Pannus....tacrolimus....

[rascalsmom]

Buddy started tacrolimus drops two days ago for *suspected* pannus. This was diagnosed by an ophthalmologist.

 

The drops are making him want to rub his eye, which of course I don't want him to do, since we just got the ulcer healed up! :

 

I called them today, and the doc who has been seeing him isn't in today, so the tech will talk to her tomorrow and call me then. In the meantime I quit giving the drops; he is still getting his antibiotic drops today. Yesterday he even tried rubbing his eye after the antibiotic drops!!...which he wasn't doing before.

 

This is so frustrating. We are many hundreds of dollars into it, and there doesn't seem to be an end in sight. The doggone pannus drops were like $50....And now they are irritating him....the four drops I've given him have proven to be VERY expensive, if I can't use the rest of the bottle!

 

Sorry for the rant, just needed to vent a little.

Edited November 12, 2008 by rascalsmom

[CaliforniaGreys]

Poor Buddy!! This has been going on for awhile now. I'm going to email Connie and point her here and maybe she can shed some light on this with what she's been through with Carl. Feel better Buddy!!

Edited November 12, 2008 by cbudshome

[Guest greytmonty]

Buddy started tacrolimus drops two days ago for *suspected* pannus. This was diagnosed by an ophthalmologist.

 

The drops are making him want to rub his eye, which of course I don't want him to do, since we just got the ulcer healed up! :

 

I called them today, and the doc who has been seeing him isn't in today, so the tech will talk to her tomorrow and call me then. In the meantime I quit giving the drops; he is still getting his antibiotic drops today. Yesterday he even tried rubbing his eye after the antibiotic drops!!...which he wasn't doing before.

 

This is so frustrating. We are many hundreds of dollars into it, and there doesn't seem to be an end in sight. The doggone pannus drops were like $50....And now they are irritating him....the four drops I've given him have proven to be VERY expensive, if I can't use the rest of the bottle!

 

Sorry for the rant, just needed to vent a little.

Been there, done that. We donated over $125 of pannus meds to our adoption group as Monty couldn't tolerate them. We just went back to the Pred. Good luck.

[rascalsmom]

Yes, this has been since the first part of October!!

 

Initially we went to our regular vet for the scratch which produced the ulcer.

Didn't heal, so we went to the specialist.

Specialist did the debridement/keratotomy.

Upon the checkup, she noticed another "area" that was taking up the dye.

Upon second checkup, she "thinks" he may have pannus.

Now the tacrolimus drops are really bothering him, and he's rubbing the eye again!!

 

AAAAAAGGHGHHHGH!!!

 

(I might add, DH is not happy about the cost of all this, and he doesn't even know the running total...he realizes we have to do what needs to be done, but he tends to look at things like "it will take me XXX hours of work to pay for that")

[CaliforniaGreys]

First, I know nothing about this condition but do know a few people dealing with it. Here's what I don't understand, how is it that a specialist "thinks" it's Pannus? Thinks??

[rycezmom]

Gustopher P didn't much care for his tacro drops when we first started them. The first couple of days he would rub his face on his pillow. After that he simply let me put the drops in without much fuss. He now comes and stands at the kitchen doorway just before morning snack and outside playtime then again as we are closing up the house for bed. He stands there and waits for his drops. He certainly keeps me from forgetting to put them in! He won't even leave that spot for cookies or bed until they are in....Hopefully your hound and you will find what works. Maybe he just needs to get use to them..

 

L.

[rascalsmom]

First, I know nothing about this condition but do know a few people dealing with it. Here's what I don't understand, how is it that a specialist "thinks" it's Pannus? Thinks??

I admit I wonder about this, too. She said she felt it was an atypical way for pannus to develop; the ulcer first, and then in another part of the eye something that looks like pannus.

 

I have thought about seeing if we could make the follow up appointment with the "original" doctor of the practice (Dr. B.) instead; he was the one who treated Buddy five years ago. For this incident we've been seeing his associate, a young woman (Dr. K). Then again, Dr. K is the one who knows what this has looked like all along, not Dr. B.

 

rycezmom, I thought about an adjustment period too, but I am so concerned about him redamaging the area that was ulcerated....I hate to have him go through treatment for THAT again!

Edited November 12, 2008 by rascalsmom

[Guest MnMDogs]

Regarding the cost - see if your vet will write you a script to send to an independent pharmacy. We got tacro ointment for a bit cheaper (even with shipping) by doing that. I think it was Wedgewood or something like that.

 

I hope you find out what's wrong. Mork is on tacro for severe dry eye and only rubs his eye occasionally. Mara is on cyclosporine for her pannus, and seems to hate it, but doesn't rub too much. Can you try a different med if it is indeed pannus? I think we spend 40 dollars on a small bottle for each (it's cheaper at the pharmacy, but I'm not good at planning ahead and ordering).

[Guest ss556]

Alan has atypical pannus and the tacro drops irritated him. We discontinued that and he is on sodium prednisolone phosphate drops every day.

[patricia]

I'm sorry. I know it is so frustrating.

[duncan41]

I know absolutely zip about Pannus, so I thought I would take a look-see in cyberspace and came across a possible resource for you; http://www.retiredgreyhound.tv/pannus.htm. I have no idea if the offer to swap stories is still valid, but it might be worth a try.

It doesn't sound like Dr. K is giving you the "warm fuzzies". If it were me, I would ask that Dr. B examine him. I love my young Vet, but I absolutely adore my "old" Vet. There are times when there is no substitution for 35 years of experience!

Here's hoping that Buddy will get a good diagnosis soon and make everyone a lot less frustrated!

[rascalsmom]

I know absolutely zip about Pannus, so I thought I would take a look-see in cyberspace and came across a possible resource for you; http://www.retiredgreyhound.tv/pannus.htm. I have no idea if the offer to swap stories is still valid, but it might be worth a try.

It doesn't sound like Dr. K is giving you the "warm fuzzies". If it were me, I would ask that Dr. B examine him. I love my young Vet, but I absolutely adore my "old" Vet. There are times when there is no substitution for 35 years of experience!

Here's hoping that Buddy will get a good diagnosis soon and make everyone a lot less frustrated!

You are right. I was just kind of surprised that a young woman vet would not have a better "manner". She was OK, but not very personable....

[seeh2o]

I finally saw this thread, Claudia told me about it and I'd seen your other Buddy threads, but somehow kept missing this one.

 

Carl was misdiagnosed with Pannus in June by our regular vet. He prescribed Pred drops. We went back for a bunch of follow-up visits, it was not really getting better. I decided to ask for a referral to a specialist because my gut told me it was time to bring in an expert. We went to another vet, he diagnosed Carl with Corneal Endothelial Dystrophy, but he didn't seem real certain of the diagnosis. He prescribed Tacrolimus, which came in ointment form, and wanted to continue with the Pred. That night Carl's eyes looked glassy and swollen - before I gave him the Tacro. The next morning his eyes looked AWFUL, glassy and swollen, he acted like they were very uncomfortable. I left a msg w/ the vet, he told me to stop the Tacro immediately.

 

We went back for a follow-up app't. He changed Carl to Cyclosporin ointment. I put that in his eyes before bed, the next morning he had another bad reaction, though not as bad as it was to the Tacro. Both the Cyclosporin and Tacro have been donated to my local group. I asked if we could try one of the meds compounded with a different delivery agent, the vet balked and said it would be expensive, might cause another bad reaction and I would be out the money. Well, yes that's true, but if it works we've stabilized his eyes....priceless.

 

My gut started talking to me again...so I went back to the vet who I go to with my other dog, she's very hard to get into see and does not see emergencies, so Carl hadn't seen her up to this point. As luck would have it, she had a cancellation this past Wed. and we went to see her. She is a vet who practices western and homeopathic medicine, she's much sought after in the area. She spent an hour with us, she doesn't believe that Carl has Corneal Endothelial Dystrophy, but because she is not an ophthalmologist she cannot go further and make a diagnosis. Because thyroid can cause some eye problems, she drew blood and is running a full thyroid panel. Carl has a lot of fur loss and balding on his thighs, belly and neck which may or may not indicate thyroid problems.

 

She also dropped a little bomb - the vet I went to, thinking he was a veterinary ophthalmologist since we were referred to him as such by our regular vet - is not a board certified veterinary ophthalmologist. He did the standard 2 year veterinary ophthalmologist residency, but has never become board certified. As nice as he was, it left me shaking in my boots. I would never have gone to him if I had known that. Now we've lost time and money and we don't have a surplus of either. I am going to be making him an appointment with a real veterinary ophthalmologist and we will take it from there.

 

At this point we are still waiting for the results of the thyroid test. She has Carl continuing on with the Pred drops (1 drop in each eye 2 times a day), put him on some Calendula drops (2 drops in each eye 2 times a day) that she mixed in her office for us and put him on two tabs of Drenatrophin PMG by Standard Process in case he needs adrenal or thyroid support. We'll know more soon.

 

I don't know if any of that information helps, but I hope it can! I hope they can figure out what's going on with Buddy's eyes and get the treatment started soon!

Edited November 14, 2008 by ckruzan

[rascalsmom]

Thanks for the info. It really seems that pannus isn't something that is easily diagnosed....or maybe "frequently misdiagnosed" might be a better way to put it.

 

Buddy had the Optimmune ointment last night and he seemed fine with it. His follow up appointment on Dec. 1 is with the OTHER, older, original doctor from this practice, so hopefully a second set of eyes looking at Buddy will bring some sort of definitive answer.

 

I hope you get Carl figured out, too. It's so hard when they "think" something is wrong but can't really say what it is.