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My 8 year old pup recently under went a keratotomy procedure to correct an eye ulcer. He finally got the all clear after two months of vet visits. The eye doc said I could discontinue all meds but the other vets who have consulted on Thunder's eye have said he would be on the Optimmune for the rest of his life. Optimmune is a lubricant used for low tear production in dogs. From what I've gathered via research, it's unknown whether the ulcer caused the low tear production or the low tear production was a result of the ulcer. Anyway, at the very first visit to the e-vet (of course this whole thing started on the Saturday morning of Labor Day weekend), he had hardly ANY tear production. We eventually ended up at a specialist who did the keratotomy. The eye doc repeated the Shirmer test before his surgery but he was on Optimmune at the time. When I asked if I needed to continue with the Optimmune she first said "no, his tear production was on the low side of normal " but then I reminder her that he was on the Optimmune when she did the test. Her answer then was okay, go ahead and continue with it as it won't hurt him. That WASN'T my question but I didn't prob and left. So today I did some digging and found a precaution from the drug manufacturer that stated long term use COULD cause lymphoma. Given that finding and the cost of the drug at a little over $30/month and the 2x/day fight to get it into Thunder's eyes, I'm frustrated over what the right way to proceed really is.

As a side note, Thunder had a tough time with either the pain med or sedation from the procedure and we ended up back at the e-vets at 2 am following the procedure. He was fine but it was 14 hours from the time of the procedure until he finally settled and went to sleep. The eye doc didn't seem concerned by this and basically said it was a sight hound thing. I don't think going back to the eye doc is going to get me anywhere nor do I want to go back to her. Not thrilled by the idea of having to spend more money for a second opinion but not against the idea either. I have written to my regular vet to see if he has a perspective. I will continue for now but I need a long term solution. The eye doc thought the ulcer was age related and there was a chance it could reoccur in either eye. I don't want him to develop another ulcer, especially given what happened with the sedation, and if the low tear production is the cause, stopping the med is clearly not the right move.

 

Anyone been down this path or have thoughts about the long term use of Optimmune.

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Did the lymphoma warning apply to topical application in the eye? (I ask because eyes are a little different from the rest of the body / immune system.)

 

I'm with GeorgeofNE -- I'd talk to the vet again. Sometimes it helps me to write my questions down on a piece of paper, with space to write the vet's answer. Sometimes it also helps me to paraphrase what the vet said and ask, "Is that correct? Have I overlooked anything important?"

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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I find doctors very vague about things sometimes. I would ask the opth your question again because I would hope she would be able to give you a definitive answer. I'd also keep digging myself for other dog owner's experiences with optimmune. I would guess it's like other meds that suppress the immune system - rheumatoid arthritis meds come to mind. The warning is always there about cancer, not from the drug but from the suppression. I know he hates it anyway but are there other products you could use to keep his eyes lubricated without scary side effects?

 

As for the sedation, I'd find out exactly what drugs they used. It's true that opiates & sighthounds don't always get along so I'd want to have a better cocktail to give him if he ever needs to be under again. My angel Faolin had a hell of a time with a fentanyl patch that took as long to wear off as Thunder experienced.

 

I think I saw Thunder at Dewey - he was wearing a cone of shame? You might remember a rude white dog barking at you on Rt 1 as we passed? If so, sorry bout that...... :blush

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Deirdre with Conor (Daring Pocobueno), Keeva (Kiowa Mimi Mona), & kittehs Gemma & robthomas.

Our beloved angels Faolin & Liath, & kittehs Mona & Caesar. Remembering Bobby, Doc McCoy, & Chip McGrath.

"He feeds you, pets you, adores you, collects your poop in a bag. There's only one explanation: you are a hairy little god." Nick Galifinakis

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I agree I paid a vet for answers but the reality now is that I'm not going to trust any answer I am given by this doc given the previous experiences with her so it doesn't feel like it's worth the time. I am tracking down his medical records to determine what sedation was given to him. He had a hard time with a previous dental four years ago which they thought was a pain med but I now know I need to figure out a cocktail that works for him. In this case, I just took him in for a consult and within 15 minutes, they were whisking him away to do the procedure. I barely had time to think. I did mention the previous reaction but because they weren't doing full anethisia, I think they discounted it.

 

Yes, the warning was specific to the Optimmune lubricant, however, longterm was not defined but hopefully, I have years left to be with Thunder so years feel longterm to me.

 

Sweetdogs, I don't think it was me at Dewey. Thunder was wearing http://optivizor.com/ but not the cone of shame. Then again all I remember of Dewey was hair in my face the whole time due to the wind so I don't remember seeing much. It's usually my guys who are being mouthy and bratty so I likely won't have noticed any barking:-) Love the vocal pups!

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Ah, got it. Hopefully your regular vet can ask/read around and help you out.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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Many, many dogs use life long cyclosporine for dry eye. My question to the vet would be if you could use something else like gentile. Do you remember exact number of the schirmer test? My guess is you should continue something if his test back back low normal while using optimune--number should have been high.

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Thanks tbhonds! I believe the left eye (non ulcer eye) was 20% and the right eye (ulcer eye) was 15%. The first trip to e-vets (probably six weeks prior to this visit) there was barely any sign that he hads tears at all. My regular vet did talk about the Gentile product during all the various visits but he said it was very different than Optimmune. I will ask again for clarification.

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Guest Nitemare

Not long term yet, but will be :( I have a recently acquired little girl who came to us with this condition. She is producing no tears in either eye. We started her on Optimmune 2x per day and Puralube 3x per day. At a follow up visit, this was not helping. She is now on Optimmune 3x per day and GenTeal lubricant eye gel for severe dry eye 4x per day. She has a follow up appointment on Saturday morning and you have just given me another question to ask.

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