Entropion in Cats and Dogs – Causes, Symptoms, and Treatment

What is Entropion in Cats and Dogs

Entropion is a common ophthalmic disorder characterized by the inward rolling of one or both eyelids. This causes the eyelashes and surrounding hair to rub against the cornea, leading to irritation, inflammation, pain, and potential ulceration. In both cats and dogs, this condition can severely impact vision and overall eye health if not recognized and treated promptly.

In dogs, entropion is predominantly hereditary, arising from specific genetic conformations associated with facial structure and eyelid anatomy. In contrast, in cats, it is more often acquired, developing secondary to chronic inflammation, trauma, or scarring. Regardless of the cause, the constant friction between the eyelid and cornea produces discomfort, excessive tearing, and, in advanced cases, corneal opacity or blindness.

Anatomically, the eyelid’s purpose is to protect the eye by evenly distributing tear film and shielding it from debris. When the lid turns inward, this natural protection becomes destructive. The friction disrupts the corneal epithelium, opening the door to bacterial infections and ulcers. This makes early diagnosis and proper correction essential for maintaining ocular integrity.

Types of Entropion in Cats and Dogs

Entropion is classified based on its underlying cause and presentation. Understanding these categories helps veterinarians tailor both medical and surgical management:

• Congenital Entropion: Present at birth or early life, typically caused by inherited eyelid conformations. Common in breeds with excessive facial folds or loose skin.

• Acquired Entropion: Develops later in life due to trauma, chronic inflammation, or neuromuscular dysfunction.

• Spastic Entropion: A temporary inward rolling caused by ocular pain or irritation; once the primary irritation resolves, the eyelid may return to normal.

• Cicatricial Entropion: The result of scar tissue formation following surgery, burns, or infection that pulls the lid margin inward.

In cats, spastic and cicatricial entropion are most frequently encountered, often associated with feline herpesvirus infections (FHV-1). In dogs, congenital entropion dominates, especially among large or brachycephalic breeds.

Causes of Entropion in Cats and Dogs

Several etiological factors contribute to entropion formation. These may be anatomical, hereditary, inflammatory, or traumatic in nature.

1. Genetic and Anatomical Causes

• Breeds with excessive facial skin or loose connective tissue (e.g., Shar Pei, Chow Chow, Bloodhound) are predisposed.

• Dogs with large, deep-set eyes or short muzzles often have eyelids that fold inward naturally.

• Cats with flat faces, like Persians, may develop mild inward rolling due to orbital anatomy.

2. Chronic Inflammation

Repeated bouts of conjunctivitis or keratitis can cause eyelid spasms and tissue contraction. In cats, chronic herpesvirus infections are a major trigger.

3. Trauma or Surgery

Injury near the eyelid margin or poorly healed surgical wounds can lead to scar formation, distorting the eyelid’s shape.

4. Neurological or Muscular Weakness

Facial nerve paralysis or age-related muscle atrophy can cause poor eyelid tone, leading to secondary entropion.

5. Environmental Factors

Dust, allergies, and chronic irritation may exacerbate spastic entropion by causing repetitive squinting and tissue contraction.

Breeds Predisposed to Entropion

Species & Breed	Reason for Predisposition	Risk Level
Shar Pei (Dog)	Loose, wrinkled facial skin creates inward eyelid tension.	High
Chow Chow (Dog)	Heavy eyelids and facial folds.	High
English Bulldog (Dog)	Brachycephalic skull shape, redundant skin.	High
St. Bernard (Dog)	Deep-set eyes with weak lid support.	High
Labrador Retriever (Dog)	Occasional congenital form seen.	Medium
Rottweiler (Dog)	Lower eyelid laxity leading to inversion.	Medium
Persian Cat	Flat facial structure predisposes to lower eyelid entropion.	Medium
Burmese Cat	Documented hereditary tendency in certain bloodlines.	Medium
Siamese Cat	Secondary to chronic ocular inflammation.	Low
Domestic Shorthair Cat	Usually traumatic or inflammatory in origin.	Low

Symptoms of Entropion in Cats and Dogs

Clinical presentation can range from mild discomfort to severe corneal damage. Typical signs include:

• Squinting or partial eye closure (blepharospasm)

• Redness, swelling, and watery discharge (epiphora)

• Rubbing or scratching at the face and eyes

• Cloudiness or visible corneal ulceration

• Thick mucous discharge in chronic cases

• Light sensitivity (photophobia)

• Pigmentation or scarring on the cornea

The severity of symptoms depends on how much of the eyelid is turned inward and how long the condition persists. Chronic friction not only causes pain but also leads to corneal neovascularization — the abnormal growth of blood vessels over the cornea that permanently affects vision.

Diagnosis of Entropion in Cats and Dogs

Diagnosis is typically straightforward, though proper examination requires experience and patience. The veterinarian will:

1. Observe eyelid conformation in a relaxed, unsedated state.

2. Use topical anesthetics to distinguish between true (structural) and spastic (pain-induced) entropion.

3. Apply fluorescein dye to identify corneal abrasions or ulcers.

4. Evaluate tear production using the Schirmer tear test.

5. Assess for secondary bacterial infections with cytology or culture if discharge is present.

6. Measure intraocular pressure to rule out concurrent ocular disorders like glaucoma.

In severe or chronic cases, ophthalmic photography, slit-lamp biomicroscopy, or referral to a veterinary ophthalmologist is recommended for surgical planning.

Treatment of Entropion in Cats and Dogs

The mainstay of treatment for entropion is surgical correction, tailored to the severity and cause.

1. Medical Management (Temporary Relief)

• Lubricating eye drops and ointments reduce corneal friction.

• Antibiotic drops treat or prevent infection.

• Anti-inflammatory medication can decrease swelling and spasms.These are only temporary solutions and used preoperatively or in mild, spastic cases.

2. Tacking Sutures (Temporary Surgery)

Used for young animals whose facial structure is still developing.

• Non-absorbable sutures are placed to roll the eyelid outward.

• After several weeks, the sutures are removed and re-evaluated.

• Particularly effective in puppies and kittens.

3. Definitive Surgical Correction

• The Hotz-Celsus procedure is the gold standard, involving removal of a crescent-shaped section of skin near the eyelid margin to evert the eyelid.

• Wyman’s modification or Stades technique may be applied in complex cases.

• In cats, minimal tissue removal is critical to avoid overcorrection (ectropion).

4. Postoperative Care

• Elizabethan collar to prevent self-trauma.

• Topical antibiotics and lubricants for 10–14 days.

• Stitches are removed after 10–14 days, and most patients recover fully within 3 weeks.

Complications and Prognosis of Entropion in Cats and Dogs

If untreated, entropion can lead to serious, vision-threatening complications such as:

• Corneal ulceration and perforation

• Chronic keratitis (inflammation of the cornea)

• Pigmentary keratitis (dark pigmentation of the cornea)

• Vision loss or blindness

• Chronic pain and scarring

However, the prognosis after surgery is excellent. The success rate exceeds 90% in most dogs and cats when performed by experienced veterinarians. Revision surgeries may be necessary in breeds like Shar Pei due to persistent skin tension or recurring eyelid laxity.

Home Care and Prevention of Entropion

Although hereditary entropion cannot be fully prevented, responsible pet care significantly reduces complications:

• Conduct routine eye checks at home for signs of tearing or squinting.

• Keep the facial area clean and dry, especially in wrinkled breeds.

• Avoid breeding animals known to have hereditary entropion.

• Maintain a balanced diet rich in omega-3 fatty acids for skin and eye health.

• Avoid exposure to dusty or windy environments that may aggravate ocular irritation.

• Schedule biannual veterinary eye exams for predisposed breeds.

Preventive strategies in breeding programs, including genetic screening and responsible mate selection, are crucial to reducing the incidence of congenital entropion in future generations.

Owner Responsibilities for Entropion Treatment

Postoperative and general care determine long-term success:

• Administer all medications exactly as prescribed.

• Prevent the animal from rubbing its face using an Elizabethan collar.

• Clean discharge gently with sterile saline or wipes.

• Attend all scheduled follow-ups for suture removal and re-evaluation.

• Report any recurrence of tearing or discomfort promptly.

• Avoid home remedies or over-the-counter products unless directed by a vet.

Owners should understand that entropion is not a cosmetic issue — it is a painful condition requiring prompt veterinary care. Proper management ensures comfort and prevents irreversible damage.

Differences Between Cats and Dogs with Entropion

Characteristic	Cats	Dogs
Common Cause	Chronic inflammation, scarring	Hereditary eyelid anatomy
Typical Age	Middle-aged or senior	Young adults or puppies
Surgical Need	Often mild, sometimes self-limiting	Usually requires correction
Recovery	Rapid with proper management	Excellent with skilled surgery
Recurrence	Rare	Occasional in skin-heavy breeds

In essence, entropion behaves differently across species. While feline cases are often secondary and less severe, canine cases tend to be structural and more likely to require surgery.

FAQ – Entropion in Cats and Dogs

What is entropion in cats and dogs?Entropion is an eyelid disorder where the margin of the eyelid rolls inward, causing the eyelashes and surrounding fur to rub against the cornea. This constant friction irritates the eye, leading to inflammation, tearing, and corneal ulcers if untreated.

Is entropion painful for cats and dogs?Yes, entropion is extremely painful because the cornea is one of the most sensitive tissues in the body. The constant rubbing of eyelashes creates a foreign-body sensation, causing squinting, excessive tearing, and light sensitivity.

Can entropion cause blindness in pets?Yes. If the condition is left untreated, persistent corneal ulceration, scarring, and pigment deposition can permanently damage the eye and result in partial or total vision loss.

What are the early signs of entropion in cats and dogs?Typical signs include squinting, watery eyes, discharge, redness, and pawing at the face. Some animals may avoid light or blink excessively due to discomfort.

How is entropion diagnosed by a veterinarian?Diagnosis involves a physical eye examination, use of fluorescein stain to check for ulcers, and sometimes a topical anesthetic test to distinguish true entropion from spastic entropion caused by pain or irritation.

Are certain breeds more likely to get entropion?Yes. Dog breeds such as Shar Pei, Chow Chow, English Bulldog, and St. Bernard are highly predisposed due to facial conformation. In cats, Persian and Burmese breeds are more prone to developing entropion.

Can kittens and puppies develop entropion?Yes. Congenital entropion can appear at a very young age, particularly in purebred puppies. Some mild cases resolve as the animal grows, but most require temporary sutures or surgery.

Is entropion in cats and dogs hereditary?In dogs, hereditary entropion is well documented and can pass from parents to offspring. Responsible breeders should avoid breeding affected animals. In cats, hereditary entropion is less common but possible in certain lines.

Can entropion occur after an injury?Yes. Scarring or tissue contraction following trauma or surgery around the eye can distort the eyelid margin and cause cicatricial entropion.

What is the difference between entropion and ectropion?Entropion is the inward rolling of the eyelid, while ectropion is the outward drooping of the lid. Both can cause irritation but require opposite surgical corrections.

How is entropion treated in cats and dogs?Surgical correction is the most effective treatment. The veterinarian removes a small section of skin near the eyelid margin (Hotz-Celsus procedure) to roll the lid outward and prevent further friction.

Can medication alone fix entropion?No. Eye drops and ointments may reduce irritation temporarily but do not address the anatomical defect. Surgery is usually necessary for a permanent solution.

What happens if entropion is not treated?If left untreated, the pet may suffer from chronic pain, recurrent infections, corneal ulcers, and eventually blindness. Untreated cases often worsen over time.

How long is recovery after entropion surgery?Most pets recover within two to three weeks. Stitches are typically removed after 10–14 days, and the use of an Elizabethan collar is recommended to prevent scratching.

Can entropion recur after surgery?Yes, recurrence is possible, especially in breeds with excessive skin folds. However, when performed by an experienced surgeon, recurrence rates are low.

Is entropion surgery safe?Yes. It’s a routine ophthalmic procedure with a high success rate. Most complications occur if the correction is too minimal (recurrence) or excessive (ectropion).

How much does entropion surgery cost for pets?The cost varies by country, clinic, and severity but generally ranges between 300 and 1000 USD. Bilateral or revision surgeries may increase the price.

Can I prevent entropion in my pet?You can’t prevent hereditary entropion, but early detection and responsible breeding reduce risk. Keeping the eyes clean and managing inflammation can prevent secondary entropion.

Does entropion affect one eye or both eyes?It can affect one or both eyes. Bilateral cases are common in dogs with hereditary forms, while cats often develop entropion in one eye due to localized inflammation or injury.

Are cats or dogs more affected by entropion?Dogs are affected far more often than cats. Feline cases are typically secondary, whereas many canine breeds inherit the condition.

What is spastic entropion in pets?Spastic entropion occurs when eyelid muscles spasm due to eye pain or irritation. Once the underlying cause (like conjunctivitis) is treated, the eyelid may return to normal.

Can entropion occur after other eye diseases?Yes. Chronic infections, inflammation, or ulceration can lead to scar formation that pulls the eyelid inward, especially in cats with viral conjunctivitis.

Will my pet need general anesthesia for entropion surgery?Yes, general anesthesia is required to ensure precision and safety. The surgeon must position the eyelid accurately, which is not possible under local anesthesia.

Can entropion in cats and dogs be corrected permanently?Yes. Proper surgical correction offers a long-term cure, especially when combined with careful postoperative monitoring and good home care.

Can entropion cause behavioral changes in pets?Absolutely. Pets in constant discomfort may become withdrawn, irritable, or less playful. After successful treatment, most animals return to normal, happy behavior within weeks.

Sources

• American College of Veterinary Ophthalmologists (ACVO)

• Merck Veterinary Manual

• Cornell University College of Veterinary Medicine

• Mersin Vetlife Veterinary Clinic – Haritada Aç: https://share.google/XPP6L1V6c1EnGP3Oc