Musings of a Veterinarian

Tear Stain Products: More than Meets the Eye

January 24, 2010 By: Dr. K Category: Opinion

I’ve gotten a number of questions about Angels’ Eyes, the oral product that proclaims to rid little white dogs of their unsightly red-brown tear stains. Small breed dogs and brachycephalic cats commonly experience epiphora, or excessive tearing. Products like Angels’ Eyes promise to rid a pet of its tear stains with a daily oral supplement. I typically consider such claims nothing more than another gimmick. However, it seems as though this product might actually work for little Fluffy. I researched the miracle product and was surprised to find the secret ingredient is Tylosin.

Tylosin is a macrolide antibiotic commonly used in food animals but can also be used to treat campylobacter and mycoplasma spp infections among others in dogs and cats. It is also used as an anti-inflammatory to treat colitis, much like metronidazole. It is in the same drug family as erythromycin and azithromycin (Z-Pak). The company claims the product kills yeast, which they mistakenly call a bacterial infection, that are responsible for producing red pigment. Tylosin actually kills the bacteria that, when interacting with the yeast, cause the formation of pigment and subsequent stain.

I have some major issues with this product:

Tylosin tartrate is labeled by the FDA for OTC use in food animals. When it comes to use in dogs and cats, the FDA notes federal law restricts this drug to use by or on the order of a licensed veterinarian. This drug should not be sold OTC for pets. Period. Loopholes in the supplement labeling system allow companies like the manufacturers of Angels’ Eyes to sneak around FDA regulations with the disclaimer: These statements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure or prevent any disease. This disclaimer does not make the act of dispensing this drug legal, it merely allows the manufacturer to make the product without going through the expensive and arduous process of FDA approval. Because the FDA typically has bigger fish to fry, companies like this cruise under the radar.

Antibiotic resistance is a problem that affects all facets of medicine. Many common antibiotics have dual use in both veterinary and human medicine. While tylosin is a veterinary only drug, drug resistance to one drug can potentially result in resistance to an entire class of antibiotic.  I am concerned there are voices on the web who say that, because tylosin is a narrow-spectrum antibiotic, resistance is not a worry. Say what? First of all, tylosin has broad spectrum coverage against gram positive bacteria. Second, if an antibiotic has activity against ANY bacteria that bacteria can become resistant. Those same voices also claim tear staining leads to eye infections. Sorry, wrong again. Staining leads to unhappy owners; Improper tear production and tear flow coupled with shallow orbits, bulging globes, and underlying pathology leads to infection.

I also have serious concerns for any use of an antibiotic to treat a cosmetic issue. This is bad medicine no matter which way you slice it. Angels’ Eyes gets my stamp of disapproval.

31 Comments to “Tear Stain Products: More than Meets the Eye”

  1. Verrry interesting! What do you think of this product, which we use on the hospital cat, a rescued Exotic Shorthair with typical Persian eye issues. We like how it works for her.

    Eye Envy

  2. Thank you for posting this. I have tried, repeatedly, to tell clients at work that this is an antibiotic and nit should not be wasted on cosmetic issues, but I get nowhere. It’s good to know that others feel the same way I do about it.

  3. I’m a 4th year vet student about to graduate in May, and trying to accumulate all these bits of wisdom before I head out into the world of silly clients. So, all this being said about Angel Eyes, what do you think is the most effective way to address this product with clients so that they understand it shouldn’t be used OTC?

  4. “I also have serious concerns for any use of an antibiotic to treat a cosmetic issue.”

    I don’t disagree with you about Angel Eyes and overuse of antibiotics, but . . . acne?

  5. FurriePrincess says:

    I had a cat with a blocked or malformed tear duct. She nearly always had some goup (technical medical term?) under her eye. Best thing we were told to do…soft cotton pad with warm water. I wouldn’t have considered using something like the Angel’s Eyes on her. Stains didn’t show – she was a sable Burmese.

  6. Dr K you are a STAR!!!

    Thank you. Thank you. Thank you!!!!

    I have to admit that I used to use Angels Eyes. I rang them and ordered some. in about 2 weeks I could see that it was working but was curious as to how.

    I was very annoyed that no one had mentioned that the active ingredient was an antibiotic.

    From my research online I discovered that tylosin does not have a marketing authority for dog or cat use any where in the world. And as you stated it would be prescription only (under the Extra Label Rule or the Cascading Rule in the UK).

    This means that the info on their site is very misleading- they say it is safe for dogs (how do they know that- there is no long term research!!!) – they say it is FDA approved but do not mention that it is not FDA approved for dogs or cats (their target market!!!).

    In the UK Angels Eyes et al have been officially banned for a couple of years


    In the US the FDA admit that Angels Eyes is illegal but have not yet enforced the law.

    I do sympathise with people that used Angels Eyes years ago but now there are natural products that prevent the bacteria from metabolising the iron content WITHOUT the need for antibiotics.

    No metabolism means no yeast and ultimately no red stains.

    With the likes of

    Angels Delight by Bichon Hotel – http://www.bichonhotel.co.uk/angels_delight


    Naturvet tear stain supplement- http://www.naturvet.com

    plus other new products

    there is NO EXCUSE for using OTC tylosin based products to deal with tear stains.

    Warmest regards and keep up the good work

  7. Hungover – I second your recommendation of Naturvet’s product, and would like to add HappyTail’s Eyemmunity to the list. Antibiotic free, and great results.

  8. It is a shame that so many people think that Angels eyes is the only tear stain remover that works.

    Thanks to this site i have found someone that sells Angels delight locally.


    Not only does it stop the tear stains but it even helped with Rose’s hot spots.

    Why is it taking so long to ban the likes of Angels Eyes and Angels Glow?

    I know that some stores have stopped selling them- eg Petsmart but there are still thousands of others out there.

  9. Oh come on! This is ridiculous!! Tylosin works and it will CURE the infection causing the staining. Macrolide antibiotics are used for yeast infections. They work on curing yeast infections.

    Tylosin is completely harmless. If you eat meat, you are eating Tylosin every time you eat meat and so is your pet.

    These vets that go on and on about OTC products, THAT REALLY DO WORK BY THE WAY, are just mad because they are not making any money off the product because they don’t get to prescribe it. But they are so quick to recommend the world’s crappiest, unhealthiest pet food called Hills/Science Diet. That stuff is what is going to kill your pet, not Tylosin.

    It’s NOT just cosmetic! Those tear stains are YEAST. Yeast infections are EXTREMELY ITCHY. It is awful to not cure the infection when there are means to do it and try to just pass it off as “cosmetic”. If your pet had a bladder infection wouldn’t you give it antibiotics? If your pet had mange, a skin infection, wouldn’t you give it antibiotics? Then tear stains are no different. The INFECTION requires antibiotics to cure it.

  10. Bichongal,

    I am not sure where you have gotten your information but I certainly appreciate your illustration of common misconceptions about antibiotic use. I never disputed the product may work. In fact, if you read my post, I note I believe it could work. My major issue is with labeling and the bad rap we veterinarians get from the medical community about promoting antimicrobial resistance. A well documented medical condition, like chronic colitis, is a reasonable reason to use long-term tylosin.

    Some veterinarians DO use tylosin to treat tear staining but most are not sure of the EXACT mechanism by which it works. The major consensus is the medication prevents the production of porphyrins, a pigment, that causes the red stain. We do think the medication alters bacteria counts but it is not treating a yeast infection. Antibiotics, by definition, affect bacterial growth. Antifungals, however, are the appropriate treatment options for yeast infections.

    NO MEDICATION IS HARMLESS. None. Not one. Every drug, supplement, and herb has some type of side effect. To say otherwise is negligent and irresponsible.

    There is no Tylosin in meat. There are very specific wash-out periods that farmers must adhere to (or risk being shut down) where there can be no trace of any medication in meat and milk.
    “Milk [and meat] from animals receiving antibiotics, anthelmintics, anti-inflammatory drugs or other medications must be discarded until freedom from residue can be established, or the animals consuming the treated milk must be withheld from slaughter until a similar withdrawal time has been observed. Food Animal Residue Avoidance Databank is a valuable resource for determining appropriate drug withdrawal times.” – Joan Dean Rowe, DVM, MPVM, PhD Department of Population Health & Reproduction, School of Veterinary Medicine, University of California

    As for the accusations that I am against OTCs because of money, I suppose it doesn’t matter what I say because it appears you have your mind made up about the veterinarian mentality. I can say that thought never crossed my mind and still has no hold on me now that you brought it up. If I was in medicine for the money, I’d have been an MD.

  11. imaginarynumber says:

    You try and do the right thing but end up wasting your time


    DR K- care to wade in???

    Oh BTW Bichongal- I live in Europe and our beef is no longer pumped full of tylosin in the name of cutting food costs…

    And with respect to the yeast- when was the last time you saw a dog with tear stains scratching its eyes? or beard?? I haven’t- ever.

    Vaginal yeast infections or athlete’s foot, for example, are not of the the same magnitude as tear staining.

    The next time I have a friend that contracts MRSA I shall ask them to forward the associated bills to you.

    Stop being so selfish and irresponsible- there are natural and safe products that work- use them!

    Sorry Dr K – i hope you publish this- my ire is raised following the facebook (link) conversation. There are too many blinkered stoopid people out there that really do highlight the flaws in the education system.

    Thanks for providing the opportunity, for those of use that have the luxary of being able to wear standard gloves without the need to cram to extra digits into one, finger hole to discuss what really is a part of a much bigger and scary picuture

  12. Very interesting reading on Angels Eyes. I was about to consider ordering it, but have now changed my mind. I’ve been using Eye Envy for almost a year now, but it seems I have to use it DAILY or my poor Exotic Shorthair has horrible brown/rust crusty “goop” under her eyes. The instructions on the Eye Envy says daily for a week, then only a couple times a week. Heck, if I didn’t use it every day, I cannot imagine what mess would be under DeeDee’s eyes. I’m starting to think this product isn’t as good as they pump it up to be. I am very interested in Dr.K’s opinion on this product.

  13. Angel Eyes recommends usage for no longer than 9 mo … So what is supposed to happen then?

  14. My sweet yorkie has just died from illness complications caused by Angel Eyes! I had no idea of the damaging effects of this drug! I am devastated! I am going to make it my life mission to remove this drug from the shelves of pet stores! Please do not give your baby Angel Eyes! You can lose them! I want my dogs remains used as research! If anyone knows a vet who is researching this drug, please have them contact me. Respond with your information and I have added this to my news feeds! So sad!

  15. I tell anyone who will listen to not use this product! I have a 4 year old bichon with zero tear staining. I wipe around her eyes daily with pet eye wipes to remove any dust, pollen etc., feed her high quality food and filtered water via a drinkwell and keep the hair around her eyes trimmed so her eyes are not being poked and she is stain free. A little work is much better then risking your pets health with unnecessary antibiotics.

  16. Gina Tafoya says:

    excellent discussions. My mother has a new dog who tears excessively and stains. The folks at her facility (assisted living) are recommending Angel Eyes. My opinion doesn’t have weight on this but this discussion is invaluable. Thank-you!

  17. Any notion that the FDA is there to protect us and our pets is a bit questionable. In the human world, the data show that since the early 1960’s (about the time ot thalidomide) FDA regulations have been responsible for saving approximately 7,800 lives in the US. That’s good, right? Except that the very same regulations have caused 4.5 MILLION people to die before they should have because of the delay the FDA caused in EVENTUALLY-APPROVED drugs and other therapies getting to market. The FDA has a horrible safety record and should be banned. FDA’s biggest role is in helping large pharma maintain monopolies on drugs by making it so incredibly expensive and difficult to bring competition to market.

    Antibiotics are about the only drugs that should conceivably be controlled by regulatory authorities, or by prescription for that matter, because one person, or one dog, taking them, can adversely affect other people or animals through resistance. Why on earth there is mandatory prescriptions for cholesterol lowering drugs for humans or for diet dog food is entirely beyond me. The nanny state claims to not only try to protect us from our own stupidity (an entirely unconstitutional process, by the way), but even trying to protect our dogs from our stupidity. It is not government’s role to protect people from their own stupidity.

    Meanwhile, tylosin is an antibiotic, and the angels eyes product should state that clearly and if cross-resistance to other macrolides is a potential, then perhaps regulatory scrutiny is in order, as long as we keep in mind that the regulatory authorities are really really incompetent and hinder progress at every turn. Relying on regulatory authorities is a foolish notion. The regulatory experts usually aren’t, and if they are, there is high risk they are influenced by a combination of narcissism, eagerness for power over others, sociopathy, and potentially financially as well.

  18. Well nice but why is no one doing the same thing about the crap in soaps and gels we humans use daily. Tricolsan is the name of it and it is in everything. If you use Bath and Body works stuff, read the label as it is in almost every soap product they make. There is far more danger of antibiotic resistance from this junk washing into the streams and river beds as well as the ocean because it is NOT removed by our current water treatment plants.

  19. Thank you for this article…it was very helpful…we gave our dog Angel Eyes for a week & he got super sick two days ago …major dirrhea & vomiting. Took him to the vet & couldn’t figure out what he ate that could have made him so sick as we make all his food. The only change in his diet was Adding Angel Eyes to his food: 1 x a day & it’s now obvious this was what made him so sick ( after doing research on the product). I will be complaining to the store manager : this product should be pulled from all pet stores & online outlets. Thanks again go for the article.

  20. Nancy MD says:

    This is a very helpful discussion which convinced me not to use Angel Eyes. John MD hit it on the head about the lack of responsibility of regulatory agencies and the politics of promoting big pharma. It is clear that the chronic use of antibiotics has a risk/benefit ratio that may not be acceptable.
    My only remaining question is what is the best way/product to use for tear stains if you want to avoid the use of tylosin?

  21. I would use warm wet wash cloths and regularly clean the face. Tear stains are typically just a cosmetic problem that causes little to no discomfort in the animals affected.

  22. Shannon says:

    Oh my – I have to admit after reading the post and following comments, I’m terrified of this product now. I never knew that Angel Eyes was an anti-biotic or harmful. I’ve got 2 maltese babies that are 8 years old and I’ve been using it almost their whole lives. Before I started using the product I did my research and was assured this product was not harmful for daily use. I never even found a duration warning. I thought it was just a yeast blocker, had no idea. I haven’t had any health concerns but now I’m worried out of my mind. Thank you for all of the information.

    Are their any warning signs – health concerns I should look out for? I read Lori’s post about her Yorkie and wish I had more information about those complications she experienced.

    Thank you for your help.

  23. Stephanie says:

    Thank you for such a wonderful article. I only wish l had found it before l had ordered angels eyes. I give it to my bichon frise and a week later he has vomited a number of times and quite poorly. Taking him to the vets tomorrow. Absolutely terrible a complete waste of money.

  24. Thanks for your review, I use angels eyes for my Maltese and it’s the only thing that works for her. I’ve tried other natural supplements but they just don’t do the trick. When her eyes tear not only does it become unsightly but she itches and develops a terrible odor. I’d love to find something else that would not encourage bacterial resistance but so far I have not found that “magic” product. I do want to also touch comment you made in response to money. You said that if you wanted to make money in medicine you’d have become an MD. I am slightly offended by that commend because as you may or may not know your overworked local MD is grossly underpaid by both private insurance and Medicare. Each year for a period of about a month Medicare refuses to pay/reimburse your local doctors while they decide which cuts they’d like to make this year and which procedures will get a pay reduction. The human (not veterinary) medical practice is the only career In know where you get a pay cut for getting better and more effficient at your job. In addition student loans are the cost of a luxury home, and medical malpractice consumes more each year than the cost of new BMW. That’s like buying a new car with cash every single year. Nurses in the medical field make only a few more dollars more per hour than your overpaid Walmart employee crying for another raise, yet nurses work long grueling hours, rarely get a full 30 minute break during their 12 hour shift, or even have time to empty their bladder. We (in the medical field)all miss family events, holidays and even our own children’s birthday parties. So please, next time you talk about another career getting a great pay remember how it felt when you were accused of being in it for the money and think of the cost that person is paying to collect that salary.

  25. yeah, can I comment since my pups went off Angel Eyes they both look and feel like… well, shit! Antibiotics as defined by the FDA are for very long periods of time in human terms… not pets. Both my pets suffer from Epiphora and after running out of the “good” Angel Eyes on Christmas Eve you would not recognize them today. Shame on you for irresponsible reporting and understanding of science in general.

  26. And most folks dont understand Angel Eyes HAD a formula that worked. But their formula labeled as “natural” is basically “not good” and does not work with pets that suffer from Epiphora. It was the naturally occuring Tylosin in their product that was taken off the market these last few months and that gets the FDA idiots to side with big cattle biz and maybe even huge veterinarian bills. K?

  27. freedom from it all says:

    What the GOOD Dr is TRYING TO SAY,,,
    Half of you Are Full of Yourselves !
    Too Much of these Anti Biotics or ANY, Have LONG term
    Negative Effects on Man & Beast !
    My dog suffers from a Compromised Immune System, & Suffers From
    Yeast,,also Attributed by a Poopie Diet!
    Dogs 30 yrs ago Never Suffered likecnow from all the GARBAGE

  28. DO NOT BUY THIS PRODUCT OR FEED IT TO YOUR PET!!! I fed it to my Maltese to get rid of tear stains for about a year and had no idea that the product was actually a form of antibiotic. I used exactly the right dosage as it said to on the bottle and my maltese died from kidney failure from this antibiotic. I discussed it with several vets and they all said that Angel Eyes is what caused the kidney failure. I know you want your dog to look pretty, but is it really worth the risk of killing your pet?

  29. The reason I see so many folks interested in this issue, is the fact that the old product works. My question, after reading the Dr’s response is: a) The actual dose is extremely small. b) You have said there appears to be no bacterial reason for the tearing and staining. c) The animals treated are not consumed by humans. d) The naturopathic medicines have not been studied for efficacy, safety, or purity from one manufacturer to the next.
    Given all of this, what is the actual chance for drug resistance? What is the further chance this resistance would put humans at risk? Finally, if we could get physicians to deny antibiotics for treatment of viral infections it would make a tremendous difference in bacterial resistance.

  30. I have an 8-yr old Mini schnauzer. When she was 8months old she developed the tear stains. A breeder online recommended Pets Spark. My vet looked at the ingredients and, concerned it would kill good not just bad bacteria, gave me something to balance that (can’t recall what) it worked very well. Snowy white coat and beard all these years. Suddenly this year it’s back. Got her on distilled water and expensive grain free food, tried angel eyes (no help), wipes, Nature Vet supplement chews, Noah and Tillys natural wash…no movement! Found a 2014 warning letter from FDA to Pets Spark owner and their site is gone but can be purchased various online companies. Am tempted to return to it. Anybody else got better idea?

  31. I’ve used Angel Eyes on my dog and it worked great. This dog had more drainage than we ever had seen on any of our dogs. She had terrible red drainage and wiping with a warm cloth or cotton ball did not work. It just turned it from a dark maroon to pink. The drainage dries up and it hardens around the eyes which is not comfortable for her. The vets medicine tasted so bad we had to force feed it to her, which did not go well at all with any of us. To top it off, it did not work. With Angel Eyes, we reduce the dosage for a while and then take her off, then if it comes back we started over again. It did not injure her in any way, but I would think with all the anitibiotics we have today that using one to help the eyes stay without the stain and the crusting up it was worth using Angel Eyes.


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