is a simple non-invasive test
13:41
>> The ST is a simple non-invasive test
13:41
>> The ST is a simple non-invasive test that gives us an objective number for
13:43
that gives us an objective number for
13:43
that gives us an objective number for tear production. The vet places a small
13:46
tear production. The vet places a small
13:46
tear production. The vet places a small standardized strip of filter paper
13:48
standardized strip of filter paper
13:48
standardized strip of filter paper inside the lower eyelid for exactly 1
13:50
inside the lower eyelid for exactly 1
13:50
inside the lower eyelid for exactly 1 minute
13:51
minute
13:51
minute >> and the tears wick up the paper
13:52
>> and the tears wick up the paper
13:52
>> and the tears wick up the paper >> exactly and the strip is marked in
13:55
>> exactly and the strip is marked in
13:55
>> exactly and the strip is marked in millime. A normal reading for a dog is
13:58
millime. A normal reading for a dog is
13:58
millime. A normal reading for a dog is generally anything above 15 mm of
14:00
generally anything above 15 mm of
14:00
generally anything above 15 mm of wetting in that minute.
14:01
wetting in that minute.
14:01
wetting in that minute. >> And what's a low reading?
14:02
>> And what's a low reading?
14:02
>> And what's a low reading? >> If the reading is low, say under 10, it
14:04
>> If the reading is low, say under 10, it
14:04
>> If the reading is low, say under 10, it tells us the dog might already have some
14:06
tells us the dog might already have some
14:06
tells us the dog might already have some degree of dry eye syndrome or KCS. This
14:09
degree of dry eye syndrome or KCS. This
14:09
degree of dry eye syndrome or KCS. This is critical information to have before
14:11
is critical information to have before
14:11
is critical information to have before surgery. It tells us the health of the
14:13
surgery. It tells us the health of the
14:13
surgery. It tells us the health of the glands at that moment.
14:14
glands at that moment.
14:14
glands at that moment. >> That makes sense. You need a baseline.
14:16
>> That makes sense. You need a baseline.
14:16
>> That makes sense. You need a baseline. What about checking for that
14:17
What about checking for that
14:17
What about checking for that self-inflicted damage from all the
14:19
self-inflicted damage from all the
14:19
self-inflicted damage from all the rubbing?
14:19
rubbing?
14:19
rubbing? >> For that, we use fluorescent staining. A
14:22
>> For that, we use fluorescent staining. A
14:22
>> For that, we use fluorescent staining. A special dye, florosine, is applied to
14:24
special dye, florosine, is applied to
14:24
special dye, florosine, is applied to the surface of the eye. This dye won't
14:26
the surface of the eye. This dye won't
14:26
the surface of the eye. This dye won't stick to a healthy cornea, but if
14:28
stick to a healthy cornea, but if
14:28
stick to a healthy cornea, but if there's an abrasion or an ulcer, an area
14:30
there's an abrasion or an ulcer, an area
14:30
there's an abrasion or an ulcer, an area where the top layer of cells is scraped
14:32
where the top layer of cells is scraped
14:32
where the top layer of cells is scraped off, the dye will adhere to it and glow
14:34
off, the dye will adhere to it and glow
14:34
off, the dye will adhere to it and glow bright green under a special glue light.
14:37
bright green under a special glue light.
14:37
bright green under a special glue light. >> So, it instantly highlights any damage
14:39
>> So, it instantly highlights any damage
14:39
>> So, it instantly highlights any damage >> instantly. And it's so important to find
14:41
>> instantly. And it's so important to find
14:41
>> instantly. And it's so important to find those ulcers because they require their
14:43
those ulcers because they require their
14:43
those ulcers because they require their own specific immediate treatment.
14:45
own specific immediate treatment.
14:45
own specific immediate treatment. Sometimes even before you can proceed
14:47
Sometimes even before you can proceed
14:47
Sometimes even before you can proceed with the cherry eye surgery itself.
14:49
with the cherry eye surgery itself.
14:49
with the cherry eye surgery itself. >> So the whole process is very structured
14:51
>> So the whole process is very structured
14:51
>> So the whole process is very structured history, visual exam, test, the tear
14:54
history, visual exam, test, the tear
14:54
history, visual exam, test, the tear function, and then stain for damage.
14:55
function, and then stain for damage.
14:56
function, and then stain for damage. It's a lot more than just looking at a
14:57
It's a lot more than just looking at a
14:57
It's a lot more than just looking at a red lump.
14:58
red lump.
14:58
red lump. >> It's a complete assessment of the entire
15:00
>> It's a complete assessment of the entire
15:00
>> It's a complete assessment of the entire ocular environment. And that's why our
15:02
ocular environment. And that's why our
15:02
ocular environment. And that's why our sources are so emphatic with their
15:04
sources are so emphatic with their
15:04
sources are so emphatic with their warning. Self diagnosis is not
15:06
warning. Self diagnosis is not
15:06
warning. Self diagnosis is not recommended,
15:07
recommended,
15:07
recommended, >> right? because you can see a red eye and
15:08
>> right? because you can see a red eye and
15:08
>> right? because you can see a red eye and think it's just a simple infection,
15:10
think it's just a simple infection,
15:10
think it's just a simple infection, start putting in some old antibiotic
15:12
start putting in some old antibiotic
15:12
start putting in some old antibiotic drops.
15:12
drops.
15:12
drops. >> When the real problem is a prolapsed
15:15
>> When the real problem is a prolapsed
15:15
>> When the real problem is a prolapsed gland or a deep corial ulcer and that
15:18
gland or a deep corial ulcer and that
15:18
gland or a deep corial ulcer and that kind of mismanagement can lead to
15:20
kind of mismanagement can lead to
15:20
kind of mismanagement can lead to irreversible damage like the permanent
15:22
irreversible damage like the permanent
15:22
irreversible damage like the permanent loss of that tear gland. Professional
15:24
loss of that tear gland. Professional
15:24
loss of that tear gland. Professional diagnosis is absolutely essential for a
15:27
diagnosis is absolutely essential for a
15:27
diagnosis is absolutely essential for a good outcome.
15:28
good outcome.
15:28
good outcome. >> So the diagnosis is confirmed, it's a
15:29
>> So the diagnosis is confirmed, it's a
15:30
>> So the diagnosis is confirmed, it's a prolapse, the consensus is clear,
15:32
prolapse, the consensus is clear,
15:32
prolapse, the consensus is clear, surgery is the way to go to save that
15:34
surgery is the way to go to save that
15:34
surgery is the way to go to save that tear function.
15:36
tear function.
15:36
tear function. What is the gold standard surgical
15:38
What is the gold standard surgical
15:38
What is the gold standard surgical approach?
15:38
approach?
15:38
approach? >> The gold standard is all about
15:40
>> The gold standard is all about
15:40
>> The gold standard is all about repositioning, not removal. The problem
15:42
repositioning, not removal. The problem
15:42
repositioning, not removal. The problem is mechanical. So the solution has to be
15:44
is mechanical. So the solution has to be
15:44
is mechanical. So the solution has to be mechanical. And the goal is not just to
15:46
mechanical. And the goal is not just to
15:46
mechanical. And the goal is not just to make the eye look normal again, but to
15:48
make the eye look normal again, but to
15:48
make the eye look normal again, but to preserve that vital tear producing
15:51
preserve that vital tear producing
15:51
preserve that vital tear producing gland.
15:51
gland.
15:51
gland. >> Let's get into the specifics of the
15:53
>> Let's get into the specifics of the
15:53
>> Let's get into the specifics of the techniques. You mentioned repositioning.
15:54
techniques. You mentioned repositioning.
15:54
techniques. You mentioned repositioning. What does that actually look like?
15:55
What does that actually look like?
15:55
What does that actually look like? >> The most common and widely successful
15:57
>> The most common and widely successful
15:57
>> The most common and widely successful method is called the Morgan pocket
15:59
method is called the Morgan pocket
15:59
method is called the Morgan pocket technique.
15:59
technique.
16:00
technique. >> The pocket technique.
16:01
>> The pocket technique.
16:01
>> The pocket technique. >> Exactly. The surgeon makes a small
16:02
>> Exactly. The surgeon makes a small
16:02
>> Exactly. The surgeon makes a small incision on the surface of the third
16:03
incision on the surface of the third
16:04
incision on the surface of the third eyelid and creates a little pocket in
16:05
eyelid and creates a little pocket in
16:05
eyelid and creates a little pocket in the tissue. The prolapse gland is then
16:08
the tissue. The prolapse gland is then
16:08
the tissue. The prolapse gland is then gently tucked down into this pocket.
16:10
gently tucked down into this pocket.
16:10
gently tucked down into this pocket. >> So, the surrounding tissue becomes the
16:11
>> So, the surrounding tissue becomes the
16:12
>> So, the surrounding tissue becomes the new anchor.
16:12
new anchor.
16:12
new anchor. >> Precisely. The pocket is then closed
16:14
>> Precisely. The pocket is then closed
16:14
>> Precisely. The pocket is then closed with very fine dissolvable sutures. This
16:17
with very fine dissolvable sutures. This
16:18
with very fine dissolvable sutures. This effectively buries the gland back where
16:19
effectively buries the gland back where
16:19
effectively buries the gland back where it's supposed to be, allowing it to heal
16:22
it's supposed to be, allowing it to heal
16:22
it's supposed to be, allowing it to heal in its natural position and hopefully
16:24
in its natural position and hopefully
16:24
in its natural position and hopefully resume normal tear production.
16:26
resume normal tear production.
16:26
resume normal tear production. >> This brings up an important point about
16:28
>> This brings up an important point about
16:28
>> This brings up an important point about the history of this surgery. It used to
16:30
the history of this surgery. It used to
16:30
the history of this surgery. It used to be common practice to just cut the
16:33
be common practice to just cut the
16:33
be common practice to just cut the cherry off, right?
16:33
cherry off, right?
16:33
cherry off, right? >> Regrettably, yes. Years ago, resection,
16:37
>> Regrettably, yes. Years ago, resection,
16:37
>> Regrettably, yes. Years ago, resection, literally snipping the gland off, was a
16:39
literally snipping the gland off, was a
16:39
literally snipping the gland off, was a common procedure. It was quick and it
16:41
common procedure. It was quick and it
16:41
common procedure. It was quick and it fixed the cosmetic problem. But we now
16:43
fixed the cosmetic problem. But we now
16:43
fixed the cosmetic problem. But we now know from decades of data that it was a
16:46
know from decades of data that it was a
16:46
know from decades of data that it was a disaster for the long-term health of the
16:48
disaster for the long-term health of the
16:48
disaster for the long-term health of the eye
16:48
eye
16:48
eye >> because you're guaranteeing dry eye down
16:50
>> because you're guaranteeing dry eye down
16:50
>> because you're guaranteeing dry eye down the road.
16:50
the road.
16:50
the road. >> You are guaranteeing it. By removing
16:52
>> You are guaranteeing it. By removing
16:52
>> You are guaranteeing it. By removing that gland, you're permanently removing
16:53
that gland, you're permanently removing
16:53
that gland, you're permanently removing 30 to 40% of the dog's ability to make
16:56
30 to 40% of the dog's ability to make
16:56
30 to 40% of the dog's ability to make tears. So modern veterinary opthalmology
16:59
tears. So modern veterinary opthalmology
16:59
tears. So modern veterinary opthalmology absolutely mandates gland preservation.
17:01
absolutely mandates gland preservation.
17:01
absolutely mandates gland preservation. The goal is always to save it, never to
17:03
The goal is always to save it, never to
17:03
The goal is always to save it, never to remove it.
17:04
remove it.
17:04
remove it. >> So with these modern repositioning
17:06
>> So with these modern repositioning
17:06
>> So with these modern repositioning techniques, what are the expected
17:08
techniques, what are the expected
17:08
techniques, what are the expected outcomes? Is it generally a oneanddone
17:10
outcomes? Is it generally a oneanddone
17:10
outcomes? Is it generally a oneanddone fix?
17:10
fix?
17:10
fix? >> It's generally highly successful. The
17:13
>> It's generally highly successful. The
17:13
>> It's generally highly successful. The vast majority of dogs get significant
17:15
vast majority of dogs get significant
17:15
vast majority of dogs get significant relief from the irritation and discharge
17:17
relief from the irritation and discharge
17:17
relief from the irritation and discharge very quickly. The recurrence rate,
17:19
very quickly. The recurrence rate,
17:19
very quickly. The recurrence rate, meaning the chance of it popping out
17:20
meaning the chance of it popping out
17:20
meaning the chance of it popping out again, is pretty low after a
17:22
again, is pretty low after a
17:22
again, is pretty low after a wellperformed surgery, usually under
17:24
wellperformed surgery, usually under
17:24
wellperformed surgery, usually under 10%. But it's not zero.
17:26
10%. But it's not zero.
17:26
10%. But it's not zero. >> It's not zero. Success really depends on
17:28
>> It's not zero. Success really depends on
17:28
>> It's not zero. Success really depends on a few things. The severity of the
17:30
a few things. The severity of the
17:30
a few things. The severity of the initial prolapse, how long it was out,
17:32
initial prolapse, how long it was out,
17:32
initial prolapse, how long it was out, and honestly, the skill and experience
17:34
and honestly, the skill and experience
17:34
and honestly, the skill and experience of the surgeon. This is delicate work.
17:37
of the surgeon. This is delicate work.
17:37
of the surgeon. This is delicate work. >> And what about non-surgical options? Is
17:39
>> And what about non-surgical options? Is
17:39
>> And what about non-surgical options? Is there ever a time when you can just
17:40
there ever a time when you can just
17:40
there ever a time when you can just manage this with drops?
17:42
manage this with drops?
17:42
manage this with drops? >> It's really not a long-term solution.
17:44
>> It's really not a long-term solution.
17:44
>> It's really not a long-term solution. Using things like topical
17:46
Using things like topical
17:46
Using things like topical anti-inflammatory drops is purely
17:48
anti-inflammatory drops is purely
17:48
anti-inflammatory drops is purely paliotative. It might reduce some of the
17:50
paliotative. It might reduce some of the
17:50
paliotative. It might reduce some of the swelling and make the dog feel a little
17:52
swelling and make the dog feel a little
17:52
swelling and make the dog feel a little better for a short time, but it does
17:54
better for a short time, but it does
17:54
better for a short time, but it does absolutely nothing to fix the underlying
17:56
absolutely nothing to fix the underlying
17:56
absolutely nothing to fix the underlying mechanical problem. The broken ligaments
17:58
mechanical problem. The broken ligaments
17:58
mechanical problem. The broken ligaments are still broken.
17:59
are still broken.
17:59
are still broken. >> So, it's just a temporary band-aid.
18:01
>> So, it's just a temporary band-aid.
18:01
>> So, it's just a temporary band-aid. >> It is. The only time we'd really
18:02
>> It is. The only time we'd really
18:02
>> It is. The only time we'd really consider it is if a dog is, say,
18:04
consider it is if a dog is, say,
18:04
consider it is if a dog is, say, extremely old or has a severe heart
18:06
extremely old or has a severe heart
18:06
extremely old or has a severe heart condition that makes anesthesia too
18:07
condition that makes anesthesia too
18:07
condition that makes anesthesia too risky. For virtually every young healthy
18:10
risky. For virtually every young healthy
18:10
risky. For virtually every young healthy dog with this condition, surgery is the
18:12
dog with this condition, surgery is the
18:12
dog with this condition, surgery is the only responsible path forward.
18:14
only responsible path forward.
18:14
only responsible path forward. >> Okay, let's move to that critical
18:16
>> Okay, let's move to that critical
18:16
>> Okay, let's move to that critical recovery phase. the surgery is done.
18:19
recovery phase. the surgery is done.
18:19
recovery phase. the surgery is done. What are the absolute non-negotiables
18:21
What are the absolute non-negotiables
18:22
What are the absolute non-negotiables for an owner to make sure it's a
18:24
for an owner to make sure it's a
18:24
for an owner to make sure it's a success?
18:24
success?
18:24
success? >> Posttop care is just as important as the
18:27
>> Posttop care is just as important as the
18:27
>> Posttop care is just as important as the surgery itself. First and foremost is
18:29
surgery itself. First and foremost is
18:29
surgery itself. First and foremost is pain management. You have to give the
18:31
pain management. You have to give the
18:31
pain management. You have to give the prescribed pain medications exactly on
18:34
prescribed pain medications exactly on
18:34
prescribed pain medications exactly on schedule. And you need to watch for
18:36
schedule. And you need to watch for
18:36
schedule. And you need to watch for subtle signs of pain whining, being
18:38
subtle signs of pain whining, being
18:38
subtle signs of pain whining, being reluctant to eat, or pulling away when
18:40
reluctant to eat, or pulling away when
18:40
reluctant to eat, or pulling away when you touch their head.
18:41
you touch their head.
18:41
you touch their head. >> And what about protecting the site? That
18:43
>> And what about protecting the site? That
18:43
>> And what about protecting the site? That rubbing instinct isn't just going to
18:45
rubbing instinct isn't just going to
18:45
rubbing instinct isn't just going to disappear overnight.
18:46
disappear overnight.
18:46
disappear overnight. >> No, it won't. So sight protection is
18:47
>> No, it won't. So sight protection is
18:47
>> No, it won't. So sight protection is paramount. This means the dreaded
18:50
paramount. This means the dreaded
18:50
paramount. This means the dreaded Elizabeth and collar, the cone of shame,
18:52
Elizabeth and collar, the cone of shame,
18:52
Elizabeth and collar, the cone of shame, >> nobody's favorite accessory.
18:54
>> nobody's favorite accessory.
18:54
>> nobody's favorite accessory. >> Nobody's. But it is absolutely critical
18:57
>> Nobody's. But it is absolutely critical
18:57
>> Nobody's. But it is absolutely critical for 10 to 14 days. It physically stops
18:59
for 10 to 14 days. It physically stops
18:59
for 10 to 14 days. It physically stops the dog from scratching or pawing at
19:01
the dog from scratching or pawing at
19:01
the dog from scratching or pawing at their eye, which could easily rip those
19:03
their eye, which could easily rip those
19:03
their eye, which could easily rip those delicate sutures and cause a complete
19:05
delicate sutures and cause a complete
19:05
delicate sutures and cause a complete failure of the surgery.
19:06
failure of the surgery.
19:06
failure of the surgery. >> And no rubbing on the furniture.
19:08
>> And no rubbing on the furniture.
19:08
>> And no rubbing on the furniture. >> No rubbing on anything. You also have to
19:09
>> No rubbing on anything. You also have to
19:09
>> No rubbing on anything. You also have to keep the surgical site clean and dry.
19:11
keep the surgical site clean and dry.
19:11
keep the surgical site clean and dry. And then there's activity restriction,
19:13
And then there's activity restriction,
19:13
And then there's activity restriction, >> right? No rough play with other dogs. No
19:16
>> right? No rough play with other dogs. No
19:16
>> right? No rough play with other dogs. No jumping off the couch.
19:17
jumping off the couch.
19:17
jumping off the couch. >> Exactly. Strenuous activity can increase
19:20
>> Exactly. Strenuous activity can increase
19:20
>> Exactly. Strenuous activity can increase blood pressure and pressure within the
19:21
blood pressure and pressure within the
19:21
blood pressure and pressure within the eye, which puts stress on the repair.
19:24
eye, which puts stress on the repair.
19:24
eye, which puts stress on the repair. The dog needs a calm, controlled
19:26
The dog needs a calm, controlled
19:26
The dog needs a calm, controlled environment for at least a couple of
19:28
environment for at least a couple of
19:28
environment for at least a couple of weeks to really let things heal
19:29
weeks to really let things heal
19:29
weeks to really let things heal properly.
19:30
properly.
19:30
properly. >> And of course, follow-up visits with the
19:32
>> And of course, follow-up visits with the
19:32
>> And of course, follow-up visits with the vet are key.
19:33
vet are key.
19:33
vet are key. >> Non-negotiable. The vet needs to check
19:35
>> Non-negotiable. The vet needs to check
19:36
>> Non-negotiable. The vet needs to check on the healing, make sure there's no
19:37
on the healing, make sure there's no
19:37
on the healing, make sure there's no infection, and ensure the repair is
19:39
infection, and ensure the repair is
19:39
infection, and ensure the repair is holding. And because there's always that
19:41
holding. And because there's always that
19:41
holding. And because there's always that small risk of recurrence and because the
19:43
small risk of recurrence and because the
19:43
small risk of recurrence and because the other eye is also at risk, long-term
19:46
other eye is also at risk, long-term
19:46
other eye is also at risk, long-term care really involves just being vigilant
19:48
care really involves just being vigilant
19:48
care really involves just being vigilant and having regular eye exams.
19:50
and having regular eye exams.
19:50
and having regular eye exams. >> But we've covered the problem and the
19:51
>> But we've covered the problem and the
19:51
>> But we've covered the problem and the fix. Now let's talk about the future for
19:54
fix. Now let's talk about the future for
19:54
fix. Now let's talk about the future for someone considering getting a
19:55
someone considering getting a
19:55
someone considering getting a high-risisk breed or who already has
19:57
high-risisk breed or who already has
19:57
high-risisk breed or who already has one. Can we actually prevent this or is
20:00
one. Can we actually prevent this or is
20:00
one. Can we actually prevent this or is it just genetic destiny?
20:01
it just genetic destiny?
20:01
it just genetic destiny? >> That is the ultimate challenge, isn't
20:03
>> That is the ultimate challenge, isn't
20:03
>> That is the ultimate challenge, isn't it? And we have to be honest because the
20:05
it? And we have to be honest because the
20:05
it? And we have to be honest because the root cause is genetic and anatomical.
20:07
root cause is genetic and anatomical.
20:07
root cause is genetic and anatomical. You may not be able to prevent it
20:08
You may not be able to prevent it
20:08
You may not be able to prevent it entirely in every single atrisisk dog,
20:11
entirely in every single atrisisk dog,
20:11
entirely in every single atrisisk dog, but you can absolutely take proactive
20:13
but you can absolutely take proactive
20:13
but you can absolutely take proactive steps to significantly reduce the risk.
20:16
steps to significantly reduce the risk.
20:16
steps to significantly reduce the risk. >> So, let's start with what feels like the
20:17
>> So, let's start with what feels like the
20:17
>> So, let's start with what feels like the most powerful tool, breed selection and
20:20
most powerful tool, breed selection and
20:20
most powerful tool, breed selection and doing your homework.
20:21
doing your homework.
20:21
doing your homework. >> It all starts there. Before you even get
20:23
>> It all starts there. Before you even get
20:24
>> It all starts there. Before you even get a puppy, you have to research the
20:25
a puppy, you have to research the
20:25
a puppy, you have to research the breed's predispositions. We've said it a
20:27
breed's predispositions. We've said it a
20:27
breed's predispositions. We've said it a few times, but it bears repeating.
20:29
few times, but it bears repeating.
20:30
few times, but it bears repeating. Bulldogs, cocker spananiels, beagles,
20:32
Bulldogs, cocker spananiels, beagles,
20:32
Bulldogs, cocker spananiels, beagles, you have to go in with your eyes open
20:34
you have to go in with your eyes open
20:34
you have to go in with your eyes open knowing that this is a possibility. And
20:36
knowing that this is a possibility. And
20:36
knowing that this is a possibility. And if you are set on one of these breeds,
20:38
if you are set on one of these breeds,
20:38
if you are set on one of these breeds, what should you be asking a breeder?
20:40
what should you be asking a breeder?
20:40
what should you be asking a breeder? >> You should be looking for a responsible
20:42
>> You should be looking for a responsible
20:42
>> You should be looking for a responsible breeder who is aware of these issues,
20:44
breeder who is aware of these issues,
20:44
breeder who is aware of these issues, who screens their dogs, and who is
20:46
who screens their dogs, and who is
20:46
who screens their dogs, and who is actively trying to breed for better
20:48
actively trying to breed for better
20:48
actively trying to breed for better health, not just for more extreme
20:50
health, not just for more extreme
20:50
health, not just for more extreme features. Ask about the history of
20:52
features. Ask about the history of
20:52
features. Ask about the history of cherry in their lines. A good breeder
20:55
cherry in their lines. A good breeder
20:55
cherry in their lines. A good breeder will be transparent about this.
20:56
will be transparent about this.
20:56
will be transparent about this. >> Okay, moving to the next strategy, diet
20:59
>> Okay, moving to the next strategy, diet
20:59
>> Okay, moving to the next strategy, diet and nutrition. How can what a dog eats
21:02
and nutrition. How can what a dog eats
21:02
and nutrition. How can what a dog eats actually affect the ligaments in its
21:03
actually affect the ligaments in its
21:03
actually affect the ligaments in its eye? This is about giving the body the
21:06
eye? This is about giving the body the
21:06
eye? This is about giving the body the best possible building blocks to work
21:08
best possible building blocks to work
21:08
best possible building blocks to work with. We're talking about supporting the
21:10
with. We're talking about supporting the
21:10
with. We're talking about supporting the integrity of all the connective tissues
21:12
integrity of all the connective tissues
21:12
integrity of all the connective tissues in the body.
21:12
in the body.
21:12
in the body. >> So, what specific nutrients are we
21:14
>> So, what specific nutrients are we
21:14
>> So, what specific nutrients are we talking about?
21:15
talking about?
21:15
talking about? >> Things that are crucial for collagen
21:16
>> Things that are crucial for collagen
21:16
>> Things that are crucial for collagen synthesis. Vitamin C is a big one, as
21:19
synthesis. Vitamin C is a big one, as
21:19
synthesis. Vitamin C is a big one, as are minerals like zinc and copper.
21:21
are minerals like zinc and copper.
21:21
are minerals like zinc and copper. They're all co-actors in the processes
21:22
They're all co-actors in the processes
21:22
They're all co-actors in the processes that build and strengthen tissue. And uh
21:25
that build and strengthen tissue. And uh
21:25
that build and strengthen tissue. And uh a really important one is omega-3 fatty
21:28
a really important one is omega-3 fatty
21:28
a really important one is omega-3 fatty acids
21:28
acids
21:28
acids >> because of their anti-inflammatory
21:30
>> because of their anti-inflammatory
21:30
>> because of their anti-inflammatory properties.
21:30
properties.
21:30
properties. >> Exactly. We already established that
21:33
>> Exactly. We already established that
21:33
>> Exactly. We already established that chronic inflammation can weaken these
21:34
chronic inflammation can weaken these
21:34
chronic inflammation can weaken these ligaments. A diet rich in omega-3s can
21:37
ligaments. A diet rich in omega-3s can
21:37
ligaments. A diet rich in omega-3s can help keep that systemic inflammation at
21:39
help keep that systemic inflammation at
21:39
help keep that systemic inflammation at a low level, which might give those
21:41
a low level, which might give those
21:41
a low level, which might give those ligaments a better fighting chance. It's
21:44
ligaments a better fighting chance. It's
21:44
ligaments a better fighting chance. It's about maximizing the tissue strength
21:46
about maximizing the tissue strength
21:46
about maximizing the tissue strength that their genetics will allow.
21:47
that their genetics will allow.
21:47
that their genetics will allow. >> And the final proactive strategy is
21:49
>> And the final proactive strategy is
21:49
>> And the final proactive strategy is about routine care and managing their
21:52
about routine care and managing their
21:52
about routine care and managing their environment.
21:52
environment.
21:52
environment. >> Yes, this is all about reducing those
21:54
>> Yes, this is all about reducing those
21:54
>> Yes, this is all about reducing those external triggers, those irritants. This
21:57
external triggers, those irritants. This
21:57
external triggers, those irritants. This means routine grooming and specifically
22:01
means routine grooming and specifically
22:01
means routine grooming and specifically daily eye cleaning with a vet approved
22:03
daily eye cleaning with a vet approved
22:03
daily eye cleaning with a vet approved saline wipe or solution. You want to
22:05
saline wipe or solution. You want to
22:06
saline wipe or solution. You want to gently clear away any debris or hair
22:08
gently clear away any debris or hair
22:08
gently clear away any debris or hair that can collect in that inner corner of
22:10
that can collect in that inner corner of
22:10
that can collect in that inner corner of the eye.
22:10
the eye.
22:10
the eye. >> What about things inside the home like
22:12
>> What about things inside the home like
22:12
>> What about things inside the home like air quality?
22:13
air quality?
22:13
air quality? >> That's a great point. Especially for the
22:15
>> That's a great point. Especially for the
22:15
>> That's a great point. Especially for the brachisphalic breeds. If you live in a
22:17
brachisphalic breeds. If you live in a
22:17
brachisphalic breeds. If you live in a very dry climate or run the furnace a
22:19
very dry climate or run the furnace a
22:19
very dry climate or run the furnace a lot in the winter, the air can get very
22:20
lot in the winter, the air can get very
22:20
lot in the winter, the air can get very dry. Using a humidifier where the dog
22:23
dry. Using a humidifier where the dog
22:23
dry. Using a humidifier where the dog sleeps can help keep their eyes from
22:24
sleeps can help keep their eyes from
22:24
sleeps can help keep their eyes from drying out and getting irritated. So
22:26
drying out and getting irritated. So
22:26
drying out and getting irritated. So less irritation means less rubbing which
22:29
less irritation means less rubbing which
22:29
less irritation means less rubbing which means less stress on those ligaments.
22:31
means less stress on those ligaments.
22:31
means less stress on those ligaments. >> That's the idea. And of course being
22:33
>> That's the idea. And of course being
22:33
>> That's the idea. And of course being mindful of other irritants like strong
22:35
mindful of other irritants like strong
22:35
mindful of other irritants like strong cleaning sprays, air fresheners, or
22:37
cleaning sprays, air fresheners, or
22:37
cleaning sprays, air fresheners, or cigarette smoke. Anything that can cause
22:39
cigarette smoke. Anything that can cause
22:39
cigarette smoke. Anything that can cause that lowgrade chronic inflammation is
22:42
that lowgrade chronic inflammation is
22:42
that lowgrade chronic inflammation is something you want to minimize.
22:43
something you want to minimize.
22:43
something you want to minimize. >> So to sum it up, you can't change their
22:45
>> So to sum it up, you can't change their
22:45
>> So to sum it up, you can't change their DNA, but you can make informed choices
22:48
DNA, but you can make informed choices
22:48
DNA, but you can make informed choices about breeding. You can support their
22:50
about breeding. You can support their
22:50
about breeding. You can support their tissues with nutrition. And you can
22:51
tissues with nutrition. And you can
22:52
tissues with nutrition. And you can control their environment to reduce
22:53
control their environment to reduce
22:53
control their environment to reduce inflammation.
22:54
inflammation.
22:54
inflammation. >> Exactly. It's a multi-pronged approach
22:56
>> Exactly. It's a multi-pronged approach
22:56
>> Exactly. It's a multi-pronged approach and taking all those steps together
22:58
and taking all those steps together
22:58
and taking all those steps together gives your dog the absolute best chance
22:59
gives your dog the absolute best chance
23:00
gives your dog the absolute best chance of avoiding this or at least minimizing
23:01
of avoiding this or at least minimizing
23:02
of avoiding this or at least minimizing its severity if it does occur.
23:03
its severity if it does occur.
23:03
its severity if it does occur. >> That brings us to the end of this really
23:05
>> That brings us to the end of this really
23:05
>> That brings us to the end of this really detailed deep dive. We've covered the
23:07
detailed deep dive. We've covered the
23:07
detailed deep dive. We've covered the mechanics of the nictitating membrane
23:09
mechanics of the nictitating membrane
23:09
mechanics of the nictitating membrane prolapse. We've flagged the high-risisk
23:11
prolapse. We've flagged the high-risisk
23:11
prolapse. We've flagged the high-risisk breeds like bulldogs and beagles and
23:13
breeds like bulldogs and beagles and
23:13
breeds like bulldogs and beagles and we've hammered home that surgery
23:15
we've hammered home that surgery
23:15
we've hammered home that surgery specifically repositioning is the only
23:17
specifically repositioning is the only
23:17
specifically repositioning is the only path to saving tear function and
23:19
path to saving tear function and
23:19
path to saving tear function and avoiding KCS. So our final thought for
23:21
avoiding KCS. So our final thought for
23:22
avoiding KCS. So our final thought for you, the listener, to really maul over
23:24
you, the listener, to really maul over
23:24
you, the listener, to really maul over is this. Now that we know from veterary
23:27
is this. Now that we know from veterary
23:27
is this. Now that we know from veterary research the direct line between the
23:29
research the direct line between the
23:29
research the direct line between the physical features we select for in
23:30
physical features we select for in
23:30
physical features we select for in breeds, the flat faces, the shallow
23:33
breeds, the flat faces, the shallow
23:33
breeds, the flat faces, the shallow orbits, and the high likelihood of a
23:35
orbits, and the high likelihood of a
23:35
orbits, and the high likelihood of a painful condition that requires surgery.
23:37
painful condition that requires surgery.
23:37
painful condition that requires surgery. What ethical responsibility do we have
23:39
What ethical responsibility do we have
23:40
What ethical responsibility do we have as the people who choose and buy these
23:41
as the people who choose and buy these
23:41
as the people who choose and buy these dogs to demand and support breeding
23:43
dogs to demand and support breeding
23:43
dogs to demand and support breeding practices that prioritize health over
23:45
practices that prioritize health over
23:45
practices that prioritize health over extreme aesthetics? How can our choices
23:48
extreme aesthetics? How can our choices
23:48
extreme aesthetics? How can our choices help shape a healthier future for these
23:49
help shape a healthier future for these
23:50
help shape a healthier future for these breeds? That's something we're thinking
23:51
breeds? That's something we're thinking
23:51
breeds? That's something we're thinking about long after this is over.
23:53
about long after this is over.
23:53
about long after this is over. >> A provocative and very necessary
23:55
>> A provocative and very necessary
23:55
>> A provocative and very necessary question to end on. Thanks for joining
23:56
question to end on. Thanks for joining
23:56
question to end on. Thanks for joining us for this deep dive into K9 I