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Frankie is turning 4 in January, and today after a couple of visits for gunky eye, we find out he has borderline tearing, 11 and 15mm, to the point where Dry eye or KCS is a considered a reality and the Vet ordered Cyclosporin... Now Of course, like all of you who have experienced any diagnosis that could be a lifelong condition, as treatable as it is... I am all over the place right now...

I've read that this isn't typically a Malty Problem, but I've also seen on this site that it does happen and there are a few threads on that... Now most people also get to referrals to a specialist... I'm in Edmonton, Alberta... A big city, but not THAT big....I'm not sure how many specialists there are here...

I'm just trying to understand what I should be doing.. Should I be getting a Second Opinion? Should I be focusing on finding a specialist... Should I be changing his diet, as this could be related to allergies... I know there is surgery as well that people were talking about as far as 3 years back... I imagine this is a possibility as well...

I know, as I said, this is something that can get worse, but thankfully we seemed to have figured it out earlier, and hopefully it will get better, but what are the next steps now to try and get this under control, and myself under control...

Thoughts... comments... I'd love to hear them...
 

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Lady has had dry eye for several years. She was older when she was diagnosed, about 11.

I absolutely would ask for a referral to an ophthalmologist. Dogs with KCS/dry eye tend to have other eye problems like corneal ulcers, infections, so it's best if you are under the care of a specialist.

Cyclosporin didn't work for Lady. Tacrolimus has been her miracle drop. I also use Genteal Severe Eye gel in her eyes 4-6 times a day.

There is lots of information here:

KCS (Dry Eye)
 

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Thank you Ladysmom... I was using your thread from before as a guide as well.. I guess in the bigger picture I'm just trying to understand the processes in the beginning... I guess we start with this move to that is the tendency for any diagnosis... I'm hearing about all sorts of possibilities... But even just having an animal ophthalmologist in my city on its own is what I'm starting to have to find...
 

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Thank you Ladysmom... I was using your thread from before as a guide as well.. I guess in the bigger picture I'm just trying to understand the processes in the beginning... I guess we start with this move to that is the tendency for any diagnosis... I'm hearing about all sorts of possibilities... But even just having an animal ophthalmologist in my city on its own is what I'm starting to have to find...
Why not ask your vet for a referral to an ophthalmologist? He would know if there is one in your city.
 

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Tessa's opthomologist told me to put genteal Gel drops in her eyes to keep them from becoming too dry. It is found in any pharmacy over the counter. Maybe you can try that and see if it helps.
 

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I guess there is one in the city... that's good to know...

he's not really rubbing his eyes at all today... that's good...

should I get a second opinion? Or should I wait a little bit?

Thank you all for your reply's... Frankie and I appreciate it...
 

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My Dolcina was diagnosed with KCS few month back and I was so worried that I will have to operate on her eye.

After few weeks of giving her drops of Tacrolimus, her condition has improved :aktion033:tremendously:
the drops gave a "jump start" and now the eye has started producing tears on its own.:happy:

Eventually, we think that she will not need any drops at all.

That was a wonderful surprise for me, a miracle may happen for your fluff too.:Sunny Smile:
 

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I guess there is one in the city... that's good to know...

he's not really rubbing his eyes at all today... that's good...

should I get a second opinion? Or should I wait a little bit?

Thank you all for your reply's... Frankie and I appreciate it...

You could wait and see if the cyclosporin helps.
 

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Lady has had dry eye for several years. She was older when she was diagnosed, about 11.

I absolutely would ask for a referral to an ophthalmologist. Dogs with KCS/dry eye tend to have other eye problems like corneal ulcers, infections, so it's best if you are under the care of a specialist.

Cyclosporin didn't work for Lady. Tacrolimus has been her miracle drop. I also use Genteal Severe Eye gel in her eyes 4-6 times a day.

There is lots of information here:

KCS (Dry Eye)
We, too, used Tracrolimus (very expensive, but WELL worth it) for years on our sweet Emily - (Cocker Spaniel) it worked very well for her -

We also used a gel many times a day, just a tiny line of it - directly into her lower eye lid - oh, my baby girl.

I hope that you fluff feels better soon.
 

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Thank you all for the encouragement and experiences... I guess also for future reference, In Western Canada, there is an ophthalmologic named Dr. Bruce Ghahn out of Saskatoon. He comes in once a month to Edmonton to service the needs of all the little eyes that need him in this city. He takes a few weeks to see, but thankfully there is someone who can at least look at the situation a little closer, (although I have great confidence in my vet just for the record) and just reassure you that everything we are doing is correct. I mean really what else can you ask for.

Will keep you posted, but glad that other people have had good experiences with the drugs that were given to them as well.

One other small note because he did talk alot about possible allergies, is that despite the fact that I love taking him to work with me in my small office. The carpets on the floor have not been cleaned in some time, and they even used to smoke (private office) and I think I will keep him away until we clean the carpets from the smoke...
 

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The nice thing about seeing an ophthalmologist is that they are aware of different medications to try if Cyclosporin doesn't work. Most vets have never heard of Tacrolimus.

There is also a new tear stimulator that is supposed to be approved shortly.
 

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Ladysmom... How did you know the cyclosporin didn't work on Lady? He seems to be affected a little by it after a couple of minutes, he rubs his eyes... But then he stops right awy, so I'm not sure if he's allergic, or am I overreacting...
 

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Ladysmom... How did you know the cyclosporin didn't work on Lady? He seems to be affected a little by it after a couple of minutes, he rubs his eyes... But then he stops right awy, so I'm not sure if he's allergic, or am I overreacting...
Cyclosprin is a tear stimulant so the vet can tell if it is helping Frankie produce tears by retesting him.
 

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Tacrolimus Ophthalmic Solution (Compounded)

Tacrolimus is the drug that increases tear production. The link above is the drug information.

Lucy's sister Emmy has dry eye and I checked into all the meds for her as she is on the genteal drops now 4 times a day.

Tacrolimus has to be compounded down for smaller dogs and once you start the drug you cannot stop as it is a tear producer so starting and stopping is not good for the dog. It is not cheap but it is considered to be the best medicine for dry eye now as it is the latest drug for this.

Cyclosporine Ophthalmic Drops (Compounded)

Cyclosporine the drug above is not a tear producer like Tacrolimus

The reason opthamologists use the two above is to be able to apply less times the genteal drops. They stated it is twice a day vs 4-6 times a day

From what i researched for Emmy I would use Tacrolimus for dry eye. I spoke to opthamologist and two vets along with a client of mine that owns a compounding pharmacy.
 

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Frankie is turning 4 in January, and today after a couple of visits for gunky eye, we find out he has borderline tearing, 11 and 15mm, to the point where Dry eye or KCS is a considered a reality and the Vet ordered Cyclosporin... Now Of course, like all of you who have experienced any diagnosis that could be a lifelong condition, as treatable as it is... I am all over the place right now...

I've read that this isn't typically a Malty Problem, but I've also seen on this site that it does happen and there are a few threads on that... Now most people also get to referrals to a specialist... I'm in Edmonton, Alberta... A big city, but not THAT big....I'm not sure how many specialists there are here...

I'm just trying to understand what I should be doing.. Should I be getting a Second Opinion? Should I be focusing on finding a specialist... Should I be changing his diet, as this could be related to allergies... I know there is surgery as well that people were talking about as far as 3 years back... I imagine this is a possibility as well...

I know, as I said, this is something that can get worse, but thankfully we seemed to have figured it out earlier, and hopefully it will get better, but what are the next steps now to try and get this under control, and myself under control...

Thoughts... comments... I'd love to hear them...
Something to also watch for in dogs with dry eye is drying of the nostril. If you notice the nostril is dry on one side that is usually the eye that has dry eye. What happens is the tear duct does not drain enough down to moisten the nostril thus causing the nostril to be dry and crack. The schirmer test is the most accurate test and a vet can do this test so sounds like your vet did this. Once it is determined to be this then I personally would be going to an opthamologist for follow up on this as they know everything to do with eyes. They usually stay up on the latest meds and things with eyes so why I would work with a specialist for this type of things as I would never mess with the eyes as corneal ulcers are suppose to be very painful and they can get those from this condition as Emmy had that and that is how they knew she had dry eye.

My dex had alot of eye goo in his eyes and rubbing his eyes so i took him to opthamologist as dry eye runs in yorkie breed. It was 160.00 for an hour exam and he did not have dry eye just allergies but she was very thorough and they have equipment that the normal vet does not have to get a very complete exam. Now dex has a dry nostril on one side so we will go back to have him re-examined again as it has been 3 years I believe so want to be sure as they can get it as they age.

Dry eye is like sand paper in the eyes - very painful.

Here is a pic of the nostril being dry of my Dex as this can be a sign of dry eye or a couple other things. I have noticed that in winter/fall it is dryer than in spring/summer and vet was not too concerned about it but I want to get a follow up schirmer test to be sure
 

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Here are some pics of Emmy as well who has dry eye and you will see the nostrils are affected as well
 

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Here are some more pics of emmy - you can tell in all the pics from puppy hood she has dry eye in that right eye. Usually they will wince that eye in bright light, rub it raw, and have alot of eye goo and if green goo it is infected.

I hope the pics help someone maybe searching to see what dry eye looks like
 

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My Spunky used Cyclosporine ointment during the last year or two of his life. I thought it did act by stimulating increased tear production. :unsure: I had not heard of the other drug.

Spunky had lots of other problems in his senior years, but I don't think the lack of tear production was related to any of them. Our vet (not a specialist, but apparently well informed in many areas) said the lack of tear production was believed to be an autoimmune problem.
 

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Discussion Starter #19
Our Vet also said that is is an autoimmune problem... He recommended the cyclosporin which Frankie is now on... I have an appointment with the Ophthalmologic in 2 weeks as he comes in from out of town once a month... I just keep noticing he hates the drops at the beginning, which he didn't have a problem with the antibiotics with all the discharge when this problem started...

Anyhow... I continue to monitor... thank you all for your helpful advice again... It feels good to have people understand these types of issues and relay their experiences...
 

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Our Vet also said that is is an autoimmune problem... He recommended the cyclosporin which Frankie is now on... I have an appointment with the Ophthalmologic in 2 weeks as he comes in from out of town once a month... I just keep noticing he hates the drops at the beginning, which he didn't have a problem with the antibiotics with all the discharge when this problem started...

Anyhow... I continue to monitor... thank you all for your helpful advice again... It feels good to have people understand these types of issues and relay their experiences...
well that could be not sure as cyclosporine suppresses the immune system. My dog was on atopica (cyclosporine) for allergies which it is used in pill form for this. It does suppress the immune system for that so possibly could for this but I always thought dry eye was due to clogged tear ducts or no tear ducts but i guess the immune system could not produce tears thus causing it not sure but good question to ask the opthamologist.

here is the opthamologist we saw and she has alot of info on her site

Animal Eye Clinic
 
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