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PSOM and Myringotomy

Lani

Lani

Well-known member
:updte:

So it took a lot of following my gut, research and advocating on Lucky's behalf. Not to mention visits to our vet, an ophthalmologist, neurologist (with MRI) and dermatologist (with video otoscopy), but we finally have a diagnosis for the cause of Lucky's severe dry eye: PSOM.

The PSOM in his left ear is causing pressure on his 7th cranial nerve, resulting in Horner's Syndrome (which is apparently similar to Bell's Palsy in people). The Horner's Syndrome is the cause of Lucky's dry ear and drooling.

His Myringotomy is scheduled for Tuesday. I hate to have him have to go under anesthesia with his heart murmur but it is only grade 3 and I trust our dermatologist 100%. She'll do the myringotomy after consulting with our cardiologist.

I am so excited for Lucky that his silent pain will finally get some relief. I can't wait to see him not in pain. :*nana:

And the best news: His dry eye will most likely be cured when the inflammation in his ear goes down.

Please think good thoughts for him next week. :thnx:
 
So happy that you finally have a diagnosis and that Lucky will finally get some relief after a long, hard road. I will definitely keep him in in my thoughts and will send all good wishes to him.
 
So glad that you've finally got to the bottom of it. Hope the op goes well and you will have one happy dog (and one happy owner) at the end of it.

Kate
 
So far so good!! It's just been a day but already he seems to have more spring in his step!! Tail is wagging a lot more. He has been rubbing his head and shaking a decent amount still, but I guess that is to be expected given it will take a few days for his eardrum to heal. He's on prednisone, the antibiotics, gabapentin and some ear drops and we have a follow up visit in a week and then a month.

The dermatologist said we should be thrilled if we see improvement in his eye by next week, and it could take a month or even not at all. Hopefully we caught it in time before permanent damage was done.

Photobucket is not working for me tonight to upload some pics, so here are a couple Facebook posts that I made public so you can see them. I hope they work!!!

Lucky's ear - Myringotomy photos - they are two sheets of paper, left first, and then right, and the photos are sequential as the dermatologist went down the ear canal. The pictures on the right show the thick mucus getting suctioned up:

https://www.facebook.com/photo.php?fbid=10153655634669552&l=a7f8916cb8

And Lucky buckled into the backseat on the way home from his procedure … looking pretty out of it, but he's doing much better now. He had his right eye closed, but couldn't close his right eye:

https://www.facebook.com/photo.php?fbid=10153655522569552&l=285438437c
 
:updte:

3 weeks post-myringotomy. 2 acupuncture sessions later, we saw our Ophthalmologist today for a recheck. Lucky's tear production in his left eye is now 16. His good eye is 20. She said 16 would be normal in some dogs. Overall she was VERY happy with Lucky's improvement thus far. :*nana:

I have noticed Lucky is starting to regain some control of his facial nerves. Now when I put drops in he can close about half way. She was really impressed with that as well and thinks that in a month or so he should be pretty much normal. We're continuing the Optimmune until then, and stopping the Teramycin. We'll revisit her when I think he's back to normal for her to check and discuss discontinuing Optimmune. In the unlikely event he isn't 100% better in 3 months or so we are to come in for a recheck regardless. Until then, we'll continue with our normal vet, giving opt immune and tears and perhaps a couple more acupuncture sessions.
 
Thanks for the update Lani -- so glad there's improvement and knowing how things are developing helps others, too. :)
 
I thought I'd provide an update on Lucky. He went to the Ophthalmologist again today. He was coming up on being due for a 3 month check up anyway, but Sunday, before I had to leave for a work trip his eye was looking red and he was squinting a lot.

So we went to the ophthalmologist and apparently his progress is stalled. His movement of his eyelids is only about 25% in his left eye (the one impacted by the PSOM). His tear production is really good, but since he can't blink they basically evaporates off his eye as soon as he produces them. So we are staying the course. Optimmune (aka cyclosporine) 2x a day and Genteel Tears Severe drops/gel at least 3x a day but really whenever I can put them in since he still can't blink. His eyes are otherwise healthy - no ulcers, no glaucoma, no cataracts, etc.

Here's a photo of him today at the Eye doctor's. Can you read the eye chart? ;)

 
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