Chronic dry eye and other issues

Helo vets, can I get an opinion please? My dog is 14 months old, has chronic dry eye in one eye and the other eye has now dropped below the normal range, it’s not responding to tacrolimus or any of the other medication. I’ve noticed he drinks a lot and his urine is quite dark yellow. His anal glands aren’t quite right although the vet isn’t sure why. He is also extremely reactive and can’t ever settle down. I’m starting to wonder if this is all connected? Thanks

Hello!  I don't see an obvious connection at first glance, but it is possible.  When dogs drink water to pathological excess, it is common for their urine to be clear, so it's interesting that it looks yellow.  It could be that they are dehydrated in the heat and simply need the water that they are drinking and possibly more (only a certain amount can be absorbed in one go, so little and often is key here).  However, that depends how much you mean by 'too much' (your vet would be interested to have it in in mls or bowlfuls of a known size per day for example); it certainly doesn't rule out the possibility of a systemic problem.  Your vet might also want to check the concentration of the urine and to rule out jaundice (linked to liver problems), for example. Anal gland disease is most commonly an early manifestation of skin disease, and more rarely caused by a lack of fibre (leading to large poos) pushing against the glands to empty them.   Hyperactivity can just be a character asset, but can (rarely) be linked to eg hyperthyroidism. You will probably know by now that dry-eye can be a sign that an animal's immune system is fighting their tear-glands, as though they belonged to another animal.  Skin (AG) disease can often be linked to the immune system too. I think at the moment, you have some clinical signs that may be separate characteristics or may link together, but I cannot think of an obvious syndrome.  It sounds as though asking your vet to investigate each one - and in particular the question of water balance in order to know the kidneys are working and there is no diabetes etc -  would be a good place to start. Best of luck and please do let us know what you find out.  

Thank you for your reply! That’s really helpful, I didn’t know about the link with skin disease so that is interesting and sounds like something to look into. I will start trying to measure how much he drinks each day to look into that