Dry Eye Problems

[Ladymom]

Originally Posted by MaddiesMommie

I am giving 1/4 in. strip of Cyclosporine once a day and using Vetropolycin ointment 3 times a day. We go back Monday.

I still can't figure out why your vet would prescribe Cyclosporine if she doesn't think Maddie has dry eye.

When the ER vet said Maddie had dry eye, you started using Blink (artificial tears), right? I am guessing that Maddie had reduced tear production at that point and it has worsened which is why she got another ulcer.

Tera production isn't all or nothing. It is graded from 1-15 by the Schirmer Tear Test. For example, Lady has no tear production in one eye, but it was borderline (around 11) in the left eye for a couple of years. She didn't need Tacrolimus in that eye, but I did use Genteal. She eventually developed KCS in that eye, too. I now use Tacrolimus in both eyes.

Have your vet take sixty seconds to do a Schirmer Tear Test in both eyes on Thursday and clear up the mystery once and for all.

[kalina82]

Originally Posted by Ladymom

Tera production isn't all or nothing. It is graded from 1-15 by the Schirmer Tear Test. For example, Lady has no tear production in one eye, but it was borderline (around 11) in the left eye for a couple of years. She didn't need Tacrolimus in that eye, but I did use Genteal. She eventually developed KCS in that eye, too. I now use Tacrolimus in both eyes.

Have your vet take sixty seconds to do a Schirmer Tear Test in both eyes on Thursday and clear up the mystery once and for all.

not to be a stickler but it goes over 15 as that is what morgan's results were. 18 OD, 20 OS

[Ladymom]

Originally Posted by kalina82

not to be a stickler but it goes over 15 as that is what morgan's results were. 18 OD, 20 OS

Anything over 15 is normal so Morgan is an overachiever!

[kalina82]

Originally Posted by Ladymom

Anything over 15 is normal so Morgan is an overachiever!

yeah its excessive because of her eye lids rolling in. i'd rather she not be an overachiever, as that causes problems too

[MaddiesMommie]

Thanks you guys for all the help. I am asking for the test tomorrow. If she won't. I will be looking for another vet. I may go ahead and call UT tomorrow as well to check on just getting an appointment. Ugh! I want this better...I will update.

[Ladymom]

Originally Posted by MaddiesMommie

Thanks you guys for all the help. I am asking for the test tomorrow. If she won't. I will be looking for another vet. I may go ahead and call UT tomorrow as well to check on just getting an appointment. Ugh! I want this better...I will update.

You'll need a referral to UT, so go ahead and ask her for one. General practice vets just don't have the sophisticated equipment to do much with ophthalmology. Your vet should have the basics, like the strips to do a tear test, but beyond that you are best dealing with an ophthalmologist.

The vets I went to for years in Raleigh had training in ophthalmology and could do a basic exam, i.e, tear test, eye pressure, etc. Still, when Lady was diagnosed with KCS, they referred me to a wonderful board certified ophthalmologist.

I moved a year ago and found a wonderful general vet, but quickly found she didn't have the expertise my vets in Raleigh did. Nothing against her, they just don't see more complicated case like vets in large cities do. She just referred me to the NC State Vet School for Lady's eyes which has worked out really well.

Eyes take very specialized training. You certainly wouldn't expect your primary care doctor to be able to do eye exams, would you?

[MaddiesMommie]

When I got up this morning, my husband and I were talking and he was so aggrivated I had yet another appointment with the same vet. We decided to take Maddie somewhere else. I was driving about 30-40 minutes each time she had me return, going on 3 times. It just feels like a trial and error experience and I am getting pretty tired of it. SO, I called another vet near Knoxville: www.emoryanimalhospital.net. The soonest appointment I could get is Monday. I don't like having to wait, but I feel more confident that this time we will know the problem.
I am using a warm compress and the ointments 3X a day until then.

[Ladymom]

Originally Posted by MaddiesMommie

When I got up this morning, my husband and I were talking and he was so aggrivated I had yet another appointment with the same vet. We decided to take Maddie somewhere else. I was driving about 30-40 minutes each time she had me return, going on 3 times. It just feels like a trial and error experience and I am getting pretty tired of it. SO, I called another vet near Knoxville: www.emoryanimalhospital.net. The soonest appointment I could get is Monday. I don't like having to wait, but I feel more confident that this time we will know the problem.
I am using a warm compress and the ointments 3X a day until then.

I don't blame you for switching vets. It's ridiculous that this vet never did a tear test to find out once and for all whether or not Maddie has dry eye.

How does her eye look? If it's still gunky, I'd put artificial tears in her eye 4-6 times a day until you see the new vet.

[MaddiesMommie]

It is not too gooky, but there is what appears to be mucus some. I am keeping it lubricated with drops.
I don't know if you looked at the site but the Practice Manager, Belinda, has two adorable Yorkies. I also asked the lady on the phone if the vet saw many Yorkies. She said many of their patients were Yorkies. That makes me feel better, b/c has prob. has lots of experience with the breed.

[MaddiesMommie]

I just don't want to be accused of not updating. lol There has been no change. We had a family emergency and I was unable to make Maddie's appointment. I hope to get her there early next week. Gentak and Opti. ointment seem to be making everything ok.

[Ladymom]

Thanks for updating us. Maddie should be fine until your appointment. Gentek is an antibiotic and Optimunne is a tear stimulator (cyclosporin) so you've got your bases covered!

Do make sure you tell your new vet that Maddie is already getting a tear stimulator when she does the tear test.

[MaddiesMommie]

When I came home from work yesterday Maddie's eye was horrible. Luckily, I had taken today off so I called to see if Maddie could be worked in. When I arrived this a.m. he said he did not like to mess around with eyes and wanted to do a few test right off. He did a dye test and tear test. The tear test showed without doubt Maddie DOES have dry eye. Her Right eye was 17, while her left eye was 0, it didn't even reach the start line. I was so pleased with this visit. He explained everything to me, always told me exactly what he was doing, looking for, what her results should be, and what they were. He spent more time with us than some of MY doctors have in the past answering questions and explaining evrything I asked until I understood. (Which can take a while sometimes, LOL)
It is a little more expensive than our previous vet, but that means nothing to me when it comes to caring for my girl. I was pleased to see he wasn't going to practice trial and error with her. YEA!!!

[Ladymom]

I am so glad you finally got a vet to do a tear test! If her left eye was 0, that means the cyclosporin (Optimune) isn't working. What did he suggest?

Cyclosporin didn't work for Lady, but Tacrolimus has been a miracle. I think you have to get that through an ophthalmologist, though.

Did you ask him for a referral to the vet school? I still think Maddie needs to be evaluated by an ophthalmologist. She is such a young dog. She needs the best possible care to preserve her vision for as long as possible.

[MaddiesMommie]

Her old vet only had us use cyclosporin once a day for 3 days. SO, we don't really know its not working. I did not get a referral. Maddie was on several antibiotics, ointment and oral, however she has no infection. These were only causing her belly problems.
He looked at her eye under some kind of blue light and another very white light and said everything looks great except the bit of drainage she was producing to make moisture. Once this was irrigated, her eye looked clear again. He did an awesome job irrigating it. He did not just clean the surface, but used numbing drops to be able to gently clean in and around the eye. He was great with Maddie as was his assistant.
I am to use these 2X a day for one week. If I see no change then, we will go to ophthalmologist to try another form of treatment.

[Ladymom]

Originally Posted by MaddiesMommie

Her old vet only had us use cyclosporin once a day for 3 days. SO, we don't really know its not working. I did not get a referral. Maddie was on several antibiotics, ointment and oral, however she has no infection. These were only causing her belly problems.
He looked at her eye under some kind of blue light and another very white light and said everything looks great except the bit of drainage she was producing to make moisture. Once this was irrigated, her eye looked clear again. He did an awesome job irrigating it. He did not just clean the surface, but used numbing drops to be able to gently clean in and around the eye. He was great with Maddie as was his assistant.
I am to use these 2X a day for one week. If I see no change then, we will go to ophthalmologist to try another form of treatment.

Oh, I thought you said you were still giving her Optimmune. That's Cyclosporin in ointment form.

I am so glad you found a vet who could do a basic eye exam!