Dear Dr. John,

About two weeks ago, I noticed a swelling on the right upper eyelid of our 4-year-old large breed dog. I took him to a local emergency clinic where they gave me some antibiotics and eye ointment. Two weeks later, it has not improved, and I am reluctant to take him back to the same place. Do I need to see a specialist? Does this sound like something that warrants special care? My dog is not uncomfortable other than he occasionally rubs it. It is pink to red and raised just above the lid margin. What are the possible causes?

— O.P.

Dear O.P.,

At this time, I do not think you need to take your dog to a specialist, depending on the exact and specific location of the lesion. It sounds as if this is on the outside of the eyelid margin from your description. Nor do I think it warrants special care right now. You could take him back to the same veterinarian so they can see if there has been any change or to another veterinarian. It sounds as if they gave your dog the correct prescriptions initially based on the law of averages as to what it could be.

Your dog probably rubs it because the mere swelling is a bit uncomfortable. I believe that what you have described can be one of a few things. A chalazion is a non-infected oil gland whereas a stye is an infected oil gland. These both usually take about two weeks to resolve but there can be some variability to this.

Another possibility is something called a hordeolum, an inflammation of the glands of Zeis or Moll, both located more externally. Lastly, one can consider tumors, both benign and malignant, but I feel your dog is young for this to be the case with the exception of a histiocytoma, which is benign. These occur in younger dogs and, while usually on legs or the trunk, can be on the skin near the eyelid margins. They usually regress spontaneously but that can take a few months. For now, I would use warm compresses on the swelling avoiding any squeezing. Anti-inflammatory medication might also make sense. If unresolved in two more weeks, lancing the lesion, doing a punch biopsy, or removing it might end up needing to be done. Good luck.

Dr. John de Jong is President of the World Veterinary Association. He owns and operates the Boston Mobile Veterinary Clinic and can be reached at 781-899-9994.