CIKS and Vogt-Koyanagi-Harada


CIKS and Vogt-Koyanagi-Harada


Chronic immune mediated keratoconjunctivitis sicca (CIKS) is the newer name for pannus. It is most common in German shepherds, greyhounds and Siberian huskies. The cause of this condition is not known, at present. This may be an immune response to changes brought on by ultraviolet radiation. This is based on the increased prevalence of the disease at higher altitudes. Usually immune mediated CIKS starts at the outer edges of the cornea as blood vessel infiltration and then pigmentation of the cornea. As the disease progresses it spreads across the cornea to the nasal side of the eye and blindness can result from the condition. The third eyelid may become thickened and depigmented, which makes the eye look even worse. If the disease appears early in life (less than 2 yrs. old) it has a tendency to be very severe as it progresses. When it shows up later in life (4 to 5 yrs. or older) it usually is less severe. CIKS can be controlled with medical therapy, usually very successfully. It can not be cured, however. Medication is necessary lifelong for dogs with this condition. In areas of low elevation, it is usually possible to treat this with corticosteroid eye drops. In severe cases, injections of corticosteroids into the tissues surrounding the eye can be necessary. In areas of higher elevation it can be necessary to go to much greater lengths to control this problem. Irradiation of the cornea, surgical removal of the affected areas of the cornea and other measures may be necessary to provide relief from this problem. Mike Richards, DVM

CIKS - sunglasses for dog

Q: Dr. Mike, I live in Denver with my 1 1/2 year old Siberian who has Chronic immune mediated keratoconjunctivitis sicca (CIKS). I'd like to get sunglasses for her so we can visit the mountains on a regular basis again. Do you know of any available or do I have to adapt some human goggles? Any other ideas???

A: A number of catalogs and probably the larger pet stores have sunglasses made for dogs I think this would be a good idea if you can find or make the glasses and they provide protection from UV light. It might be a good idea to call the veterinary school in Ft. Collins, Colorado. I'm sure they have an ophthalmologist there who is a lot more familiar with this condition than I am, since I live at sea level in an area known for its continuous summer haze! Mike Richards, DVM

Staff input - Children's sunglasses are also a possibility if you can't find them for dog's- and we have seen hats and glasses together in some of the dog catalogs - we just can't find one now. Your vet may get one or more catalogs or a web search will turn them up on-line. Sonja saw a man and dog on a motorcycle - the dog was wearing goggles. Harley Davidson and just about everyone else now makes a line of pet clothing clothing and may have something. Sorry we don't have an addresses.

Vogt-Koyanagi-Harada or CIKS possible

Q: Dr. Mike, We have a husky and live in Woodland Park Colorado, Elevation 8,600 feet. This morning we noticed blood vessels migrating from the whites to the colored portion of our dogs eyes. This lead us to your article on CIKS. We will be talking to our Vet about this ASAP but would also like to know from you what methods of eye protection are available for dogs. We do notice his eyes appear to be sunburned after a day at the lake or in the snow. Two weeks ago we sent him to the Vet regarding skin problems (scabs) around his mouth and eyelids; could this be a related problem? We love our dog very much and hope that we can resolve or minimize this problem so he can live a long and healthy life with us. One more thing, is this condition contagious? Sincerely, K.

A: Your dog may have CIKS and it is also possible that he may have Vogt-Koyanagi-Harada like syndrome (VKH). This syndrome is an immune mediated disorder leading to eye problems and crusting skin lesions around the face, mostly. Your vet will be able to sort through these conditions if it seems necessary after examination. Given your location it is probably more likely to be chronic immune mediated keratoconjunctivitis sicca (see why it is usually abbreviated? Wonder why they every changed the name from pannus in the first place?). Obviously, it will take an exam to be sure. I have been wondering about sunglasses for dogs with this problem. It seems to me they would help a lot. Mike Richards, DVM

Swollen eye in Husky

Q: Hi Dr. Mike, I have a stray alaskan malamute/husky here, have had her about 3 weeks so I don't know very much about her. She is aprox 1 year old and has all her shots. She has a white spot on the colored area of her eye that I was told not to worry about. This same eye is now very swollen and it was fine an hour ago. She chases bugs so maybe she has just been stung by a bee. She seems happy and in no pain, doesn't bother her at all. I wonder if there is any strange disease that could cause this. If she is not better by am I will take her to the vet, but thought I 'd go ahead and send this. I might get lucky and catch u online, or it may help someone else. Thanks,

A: I hope your pup's eye is OK now. If not, there is a disorder of huskies and malamutes to consider. They have an auto-immune disorder that leads to eye inflammation, known as Vogt-Koanagi-Harada like syndrome. Conjunctivitis, bee-stings and things like that are more likely but this is something to keep in mind if the condition persists. Good luck with this. Mike Richards, DVM

Last edited 01/31/05


Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...