View Full Version : Corneal Ulcers

Jane P
15th September 2010, 09:06 AM
Hi everyone.

Dylan was diagnosed with corneal ulcers in both eyes two weeks ago and we were given drops and told to return in 7 days. However, within a few days they had rapidly progressed to being very severe especially one which was very large and deep. He has been on 3 different eye drops since and checks at the vet every 3 days. One eye has healed but the other has not although at each visit the vet says there is 'some' improvement. He trys to scratch and rub his eyes all the time so he has been wearing a buster collar which I didn't want because of his SM but the vet said he would lose his eye if he rubs it at all. He is not a very active dog because of his SM but since this has started he just lays all day in one spot and only gets up for food. I don't know if this is because of the pain he is in, the buster collar or because he can't see very well. I was just wondering if anyone else has had any experience like this and could give some advice. Obviously I am worried sick about him.:(

15th September 2010, 10:29 AM
I have no experience of symptomatic SM, but I do have experience of dogs with deep corneal ulcers, in fact one of my girls has Curly Coat/Dry Eye Syndrome, resulting in many ulcers during her so far short life.

I learnt the hard way that Metacam is a great anti inflamitant and pain reliever, but I wonder if it's use would conflict with the drugs your dog has been prescribed for the SM? I have found it particularly good for relieving the pain and inflamation involved in eye ulcers.

Perhaps you could ring the vet to ask if he thinks it an appropriate medicine and leave the prescription out for you if it is? The doseage is indicated in the leaflet inside the box, but I find it easier to use the drop method of measuring it rather than the syringe.

There are human medicines to help with ulcers - my Holly uses Protopic and Polyfax for the occasional ulcer.

Does your vet know that he can always obtain advice from the Animal Health Trust? Failing that, have you both considered a referral to an opthalmologist for the ulcers; there should be someone suitable, depending on where you live. My girl has been to The Willows, who are excellent.

If there is any particular help or advice that you think I can give, please feel free to PM me.

Jane P
15th September 2010, 10:57 AM
Thanks Flo. Dylan takes Trocoxil which is an NSAID and he is also having Rimadyl at the moment. I have made an appointment for the vet this afternoon as his eyes are worse today and I was going to ask if maybe he should be referred. When he tried to get out into the garden he kept walking into things including the wall. It's just so upsetting him like this.

15th September 2010, 11:39 AM
I'd certainly recommend involving an opthalmologist at this stage.If all else fails,there's a surgical procedure where the third eyelid is temporarily drawn over the ulcerated part of the eye,giving it time to heal.We had a foster cavalier with a bad eye ulcer.
However if medication helps then it may just be a matter of choosing the most effective one.But if you find something doesn't work,then just go back and insist on something else being tried.

15th September 2010, 11:48 AM
I'd certainly recommend involving an opthalmologist at this stage.If all else fails,there's a surgical procedure where the third eyelid is temporarily drawn over the ulcerated part of the eye,giving it time to heal.We had a foster cavalier with a bad eye ulcer.
However if medication helps then it may just be a matter of choosing the most effective one.But if you find something doesn't work,then just go back and insist on something else being tried.

They don't do that procedure so much now Sins, as they have another which works in many cases.

They scrape the affected tissue from the eyeball, then spin a serum from the extracted plasma from the dog's blood, which they then chill and house in a tiny bottle, which has to be kept very cold in the fridge. The serum contains the dog's own DNA to promote healing and minimise scar tissue formation. The drops are applied twice a day, often in conjunction with a tear enhancer such as Optimune.

This did not work for my Holly, in fact quite the opposite, but the opthalmologist then prescribed Protopic for tears, Lacrilube for lubrication and Polyfax to deal with any further bacterial infections that may arise.

15th September 2010, 12:22 PM
My Megan (aged 11) has just had a nasty ulcer too - we think she may have poked her eye with some stubble when she wandered off a footpath which was too thistly.

It's the second time it has happened, and on both occasions my vet used Fucithalmic ointment, which worked really quickly.

Good luck with Dylan - I would certainly get an eye specialist in now if you can. Do let us know how you get on :wggle:

Jane P
16th September 2010, 04:02 PM
When I took Dylan back to the vet yesterday they found both his eyes had become worse and they agreed he should be referred to an opthalmologist. His appointment was this morning and I am afraid it is not good news. The right eye is not too bad and he is going to put a contact lens in and stitch the corner which should hopefully allow the eye to heal with medication. The left is extremely bad and difficult to treat as there are several different depths in the ulcer. He is going to perform a graft on this eye and if it goes well he should regain partial sight in this eye. He is having the surgery this evening. The opthalmologist also diagnosed Dylan with dry eye which has caused the ulcers. I had asked my vet if he had this when first started experiencing problems several months ago and they tested him for it but said he was OK! I can't believe he is having to go through this on top of the problems he has with SM.

16th September 2010, 07:41 PM
Oh poor Dylan, and poor you too - neither of you deserve all this on top of the SM. But unfortunately these things can and do happen and you can only respond to them in the best way you can. At least you have given Dylan the benefit of an expert opinion now, and I'm sure we're all thinking of you and hoping that things will soon improve.

Do let us know how you are getting on, won't you?

16th September 2010, 09:32 PM
Poor Dylan, what a lot you both have to contend with. Sending you lots of healing thoughts and hugs. :hug:

16th September 2010, 10:18 PM
Jane, I am so sorry that the problems with Dylan's eyes are so complex and severe. Poor boy.

Please don't blame your vet for any of this either, because it takes an expert to identify and diagnose these problems and of course your local vet has neither the knowledge or equipment to do so. Don't blame yourself either as I doubt that there was anything whatsoever you could do to prevent or minimise the damage done by the ulcers.

It sounds to me as though the opthalmologist is absolutely on the ball and will do the very best that there is to be done to help Dylan. Once his treatment is finished I expect he will be prescribed Optimune to produce tears and Lacrilube to lubricate the eye and prevent the friction which causes the ulceration.

I do so agree that Dylan just doesn't deserve this to happen on top of having SM. You are in my thoughts and prayers. If there is anything I can help you with, please don't hesitate to ask.

16th September 2010, 10:20 PM
Just catching up on this thread. I do hope Dylan is ok and they manage to heal the ulcers in time.

Sending gentle:hug: :hug:from myself, Maddie and Pippin


Jane P
16th September 2010, 10:54 PM
Thanks everyone for your kind words. Dylan has come out of surgery this evening and is doing well. Everything went according to plan and he should be back home tomorrow afternoon.

Thanks again Flo - I automatically want to blame someone for this so it helps to know it probably wasn't anyone's fault. I was very impressed with the opthalmologist and felt quite happy to leave Dylan in his care (which surprised me!) It's good to know you're there if I need help or advice.

I'll keep you posted on his progress.

Jane P
18th September 2010, 10:37 PM
Well I wasn't quite prepared for just how bad Dylan would be after surgery. He cannot see at all out of either eye and will not be able to for two weeks. The eye that has the graft looks pretty horrible, he can open it but at the moment cannot see. If the graft takes it is hoped that he will regain some vision in this eye. The other eye has a contact lens/bandage on and has been stitched closed with just a tiny gap in the corner to put the drops in. The stitches will be taken out in two weeks and hopefully the ulcer will have healed and he may regain most of his sight in this eye. However, this may not work and he may need a graft on this eye too. He has to take 5 different tablets and 3 different eye drops each day, one of which has to be done 4 times a day. Because he is blind he cannot do anything for himself and it is very upsetting to see him like this. The opthalmologist said I must think of him as a patient now and not a dog as he needs constant care and will not be able to behave like a dog at all. All I can do is hope that it works.

18th September 2010, 10:45 PM
Jane how awful for you and for poor Dylan too. Sending lots of get well wishes :hug:Hopefully the contact lens and the grafts will do the trick for him. It is bad enough that he has SM without the added problem of dry eye.

19th September 2010, 08:34 AM
Sending gentle hugs to you Jane and sloppy kisses for Dylan. You will soon get into a routine for caring for Dylan and he will adjust to his convalescence.

Keep your trust in the excellent care your lovely boy is receiving and say a prayer or two as well. You will both come through this and be all the stronger for having done so.

You are in my thoughts and prayers. We are all here for you when you need us and will watch out for Dylan's progress.

19th September 2010, 09:03 AM
oh goodness I'm so sorry to read about poor Dylan - and you, it sounds a full time job caring for him :(

I hope the lack of vision is only temporary - but they adjust very well to not being able to see, even in a few days - they are amazingly resilient, and in their home environment, as long as things are not moved around, they manage extremely well. My foster oldie, Fufu, was almost completely blind, there is another blind dog on the board - both enjoyed/enjoy a very good quality of life. Dogs rely on their other senses more.

YOu can help by putting his food bowl down so it touches his paws, so he doesn't struggle to find it. Also put treats on the flat of your hand so that he doesn't snatch at them.

Sadly eye ulcers are extremely painful, which was why he was just lying quietly. It is good that he is seeing an ophthalmologist - they really are the best people to treat eye conditions.

You did the right thing going to the vets so quickly with Dylan - we always emphasise this with sore eyes - sadly things can go wrong very quickly.

My Lauren had a sore eye a few weeks ago on the Sunday evening. I washed it out with warm water in case it was a foreign body, dosed her up with homoeopathic arnica {a pain killer/anti inflammatory} but when she was still sore and quiet Monday morning, I took her to the vet who diagnosed an ulcer :( Fortunately hers healed very quickly with medication - I have had another Cavalier in the past who had to have her eye abraded and treated with serum - that worked very well for her, but she just sat on the sofa for almost two weeks hardly moving whilst she was so sore.

Jane P
21st September 2010, 11:22 AM
Thought I'd just give a quick update on Dylan. He is coping really well and his eyes seem to doing as they should. He still isn't moving about much but has tried a few times to get out to the kitchen, I suppose it will take a while for him to feel more confident. He goes back to the Opthalmologist on Friday so I'm hoping things stay OK until then. I have got used the daily round of drugs and eye drops and even managed to do all 3 lots of drops this morning on my own.:) However, I have found this SO much harder than anything I've had to deal with to do with his SM. It's so difficult coming to terms with the fact that he now has two very serious inherited diseases - he just doesn't deserve it. I'll update again after Friday.

22nd September 2010, 09:25 PM
So glad to read that Dylan is holding his own and you are coping with all the new demands, Jane. It really must be heartbreaking for you, but it's amazing what we can do when our precious Cavs are under threat!

Take small steps and time will pass quicker - it will soon be Friday, when we hope to hear more encouraging news.

Every good wish and lots of woofy wags from my gang for Dylan :l*v:

Jane P
25th September 2010, 03:39 PM
Dylan went back to the Opthalmologist yesterday for his first post-operative check up. I must say that I have never met a kinder, more caring vet than this man - we were so lucky to be referred to him and what he has done for Dylan is just amazing. The eye with the graft on is doing well although there is a very thin spot which could ulcerate again. He said it will take 16 weeks for this eye to heal. The other eye was less damaged and had a contact lens in and was stitched closed. He had originally said this would be left for two weeks so I was amazed when he said he was going to take the sutures out! A quick snip and his eye was open again! He then took the lens out and the eye looked almost perfect! Dylan can now see out of this eye although there is no vision in the other one yet. We have to carry on with the same treatment for another two weeks and then go back again for a check up. I cannot tell you how relieved I was that everything looked OK so far. The grafted eye looks so horrible I thought it must have rejected the graft but the vet said unfortunately that it how they look. The trouble with this sort of eye problem is that there are no guarantees and it can suddenly all go wrong so we just have to keep our fingers crossed.:xfngr:

25th September 2010, 04:27 PM
When Holly was so poorly and screeching every time I went near her eyes, I thought she would never get better and that perhaps I wasn't taking proper care of her, or that I should give up trying and let the vet remove the eye. Like you I stuck at it and 18 months later she has been free of eye problems for more than a year.

I think that all things considered you and Dylan are doing very well. Coping with three lots of drops isn't easy, so well done for doing it.

Thanks for the update, I think of you both every day and hope that things are going well for you.

25th September 2010, 09:34 PM
I'm so glad you finally have some better news. It's really great that Dylan is coping well - and you too, it's been a huge strain on you both. It is surprising how quickly we do get into a routine with any kind of medical care like this - but I really hope that after the next check up the work load will be greatly reduced for you.

I hope that the eyes continue to heal well - Dylan is a lucky boy indeed to have such a caring guardian - also that you have found a caring and understanding opthalmologist.

26th September 2010, 01:53 PM
Thank you so much for keeping us all "in the loop", Jane - we do feel for you going through this difficult time, but it sounds as though everything is going gently well so far, and I'm sure it will stay that way.

Looking forward to the next update. Meanwhile, gentle hugs from me and my gang of four :wggle::d*g::d*g::d*g::d*g:

Jane P
27th September 2010, 08:57 AM
Thank you Flo, Nicki and Marie-Anne. Your messages really do help.:) I'll continue to keep you posted on his progress.

Jane P
5th October 2010, 02:50 PM
Dylan had a second post-op check today with the Opthalmologist. I had a scary moment when he said he didn't like the look of the eye that has the graft but once he had a more thorough look he said everything was fine! We have now stopped the serum and Chloramphenicol drops and he just has to have Optimmune eye ointment and artificial tears twice a day. This is the treatment for dry eye and he will have to stay on these for the rest of his life. We have another check up in a month's time when he will check Dylan's tear production again.

Having to wear a buster collar for a whole month has caused an ear infection and a skin infection around his mouth so he has been given drops for his ears and cream for his mouth:sl*p:

5th October 2010, 03:44 PM
So thrilled to see that Dylan has had his second check up and is doing so well, even if the opthalmologist had to have a second look to prove himself wrong the first time, big grin.

Did they tell you what his tear count is? 20 ish a minute is really good, 15 just about normal, with anything below that number causing concern. As a guide, Holly's first count was 0 in the right eye and about 10 in the left. Now that her treatment has stabilised the condition her readings are fairly constant at 21 in the right eye and 20 in the left. If you watch the colour changing on the litmus paper stuff they put into the eye, you can see the numbers creeping up.

As time goes on you will absolutely thrilled as I get with Holly's counts each time you watch those numbers come up to normal.

By the way, do you know that you can get Optimune on prescription cheaper than the vet's if you buy on line. Canine Chemists are pretty good, but be careful of any sites not giving a contact landline and address on them, as there are dangerous fake medicines about.

Jane P
6th October 2010, 06:02 AM
Hi Flo. Dylan's tear count was 7 in his right eye and 15 in the left eye although the opthalmologist said this was only that high because the ulcer was so severe it was making the eye very watery. I'm hoping that the dry eye isn't too bad and will respond to treatment well.

Thanks for the advice on Optimmune, I'll check out some prices.

Jane P
3rd November 2010, 11:09 AM
Thought I'd give a quick update on Dylan's progress. We had a check up yesterday with the Opthalmologist and everything seems very good. His tear count was 20 in both eyes which is excellent so we are reducing the Optimmune to once a day and artificial tears twice a day. He wants to see Dylan again in 10 weeks and if his tear count stays above 16 the treatment will be left as it is now and he will be signed off but if it is below 16 the Optimmune will be upped to twice a day again and we will have to continue under the opthalmologist. He still has no vision in the eye that was operated on but no pigment has grown over the cornea which is good as if that happens then he definately will not be able to see again.

3rd November 2010, 01:07 PM
That's really good news on Dylan again Jane. I am so glad to read it all.

Your opthalmologist sounds really on the ball. Let's hope Dylan is stable enough on the reduced medication to get discharged.

Sending gentle hugs for both of you and keeping fingers crossed that some sight will be restored to that eye. :D

Jane P
4th November 2010, 09:56 AM
Thank you so much Flo. Your kind words and advice have really helped to keep me positive during this horrible time - much appreciated.:)

Rick, the opthalmologist is absolutely brilliant. The ulcer was so large there was hardly any cornea left to use for the graft so he had to use the white part (not sure of the correct name) of the eye as well. When we saw him this week he said Dylan has proved that even when there is only the tiniest amount of cornea to work with it is still worth doing.