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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 28967
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My pup's eye lids are swollen. They were treated with

Customer Question

My pup's eye lids are swollen. They were treated with steroids and antibiotics which resolved the problem but when the meds were done it came back.
Submitted: 11 months ago.
Category: Dog Veterinary
Customer: replied 11 months ago.
The eye doctor said she could be on steroids for two months to help suppress but I am not sure that is a good solution. So I am checking things out - being diligent for Lilly Kate.
Expert:  Dr. Michael Salkin replied 11 months ago.

You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply.

Expert:  Dr. Michael Salkin replied 11 months ago.

Sheila, has Lilly Kate's vet given you a diagnosis for Lilly Kate's blepharitis (inflammation of the eyelids)? We have to clarify if a bacterial blepharitis, contact hypersensitivity from topical ophthalmic medication, allergy - both seasonal (atopy/allergies to environmental allergens) and nonseasonal (atopy, food hypersensitity), or autoimmune disease (similar lesions involving the dorsum or planum of the nose, lips, ears, footpads, or other mucocutaneous junctions, or generalized skin lesions, are present concurrently) is present.

The diagnosis is usually based on history, clinical findings, and ruling out other differentials with cytology (microscopic exam of a small sample of the affected skin surface), bacterial culture of pustules, and an allergy workup if atopy or food hypersensitivity is suspected.

Can you upload a photo(s) of Lilly Kate's eyes to our conversation? You can use the paperclip icon in the toolbar above your message box (if you can see that icon) or you can use an external app such as I can be more accurate if I can see what you're seeing.

Customer: replied 11 months ago.
I am hoping the photos uploaded.We first tried the following topical neomycin drops and ointment. To me it just got worse with that. The eye doctor took her off that when I finally made it to her after our other vet tried for 2 1/2 weeks to solve the issue. I saw the eye doctor yesterday and she said that she may have to go back on steroids for 2 months...
Expert:  Dr. Michael Salkin replied 11 months ago.

Thank you for your efforts but the shadows obscure Lilly Kate's eyes. I must, however, defer to a specialist veterinary ophthalmologist. If she has said that steroids might have to be continued, I have no reason to question that thinking. I do want to know, however, what type of blepharitis was diagnosed. If allergic, the immunosuppressive drug oclacitinib (Apoquel) should be discussed with the specialist as a replacement for steroids. Oclacitinib can work as well as a steroid without the steroid's adverse effects.

Customer: replied 11 months ago.
I appreciate you referring to a specialist. This girl is special like a doll and even though she is not acting like she has any issues at all I want to get a hold of this. It is not that I do not trust the current doctors but no solution has been provided. The paperwork does say Blepharitis in both eyes. It also says that cyclosporine would be the next round of treatment.
Expert:  Dr. Michael Salkin replied 11 months ago.

Thank you. I believe that the specialist thinks that there's an autoimmune (Lilly Kate's immune system would be attacking her own eyelids!) component to Lilly Kate's blepharitis. Cyclosporine is another immunosuppressant drug in our arsenal and can take the place of a steroid just as can oclacitinib. Put your faith in the specialist. She's seen more eyes like this than generalist vets such as Lilly's vet and I.

Please continue our conversation if you wish.

Customer: replied 11 months ago.
But is that a solution or a band-aid? She is two years old and I am worried or I would not be online trying to figure out things. I did start her on Colostrum last night and is being migrated to new food made by Acana. I am looking long term as well.
Customer: replied 11 months ago.
Oh and she is playing and eating so I am thankful for this.
Expert:  Dr. Michael Salkin replied 11 months ago.

No necessarily. Some autoimmune skin conditions go away never to be seen again. Others wax and wane life-long. Allergies can be particularly vexing because avoidance of offending allergens may be next to impossible. Such dogs may require allergy testing and desensitization with allergy "shots" or sublingual therapy. Her overall behavior suggests that her current therapy is working.

Customer: replied 11 months ago.
Ok thank you! God bless you!
Expert:  Dr. Michael Salkin replied 11 months ago.

You're quite welcome. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

Expert:  Dr. Michael Salkin replied 11 months ago.
Hi Sheila,
I'm just following up on our conversation about Lilly Kate. How is everything going?
Dr. Michael Salkin
Customer: replied 11 months ago.
Hi Dr. Salkin,Her eyes got better for a couple of days but they are swollen again. Our eye dr and vet have put her on the following:
1/2 of prednisolone 5 mg and Atopica 50 mg and opt immune which the ointment seems to make it worse…you know I am just trying. I added carrots to her diet and she is also taking Colostrum.
Expert:  Dr. Michael Salkin replied 11 months ago.

That's certainly a reasonable course of action. Optimmune (cyclosporin) isn't expected to worsen her eyes. Make sure that her vet(s) know what you're seeing. Carrots are great for eye health but I don't believe they're going to have an effect on a blepharitis! Please note, too, that we all lose the ability to absorb colostrum after just a couple of days after being born.

Thank you for the update, Sheila. You're going to win this battle.

Customer: replied 11 months ago.
Thank you.
Expert:  Dr. Michael Salkin replied 11 months ago.

You're welcome.