From Drug Choice to Drug Delivery: A Viewpoint on Measuring and Improving Owner Adherence in Canine Corneal Ulcers

Therapeutic success in canine corneal ulcers depends on appropriate antimicrobial selection and reliable at-home drug delivery. However, veterinary data on owner adherence remain limited and are largely self-reported. Evidence from human ophthalmology indicates that dosing frequency, follow-up interval, and hands-on technique training strongly influence treatment outcomes. This viewpoint advocates a shift from drug-centered to delivery-centered management and proposes a testable four-part Clinical Adherence Bundle (CAB-4): scheduling timely rechecks within 14 days, minimizing dosing frequency when microbiologically appropriate, providing standardized staff-led technique education with written or video materials, and anticipating medication needs to prevent stockouts. Each component is designed to be measurable in routine practice, auditable within clinical workflows, and scalable across both referral and primary-care settings. Finally, we propose a pragmatic research framework to prospectively evaluate the CAB-4 by linking adherence metrics with objective clinical outcomes, including epithelial healing time and corneal perforation.