Sudden Acquired Retinal Degeneration Syndrome (SARDS)

Muffin- the inspiration for Muffin’s Halo

Over the years I’ve developed a top ten list of my most despised diseases. Those that make it to this list tend to be diseases that are untreatable, leaving me helpless to help my patient. Such is the case with Sudden Acquired Retinal Degeneration Syndrome (aka, SARDS). In addition to being untreatable, the cause of SARDS is unknown. (Note to reader: the less that is known about a disease, the longer the name of that disease.)

What we do know about SARDS

SARDS is a disease of middle age, and approximately 60% of affected dogs are females. Any breed is susceptible, but Dachshunds, Miniature Schnauzers, Pugs, Brittany Spaniels, Malteses, Bichon Frises, and mixed-breed dogs are particularly predisposed.

SARDS affects the retinas which receive visual input and then transport this information to the brain via the optic nerve. In dogs with SARDS, the photoreceptors (rods and cones) and possibly the nerve fiber layer within the thin-layered retinas undergo degenerative changes. The end result is complete blindness. These changes are microscopic in nature- one cannot detect them by performing a basic eye exam. The diagnosis of SARDS is made based on the patient’s history, the presence of partial to complete blindness in both eyes, normal appearing retinas, and characteristic changes on an electroretinogram (ERG). The ERG is a test used to evaluate photoreceptor function and is performed by veterinarians who are specialists in ophthalmology.

It’s been theorized that SARDS is an autoimmune disease in which a misbehaving immune system attacks the body’s own normal cells. Dogs with SARDS who have received immunosuppressive therapy (the treatment of choice for autoimmune diseases) have not demonstrated any clear improvement in overall outcome compared to untreated dogs.

Symptoms

All dogs with SARDS develop complete and permanent blindness over a rapid course, typically days to weeks. Stumbling, difficulty navigating at night, and failure to track treats are the most commonly reported early symptoms of visual impairment.

During the weeks to months preceding their blindness, most SARDS-affected dogs also experience marked increases in appetite and/or thirst with subsequent weight gain and changes in urinary behavior. Testing for hormonal imbalances (diabetes mellitus, Cushing’s Disease) that classically cause these symptoms is commonly pursued and typically comes up empty. Savvy veterinarians consider the possibility of SARDS before loss of vision becomes apparent. In most cases, it is not until vision wanes that the diagnosis of SARDS becomes suspect.

Long-term outcomes for affected dogs and their human companions

When a dog develops SARDS, a significant period of adjustment is required for everyone involved. Imagine living with a newly blind dog who is begging for food, drinking incessantly, and urinating copious amounts (all that water has to go somewhere).

A study of long-term outcomes in dogs with SARDS surveyed 100 people living with SARDS-affected dogs. In addition to blindness, most of the dogs were reported to have increased thirst, urine output, and appetite along with weight gain. Increased appetite was the only one of these symptoms reported to increase over the course of one year following the SARDS diagnosis.

In this study, 22 of the 100 dogs received some sort of treatment (corticosteroids, nutritional supplements, melatonin, and/or doxycycline) for their blindness. None experienced improved vision in response to therapy.

Eighty-seven percent of the dogs were reported to have moderate to excellent navigation skills within their home environments, and 81% had moderate to excellent navigation skills within their yard environments. Of the people surveyed, 48% reported making special provisions for their dogs such as the use of baby gates, fencing, and ramps, carpeting pathways to important locations, and auditory clues or scents to signify certain locations.

Thirty-seven percent of respondents reported that the relationship with their dog actually improved after the SARDS diagnosis. The authors of the study theorized that the increased time and involvement necessary to care for a blind dog may have been responsible for enhancing the human-animal connection. Only 17% reported that the relationship with their dog worsened.

Seventy-six percent of respondents ranked the quality of their dog’s life to be moderate to excellent. Only nine dogs were reported to have a poor quality of life. Of the 100 people surveyed, 95 indicated that they would discourage euthanasia if advising others caring for dogs with SARDS. One must bear in mind that those who chose to euthanize when SARDS was diagnosed were not surveyed.

This study provides truly uplifting results. While adaptation to a dog’s loss of vision usually proceeds smoothly, when one factors in the other SARDS symptoms that accompany the blindness, the challenge to maintain quality of life for everyone involved increases significantly. Dogs and the people who love them can be amazingly adaptive creatures!

Muffin’s Halo

The photo accompanying this article is of Muffin, a Poodle with cataracts. The halo apparatus he is wearing was designed by his clever companion, Silvie as a means to allow Muffin to explore his environment without bumping his face into things. While I have no direct experience with Muffin’s Halo (I just learned of this product a couple of weeks ago), the concept is intriguing to me. My impression is that this device would significantly boost a blind dog’s confidence level, particularly one who is newly blind. If you have used this product, I would value your feedback.

Have you ever cared for a blind dog? How was the quality of your lives impacted?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

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15 Comments on “Sudden Acquired Retinal Degeneration Syndrome (SARDS)

  1. Thank you so much Dr. Nancy Kay for including Muffin’s Halo in your article. Muffin had a really hard time with blindness and his halo helped him immensely and I am so happy to have it on the market to help other blind dogs transition. I am proud to share that over a thousand blind dogs in all sizes all over the world are navigating happily with our halos and leading a bump-free life :)
    Silvie Bordeaux
    Inventor/Founder of Muffin’s Halo for Blind Dogs
    http://www.muffinshalo.com

  2. My two Aussies, who were brothers went blind at 10 years old. They were both diagnosed with PRA. The dogs were not as affected as I was. At first, I was very upset but when I realized how well they were dealing with their blindness, I relaxed. The more confident of the two did not seem affected at all and if you didn’t know, you would not realize he was blind. The more sensitive of the two used the other one as a guide dog, always following just at his hip.
    The adjustments I made were minor. I never moved the furniture or left things out on the floor for them to trip over. Of course, there weren’t any more off leash walks.

  3. My 4 year old maltese was diagnosed with SARDS after rapid weight gain and blindness, an ERG confirmed the diagnoses in September 2013. He became very depressed, rarely played and continued with weight gain even when eating half his recommended daily allowance on special weightloss food. Eventually a few months later his emotional state increased and we were so happy that he was almost his old self but end of January 2014, he jumped off our couch and broke his back. He was in immense pain and after looking at the x-rays the vet recommended that we euthanize him. We still miss him everyday and I keep monitoring all the sites to see if there are new studies or treatments available. Please keep up the good work!

  4. Our Labrador, Nikki was diagnosed with brain cancer and she went blind a few months later. Nikki was eight years old at the time, and unlike the more typically exuberant Lab personality, our Nikki was an extraordinarily mellow girl who took it all in stride.
    Our walks slowed to gentle strolls around the block where Nikki kept tabs on me by nudging my leg. This allowed us to navigate together steadily and contentedly.
    Although she had never been a very affectionate girl, we began to have times where we would sit together and “chat” and she would allow me to drape one of my arms around her.
    Nikki’s blindness was probably the closest time we shared together as we (both) made it a point to appreciate what time we had left.

  5. Hi Dr Kay,
    My Chanel went blind around 8 yrs old. She adjusted to a lot in her life so going blind wasn’t to bad. We never moved furniture so she could remember where she was going. The scent thing never worked . For 3 yrs she did pretty good, even going for walks & roaming around the fenced in yard. But when she lost her right eye completely she changed a lot. She would eat all the time , drink a lot & had a lot of accidents. When she went outside I would watch her closely because she constantly bumped into things. She di d know the difference between the grass and patio, and she would manage to get to the stairs to come in because I would go to her and say laoudly ” time to go in, UP, UP UP!” and she would do it each time. I tried to put a type of hat on her that was cushioned but she didn’t like it. I don’t think she would have liked the Halo. Thanks for your great articles. I always look forward to reading them.

  6. I’m the president of Blind Dog Rescue Alliance. We are a 501(c)(3) nonprofit organization that rescues and rehomes blind and visually impaired dogs. There is a great email list for blind dog support. pets.groups.yahoo.com/group/blinddogs
    Hoops do help some dogs. I haven’t had any who really needed one, but I would get one if I did! There are even patterns online to make your own, as well as make a collar with “whiskers” using electrical zip ties to act as feelers for your dog. You can also scent things they tend to bump into and use textured rugs and mats at doorways, bottoms of stairs, etc. Also, teach your dog a “watch” command when something is in their way, and “step” for stairs.

  7. When I was a teen we had a Beagle/Manchester Terrier mix who became diabetic & blind. Baron’s adjustment was seamless. In fact, we had no idea he’d lost his vision until someone shut a door between two rooms and the family witnessed him walk into it hitting his head.

    The adjustment was harder on the humans of our family. Baron would run through the house to bark at the front window. He jumped on and off chairs and beds fearlessly. The rest of us were always making sure nothing was moved because we didn’t want him to get hurt.

    He learned to tip his head using his hearing to compensate for the loss of vision. Most people would remark on how expressive he was because of this. If we told anyone he was blind very few believed it.

    He ate and drank unassisted and lived 2 years with daily insulin shots and Kidney Diet food until he had a stroke and we had to euthanize him.
    Baron was my first chronic care dog. I learned to adjust and administer insulin, do litmus testing of his urine and regulate his eating. I think Muffin’s Halo is a great idea.

  8. Hi, Many degenerative diseases have a genetic predisposition. However, that does not mean that nutrition does not play a big role in the onset and progression. One thing that needs to change in veterinary medicine (and in human medicine in the USA) is the disregard for nutrition to a large degree as an integral part of the patients wellness and treatment when illness occurs. How many of your patients who develop retinal degeneration were fed a vapid diet of commercial kibble with corn fodder waste as the main ingredient? How many of these dogs are fed from a 40 lb economy bag of kibble for a month even though the vitamins have oxidized a week after the bag was opened? The essential fatty acids go rancid in kibble and then are not available for the retina. Retinal cells and the tiny capillaries that feed retinas are delicate and have nutritional requirements that are not contained in rancid kibble. You should collect survey data from your patients and then publish. Also, I want to say that the halo apparatus should be redesigned to have flexible/whisker projections in the front. This would be a much better design than the cumbersome, banging helmet that goes all the way around the little dog’s head. Dr. Susan Porter

  9. My rescue pointer went blind from SARDS when she was 8yrs old (2007). I purchased a similar halo apparatus for her when she first lost her sight. I also had a crafty friend construct another. They did not work for my girl. She found it extremely frustrating and would get stuck and lose her bearings. She bent the halo trying to push her way around the house. She wanted to be able to feel her way around, even though her face looked like a prize fighter. The halo took away her ability to feel for her landmarks. She did much better just figuring things out on her own. Whoever was selling a similar version of Muffin’s Halo at the time said they work better for smaller dogs. The halo is smaller and they are less cumbersome. And, perhaps they would work for a larger dog who is more passive than my girl was. She was a very strong willed, independent, proud girl.

    After her SARDS diagnosis, she was found to also have atypical Cushings disease, which we treated. She passed on at almost 15yrs old last year from something not at all related to SARDS or Cushings. She was a truly special dog. I learned a lot about life from her. Going blind didn’t slow her down. She adjusted really well. And we made sure she could still do most of the things she loved. It didn’t shake her spirit.

  10. Luckily my gal has a bunch of pluck! As well as sudden blindness, she was really frosted by her inability to control her urination. But… voila, DES!
    She takes one small pill per month and she is just fine. I don’t know how the boys do it, though. I think “diethyl stilbesterol” is a synthetic estrogen.

  11. My Brittany was diagnosed with SARDS at 6 years old. She missed a treat toss and turned to locate it by the sound of it hitting the floor and we were off to the vet and then the Atlantic Veternary College. She also became obsessed with food but thankfully not so much the excessive drinking/urinating.
    We did agility so I had some loss around not being able to continue with that but otherwise we both adjusted fairly well.
    The furniture at our house is moved around all the time but she never really ran into anything except the newel post at the bottom of the stairs which never moved!! She also never mistepped on the stairs.
    We have acres of hay fields and she would run and tear around. Infact we competed in some clicker games and no one knew she was blind–pretty cool!
    I did worry about her getting poked in the eye with a piece of grass or something but it never happened.

    She died 5 years later at 11 of a mast cell tumour by her jaw.

  12. I have had two blind dogs, one who went slowly blind as he aged, and one with glaucoma. In my experience, a dog who goes blind slowly and quietly is much easier on both the dog and human. Neither of my dogs had difficulty dealing with the blindness, after the fact. I think the reason they did not have trouble was that I encouraged them and trained Dexter, my dog with glaucoma, before he lost his sight. If the humans lose it emotionally, the dog will too.

    SARDS is more difficult because it happens so quickly and unexpectedly. Until the dog knows that it can make it without sight, it may react negatively. Once the human starts showing the dog the way, it can move ahead with confidence.

    I highly recommend the Website http://www.blinddogs.com, which provides lots of advice and has an e-mail list that people can sign up for, where they can ask questions of those who have gone through this with their dogs. The information people share is very useful, and the group gently supports humans who are disturbed at their dogs’ loss of sight. It is especially useful for dogs with SARDS or glaucoma, since others can share what to expect and how to help the dog. Knowing how things happen helps people get through it. Someone who has been through it does that best.

    There is life beyond blindness. Dexter has proved that to me. He is a generally well-adjusted boy who finds his way around with very little trouble. Of course I wish he had never lost his sight, but it is not the show stopper I thought it might be.

  13. Yes I did. In fact, I adopted a 2 year old Golden Retriecer who was about to be “executed” because he became blind. It was the irony and cruel sense of humor of Fate that he was named Oedipus long before he became blind.

    I used auditory and olfactory aides to guide him and learn the layout of my house and the securely fenced yard. My other three companions became his guardians and guides and it was touching and humbling to see the care and devotion they gave him.

    He was never alone, there was always one of his “guides” next to him. He was always qithin the reach of my hand and he felt safe and secure in a very short time after he joined us.

    Of course, he was NEVER allowed off leash outside the home territory (but then none of my companions are!) and he never felt handicapped or limited in any way.

    The only thing that used to annoy me was when people would refer to him as “that poor dog” or “that handicapped dog”. He never felt that he was any of those things.

    He lived to be 16 years old ans the 14 he spent with me were a gift to him, but even more so – to ME.

  14. A lab mix I had went blind when she was around 10. At the vet’s recommendation I got a copy of Living With Blind Dogs. We scented the doorways with differnt scents to help her keep oriented. She would go out the dog door on her own. She continued to enjoy hunting rodents in the yard for three years, a great girl. The other dogs quickly figured out she wasn’t being aggressive when she walked into them. The pit mix was her self-appointed minder. I would do it all again.

  15. Yes, my Dachy mixed w/Pappilion, lived to be 18 & went blind slowly when she was about 14. It was so gradual I didn’t realize it until it was too late.
    She accommodated very well & even learned a whole new apartment and outside area. I always worried re her eyes and watched her constantly as I was able to stay home with her. Her pet companion helped her too. I had to spoon feed her at times to get her started but then she would eat.
    She was so precious, her name was Princess & she had the cutest ears and softest fur. Smart too. Thank you for the info on the Halo, I passed it on to my email friends too. Whst a wonderful inventor & I love her ideas.
    I like your blog too. We need more caring vets here in San Diego as a lot are only in it for the money. So sad.