My Dog Has a Retro-bulb-what?

One day your dog is chewing on a stick. A couple days later, there’s a diagnosis of retrobulbar abscess. Huh?

Retrobulbar abscess in dogs that chew sticks
Retrobulbar abscess can occur in dogs that chew sticks, though it’s rare.

My dog has a what? A retrobulbar abscess? Hmmm.

Retro, like retro chic! Like my Mom’s old clothes. Okay. Retro means back.

What about bulbar? You need a little medical background here. Bulbar? Bulb? The eyeball is kind of a bulb. Retrobulbar means behind the eye. An abscess? Yuck! My dog has an abscess behind his eyeball. How did that happen?

A dog enters my hospital with one of these abscesses about once a month. (It occurs in cats but very rarely.) These are more common in summers like this, where much of the country is experiencing a long drought.

“Okay, so my dog has a bulging eyeball because we’ve had no rain? Has Dr. Deb lost her marbles?” Well, perhaps, but that’s another story. Here’s some usable info on retrobulbar abscess causes and treatment.

Drop That Stick!

Dogs like to chew things, like sticks and plant material and all kinds of good stuff out there. How cute when Chomper is holding that brittle, dry stick between his front paws and chewing away at it, back of stick wedged nicely up in the corner of his mouth. And you’re happy because he’s leaving you alone, just whittling away, using his back molars as a paring knife.

And then a little piece of that stick breaks off just up behind his last tooth. It’s so dry that it’s easy to migrate, like a little nomad splinter, up through the roof of his mouth and fester, in that space above the roof of his mouth and behind his eyeball. It stays there, causing no problems, for a few days. Then, he tries to yawn or open wide and he cries. You try to look in his mouth and he cries louder. He screams and won’t let you open his mouth. It’s time to call the vet.

These infections can occur from other trauma, tooth infections, etc., but most of my cases occur in ardent stick chewers. Even chewing on some dried up old weeds or plant material can do it. Just think about how annoying it is for you if you get a little something caught behind a tooth requiring the emergency dental floss. Well, a dog is unable to tell you he needs to floss.

Chomper Can’t Chew

A classic telltale sign of a retrobulbar abscess is a slightly swollen or protruding eye. Maybe the third eyelid is protruding too. But these symptoms can be very subtle. Most of the time, the dog is unwilling to eat, “afraid” of his food or, as I said, crying when he tries to open his mouth.

Treatment of Retrobulbar Abscess

Oral antibiotics, topical ophthalmic antibiotics and pain medications are the first line of treatment.

But these abscesses often require a short procedure, under anesthesia, to surgically open up the area on the top of the mouth, behind the last molar. This enables that retrobulbar area to drain so the infection can be cleared up. These are painful, and there’s nothing you can do at home except pick up the phone and make a veterinary appointment.

Keep an Eye on the Eye

retrobulbar abscess dog eye
Remember this: If an eye “looks funny,” see a vet.

As with any ophthalmic problem, please get to the veterinarian whenever you think the eye “looks funny.”

This goes for all pets. Eye problems are not something you can fix at home. Most eye issues get worse quickly without veterinary intervention. Not to be too dramatic, but what might just look like a slightly swollen eye or a hazy eye could mean loss of vision without quick attention.

Just this week, I did a follow-up exam on a dog that had had an acute episode of bleeding into the eye. This was caused by very high blood pressure. Without emergency treatment, the dog would have lost vision and been at great risk because of the hypertension. She is doing very well on high blood pressure and eye medications. Her incredibly attuned owner saved her eye by getting this little Dachshund to the ophthalmologist immediately.

Veterinary Ophthalmologists

“Oh, no, please don’t send me to a specialist.” Well, here’s my take on this very important and needed specialty: Ophthalmologists are worth it!

When I mention a second opinion or a referral to a specialist, many of my clients think of one thing: MONEY. Specialist = expensive, in their minds.

While it’s true that there is a price tag associated with a specialist, ophthalmologists are invaluable if your pet has an involved eye problem. Retrobulbar abscesses are not generally in this category. They can usually be managed by your general veterinarian. But what about the bulging eye that isn’t improving? Or the hazy eye with the ocular bleed? Without special equipment and special knowledge, the root of the problem sometimes can’t be diagnosed or treated appropriately.

Man playing with dog If a veterinarian is boarded in ophthalmology, he or she has completed four years of veterinary school, an internship, a residency in ophthalmology and then passed the ophthalmology boards. These specialists have much of the same high-tech equipment and skills that human eye specialists have; these instruments are needed for many involved diagnoses.

The human field has come miles in treating eyes, and much of that knowledge is now being used in the veterinary field. Veterinary ophthalmologists are making early diagnoses, performing involved cataract surgeries and other procedures, and saving eyes and sight that would have been lost in years past.

I am very grateful to share a close relationship with a board-certified veterinary ophthalmologist whose office is just a few miles away. (I also like how she says my last name. She’s German! The way she says “Good morning, Dr. LEESHTENBOURG” makes me sound very smart.)

If your vet is urging you to have your pet’s eyes seen by a specialist, heed the advice and go sooner rather than later. You may save an eye, save vision and, as with all earlier intervention, maybe save some veterinary bills in the long run. I, unfortunately, have had to remove eyes from dogs and cats to relieve pain when an eye is considered no longer salvageable, if the owners waited too long to seek treatment. But our goal is to save these eyes, not remove them.

If you have big concerns about the expense of a visit to an ophthalmologist or specialist, this is what I tell my clients: Go for the consult and get the valued opinion. You may be able to return for follow-ups with your regular vet, who can manage the treatment plan and the medications. But with difficult cases, having the diagnosis pinned down and the state-of-the-art treatment delineated by a specialist is worth its weight in gold.

So enjoy these last, waning weeks of this dry, hot summer. If your dog is chewing on a stick, let him enjoy his bit of natural fiber. Retrobulbar abscesses are not that common. But if he’s attacking it like it’s a steak bone, maybe you could replace it with a nice, water-soaked, safe toy!

Photos, from top to bottom: TheGiantVermin/Flickr, shanon wise/Flickr, Shutterstock

Dr. Debora Lichtenberg, VMD

View posts by Dr. Debora Lichtenberg, VMD
Dr. Debora Lichtenberg, VMD, is a small animal and exotics veterinarian who has split her time between a veterinary practice in Pelham, Massachusetts, and her studio in New York City. Dr. Lichtenberg is a graduate of the University of Pennsylvania School of Veterinary Medicine with 30 years of experience. Her special interests are soft tissue surgery and oncology.

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