Anticollagenase Therapy for Canine Corneal Ulcers: A Narrative Review of Mechanisms, Efficacy, and Clinical Implementation.

Anticollagenase therapy shows adjunctive promise but requires further controlled clinical validation.

Corneal ulceration in dogs frequently involves proteolytic enzyme activity, particularly matrix metalloproteinases and collagenases, which accelerate stromal degradation and risk corneal perforation. While antimicrobial therapy addresses infection, it does not prevent enzyme-mediated tissue destruction. This narrative review examines anticollagenase therapies for canine corneal ulcers, analyzing mechanisms of action, efficacy, and clinical implementation. Several agents demonstrate potential anticollagenase activity, including N-acetylcysteine, ethylenediaminetetraacetic acid, tetracyclines, and autologous serum. Evidence suggests these agents may moderate stromal degradation when combined with appropriate antimicrobial therapy, though supporting data quality and quantity vary considerably. Clinical considerations include formulation feasibility, compounding stability, administration frequency, and safety concerns. Emerging agents show promise but require further veterinary clinical validation. Anticollagenase therapy may provide adjunctive benefit, particularly when proteolytic activity contributes to disease progression. However, current evidence remains limited and heterogeneous, necessitating controlled clinical studies before specific agent recommendations can be definitively established.

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