It's Not Pannus, It's Corneal Dystropy

[seeh2o]

After 3 months of treatment with Pred Forte and no change (maybe a bit worse) I asked the vet for a referral to a specialist. We were lucky, we saw our regular vet in the am, got the referral and was able to get in to see the animal ophthalmologist this afternoon.

 

Except for the CD, his eyes are healthy. The treatment is now 1 drop of Pred in each eye in the am, one little squirt of Tacrolimus in each eye before bed. He was a great vet, very personable, very upbeat. He thinks (hopes) this can be controlled with medication. He's not 100% sure of the diagnosis, but feels fairly confident this is the correct dx.

 

Does anyone have any experience with this? I did a search on it and there haven't been a lot of others on the board writing about it. If anyone has any information I'd appreciate hearing about it and learning as much as I can.

[iluvgreys]

No experience with visual problems but am hoping that this treatment protocol works for Carl.

[Guest argolola]

I don't have any experience with that but I wanted to offer my prayers for your sweet pup. When Lola had to have eye surgery, we consulted with (and they did the surgery) the vet school at University of Florida. A good teaching hospital is wonderful for dx and treatment.

[CaliforniaGreys]

Connie, no experience here, but know we are wishing the very best for handsome Carl. Misty is concerned you're not giving him enough ice cream. Hopefully someone here has experience

[rycezmom]

Gustopher P Jones has Pannus. He has been on Tacro twice a day for about 8 months. Pannus is an autoimmune disorder. His doggy eye doctor says the over vascularization is retreating at a steady rate. We are not going to cut back to once a day until it is gone. He will require Tacro for the rest of his life. It doesn't cure it. Gus is restricted to limited daylight play outside because the ultraviolet/sunlight exacerbates it. He is given extended play periods in the early morning, late late afternoon and night. My backyard is fully lighted for night time playtime. Its also the best time for him to stalk bugs and leaves and things that go bump in the night. Is the vet you are seeing a canine ophthalmologist? If not, you may want to seek one out. Gus is doing well and is very good at coming to the kitchen twice a day for his drops. Tacro needs to be refridgerated! Hope this helps.

 

L.

[Guest Speedhoundz]

Tacro needs to be refridgerated! Hope this helps.

 

Not all Tacrolimus solutions need to be refrigerated--my bottle says to store at room temperature.

Edited September 20, 2008 by Speedhoundz

[seeh2o]

Gustopher P Jones has Pannus. He has been on Tacro twice a day for about 8 months. Pannus is an autoimmune disorder. His doggy eye doctor says the over vascularization is retreating at a steady rate. We are not going to cut back to once a day until it is gone. He will require Tacro for the rest of his life. It doesn't cure it. Gus is restricted to limited daylight play outside because the ultraviolet/sunlight exacerbates it. He is given extended play periods in the early morning, late late afternoon and night. My backyard is fully lighted for night time playtime. Its also the best time for him to stalk bugs and leaves and things that go bump in the night. Is the vet you are seeing a canine ophthalmologist? If not, you may want to seek one out. Gus is doing well and is very good at coming to the kitchen twice a day for his drops. Tacro needs to be refridgerated! Hope this helps.

 

L.

 

Yes, we went to the animal opthalmologist yesterday, he is the one who said it was not Pannus, but Corneal Dystrophy.

 

My poor boy, I woke up this morning and both of his eyes are very irritated and the lids are swollen, one moreso than the other. I don't know if it is from a the Tacro I gave him last night, from all the poking and prodding to his eyes yesterday or a combination of both.

 

This just makes me sick. I know it could be worse, much much worse, but it's still getting me down.

 

[carronstar]

I have no experience with this but definitely send lots of prayers and good thoughts for you cand Carl.

[TheFullHouse]

I had never heard of it so I googled it and this is what I came up with:

 

 

Confusion often arises over the use of the term "corneal dystrophy" in dogs. Technically, "corneal dystrophies" are diseases of the cornea that are bilateral, non-inflammatory and inherited(*1,2). The confusion arises because the term "corneal dystrophy" is sometimes used to refer to a disease with similar clinical signs but is not hereditary. A more appropriate term for the non-inherited conditions is corneal degeneration.

 

In most breeds, corneal dystrophy appears as gray-white, crystalline or metallic opacities in the center of the cornea or close to the periphery. These opacities may affect any layer of the cornea, the epithelium (outer layer), the stroma (the thick, middle layer), or the endothelium (the inner layer). The opacities are usually oval or round and are sometimes doughnut-shaped. The age of onset of the disease varies within and among dog breeds and may range from 4 months in Airedale Terriers, to up to 13 years in Chihuahuas. The opacities usually progress but in some cases they remain static. Their progression may be very slow and may or may not lead to blindness (common in Cocker Spaniels, Poodles, Samoyeds, Siberian Huskies, Pointers, German Shepherds, and Bichon Frises). On the other hand, progression may be rapid and lead to blindness (more common in Airdale Terriers, Boston Terriers, Chihuahuas and Dachshunds)(*.2) The mode of inheritance varies among breeds and in many breeds it is unknown. In the airedale terrier it is thought to be a sex-linked trait(*1,3) and in the Siberian Husky, Corneal Dystrophy has been shown to be a recessively inherited trait with variable expression(*4).

 

Corneal dystrophies are usually not painful. In a few breeds, however, a dystrophy can lead to secondary breaks in the epithelial (outer) layer of the cornea. When this occurs a painful corneal ulcer develops requiring intense treatment. In other breeds, a painful ulcer may not develop and the dystrophy itself is not treatable. No medication will "dissolve" the opacity. Surgical removal of the dystrophic area may temporarily decrease the opacity in cases of epithelial dystrophy. Often, however the opacities will reform in the healed cornea.

 

 

 

edited to add: I hope your baby is feeling better soon.

Edited September 20, 2008 by JillysFullHouse

[CaliforniaGreys]

Connie, please update if you can later today on how he's doing. I'm hoping he's more comfortable as the day goes on. For Carl,

[seeh2o]

I left a message for the vet, they are closed Sat so I left it in case he checks his messages. He did and he called me (I didn't hear my cell) and left me a message to stop the Tacro for the rest of the weekend and replace it with the Pred drops, he wants me to call him Mon. @9. I think he's a good guy. When I came home from work his lids were still swollen, but not like they had been in the morning. I hope they will be better by tomorrow. He's got a good appetite, but I can tell he's "off". Poor baby.

[CaliforniaGreys]

Just checking in to see how Carl is this am

[Guest greytpets]

Is it Prednefrin? the eye drops? Nu-Mee has episcleritis which is in inflammatory disorder of the sclera. Her inflammation is under her right eyelid and after 6 weeks of firstly 4x daily now down to 2 its working like a charm

 

Hope Carls feeling better soon *hugs*

[seeh2o]

The eye drops are Pred Forte.

 

His left eye is much better today, it doesn't look puffy like yesterday and the eyeball is not glassy, the left cornea does not look irritated this morning. His right eye is also better, there is still some lid swelling, but it's not nearly like it was yesterday - it was nearly swelled shut. The third lid looks better, not swollen and covering part of the eye like yesterday. The cornea looks less irritated as well, but it's still sort of glassy and whitish around the edge, but not like it was yesterday.

 

I'm making a list of questions for the vet tomorrow morning:

1. Was the exam or the Tacro the result of his eye irritation, or both?

2. Could this all be a result of his thyroid? If so, I want to have a full thyroid panel run, not just a T4 and a TSH.

3. Would it be helpful to start him on Ocuvite? I take it, my parents take it (glaucoma runs in my family), so could it help the health of his eyes?

4. The narrative of his findings was a lot different and a lot more negative in terms of prognosis than what he said to me. Why the difference?

 

He got very playful last night when we came home from dinner, it was good to see him being goofy. I don't think he was in pain yesterday, but I do think he was uncomfortable. He seems much less uncomfortable this morning.

 

Thanks for asking and thinking of my boy!

Edited September 21, 2008 by ckruzan

[CaliforniaGreys]

Thanks for the update...it's good to know Carl is more comfortable. And it sounds like you are more than prepared for the vet tomorrow.

[seeh2o]

Thanks, if a good question occurs to anyone who reads this please PM me with it, I need all the brainpower I can get at this point.

 

Jillysfullhouse, thanks for the info. It's so weird that my vet is saying this is common to greys, but I've only seen one other GTer whose dog was diagnosed with it...I would think if it were common we'd be reading more about it. Your definition doesn't sound nearly as grave as my vet's written prognosis....though your definition does sound a lot more like his verbal prognosis. I don't get it. I work in a clinic and with clinicians every day, I know that medicine is rarely ever an exact science and they can never say anything is 100%. Maybe he just had to put the worst down in writing, like informed consent...this asprin may make your headache go away, and oh by the way, it might give you bleeding ulcers, too.

 

Tomorrow....tomorrow...tomorrow, hopefully I'll get some answers tomorrow!

[CaliforniaGreys]

Just checking in to see how Carl's doing

[seeh2o]

His left eye and third lid still continues to be a bit swollen, but looks better every day. I spoke with the opth. vet he doesn't seem to think it could be thyroid, but I still think I want to ask for a panel. He has him back up to Pred Forte x 3 drops per day. He said in his 20+ years he has never had a dog with a bad reaction to Tacro, but said it is possible that Carl "is the one dog" that had it. I think he's afraid if we try the Tacro again there might be damage done, so no more of the Tacro. He insisted on giving me a credit for the medication (WOW, I can't believe that...it was $40 for a tube smaller than my pinky finger). He wants me to call if there are any changes and wants me to call him on Friday to check in. We have an appointment a week from this Thurs.

 

He's still a happy boy, he and Sheila are sharing Sheila's birthday treat...big rawhide pigs in blankets. He still seems a tiny bit under the weather, but he wants to go for walks and still wants to play at his usual times.

 

Thanks for asking, Claudia.