Embedding Technique for Canine Third Eyelid Protrusion

At the initial stage, the third eyelid of the dog swells due to infection, leading to symptoms such as conjunctival redness, excessive tearing, and discomfort. Over time, a tiny, pink, cauliflowerlike growth begins to appear within the lower eyelid, specifically at the corner of the eye. This growth can rapidly increase in size, often affecting one eye first, followed by the other. In some cases, both eyes may be affected simultaneously, or only one eye may be involved. These growths typically persist, and while some may disappear after eye drops, they often return after a temporary resolution. There is rarely a complete spontaneous recovery, and if left untreated, they can lead to complications such as keratitis, conjunctivitis, corneal ulcers, or even perforation, potentially resulting in blindness.

During the early stages of the condition, it is recommended to use a combination of gentamicin eye drops, olopatadine hydrochloride eye drops, and hydrocortisone eye drops alternately, applying them several times a day. This treatment can often lead to the shrinkage of the growth within a few days. If medication is ineffective or the condition has been present for an extended period, surgical intervention may be necessary.

This condition is not seasonal and is more prevalent in poorly managed pets, particularly in dogs aged between 3 to 15 months that are in the midst of growth and development. It often starts as a unilateral issue, with some cases progressing to bilateral involvement. It is commonly seen in breeds such as Tibetan Mastiffs, Bull Terriers, Pomeranians, SharPeis, Beagles, Pekingese, and small mixedbreed dogs.

The surgical method for enucleation involves the following steps:

First, the dog is anesthetized using Xylazine and placed in a lateral recumbent position. An sterile drape is used to isolate the affected eye. The growth is then elevated on both sides with surgical sutures to expose the gland fully, allowing visibility of the base. A Tshaped cartilage is removed from behind the gland, and the opening is sutured closed.

An incision is made around the protruding gland, freeing it up and ensuring the depth is sufficient to penetrate the conjunctiva and underlying tissue. This is done to provide enough tension for the sutures during the subsequent closure, preventing the conjunctiva from being torn by the sutures. The gland itself should not be cut or the conjunctiva on its surface removed. The 30 absorbable suture is used for the closure.

When closing the wound, a simple doublelayer continuous suture is employed, crossing over the gland to bury it within the conjunctiva. The last stitch should leave an opening to allow for tear drainage. The knot should be tied on the side of the eyelid furthest from the cornea to avoid irritation and the potential for corneal ulcers.

In cases of unilateral gland prolapse, considering that many will eventually prolapse bilaterally, it is advisable to perform a prophylactic enucleation on the unaffected side. Postoperatively, a combination antibiotic ointment (bacitracin, polymyxin B, and neomycin) should be applied locally, and systemic antibiotics should be administered for at least 7 days.