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Dr. Bruce
Dr. Bruce, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18768
Experience:  15 years of experience as a small animal veterinarian
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I have a dog that had a scratch on his eye. The Vet gave us

Customer Question

I have a dog that had a scratch on his eye. The Vet gave us some eye drops for him and the scratch healed up in about a week but he still keeps his eye closed. Went back to the Vet and he was tested for dry eye. He had no tears in that eye so she prescribed restasis and an ointment. It has now been 3 days and the eye doesn't seem to be any better and he still has some matting. The botton of the eye on the outside looks swollen. What would you do next or do you have an answer for me.
Submitted: 8 years ago.
Category: Dog Veterinary
Expert:  Dr. Bruce replied 8 years ago.

First of all, here is a great link that talks about KCS. Please read it to help increase your understanding of the disease and what our goals are.

So, in summary KCS is the decreased tear production of that eye. Our goal is to increase that production, but this is not always possible. In your case, the first thing that I would absolutely do is to use the Veterinary approved cyclosporine topical product called optimmune. The Restasis is the human medication for dry eye with optimmune in it. The difference between the products is that the Restasis has a 0.05% concentration of the cyclosporine where the optimmune has a 0.2% concentration.

So the veterinary product is much stronger and has a better chance of stimulating the tear glands. If it is going to stimulate them. I always start my KCS cases on the veterinary product.

Sometimes other topical medications are needed to help break up the mucous in the eye. Here is copy from the above link.

Mucomyst® Eye Drops are made from a respiratory product used to dissolve thick mucus. In an eye formula, Mucomyst (active ingredient is Acetylcysteine) helps remove the thick eye discharge that accompanies dry eye.

Severin's Solution is a mixture of Mucomyst, pilocarpine, artificial tears, and antibiotic that can be made up and prescribed. The recipe originated in an article published by a veterinary ophthalmologist named Dr. Severin in 1996. Many animal hospitals mix up their own conglomerations based on this recipe. In most cases, cyclosporine has made these mixtures obsolete.

Both of these can be used if the optimmune doesn't work.

So again, ask your vet to get you the vet product for dry eye and make sure you use it twice a day for a couple weeks and then recheck his tear production to see if the glands have responded. They may or may not depending on how much functional gland is left.

Dr. Bruce
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Customer: replied 8 years ago.

So would you discontinue the Restasis medication and just use the optimmune for now.?

My dog ususally wipes off the optimmune so I had not been using it as much. I will start using it again.

How long should I use this before seeing an improvement if any ? I am suppose to see the Vet. again on Tuesday. Also is there anything else to do if this doesn't work and do you think that the scratch on the eye caused the tear ducts to dry out. His eyes were always had plenty of water in them before this happened.

Expert:  Dr. Bruce replied 8 years ago.
So you initially were using optimmune? It was switched to the Restasis due to comfort reasons? How long was he on the optimmune before?

The Restasis is the same medication as optimmune, just in a lot less concentrated form.
Customer: replied 8 years ago.
I am sorry I didn't make myself plan to you. I came home from work 2 weeks ago and his eye had a scratch on it. We immediatley ran him to our Vet. and she said he had a scratch on his eye. She gave us an antibiotic in the form of eye drops. We used this for over a week and the eye seemed to clear up as far as the scratch but still very dry. Went back to the Vet this last Tues. and she measured the eye for tears and he had none in the hurt eye. She gave us th optimmune to be used twice daily and the Prednisolone Acetate also to be used twice daily. I stopped using the optimmune on Thurs of this week because he continued to wipe it off. Since I have heard back from you this morning I have started using it again.
Expert:  Dr. Bruce replied 8 years ago.
I want to make sure that I understand which products your using. Are you using or have used Restasis? Is this the product that you are using that has the cyclosporine in it?
Customer: replied 8 years ago.

The Vet. I thought said that the drops Prednisolone Acetate was another name for Restasis. I might have misunderstood her. My yorkie is on the drops Prednisolone Acetate and the optimmune. These meds were given to me this last Tues. He was suppose to take the drops twice daily of the Prednisolon and the optimmune tube(small amount covering the eyelid twice daily. I stopped the optimmune tube application due to my dog whipping it off. But since I have talked to you I am using the optimmune on him again. My question is: Do you think he needs both of these meds and how long do you think they will take to work on him? Also do you have any ideas that would help us in keeping the ointment on his eyes?

Thank you

Expert:  Dr. Bruce replied 8 years ago.
Ok. Now I'm understanding your situation better. No the Restasis is the human 0.05 % version of cyclosporine ophthalmic. The optimmune is the veterinary 0.2% ophthalmic version. The prednisolone acetate is not another name for Restasis.

Now that we have this straight, and don't feel bad at all about this, we can move on. I would definitely continue with the optimmune twice a day as recommended by your vet. As far as keeping the ointment on his eyes, I would only put about 1/4" strip on the affected eye/s. If your putting more than this on, it might feel like too much and that might be why he's rubbing them. The other thing you can try to do is put it on when he's going to be sleeping soon so he's likely to want to just lay with his eyes shut. As far as needing both meds, I would check with your vet on the prednisolone acetate drops. They might be using them to help reduce any opacification of the cornea after his previous scratch.

I would honestly recommend using the optimmune for the entire bottle (hopefully that is at least 2 weeks) and then have your vet recheck the tear production. If the tear production is better, then you know the medication is stimulating the tear glands and doing a good job helping to keep the eye moist. If the tear production is still very low, then you have two choices - 1) continue with the cyclosporine since it may slow down further tear production loss or 2) go to a less expensive sterile eye ointment to keep the eye moist since his own natural tear production isn't enough.

One other idea on keeping the ointment in his eyes, I've had one owner use an elizabethan collar on the dog for the first 10 minutes after applying the ointment so he couldn't rub his eyes. Then take the collar off after that.

Hope all goes well.

Dr. Bruce