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Tuesday 15 February 2011

Looking for information on pannus

I have two Greyhounds. Bimbo, a female, will be three years old in March, and developed an eye problem (in the right eye, but we were told there is evidence that the left eye is affected as well) at the beginning of December last year. It is believed to be pannus, also known as Chronic Superficial Keraritis (CSK) or Uberreiter's disease.

Pannus is an inflammatory condition of the cornea, immune-mediated and characterised by an infiltration of the white blood cells into the cornea. What I was told is that, in plain language, a dog's own immune system is not recognising the cornea as its own, but as a foreign body, so it tries to 'cure' the cornea by sending defensive white cells to that area. That results in pigmentation and the extension of the blood vessels onto the cornea and the appearance of a purple/white film-like cover.

Pannus is not curable, but is treatable and is thought to be triggered by exposure to UV light or the sun glare from snow. If left untreated, pannus can cause blindness. Treatment is to be continued through the dog's lifetime.

It is believed that this is a hereditary condition and it is most commonly found in German Shepherd Dogs, but is also found in Greyhounds, Belgian Tervurens, Siberian Huskies, Australian Shepherds and Border Collies.

As you can see, I have done my research on the internet, but I would really appreciate it if any of your experts or readers can help by telling me more details about this disease.

Bimbo's therapy started with Maxitrol (Steroid) Eye Drops, which have cleared much of the purple/white film, although there is some scar tissue still there. After that, she was prescribed an Optimmune Eye Ointment (contains Ciclosporin or Cyclosporin), to be given twice daily.

She is still 'squinting' with her right eye, and I am beginning to wonder if she was correctly diagnosed in the first place. Should I insist on Veterinary Ophthalmology Referral, or am I being paranoid? Is there any alternative ways of addressing this illness, any diets or supplements to follow?

Also, I can not find much information about it affecting Greyhounds, mainly German Shepherd Dogs. I would be extremely grateful to hear from any other Greyhound owners to hear their experiences.

Bimbo is my first ever dog, and is much loved. One of the reasons I opted for the Greyhound is that I consulted your Perfect Pup section, where all the dots are white and there is no mention of any hereditary disorders, so this came as a big surprise. However, I would not change her for the world, and am very much concerned to find the best possible treatment for her.

I am very much obliged to you for your time, and hope that you will be able to help out by addressing this issue in your fantastic magazine.

Many thanks.

Petar Matic, by email

5 comments:

  1. I am no expert on Veterinary Opthalmology so I cannot give advice on treatment. On the other hand I do know a little about Traditional Oriental Medicine which makes an interesting connection between the eyes and the liver. We see an example of this in diabetes; diabetic dogs (and humans) often develop cataracts. It would be worth trying that avenue here using a diet which is intended primarily to manage liver disease. This requires a diet low in fat and protein and high in complex carbohydrate. Several Burns adult holistic complete foods are suitable for the purpose and can even replace the expensive Veterinary and Prescription diets for liver disease.It is also important that you feed as little as you can get away with as all food has to be processed by the liver. This is not something you should do on your own; the Burns nutrition team can advise and support you on this.
    John Burns BVMS MRCVS
    Burns Pet Nutrition.

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  2. Dear Petar

    You have done some excellent research into the condition known as Pannus or Chronic Superficial Keratitis. It is indeed an immune-mediated corneal problem which is more commonly encountered in certain breeds of dog and which is exacerbated by ultraviolet light. The condition is commonly managed by the use of topical steroids and/or cyclosporine, although other therapies are available for selected cases.

    Whilst, as you rightly mention, chronic superficial keratitis can be blinding, the majority of patients with the condition do not exhibit significant discomfort, and I am somewhat concerned that you mention that Bimbo is squinting her right eye. This does suggest that she is suffering a degree of irritation, and this could be associated with the presence of complicating factors such as corneal ulceration, or possibly an eye condition other than chronic superficial keratitis. Should ulceration be present this can, depending upon the cause of the ulceration, be worsened by the use of topical steroids.

    Further to John Burns comments, diabetes can and often does result in the development of cataracts, but this is due to the build up of sugars inside the lens of the eye, not as a result of liver disease, and there is no scientific evidence whatsoever that chronic superficial keratitis has any causal relationship with liver disease.

    Given that chronic superficial keratitis can require long-term medication and also gradually lead to loss of vision, I would always recommend that an expert opinion be sought, at least at the outset, in order to accurately establish the diagnosis and commence appropriate therapy. In Bimbo’s case, especially with the signs of irritation that you are reporting, I would definitively advise that you seek the assistance of a Veterinary Specialist Ophthalmologist so that the situation can be carefully assessed and any appropriate adjustments to her treatment can be made.

    I wish you and Bimbo well in getting the problem properly addressed.

    Peter Renwick DVOphthal MRCVS
    Specialist in Veterinary Ophthalmology
    Willows Referral Service, Solihull, West Midlands.

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  3. my wire haired fox terrier has just had his eye removed at pdsa with pannus and now the other eye is infected he is being treated with maxitrol and antibiotics but i am worried sick is it normal to lose an eye to this disease he is nine and he started with eye trouble two years ago does anyone know anything that can help me

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  4. Hi,

    Sorry to hear about your fox terrier. From what I have learned so far, it looks like that the onset of pannus was not initially recognised and treated in the case of your dog, and that resulted in the loss of one eye.

    Maxitrol is a steroid drug, and it is good to use for the eyes which are much inflamed by pannus. Vet must ensure that there are no any signs of eye ulcerisations, othervise, maxitrol treatment should be stopped.

    Optimmune treatment works very good for my dog (Bimbo), but I am very carefull that i apply it every day, although, at present, her eyes seem to be fine. But, it helps keeping pannus at bay. I would recommend it. It is not cheap drug, and I not sure would PDSA be happy to prescribe it.

    If a dog gets pannus, it will never go away, but if you treat it ao the daily bases, it can be kept dormant.

    It is such a shame that your dog lost the eye, and there is no reason that he should loose the other one as well.I hope that this will be of some help, and that your dog will get better.

    I'd like also to thank to both Peter Renwick and John Burns for their answers. I have taken Bimbo to be examined by Veterinary Specialist Ophthalmologist, and pannus was confirmed. Presently, she is doing very well on the optimmune treatment.

    Regards,

    Petar Matic

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    Replies
    1. Greetings, I have a belgian sheepdog with pannus, have been batteling this for about three and a half years, He was diagnosed at about a year old. Optimune and Neo Poly do there job well.
      During this time I have watched closly and asked allot of questions at evaluations by specialists. I have found that brighter days in the summer and snow effect this cursed disorder dramaticly. I say this because usually two to three days after exposure to brightness we have flareups. I have discovered that dosing Neo-Poly 1 hour before the regular twice a day Optimune is a huge help in reducing these flare ups usually within 24-36 hrs. I will say this Do Not slack off on treatment. While away for a few weeks, care takers got lazy, upon my return it took about three weeks to get this under control again.
      Over time my dog has had some trouble dealing with adjusting to the loss or lack of eyesight. It started as skittishness and has progressed into yelping and jumping sideway's to all out screaming if things get moving to fast, mainly himself or my other dog.
      In the past several months he has taken to growling when he lays down to sleep and as he is falling to sleep he will suddenly bark and jump up ferosiously over and over. Sadly it's in his head as there is no one near him.
      There is so little information out there I thought someone here may have some sort of life experience that may give me some insight on this behaviour. Thank you and just keep after it !

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