Pannus

[rascalsmom]

Friends of ours...their one dog has been diagnosed with pannus. The dog is six years old, and has been on drops for this for about a year. It recently started looking worse, so they took her to the vet, who referred them to an ophthalmologist. That doc prescribed more drops--I think she was on three or four different meds, for a total of six drops a day. I believe one med was prednisone, and one was tacrolimus--not sure about the others.

 

Well after two weeks, my friend reports that "the eye just looks worse every day. We are both upset about it but don’t really know what to do at this point. We are both wondering if we should NOT take her back there. She truly looks blind in that eye now, although when I put the drops in, she blinks, so she must be able to see something."

 

They are understandably frustrated, thinking their dog may be losing sight in that eye, and are not terribly impressed with the specialist. The dog is also rubbing at her eye, which, based on my limited experience with pannus (one dog), doesn't sound 'normal'.

 

Any thoughts from those who are much more experienced in dealing with this??

Edited December 2, 2011 by rascalsmom

[Guest FawnFan]

I have a 7.5 y.o. greyhound with pannus. He was diagnosed a year ago by the University of Penn Vets during an emergency visit (thank doG for miracles because the regular Vet was unsure of what his eye problem was.) He is on 2 different meds - both are gels/ointments - not liquid drops. One which I get from a regular pharmacy is Bausch & Lomb's Neomycin and Polymyxin B Sulfates and Dexamethasone Ophthalmic Ointment USP. The other is made by Wedgewood Pharmacy and is called Tacrolimus (I think - the label has been rubbed off from me using it every day.) The Neo goes in 2x's/day; the Tacrolimus goes in 3x's/day. And once he started on these ointments, his pannus was quickly under control, maybe a week - two at most.

 

My suggestion would be to have them go to another specialist. If they are close to Philadelphia, I would highly recommend a visit to the Univ of Penn Vet Eye Doctors. They diagnosed it immediately. My regular Vet was thinking it was something else. Given this, we were glad we had to go to U of P for another issue unrelated to his eyes.

 

ETA: About the eye rubbing, Gunner rubbed at his eyes a lot before the treatment. And now he'll rub at them if I get a little lax in getting the ointments in each day. The eye rubbing (for my hound) was a symptom, if you will, of the pannus.

 

Good luck!

Jean

Edited December 2, 2011 by FawnFan

[seeh2o]

Long story, but when Carl's eye issue came up he was VERY allergic to tacrolimus and cyclosporine, both were ointments His eyes swelled up like giant almonds and he was very uncomfortable, so I stopped the treatment immediately.

 

Also, check on the ophthalmologist and make sure they are board certified. In any case, if the ophthal did not take the problem seriously and have me bring the dog in right away, I would also be looking for a new ophthalmologist immediately.

[rascalsmom]

Yes, it is a board certified,very reputable group of docs. I, too, wonder about allergic reaction. I know Buddy couldn't tolerate the first drop they prescribed for him, but when they changed the med he was fine.

[krissy]

Summit has pannus. He gets one eye med (cyclosporine and dexamethasone combo) and within a week or two his eyes looked better. His case was extremely mild and his eyes now look perfectly clear.

 

If a dog getting steroid eye drops (which is what you give for pannus) starts showing eye discomfort (rubbing, blinking, excessive tearing) the eye drops should be stopped immediately and the dog taken to get its eyes checked for corneal ulcers. Steroids worsen ulcers and ulcers are very serious.

 

Not saying this is what happened, but when in doubt an ulcer is not something to wait or mess around for.

 

Also, unless there are complicating factors a dog with pannus should really just be on one medication... a steroid or similar immunosuppressive eye drop. There aren't usually 6 medications involved for a simple case. Of course, I don't know if this dog has a simple case.

[ramamama]

We had a hound with pannus. Caesar had two different meds for a long while until we got it under control. At one point, he got a small scratch on his eye and we had to stop the steroid and add some kind of antibiotic. It was very difficult at first, but after finally getting it under control he went down to just a couple of drops a week.

 

Here's a blurb from a site to explain why two meds are commonly used:

http://animaleyecare.net/diseases/pannus.htm

Steroid eye drops or ointments are usually used, in addition to topical tacrolimus solution or ointment. The steroid and tacrolimus work together to help decrease corneal scarring and vascularization.

 

Not all dogs respond to the meds for treatment. Caesar's specialist said that a low percentage of cases will never improve on meds and surgical steps would have to be taken. But, thankfully, Caesar did eventually get much better with the meds.

[Guest greytkidsmom]

Tiel is on cyclosporin drops. We had the ointment but DH wasn't comfortable using it so we switched. The first drops were compounded in corn oil. Our vet told us to watch her because many dogs are sensitive to the corn oil base. After a few weeks of use, her eye got progressively more red and she was rubbing it a lot. We switched to a drop that is compounded in sterile water and the problem resolved.

 

All that to say that there might not be a problem with the meds the dog is getting but an allergy to the carrier the meds are mixed in.

 

Good luck.

[rascalsmom]

I saw this dog's eye today. It looks absolutely horrible. Truly, you cannot even tell her eye is brown--it is that red. My friend has a call in to the practice, and they are to call her Monday. Poor pup wants to rub at it. They have discontinued ALL meds, except for saline to hopefully make it feel a little better.