It's been suggested that Arthur may need his eye removed.Thoughts

Arthur has PK. He has very dry eyes and I give him blink 4 x a day in both eyes (moisturising drops). His vision is obviously impaired but it's barely noticable at this stage. He has a sliver of non pigment covered eye in both which I imagine serves him well. He's had a few ulcers in the past but apparently the pigment acts as a protective barrier so he hasn't had any recently. His left eye has suddenly become badly ulcerated. My vet advised that his immune system is attacking itself and causing this (rejecting the pigment??). He's on anti inflammatory meds and antibiotics but she suggested that ultimately if this continues to happen due to the pain and discomfort involved it may be kinder to remove the eye. We are going to see a specialist shortly for a second opinion. I just wondered wht people's experience has been of this and what usually merits this operation? He's only 5.
Thanks!

Poor Arthur! There are certainly folks here who know a lot more about eyes than I do. Nell has horribly pigmented eyes but she hasn't had any ulcer issues since she was a puppy. I don't think her vision is great but she functions fine and there is no discomfort involved. I'd say if he's having chronic ulcer issues or the potential to have them, I'd be inclined to just get the eye out and make him more comfortable but I'm sure the specialist can certainly let you know how treatable it is.

I don't have any experience with having an eye removed but Buster recently had a bad corneal ulcer that got infected & required surgery. They used a conjuctival flap to cover the lesion. Not sure if that will be an option for Arthur but it has worked well for us so far (knock wood!). Buster has had several ulcers in the past and also suffers from glaucoma & cataracts in the eye that they did surgery on, but they never mentioned removing his eye (much to my surprise). Good luck at the specialist & please let us know what they say.

I tried to add a link in my text above about the conjuctival flap, but it's not working so here you go:

http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00519.htm

I have LOTS of experience with this. I have three dogs that have had enucleations. Personally, if the eye is going to be a constant source of irritation and pain, I'd take it out. My 14/15 year old pom just had an eye removed this spring and has done GREAT. In fact, all of my dogs were better after enucleation as I think they were pain free for the first time in a long time.

Hazel (pug) has had both eyes removed--and has no issues at all--she had massive PK, dry eye and her eyes were finally not producing any tears at all. She was, mostly, blind so there was no sight to lose and alot of discomfort and pain to be lost by enucleation. I wouldn't hesitate to do this for any of my dogs depending on the circumstances.

Feel free to email me if you want to ask more questions. I hate to sound like an advocate for the procedure as it horrifies so many people, but honestly, it's been a blessing for all of my guys.

Becca, my heart is breaking reading this. Dont know enough to comment but would boosting his immune sym with probiotics fish oils etc, all natural anti inflamatorys help? Anything I can send from the USA let me know. Give Mickey Arthur and Marmite a big kiss from me. xxx

Becca, I'm glad Blanche jumped in - she's one of the best sources of advice on this. Her "Death Pom" Lola's change pre- and post-enucleation really was not much short of miraculous. Lots of love and hugs coming from us.

Thanks so much for all the repsonses. It's arming me with info to take to the appt tomorrow. I'm afraid the poor vet is going to get bombarded! On the up side Arthur seems a happy chappy so either he is accommodating the pain very well or it's not that acute. On the down side the ulceration doesn't seem to have improved with meds although the rest of the eye seems less inflamed - the inflammation just appears to be restricted to the one area right across the top of the cornea. I'll be asking the vet about Optimune, this has never been suggested. My vets are excelllent and forward thinking so I'm confused about this. The pigment deposits allthough extensive can't be that thick as his lack of vision only manifests itself wuith close up stuff. Will update tomorrow. Thanks again.

ewoodpugz wrote:Thanks so much for all the repsonses. It's arming me with info to take to the appt tomorrow. I'm afraid the poor vet is going to get bombarded! On the up side Arthur seems a happy chappy so either he is accommodating the pain very well or it's not that acute. On the down side the ulceration doesn't seem to have improved with meds although the rest of the eye seems less inflamed - the inflammation just appears to be restricted to the one area right across the top of the cornea. I'll be asking the vet about Optimune, this has never been suggested. My vets are excelllent and forward thinking so I'm confused about this. The pigment deposits allthough extensive can't be that thick as his lack of vision only manifests itself wuith close up stuff. Will update tomorrow. Thanks again.

Careful with Optimmune. While it does help with the pigmentation, it IS a steroid and as a result, compromises the immune system of the eye making it less able to heal ulcers. I don't think it's ever recommended where an active ulcer is in place. My foster puppy has disticia and a couple of other issues with eyelids abrading his eye (soon to be fixed) and the ophthalmologist took him off of the Optimmune as he felt that it was too risky given the way in which it compromises the eyes ability to heal itself.

And pugs are frighteningly stoic. Hazel who has had both of her eyes removed didn't present any obvious signs of pain, but her general energy and liveliness improved after each enucleation. She had severe dry eye and her tear tests were in the negative numbers by the time we removed each eye.

Eye stuff IS painful. Dogs won't present with pain if they can avoid it, especially if it isn't agonizing, but there is a constant level of discomfort there.

If you haven't seen an ophthalmologist, I would--just so you can hear from a specialist what your options are. But don't shy away from enucleation just because we have such a visceral reaction to it.

Hi folks - quick update. Arthur's ulcer turned a corner on Saturday and has healed up really well now. The vet is starting to think it was the cause of an injury as opposed to the original theory of some kind of auto immune response to his dry eye induced PK. Especially as we have a puppy play fighting with them constantly atm. Anyway we got a swift referral to see the doggy ophthalmologist and we're going Wednesday AM. I'm assured he is excellent. His PK is due to dry eye rather than the eyelash issue so I know entropion surgery isn't an option. If ultimately it has to be the enucleation then that's fine but I'll feel alot more comfortable getting an expert opinion. I'll check in with you after the appt to let you know the verdict.

Good news from the appointment: The vet felt that the eye ulcer was as a result of an isolated injury and not an immune response to the PK. The ulcer has healed completely now so it is safe to commence Cyclosporin drops which they made up for us to a high strength to try and start tackl ing the pigment and tear production. As the pigment deposits are extensive it will take persistence and time to make progress but they are confident that he can and will. His tear production was 15 in one eye and 5 in the other. I'm now wondering about my vet...they should have really suggested a referral a year or more ago and I'm questioning them. Hmmm. We'll see.

Excellent news. Please give Arthur a hug from me and tell him to quit scaring you like that.