Keratoconjunctivitis Sicca (KCS) in young Miniature Poodle

[SCM1959]

Does anyone have any experience with Keratoconjunctivitis Sicca (KCS), which is sometimes just called Dry Eyes:

I have a young Miniature Poodle who has had “goopy eyes” off and on since about 4 months of age. The groomer first noticed it and I asked the veterinarian and he prescribed steroid drops. Blackie’s eyes cleared up and I thought all was fine. Not. The goopy eyes kept coming back and three more times, the steroid drops were prescribed. All along, I kept asking the veterinarian what could be causing this and finally in March of this year, he tested Blackie’s tears. He then told me that Blackie has KCS which means that the most liquid form of his tears is insufficient. He explained that dogs have 3 kinds of tears – 2 very thick and 1 very liquid-y and without the very liquid-y tears, Blackie will have goop in his eyes every day. Sometimes the goop is so thick and prolific that it covers his entire eyeball.

The veterinarian prescribed eye drops. . I had to pick up a compounded cyclosporine medication (eye drops) and will have to give him one drop in each eye twice a day for 30 days and then just one drop a day for a maintenance dose.

I have now done this for nearly three months. Unlike the steroid drops, these eyedrops seem to bother Blackie. He lets me put them in, but he hates it. I also notice that his eyes are always red and inflamed. I have spoken to the veterinarian’s office about this, but they just say I need to “give it more time”.

I worry about the long-term effect on Blackie’s sight. He is only 18 months old and he is a happy, exuberant dog. I don’t want him to have vision problems. I also am not thrilled with doing something to him every day that makes him uncomfortable.

For a number of other reasons, I am not too happy with this veterinarian’s office and have made an appointment at another clinic for tomorrow at 2 PM. The first place has so many doctors that I think communication is not the best, and of course there are the “good doctors” and the other ones and no matter how hard I try to have the same doctor each time, I always get someone different. The new clinic has only 2 doctors, so I am hoping for more consistent treatment.

In the meantime, I thought I would ask the smart folks here about KCS.

Thank you!

SCM1959

[S1969]

I don’t have experience with that issue specifically but would encourage you to try to get in to see a canine ophthalmologist. My experience with other vets and eye issues is that many vets are not well-versed and/or comfortable treating eye issues.

I had a dog with a mild eye injury and had a similar issue that the drops bothered him more than the injury, and while there was no ulcer found on initial examination, he developed one because he scratched his eyes after the medication was administered. The vet said this reaction was atypical but by then it was too late…then we ended up with a new problem.

I had a good friend that had a serious eye issue with her Springer Spaniel and when she finally took her to an ophthalmologist instead of her regular vet she found that the regular vet had underprescribed pain meds for the eye issue - she had thought her poor dog was suffering and turns out she was right.

If you can, get to a specialist.

[vxf111]

Maggie has a heritable eye condition (two are very prevalent in collies and thank god she has the more benign of the two). She sees a veterinary ophthalmologist. It makes a HUGE huge difference. This is an area where things are very specialized and a general practice vet can’t hope to have the same level of experience/knowledge. Mine is in DE although there’s another well regarded one in the King of Prussia PA general area. Happy to give you the contact info if that’s a distance you’re willing to go. There may well be someone closer.

[Marshfield]

I am told that the cyclosporine eye drops can sting. Haven’t had to use them on myself. Tacrolimus is another medication option. This is a non prescription item which helps soother everything http://www.allivet.com/p-8072-optixcare-eye-lube-plus.aspx?sku=50903-2&gclid=CjwKEAjwl9DIBRCG_e3DwsKsizsSJADMmJ11fbTGBei4Zy3JmnCqOZFod4WhDbxDD0dP5htv_gIW8hoCt0rw_wcB

[vxf111]

Maggie doesn’t act like the cyclosporine hurts but she doesn’t enjoy having stuff put in her eyes and I can’t say I blame her. She’s pretty tough/stoic so maybe it does sting and she’s not letting on?!

[SCM1959]

Thank you to everyone. I am going to hold off putting the drops in Blackie’s eyes tomorrow until we are at the new veterinarian’s office so they can see Blackie’s reaction. #1 he doesn’t even want to come near me. #2 he submits, but is also trying a little to pull away. #3 the minute I am done, even though he gets a “good boy” treat, he is shaking his head and using his front paws to rub at his eyes. Usually I have to put him outside right away or he rubs both sides of his face all over the carpet, couch, upholstered chair.

Also the fact that the sclera in both eyes is always red … I am sure that is not right. When I was using the steroid drops, the sclera was a nice white color after only a day or two.

Veronica, I am in upstate SC, so Pennsylvania is a bit of a hike, ha, ha. There is an eye specialist in Greenville, SC about an hour away and I will go there if necessary after tomorrow’s new vet visit.

SCM1959

[DrBeckett]

Optimmune, which is cyclosporine, is wonderful. I have seen it turn the worst mucousy eyes into clear eyes. I never heard anyone say that it seems to irritate their pet. You have to be diligent about it. Optimmune is expensive. It’s a life long problem.

[vxf111]

@SCM1959

Thank you to everyone. I am going to hold off putting the drops in Blackie’s eyes tomorrow until we are at the new veterinarian’s office so they can see Blackie’s reaction. #1 he doesn’t even want to come near me. #2 he submits, but is also trying a little to pull away. #3 the minute I am done, even though he gets a “good boy” treat, he is shaking his head and using his front paws to rub at his eyes. Usually I have to put him outside right away or he rubs both sides of his face all over the carpet, couch, upholstered chair.

Also the fact that the sclera in both eyes is always red … I am sure that is not right. When I was using the steroid drops, the sclera was a nice white color after only a day or two.

Veronica, I am in upstate SC, so Pennsylvania is a bit of a hike, ha, ha. There is an eye specialist in Greenville, SC about an hour away and I will go there if necessary after tomorrow’s new vet visit.

SCM1959

I’m sorry, I thought you were in Maryland. Duh, mybad

[vxf111]

@DrBeckett

Optimmune, which is cyclosporine, is wonderful. I have seen it turn the worst mucousy eyes into clear eyes. I never heard anyone say that it seems to irritate their pet. You have to be diligent about it. Optimmune is expensive. It’s a life long problem.

That’s what I am using for Maggie’s corneal dystrophy. She doesn’t act like it stings/hurts but having something put in her eyes is clearly (and understandably) not on her top 10 list.

[SCM1959]

@DrBeckett

Optimmune, which is cyclosporine, is wonderful. I have seen it turn the worst mucousy eyes into clear eyes. I never heard anyone say that it seems to irritate their pet. You have to be diligent about it. Optimmune is expensive. It’s a life long problem.

This tiny bottle of Cyclosporine 2% (compounded at a people pharmacy) is $25 per month. Is Optimmune different? I do not mind the cost, particularly if it keeps Blackie’s eyes clear. I know that the KCS diagnosis is a chronic problem and I don’t mind treating Blackie for it.

What troubles me is that even though I put it into Blackie’s eyes every single day, the sclera in both eyes is red and inflamed looking. I know the steroid drops are totally different, but a couple of days of those drops and the redness was gone. With this medication, the redness that was there when we started is still there and has never improved.

I put the drops into his eyes this morning and now, about 9 hours later, he has a thick mucous glob along the bottom of both eyes. The only way to remove it is to lightly touch it with a tissue. I did buy some eye cleaning pads, but anything that is moist will not allow the mucous to stick to it. I use a separate tissue for each eye.

The appointment tomorrow cannot come soon enough!

SCM1959

[EquestrianRunner]

No tips with this, but from one poodle lover/mom to another, my heart goes out to you!!!

[vxf111]

The Optimmune I have is a gel in a tube. It’s also crazy expensive. I think it’s a smidge easier to get a solid into the eye than to try to get a liquid in.

[SCM1959]

@vxf111

The Optimmune I have is a gel in a tube. It’s also crazy expensive. I think it’s a smidge easier to get a solid into the eye than to try to get a liquid in.

I looked it up online and I saw only gel in tubes. I think that would be so much easier. And, maybe Blackie wouldn’t be able to shake his head and send the drops flying right out of his eyes the second I am done. Ugh.

Initially, these eye drops were given to me in a little glass bottle with a tube/squeeze top (like old-fashioned nose drops). Talk about impossible! Trying to draw the drops into the little tube, holding the squeeze top tight, wrestling a dog, trying to FIND his eye – he is so black it is hard to see, especially first thing in the morning - yikes. I had to take an old plastic squeeze bottle from the steroid drops to the compounding pharmacy to show them that I needed something like that. It is easier to use, but I am still not happy at all with the results.

SCM1959

[vxf111]

Oh FORGET IT, that sounds WAY hard and not user friendly! Ugh.

[EquestrianRunner]

Also, how did the appointment go today?

[SCM1959]

@EquestrianRunner

He is too handsome!!! This is my wild child, Bailey. She turns 7 on Tuesday (and even while she is recovering from her second TPLO surgery on her knee, she still doesn’t act like her age!)

I love the chocolate color! She is beautiful.

Many years ago we had a Toy Poodle and she was white. I live in Upstate South Carolina with red/orange clay dirt. Never, ever again will I have a white dog! My horse is a beautiful bay color and Blackie is obviously black (officially “blue”) for a reason!

[SCM1959]

I really liked the new veterinarian. He listened very carefully to what I told him about Blackie’s history. He tested Blackie’s tears again and this time, the results were not what he would have expected to see if Blackie does indeed have KCS. I did not give Blackie his eye drops this morning because of this afternoon’s appointment, but still his tear production was very close to normal. The vet agreed about the inflammation in Blackie’s eyes and also commented on the slight puffiness.

We talked in detail about the three times I had steroid drops for Blackie and how everything cleared up. He does not think it would be worth trying Optimmune in gel form because we already know that cyclosporine is not helping. Or at least he doesn’t want to try the gel form yet. He recommended that we do the steroid drops again – 2x a day over the weekend, 1x a day next week, and by next weekend every other day and by the following weekend every two days, with the idea of eventually doing it every third day. He thinks, and I agree, that if we can get the inflammation down and keep it away, that we may have a better chance of figuring out what is going on.

He did say that the next step is an ophthalmologist, and I agree.

As a bonus, it turns out that the vet tech used to ride with my instructor. I haven’t seen her for about 5 years and it was great to catch up.

I will say that using the steroids in Blackie’s eyes — no backing away, no pawing at his eyes or rubbing on the carpet. I still say there is something in those cyclosporine eye drops that bothers Blackie’s eyes.

SCM1959

[DrBeckett]

Our Optimmune is about $57 for a small tube. I think most go through 2 tubes a month.

[SCM1959]

@DrBeckett

Our Optimmune is about $57 for a small tube. I think most go through 2 tubes a month.

That is pricey, but if it worked to keep my dog comfortable and to keep his eyes clear, I would do it.

The little bottle of drops is $25 and it lasts not quite a month, but considering how much Blackie doesn’t like it and how much he rubs his eyes on the floor, with his paws, on the side of the couch, I am glad the new veterinarian told me to discontinue use.

I don’t know if the gel form of the cyclosporine medication would be bothersome or not.

What do you think of the plan to use the steroid drops to reduce the inflammation and then “start over”. It seems like a good plan to me. When I put the steroid drops into Blackie’s eyes this morning, he was very calm and did not pull away from me when I went to do the second eye, as he did every single time with the cyclosporine drops.

SCM1959

[EquestrianRunner]

@SCM1959

I love the chocolate color! She is beautiful.

Many years ago we had a Toy Poodle and she was white. I live in Upstate South Carolina with red/orange clay dirt. Never, ever again will I have a white dog! My horse is a beautiful bay color and Blackie is obviously black (officially “blue”) for a reason!

Thanks!!! It is amazing she has kept her color- usually chocolates grey out by their second/third birthday. Orange/Red clay would be horrible with a white dog!!! OY! Does Blackie like your horse?

I am glad that the new vet is trying to figure his eyes out. Sometimes starting totally over and calming the issue down then problem solving is best. Its like you cant really diagnose a lameness if the horse is all drugged up on Bute. The new vet sounds like a great doctor and I am curious to see what they say.

Has Blackie ever had allergies? Bailey has bad environmental allergies and it comes out in itching her ears and skin issues. I wonder if eye goop could be related to allergies? (similar to how people get watery eyes?) I am very interested to see what this new vet says!!!