Videos

How to flush a nasolacrimal duct in a dog or cat | VETgirl Veterinary CE Videos

In today’s VETgirl online veterinary CE video, we demonstrate how to flush the nasolacrimal duct of the feline or canine patient. Normal tear drainage occurs via the nasolacrimal system, beginning at the tear ducts (lacrimal puncta), passing through the nasolacrimal duct, and draining into the nasopharynx. Poor drainage through this system can lead to clinical signs such as epiphora (e.g., tear overflow), ocular discharge (e.g., varying from mucoid to mucopurulent discharge), and sometimes signs of conjunctivitis with hyperemia. Certain conformational abnormalities can lead to decreased tear drainage, including medial entropion seen in brachycephalic breeds, or failure to form tear duct openings (e.g., imperforate lacrimal punctae). Additionally, dacryocystitis (e.g., inflammation of the lacrimal system) will result in decreased tear drainage and excessive ocular discharge.

If there is a concern for nasolacrimal disease, the patency of the system can also be tested by cannulation and flushing with saline. In most dogs and cats, nasolacrimal duct flushing can be performed without sedation. Under topical anesthesia, for example, proparacaine, the upper lacrimal punctum and canaliculus can be cannulated using a nasolacrimal cannula (e.g., 22 to 24 gauge) or 22 to 24 gauge intravenous catheter (with the stylet removed!), and flushed with saline. Saline should be flushed from the upper punctum to the lower punctum initially to assess the patency between the two puncta. Then, gentle digital pressure can be used to occlude one puncta while the other is flushed, assessing the patency into the nasopharynx. Often you see the patient swallow due to the movement of the saline into the pharynx.

When in doubt, know that this procedure can be easily performed at your veterinary clinic!

Only VETgirl members can leave comments. Sign In or Join VETgirl now!