Dry Eye help needed plse

Hi,
Would any of you have any advice or tips to make life more comfortable for Ruby with her poorly eyes? She has had sore eyes since i got her & has been diagnosed with "dry eye",in the early days it was lots of trips to the vets,he went so far as to have her in,anesthetised & he removed any stray eye lashes back in May last year,with no difference. that was followed with ointments, with no difference until Feb of this year when he put her on steriod eye drops & the same op to remove stray lashes(even tho it made no difference before)it was around this time i changed vets & started taking her to an eye consultant in early March & every 6 weeks since.
The good news is she has lost no sight,however the drops we have from him are no longer helping-we were there yesterday( a 7 hour round trip)& her poor eyes have been so sore today,its been heartbreaking as there has been nothing i could do to help her apart from her Maxitrol drops,& ointment & viscotears.I resorted to extra choccie drops & cuddles with me in tears. She has 2 different drops twice a day,ointment 3 times & viscotears in between.Im really sorry for the long post but i thought it best to give background(She also has SM) I cant bathe her eyes as i would be washing her drops out.
All advice welcome,she can/is only opening them approx 1mm so she's either squinting or has them closed

What is the specialist suggesting? Is there the possibility that she has dry eye/curly coat syndrome? This would likely make the eyes more difficult to manage than normal... is there any suggestion to remove her eyes if she is in a lot of pain? Maybe that will need to be considered if she is in severe pain with them. They do tend to get along fine though as other sense make up for lack of sight and dogs rely more on scent than sight... and the pain would be gone.

I'd want a long discussion with the specialist if she is having such problems that she can barely open her eyes -- poor thing, and it must be very distressing for you. :flwr:

Aww - poor girl. Mindy has dry eye in one eye only and daily doses of optimmune ointment have cleare her problem right up. She's been on it for probably two years now and has not had an eye problem since and her tear production in that eye is normal. I imagine that might be one of the things that you have already tried though?

I have PM'd you...

My new foster girl has dry eye. I don't know how to tell, it doesn't look like she does, but she came with an ointment. I'm confused by it, though. It doesn't seem to be artificial tears, it is petroleum jelly and mineral oil???? Does that sound right? I know nothing about dry eye so I'm curious to see what everyone says here.

Thank you for those replies
We had optimune,steroid drops,Fucithalmic drops,to no avail-Mindysmom im told the optimune nearly always works.
From the consultant weve had Cyclosporin(SP?)& maxitrol drops,which worked wonderfully to begin with,the best id seen her eyes(wide like a Cavaliers should be)& 6 weeks ago she had a paper test reading of 5+7 so we continued with those meds but i saw her eyes declining again,this week she had paper tests of 0 both eyes.Now she is on maxitrol drops 2x per day,maxitrol ointment 3xpd, Protopic ointment 2xpd & viscotears as required,until we go again in 6weeks.we have discussed an operation to move her saliva gland from mouth to eyes(very clever but not without its problems)but consult feels that is a last resort.He has had good results with the Protopic so plse keep :xfngr: its good for Rubes.
Karlin plse excuse my ignorance but what are the symptoms/differences between dry eye & dry eye/curly coat?
What with her eyes & her SM ive produced enough tears to last us both a long time
P.s she has no "black eyeliner" left round her eyes,its all pink poor darling & makes her look constantly tired
Pps.The consultant said im doing very well keeping up with her eye meds as she has no sight loss or inflammation of her eyes so some good news.

I have Private Messaged you as well but Dry Eye/Curly Coat is a nasty condition. My Daisy had it and only lived for a year and 2 months.

Curly Coat includes:

Eye problems

Feet/nail problems (Daisy had holes in her feet and in the end her claws came away from her foot - extremely painful and that was what ended it for her - that night we had her put to sleep)

Problems eating
Teeth problems
Dry skin
Thin fur and dry fur
Squinting eyes/dry eyes
Very curly and thick whiskers

Here are a couple of links for Curly Coat

http://www.cavalierhealth.org/dry_eye.htm
http://www.thecavalierclub.co.uk/health/eyes/eyes.html

The eye specialist we saw with Daisy, said that there is an operation they can do for saliva glands up to the eyes, but he did not recommend it as he said dogs tend to only salivate when they see food, so it would not keep the eyes as wet as you think it would. He also said it was a very serious and very painful operation.

Do you have a picture of her? How old is she?
Does she have any other symptoms?

I have a 9-year old ex-breeding bitch "rescued" from her breeder last year. She came with a neglected dry eye problem and has been having treatment for it ever since.

Like you, we found the Maxitrol worked well for some time, but she's been in trouble again for the past few weeks and my vet has now discovered an ulcer, so we're back on Fucithalmic to get that cleared up before we can go back to Maxitrol.

Do you think the worsening might be something to do with the time of year? We are surrounded by hay/wheat harvesting here at the moment and I wonder if the dust/dry grasses etc might not be helping. My poor little girl must have poked her eye on something to get this ulcer, so I'm keeping her always on the lead for the time being, even in our own field, just in case.

It sounds like your specialist feels you have the condition under good control and are doing what you can. :flwr: If it is dry eye/curly coat then it must be very mild for her to be the age she is -- the breed does get a variety of eye issues due to the oversize eyes and they can be very hard to treat. I think Pat also has had some serous eye issue along with hearts amongst her oldies -- perhaps she will see this as she is always very well up on treatments.

Thanks Karlin,i hope Pat sees this too
Wagtails im not sure tho my friend has been saying for weeks that she wonders if its the time of year making her worse?? Im sorry your girl is suffering unfortunatly with this condition i believe the ulcers are caused by any bit of grit/dust etc that then doesnt get washed out & continues to rub on the eye BUT i could be wrong,just in case i put viscotears in before we go outside,during a walk & again as soon as we get indoors.If you dont already have some(im sure you do)dont get it from the vets as its half the price in boots-just dont tell them its for your dog or they get funny!
Chloe that sounds right IMHO as most treatments are to kick start their own tear production alongside artificial tears,it must be working if you cant tell she's got dry eye,plse can you tell me what its called?

Tpup - please pm me - my vets is a specialist in eye problems - they deal with sharpe's all over the country as they have entropia from every litter as the gene pool is so small it cannot be breed out - they are probably a 4-6 hour round trip - I can get to them in 40 minutes which some think is mad but I trust them...

Tupup,
I'm so sorry that you are having such a difficult time with your Rubes at the moment, I hope you get things under control and your little girl is more comfortable very soon.
Just wanted to send a gentle hug :hug:

Hello Tupup,

I'm so sorry to read about Ruby's eyes being so sore. I do hope she will soon be more comfortable.
It does seem that you are doing everything possible for Ruby and I have no extra advice that I think will help.

She is so lucky to be owned by someone like you, you really do go the extra mile for your girls.

I'm a little confused because there is discussion here about several types of eye problems and several types of drops and ointments which can be contraindicated for some of the problems. So, first some basics:

http://www.marvistavet.com/html/body_kcs__dry_eye_.html

Dry eye (KCS - keratoconjunctivitis sicca) is an immune mediated condition where the eyes don't produce enough tears. It is usually pretty easily controlled with cyclosporin drops or ointment which actually cause the eyes to produce more tears. Most people use Optimmune ointment (contains cyclosporin) but I get cyclosporin drops from my local compounding pharmacy - cheaper and I prefer drops to ointment. Drops are given one to three times daily depending on how severe - once treatment is initiated you can sometimes reduce the number of times per day (I recently was able to drop down to once a day from twice a day). The surgery you describe is sometimes done as a last resort but there are often complications and I don't know anyone these days (since we now have cyclosporin) that has had to resort to surgery. With KCS, you can get secondary bacterial infections (you would use another antibacterial drop like Genticin) and/or inflammation - that's where you would use something like Maxitrol drops which has a steroid for inflammation and antibacterials for bacterial infection - but ONLY cyclosporin drops/ointment addresses the underlying problem of KCS. Artificial tears just help keep the eye moist and wash out irritants - but they do NOTHING for KCS so using them alone without cyclosporin does not work. Once KCS is under control with the cyclosporin, you usually don't have to use artificial tears or other over the counter eye drops or lubricants.

Distichiasis is the extra eyelash condition that you describe - the irritation causes pain and abrasions and sometimes corneal ulcers and/or secondary bacterial infections. Treatment is destroying the hair follicles (surgery) and eye drops will help the inflammation and secondary bacterial infections. That would be where you would use a drop like Maxitrol which has a steroid component for the inflammation and antibacterial agents for the secondary bacterial infection. IMPORTANT - if an eye ulcer is present you must immediately stop any product that contains a steroid or the ulcer will not heal and serious damage can be done. For ulcers, you use various antibacterial drops/ointments without steroids.

The pain and squinting that you describe should not be happening due to dry eye if it is being controlled with cyclosporin drops. That might be from the distichiais or because of a secondary abrasion or ulcer or bacterial infection which would need treatment as described above.

Uveitis (not mentioned earlier) is an inflammatory process treated with steroid drops. That can cause redness, squinting, etc.

Finally, glaucoma is a serious eye problem that can affect Cavaliers and can be a result of uveitis, cataracts, and other eye problems. (That is the serious eye problem that I've dealt with that Karlin mentioned.) Glaucoma is when the intraocular pressure becomes elevated, and it is very painful and usually eventually results in blindness despite treatment. My Cavalier with glaucoma ended up having both eyes removed as a result of uncontrolled pain; he was already blind. He was successfully treated for a few years before that happened, but the treatment (with very expensive drops that reduce intraocular pressure) usually only is sustained for a few years before the drops stop working. (There are also surgical procedures for glaucoma - complicated and lots of problems as a result. Long story that I'll skip.) Any eye specialist should do a pressure check in both eyes for any dog who has recurring eye problems to make sure that intraocular pressure is normal.

For all dogs with eye diseases, there is always the risk of secondary abrasions, injuries, and eye ulcers because the dogs will rub their eyes or bump into things and hurt their eyes. These eye diseases also can be made worse with seasonal allergies, pollens, wind blowing debris into their eyes, etc., etc., so those situations can make eye problems worse necessitating more drops to treat these secondary problems. It sounds as if some of our members are experiencing both the primary problems and the secondary problems. I know that this can be quite frustrating and expensive, but hang in there. Definitely seek a specialist if you can't get things under control. (I think I paid for my specialist's child to attend college....)

Tupup - I think Ruby is probably dealing with several different problems and this is why treatment has been so frustrating and ongoing, but keep trying and hopefully you can get things under better control.

Best wishes,

Pat

Thank you so much, Pat, for this extremely clear and helpful summary of the various eye problems.

I'm even more convinced now that I should be seeking specialist opinion (good though my general vet is) and will speak to him about that when we go for our weekly follow up tomorrow.

It is marvellous that we can get such informed opinion so quickly on this Forum. Many thanks again, Marie-Anne

Hi Pat, thank you for your reply,wow ive had to read that a few times,
I am seeing some improvement with the new protopic ointment,its a thick vasaline type but once it has dispersed her eyes are open & ive only used viscotears x3 approx today.The maxitrol ointment is to clear her eye rims as they were looking crusty in parts but now are clear tho pink. the Maxitrol drops are as you say to clear/stop any underlying infection.
As i said the optimune had no effect but cyclosporin did help & took her tear readings from 0 to 5+7 but then back to 0 within 5 months,tho at the start of them her eyes were super so i dont know why(with doing nothing different)(she also had the maxitrol drops through out this time) she went back to square 1 squinting etc.Im hoping so much that the protopic has a longer term benefit for her.
I have to watch Jelly like a hawk as she "helps" Rubys eyes by licking them hence taking any meds back out given the chance For her bedtime meds i have to send Ruby to bed at least 30mins before i can let Jels go too(as both sleep with me)
Thank you again for your help,if youve any more tips for me plse let me know