Breed and conformational predispositions for prolapsed nictitating membrane gland (PNMG) in dogs in the UK: A VetCompass study

Background Prolapsed nictitating membrane gland (PNMG) is the most common disorder of the third eyelid in dogs. However, the epidemiology of PNMG in the wider dog population remains understudied. Methods Using de-identified clinical data from the VetCompass Programme, this cohort study aimed to report the prevalence, demographic and breed-related risk factors of PNMG in dogs attending UK primary care veterinary practices in 2016. Results There were 1,802 PNMG cases identified from 905,543 dogs, yielding an annual prevalence of 0.20% (95% confidence interval (CI) 0.19-0.21). The median age at first diagnosis was 0.63 years (IQR 0.33-1.98, range 0.11-18.00). Dogs aged under 1 year had 10.82 times the odds (95% CI 9.17-12.76) compared with dogs aged from 2 to under 4 years. Neutered animals had higher odds than entire animals within both sexes. Breeds with the highest odds of PNMG compared with crossbred dogs included Neapolitan Mastiff (odds ratio (OR) 34.26, 95%CI 15.92-73.75), English Bulldog (OR 24.08, 95% CI 20.62-28.13), Cane Corso (OR 14.66, 95% CI 8.18-26.28), Lhasa Apso (OR 12.37, 95% CI 10.26-14.92) and American Cocker Spaniel (OR 11.57, 95% CI 5.59-23.96). Purebred dogs had 1.43 times the odds (95% CI 1.26-1.63) of PNMG compared with crossbreed dogs. Breeds with brachycephalic skull conformation had 6.71 times the odds (95%CI 5.89-7.64) compared with breeds with mesocephalic skull conformation. Insured dogs had 1.89 times the odds (95% CI 1.65-2.16) compared with uninsured dogs. Conclusions This study reports the largest cohort of primary-care PNMG cases assembled to date. The results showing young age at diagnosis along with the breed, purebred and brachycephalic skull conformation predispositions suggest a hereditary involvement in PNMG development. These results may help to guide breeding strategies to reduce the prevalence of PNMG and improve welfare in predisposed individuals.

Automated summary

This study based on UK primary care veterinary practices data shows that prolapsed nictitating membrane gland (PNMG) is the most common disorder of the third eyelid in dogs, with an annual prevalence of 0.20%. Dogs under 1 year old have a 10.82 times higher odds of PNMG compared to dogs aged 2 to 4 years. Purebred dogs, brachycephalic skull conformation breeds, and insured dogs are more predisposed to PNMG.