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Hello Silvia and welcome to Just Answer. I am a licensed veterinarian and would be happy to answer your questions but need a little more information.
Is the cyclosporin cream one that your vet sent home or did it need to be formulated at a compounding pharmacy? Can you tell me what % of cyclosporin it contains? Is it 0.5%?
How often are you using the over the counter eye drops?
Is only one eye affected or both? Was there any know trauma to the eye area?
Thanks and I will respond when you reply.
I forgot to ask you what her tear production values were (if you know) but it doesn't really matter and it sure does sound like she has a dry eye problem. This is called keratoconjunctivitis sicca (KCS). Some dogs in spite of what we try do not improve, but there are more effective treatments than what you are using, and making some changes may help.
While cyclosporin does help many dogs, the ready made product at that concentration is often not strong enough and we have to have a stronger preparation formulated at a compounding pharmacy. The product you are using has a very small percentage of cyclosporin and in some dogs, a higher percentage is need for a better results. Ask your vet to prescribe a 1% or 2% solution to be made up at a compounding pharmacy. There is another compound that is similar and works in some when the cyclosporin doesn't and it is called tacrolimus. That would be another thing to try as well.
I have never had a lot of like with the pilocarpine drops in the food. As far as the over the counter drops, they are simply lubricants. You can't use them too often. I personally like the OTC brand called GenTeal as they have a drop form for daytime and an ointment to put in before bed.
Finally, if you are not getting good response to medications, it would be a good idea to seek the input of a specialist. I would recommend consulting with a veterinary ophthalmologist for another opinion or additional suggestions they may have to help. Here is a link to find one in your area: ophthalmologists
Also here is a link with more information about KCS: KCS
I hope this helps. Please let me know if you have any further questions.