Our beautiful Lexie is going to be nine years old. Over the past few months she's been been plagued by recurrent corneal ulcers. She's responded to antibiotics and tacrolimus drops. The ulcers are most likely the result of trauma (rubbing or pawing) and dry eye syndrome. We wonder if there are any home remedies- or if someone can offer any on how to prevent this from recurring. Lexie has been wearing a protective cone on and off since Thanksgiving- ugh!
If Lexie has dry eye I presume she will now be prescribed lubricating drops indefinitely?
I have a friend who has a dry eye/curly coat cavalier and she recommends a non-prescription ointment called Lacri-Lube. This is very thick and appears to coat the eye for longer than most eye drops.
Grumpy Old William has had ulcers develop in both eyes in the past and, as my vet has said that many dogs develop a degree of dry eye as they get old, I use Lacri-Lube once a day as a preventative measure.
I am all for home remedies in many cases, but this is not one of them.
Holly is the third Cavalier I have had with dry eye which has required treatment and regular monitoring by a vet. This is definitely not a case for home remedies and Lacri-lube, although the best of the eye lubricants, is not usually enough to prevent corneal ulcers.
You must take Lexie to your vet, who will initially examine the eyes with an opthalmoscope, then probably do a tear count for each eye. A count of 20 is excellent, but anything of 15 upwards is very good.
Once the rate of tear production has been assessed, your vet is likely to prescribe an ointment called Optimune. This costs about £40 a tube from the vet, with each tube lasting about a month, after which it should be replaced with a new one. It is important to use Optimune to encourage the eye to produce tears, but if Trixie is prescribed this it will be for life, as once they stop producing tears on their own they do not recover this ability with treatment.
Optimune can be purchased with a vet's prescription, which he will charge for providing, for about £25 from internet chemists, but be very careful to make sure that you are buying from a reputable UK company, as there are many fakes out there.
If the eye(s) continue to develop corneal ulcers, despite this treatment then your vet should refer Lexie to an opthalmic consultant, who will make a detailed investigation of the condition and prescribe certain stronger human type medicines and ointments to prevent further ulcerations.
My Holly has curly coat/dry eye syndrome with the added refinement of an over active immune system, so she has had specialist treatment and diagnosis, which has saved her right eye.
I cannot stress strongly enough that you must work with your vet and/or opthalmologist to assess this condition and use prescribed medications to control it.
If there is anything I can do to help and advise you or anyone else on this list about this horrible defect and the procedures to relieve it, then please feel free to get in touch with me.
The poster is actually US based so some of the brand names being discussed may not be the same. Thanks for the name of the ointment Margaret, I was trying to remember that recently.
Thanks for telling us where this lady is based Karlin. It does help if members state their country of residence either on their profile page or at the top of their posts.
Originally Posted by Karlin
Having been through so much with Holly I am particularly anxious that no dog will suffer as a result of misdiagnosis or inappropriate treatment. Believe me, if you had spent so many sleepless nights trying to relieve the pain of deep corneal ulcers in a very young puppy or stood by while your vet has tried to examine that same pup who is screeching in agony every time her eye area is touched, or had that very same sweet little thing bite deep into your fingers while you are trying to apply the very treatment which might help her, you may begin to understand why I am reacting so strongly.
I have now looked up the Tacrolimus Ointment which is being used on this lady's dog. It is in fact known as Protopic here and is the same ointment designed for use in human exzema that has worked so well in combination with other ointments for my Holly.
This has led me to wonder why this advanced prescription only preparation is being used? Optimune, which may be known as Cyclosporin in the USA, should surely be tried first? Is there some history here which has not been mentioned?
Eye Problem cont...
Thank you for your thoughtful replies. Our vet recommended an eye specialist when Lexie's ulcer didn't heal completely. Initially antibiotic ointment was prescribed- Lexie tested positively for dry eye. Soon after she started on the
tacrolimus and Olfoxacin drops. A contact lens is protecting the eye. The drops cross the contact lens easier than ointments. And, yes she will need to be on the Tacrolimus forever. We don't wish to replace medical treatment with home remedies. We wonder what else we can do to help prevent this.
Lexie is still trying to paw at the eye with her hinds- that's with two meds and an Elizabethan collar! Her eye looks much improved but we're nervous about removing the collar. Tomorrow the opthamologist is getting a phone update.
And, yes, of course we are from across the pond...NYC.
One thing you might consider is a soft inflateable collar -- much nicer for the dog than the hard ones and it would help with healing perhaps too. I just put a link on a thread in the SM section -- will go find it.
Hi there - it's nice to hear from you again. I am Flo, sharing my life and home with five Cavaliers. We live in Birmingham, UK.
Originally Posted by manhatslim
It does seem to me that you are getting the very best treatment that there is for Lexie. I must admit that the use of a contact lens as you describe is completely new to me, although Holly did have her eyeball scraped and a serum spun from her blood plasma to try to heal a very deep ulcer, but this did not work for her, as she has an autoimmune disease which makes her system overactive, resulting in complete rejection of her own DNA.
After a shouting match with my regular vet, who wanted to remove the eye alltogether, I insisted on following the complex set of ointments and antibiotic creams that the consultant opthalmologist recommended. It was quite a regime, around the clock, but after a couple of weeks the ulcer began to heal and my own vet and I agreed that we both had much to learn and we are working together to keep Holly's eyes both healthy. Eventually Holly was placed on a maintenance regime of the Lacrilube twice daily and the Tacrolimus (Protopic) twice too.
I was over the moon 3 months ago when a routine tear count yielded 19 in the best eye and 15 in the eye that was nearly lost. We have an appointment for January 18 for another visual check and tear count and I am optimistic that the counts will be good again.
It sounds to me as though there is little excepting pain relief that you could or should do to improve Lexie's condition except to be patient and work towards the time when she will no longer want to scratch or paw at the eye(s) and the collar can come off. Have you tried Metacam (could be called something else your side of the pond)? This is very effective for the pain of corneal ulcers and with my vet's agreement I always have a new bottle in the cupboard ready for use if needed. There is another eye ointment for the relief of extreme pain in the eye, which you will probably never need, but if you are using Metacam without success, please let me know and I will find the name of the drug for your vet to prescribe.
I think we should both thank Karlin for telling us about the inflatable collars , which sound much more comfortable than the traditional buster collar and I do agree that Lexie could be much happier wearing one of those. I will not tempt fate by purchasing an inflatable for the time being. Holly hasn't been worried about her eyes for some time now, so I am not going to tempt fate by purchasing a collar I hope she will never need.
Please keep in touch - I am sure we can help and learn from each other.
Here's an update on the Lexie eye situation. As per your suggestion, Karlin, we ordered a soft collar. We also ordered a lubricant eye ointment much like the one Flo suggests. It contains the same ingredients as the lacrilube? (I think that's one you suggested).
We had an email update /question and answer with the opthamologist. As of now Lexie is heading in the right direction. She (the Dr.) recommended getting Lexie groomed. Once we remove the Ecollar she won't be rubbing her ears and accidentally hit her eyes. We were nervous about getting her groomed recently because of the eye trouble- soap, dryers.......scary!
We ordered a product containing hyaluronate which is considered a somewhat stronger lubricant. The doc thinks a drop before walks or playtime can be helpful in preventing future injury. Of course we don't want to overmedicate either. But, the product (Hy-Optic) doesn't seem too extreme.
We're leaving the contact lens in place while the eye is still healing. Once the eye seems nearly white, we can remove it according to the doctor.
'Glad to hear your Holly responded well to the much much less extreme treatment Flo. Perhaps this bodes well for Lexie.
I'd love to see photos of all the Cavaliers. I imagine there's a spot on the site to view and upload photos?
All the best,
Michael and Jackie