Pannus (eye Disease)

[Guest Tequila]

Hi, I'm new to these boards (though I often read them & appreciate all the great advice).

 

My grey, Tequila, was just diagnosed with Pannus; an eye disease which can lead to blindness if not treated effectively.

 

Fortunately, we caught it early, and both my vet and the ophthalmologist we went to believe we will be able to halt the progression of the disease (and possibly reverse some of it) with medication. They have prescribed 2 types of eye drops: Prednisolone Acetate and Cyclosporin, to be taken twice a day.... forever.

 

The problem is, I'm having difficulty administering the drops. Have done a LOT of online reading, and watched videos of how to give a dog eye drops, and asked everyone I know for advice. I've been able to "sneak" them in by coming from behind her head so she does not see the bottle (best way to do this with her).... but if I miss, and the eye drop falls on her fur near her eye, she is then reluctant to hold still while I try again. So....it's a challenge. Of course I will keep trying, and I've tried various methods (giving her a treat before, during, and after)....talking to her in a soothing voice and petting her while I attempt to administer them... but the bottom line is she doesn't like it. I think in TIME she'll get used to it....but for now, wow, it sure is frustrating.

 

So....I have a few questions:

 

1) Does anyone here have experience with Pannus?

2) If so, what medication do you use, how often, and how do you best administer this medication?

3) Are there other options for treatment? (ie: a PILL, rather than eye drops?)

 

I am also interested in any tips on how to administer eye drops!

 

Thanks,

Kathy

Edited November 21, 2009 by Tequila

[Guest 4greytful]

Yes only the 2 drops you listed is what we used as well 2x a day, and yes for life. I never had any issues with administering drops. Maybe someone else can give some suggestions.

[Guest mcsheltie]

If they are difficult I back them into a corner and stand over them (like riding a horse) tip their head back and hold the eye open with my left hand (I'm right handed) and put the drops in with my right hand.

[rycezmom]

If they are difficult I back them into a corner and stand over them (like riding a horse) tip their head back and hold the eye open with my left hand (I'm right handed) and put the drops in with my right hand.

 

Yep! thats the easy way. Just takes a little practice to get your hands coordinated. Gustopher P has been on Tacro 2% I think twice a day for the first year. Its compounded by Roadrunner Pharmacy in Phoenix. I call when I'm almost out and 3 days later the new bottle shows up. The vascularization in his eyes has pretty much receded and he is down to once per day. He gets his in the morning. He comes and stares at me from the kitchen doorway until I put the gtts in then he heads for the yard. He has never given me any trouble. I also dont let him hang around in the yard for long in the middle of the day because UV/sunlight can exacerbate it. He does most of his best "barkyard hunting" in the early morning hours or late afternoon/evening. Thanks for asking the question because it reminded me GPJ is due for his "doggy eye doctor appointment for his every 6 months follow up. Once you start putting them in with a little more dexterity/confidence, your hound will settle in with the drops. Good luck and dont forget your follow ups1

 

L.

[Dawnnziggy]

This is interesting to me. Ziggy was diagnosed with pannus very soon after we got him. We have tried many meds but Tacrolimus is the only one that seems to help. He has never had drops twice a day. I do his eye every night before we go to bed. He has never had any follow up visits either.

[Guest BleuDog]

My Wendell has been on treatment Optimmune (cyclosporin) Ointment for 5 years now. I have tried two or three cyclosporin drops over this time...and he HATES them....I gather he is sensitive to the carrier liquid. We now only use the Optimmune Ointment (about $32 a tube, once a day-lasts just over a month)---and he Wants the Ointment...must feel REALLY good on the eye!

 

He goes to the Doggie Eye Doctor once a year for a check-up----has held stable!!!!!!!!!!

 

Good Luck!

[Guest whatahound]

Ace has it and gets one drop of pred each day. The vet says he is responding very well.

[Burpdog]

I've had a few with pannus. Usually you start out twice a day and eventually go to once a day if the improvement warrants it. No, there is not a pill for it.

 

Try giving a very yummy treat afterwards, or even one before and one after. I have been fortunate in that all the ones I've had were ok with the drops.

[Guest KennelMom]

Have had one pannus pup - as mentioned earlier, drops are the only treatment. We were able to take Caesar's drops back to once a day after everything was under control. We only used the prednisolone drops and that worked very well for him.

 

You may want to try giving the drops after a nice, long walk or exercise session. Tired dogs are usually more pliable and less likely to have pent up anxiety or resistance. Also remember to keep your own anxiet in check. When I first started giving Quilty her insulin shots I was nervous as h*ll!! And she could tell. She'd start screaming, which only made me more anxious. I had the doc practice with me a few times one day until I was SURE I was doing it right and not hurting her. She was actually just being a drama queen the whole time! As soon as I gained confidence in what I was doing, the screaming stopped. Now it's just part of our routine and no big deal for either of us. You'll get there, it's just a matter of practice.

[Guest Greensleeves]

Treatment must be given topically, into the eye itself, because the eye is a "closed system," with its own immune response, etc. Systemic drugs taken orally won't reach the eye with proper efficacy.

 

Treatment varies--Whistler had severe atypical/secondary pannus (involvement of the third eyelid), which we were only ever able to moderately control (and when we got that far, his ophthalmologist was happy!). IIRC he was on Neo/Poly/Dex (?) twice a day and Tacrolimus once or twice a day (depending on symptoms). The Neo/Poly/Dex treated the inflammation, and the Tacrolimus was the immuno-suppressor.

 

A more aggressive option you might ask your ophthalmologist about is a steroid injection given into the eye itself. I don't know if this would allow you to ease off on the eye drops, though. Whistler had this done two or three times. It's been a few years now, and I'm afraid I can't recall the specifics of what was in the injection or how we knew when he needed one (I'm guessing he must have been squinting or rubbing his eyes)... but I do remember that they give a local anaesthetic, and that they *told* us there wouldn't be any discomfort... but Whistler disagreed. He had some pain and restlessness the evening of/after the procedure, but was fine by the next morning.

 

If she doesn't like the eyedrops, she'll probably hate the Doggles.

[Guest GentleHugs]

LuLu has pannus in both eyes and was diagnosed 2 years ago. Luckily my regular vet is very experienced with pannus so we didn't need to go to a specialist. She gets the pred drops and will for the rest of her life, too. She had just turned 5 when she was diagnosed and that's about the age that it will start showing up if a dog has pannus. She just turned 7.

 

At first she didn't care too much for getting drops put in her eyes every day twice a day but she got used to it quickly. Most of the time now she lets me know when its time for her meds.

 

She started out with 2 drops per eye twice a day until just recently and we've had a breakthrough! She now gets 1 drop in each eye twice a day and its keeping the pannus at bay for now. The only problem she has is at night outside. If I don't have the light shining on the deck steps, she has a bit of a problem seeing them lately. I'll probably call my vet about it and discuss that with him though.

 

If its sunny outside, she can go out for about 10 minutes but any longer than that and she has to wear her doggles. She doesn't care to wear her doggles but they help keep out the UV light.

 

To administer the drops - I straddle her, tilt her head back and hold her top eyelid open with my right hand while I put in the drops with my left hand (I'm left handed). She rarely backs up on me when I straddle her. I don't stand in front of her though - she backs up on me every time so I straddle her and that helps.

 

If you happen to miss and the meds drop on her fur - make sure you wipe it off asap. Don't let her lick it. It's not supposed to be ingested - just used as a topical treatment. As far as I know, there are no oral meds for treating pannus - only topical treatments such as drops and ointments.

 

Hope this helps.

 

[Guest BlackandBrindle]

Sadie was just diagnosed. She's on an ointment (don't know the name off the top of my head) and I've been giving it three times a day.

 

The ointment is pretty easy to get in her eye but she stands pretty still for me.

 

I'll post the name of the ointment when I get home. Having spoken to people who use both, some prefer the ointment and some prefer the drops.

[Guest Tequila]

Thanks very much for all the replies.

 

Here is a little more info: She was diagnosed last Monday by my regular vet. That evening, I was able to give her the Prednisolone drops pretty easily.... she squirmed a little bit, but I was able to do it. The next morning I also was able to put the Pred drops in. (I had not yet filled the prescription for Cyclosporin, so I was only giving the one type of drop). I was able to get an appt with the Ophthalmologist that afternoon, and she was very good about letting the doctor give her the eye stain, and tear test, and then they recommended giving her an injection of a steroid to "kick-start the healing process." They took her into another room to do this, so I didn't see it and I'm not 100% sure she was "okay" with it. They told me she did well. But....when I got her home that night, she would not let me give her the eye drops....and she squirmed even more when I tried again. I didn't want to freak her out, so I called my regular vet for advice..... he advised me to "take a break" from giving her drops for 48 hours (said she would be okay, especially since she had received the injection) and try to de-sensitize her by showing her the bottle, giving a treat, touching her near her eyes, giving a treat. I tried that for 2 days (Weds & Thurs), and then attempted to administer the eye drops again Friday morning, with the help of a 2nd person. I was able to get the Pred and Cyclosporin in one eye, then she got too antsy so I decided to take a break for a few hours and try later. While she was laying down (relaxed), I went over to pet her and spoke in a soothing voice while positioning the eye drop bottle behind her head so she didn't see it. When she seemed relaxed enough, I gently lifted her upper eyelid and "snuck" one of the drops in. She didn't flinch or seem bothered by it at all, she simply blinked, and then looked up at the ceiling wondering where it came from (because she never saw the bottle). That worked GREAT....but when I tried to give the 2nd drop (of Cyclosporin) she moved a little and the drop landed on her fur near her eye. THEN she knew what I was trying to do, and promptly got up and walked away. Sigh.....

 

Today (Saturday), I tried again to administer the drops -- no luck. First, I tried while she was relaxed.....gently lifted an eyelid while talking to her and petting her, but she kept moving. A waited about an hour, then tried with treats, while she was in a sitting position. No luck -- she kept squirming. I don't want to create a situation where she is terrified of me touching her eyes, so I have decided to wait until I can see my regular vet on Monday and have them do it for me, and show me how best to do this. Since it's "forever"....I need to learn to do this where she is comfortable. Trying to hold her head still doesn't work -- it really freaks her out -- so I think my best bet is to get her more "comfortable" by associating the drops with a tasty treat. I think I'll try that later today, and also tomorrow. (Show eye drop bottle, give treat..... touch near eyes, give treat).

 

For those who have had success giving eye drops, how long did it take for your dog to accept this, and be comfortable with it?

 

It's breaking my heart that I am not able to give her the medication she needs, but I will not give up. I will keep on trying until I find a way to make this work.... and I know it will... I just need to be patient and persistent. I'm hoping my vet will be able to help show me how best to do this.

 

Kathy

Edited November 21, 2009 by Tequila

[Guest Greensleeves]

I imagine that her eyes were a little bit painful after the steroid injection (Whistler's always were), and now she's associating the eyedrops with that sensitivity (along with plain not liking them!).

 

One thing you might try is smearing something really tasty (peanut butter, cream cheese, etc) on your dishwasher/sliding glass doors/back of the shower wall... and letting her lick that off while you give her the eyedrops (or trim her nails, etc). If she's food motivated, this might keep her still longer than just a treat in your hand, plus it gives you both hands free!

[Guest spider9174]

I have a pup with Pannus. We give drops once a day in both eyes. There is no other option. You'll have to learn the best way for you to give tem to your pup.

 

This is how I do it...I will craddle Kit's head and hold both eyelids open with a thumb and finger then squirt in a drop. Sometimes I miss.

 

I thought there was a gel with the same medications in it available, but it has to be applied to the eye as well.

 

Good luck. It will take some practice, but you'll figure it out.

[Batmom]

FWIW, when I have to do eyedrops or eardrops, I either straddle the dog and tilt chin up, or else come in from the side and hold head still against my leg. The latter makes for some nice nose rubs first. "Good dog!" and yummy little treat after.

[Guest Tequila]

Thanks for the great suggestions.

 

Unfortunately, any attempt at lifting her chin results in her pulling away.....so that will take some time (conditioning her to be used to that). I like the peanut butter idea! Might try that....

[Guest mountain4greys]

Holly was diagnosed recently with Pannus. She was on eye drops 3 times a day as well as ointment 3 times a day.

 

We caught it early, although it involved the 3rd eyelid in one of her eyes. The medicine corrected this immediately.

 

Now, were down to drops in both eyes twice a day(Flurbiprofen), and Optimmune ointment twice a day also. Holly is 5, turning six on Friday. We go back to the Dr. in the spring, but he thought she might be on this regimen for the rest of her life.

[Guest GentleHugs]

Thanks very much for all the replies.

For those who have had success giving eye drops, how long did it take for your dog to accept this, and be comfortable with it?

It's breaking my heart that I am not able to give her the medication she needs, but I will not give up. I will keep on trying until I find a way to make this work.... and I know it will... I just need to be patient and persistent. I'm hoping my vet will be able to help show me how best to do this.

Kathy

 

 

For LuLu, just a day or two for her to accept getting the drops in her eyes but she didn't get a steriod injection either like Tequila got. LuLu has been doing just fine since.

 

Tequila might be picking up on your being a bit uncomfortable on how to give her the drops, too. I was a bit nervous the first time as well.

 

Just take a deep breath, relax and get into the frame of mind this has to be done for her sake. If you are relaxed, she might relax, too.

 

Btw - when one of my other dogs needed a steriod injection to reduce some inflamation, the vet told me steriod injections sting and hurt a bit but they should be ok in a couple of days after getting one.