# Cyclosporin Eye Drops Odd Question



## JeanKBBMMMAAN

For those of you (and I know you are out there) who are giving your Pannus/Plasmoma dogs cyclosporin drops does your bottle get all greasy? I swear that it is coming out through the plastic. First, because the bottle is slimy. I wrap it in tissue and put it in a pill bottle to try to reduce that yuck factor. Second, I went through a whole bottle in a month. 

Could it be leaking through the bottle somehow? No other drops I've had do this. My contact lens drops certainly don't! I don't let the corn oil/drop drizzle down the sides either. 








Is my vet office out to get me?


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## middleofnowhere

Sounds like you've got the stuff that comes in the little white bottle. Those never got messy for me. The brown glass ones with the rubber "eye dropper" top 'though... Those muck up fast. It's probably the composition of the drops fighting with the container. I'd ask the vet if other people had the problem.


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## amackinpitt

LOL Jean. Bear's is a teeny bit greasy too. But our problem with the latest bottle we got is that it seems to have a hole smaller than the consistency of the drops! I swear--I have to squeeze that thing like a maniac to get the smallest drop out. And Bear--drama queen extraordinaire that she is--actually cries like she's getting overdosed with drops as I'm breaking into a sweat just trying to get one darn drip out of the bottle! 

"Help! My eyes, my eyes! Mother--you're killing me!"









"Umm, Bear, I haven't done anything yet."


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## ILGHAUS

I am so glad to see this thread as I though I was being a big clutz. When I sit the bottle down between doing eyes and putting away I have started leaving an old white bottle cap on the shelf for this reason. Before the bottle is empty the label tends to wear off so I keep the plastic canister that is was in when shipped to set the messy bottle in between uses. (I get mine from West Labs and it is shipped to me.)

That stuff is too expensive to waste for sure. And it is bad enough when you first get it and see the bottle only half full to begin with. Guess if they sent the correct size bottle (in relation to the liquid) it would be lost in the wrapping.


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## katieliz

both things have happend to me...the bottle does seem porous in some way and gets greasy, AND the hole is smaller than small so you have to squeeeeze forever to get the stuff to come out.

just wondering about something regarding pannus/plasmoma...what would you think if you had a dog diagnosed with plasmoma by a well respected doctor at a very expensive specialty clinic, and then when you took her to the department of ophthalmology at a VERY well respected college of veterinary medicine, at a large midwestern university, their conclusion was that they found no evidence of plasmoma? all information i can find on this condition indicates it can be treated but not cured. anybody have any thoughts/opinions about this?


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## debbiebrown

jean,
is it a tube, or plastic bottle? my optimologist has his made up by a company and its in a glass bottle with a dropper. i have never had a grease problem on the bottle itself. although i never get a full bottle i get half filled bottles because a full bottle tends to get cloudy on me, i don't think the cyclosporin has a very long shelf life., so the half bottle works better for us.

to answer the above post there is no cure for pannus, the best you can do is control it for the life of the dog. there haven't been any conclusive studies on why dogs get pannus, yes, gsd's seem to be targeted more than others. my thoughts is that it lies dormant as a weakness and certain issues could make it show up.
things that effect the immune system like vaccinations, lyme disease, etc.

debbie


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## JeanKBBMMMAAN

YES! Plastic bottle-the label slides off, the grease is everywhere. TJ it's not just us!

Now they are using the white bottle and not the clear so I can't even tell until I am almost done that I am-but with the other bottle I would watch the level go down way faster than seemed possible-I mean-2 total drops a day should last more than a month! 

Some plastic is porous, right? Maybe that is it? Maybe the glass bottles are the key. 

I feel like if it is coming out of the bottle somehow, I am losing a lot of money over time. And I don't like that thought. 

I am very glad I asked because I know when I call them (I am not sure if they have a lot of customers using this stuff) they are going to think I am being dramatic (WHO? ME?). I am going to bring it in with me though when I pick up my refill. Actually, I think my one vet uses it...hmmmm...















Bear! 

Between those appointments katieliz was the dog treated for Plasmoma. Do you have pictures?


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## debbiebrown

i thought most optimologists had the cyclosporin 2% specially made. i don't think it comes already made in the plastic bottles, does it? i have always gotten the glass from my OP. and yes, plastic can seep and leak. i like the glass much better. and yes, you are loosing money. god knows the stuff is not cheap to begin with, or at least mine isn't. i would find out about it.
i often wondered if the human eye med (restasis) would be comparable to the cyclosprin we get for out dogs. i do get toby's FML from a friend that works at a human eye drs office, they have samples, which is awesome.

debbie


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## chjhu

My K9 ophtalmologist prescribed tacrolymus instead of the cyclosporin. They told me the effect is the same but it costs less. It was like water and lasted for quite a while.


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## middleofnowhere

Here's our experience:
The disease responds differently at different altitudes. (Less UV at sea level than at 6,000ft.) We used different drops because of this - milder drops at lower elevation to control the disease.
We had the white bottles for a while (2 different meds) then an even different med in the white bottle, now a mild med in a brown glass bottle. The tiny white bottles were pre-made; the brown bottle the pharmacy mixes. 
I refridgerate it to preserve it.


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## amackinpitt

> Quote:i thought most optimologists had the cyclosporin 2% specially made.


Yes, Bear's is made for her by a local company.


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## katieliz

yes jean, she was briefly treated with cyclosporine between those two appointments (which were maybe six months apart), she hated the cyclosporine drops and it was looking like she was having some kind of reaction (greenish discharge...allergy to the carrier oil, concurrent bacterial infection from some kind of immune suppression from the cyclosporine, ???), never did figure it out, but that's when i decided to take her to ophthy at MSU for a second opinion (specialty clinic where i first took her, who gave me the original dx of plasmoma, was recommended by the local vet). 

ophthy at MSU said they found no evidence of plasmoma but diagnosed her with ckc, unknown etiology, only possibility they suggested was drug reaction, although there was no history of her having had any of the drugs known to cause ckc, though she had done a course of oral antibiotics for a uti in the interim (not sulfa). so they (MSU) prescribe eyewash to clean, artificial tear gel, cyclosporine again to possibly re-initiate tear production...then we get the greenish discharge again, local vet prescribes neopolybax,..okay, by this time all i have to do is open the pantry door where the meds are kept and SHE'S GONE. at this point i'm just trying to keep them clean and use the artificial tears. 

while using the cyclosporine her symptoms would be a sticky, pearly white goo that would accumulate in the inner corners of her eyes, stringy and easily removed. then it would become the greenish discharge, rx with the neopolybax, now she has crusty residue at the outer corners of her eyes, hard to get off, dark in color, sometimes greenish, oh and her little eyebrow "bumps" are swollen and kinda irritated looking (pink under the hair). don't know what conclusion to come to, except i'm totally confused. and she's a good girl but her patience for the eye meds is gone.

pictures to follow soon. (thanks all for your opinions.)


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## middleofnowhere

How I conditioned my dog for eye drops. First thing in the morning both dogs sit by the door on command, the eldest gets her eye drops and everyone gets the reward of being released into the yard. It immediately took the dog's attention off the sting of the eye drops.


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## debbiebrown

some dogs can be very allergic to certain eye drops. i think the biggest reason is the additives and preservatives, etc.
toby had red irritated areas around his eyes when we first started with the basic steroid drops, then we changed to the FML, and haven't had any problems since. he never had a problem with the cyclosporin drops.
i do notice that when i apply the cylosporin the eyes aren't clear, but when i apply the FML the eyes get clear.
the cycolsporin doesn't seem to sting his eyes, but the FML, seems to for a minute or two. but, i agree with middle, after application i take his mind off it with treats.

debbie


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## JeanKBBMMMAAN

What is the FML? Is it for pannus/plasmoma?

katieliz-Bella's cyclosporin is mixed with corn oil and when I wasn't being careful she'd rub and had some hair loss. Luckily she is not allergic. I know someone who has to do these drops themselves and said yes, they are very sting-y. Plus if you are having a reaction to them like your dog you would definitely want to avoid them. I actually am allergic to a certain abx eye drop-so it can be the filler or the actual medicine. Those are my only thoughts on that.







I hope something can be figured out though-weird, weird, weird. 

I have no idea where her eye drops are coming from-other than my vet office. So what should I be asking them I wonder. I go on Monday. 

Mom-tacrolymus is more expensive here. That's weird...but that is something that can also be used for this condition-but if it lasts longer and is a cleaner drop? That would be nice.


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## debbiebrown

i don't know where the vets get their eye drops, but i do know most of the optimologists have things specially made, probably because dogs can have allergic reations to certain bases of the eye drops.
back when we first discovered toby had pannus our regular vets had 1% cyclosporin ointment, which really was a hassel to get the ointment in the eye. when we saw the optimologist he said 1 % cyclosporin wasn't enough to keep the pannus at bay. so, thats when we started getting the 2% cyclosporin from the OP. and since then we just order it from him.

FML, is fluorometholone drops, its a steroid drop, but dogs tend to have less allergies to it. vs, the regular steroid drops that probably the vet gives out.

debbie


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## katieliz

need to correct a mistake...the dry eye condition sera-girl has been dx with by msu is kcs (keratoconjunctivitis sicca). end of the week brain freeze i guess. 

got some good pictures of her eyes, will post a link tomorrow.

would anyone else have wondered if plasmoma was an incorrect diagnosis by the specialty clinic who first saw her?

cyclosporine ophthy meds are usually made by a compounding pharmacy. the specialty clinic (and msu, of course), have in-house compounding. most local vets order over the internet, although there are more and more compounding pharmacies all the time. i've not heard of the fml but i'll have to check into that. sometimes i just think when you're giving multiple meds it's so hard to figure out what's causing what. and i've never been totally comfortable with that first diagnosis of plasmoma. cause i've just never talked to anybody who's heard of it going away, and i have a hard time accepting that a subsequent diagnosis by michigan state would be wrong, and they say she does not have plasmoma. when i asked them point blank if the specialty clinic could have mis-diagnosed, all they would say is, "we can't say what her condition was when they saw her", when i asked them if plasmoma ever goes away, their answer was "no". so what other conclusion can i come to? what would you think? 

picture link to follow tomorrow.


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## katieliz

link for pictures of sera's eyes:

http://seras-eyes.blogspot.com


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## JeanKBBMMMAAN

http://www.upei.ca/~cidd/Diseases/ocular%20disorders/keratoconjunctivitis%20sicca%20.htm

http://www.veterinarypartner.com/Content.plx?P=A&A=1326

Huh-I don't know, katieliz, that is weird. Pretty pictures! I see a little extra 3rd eyelid-does everyone else see that? 

I am looking for the pictures of when Bella was diagnosed-she was in a major flareup. EEK! 

I took the bottle in to show my vet today-it was all slimey-he thinks it was that bottle, I said I don't knowwwwww...then he gave me a free bottle so I just shut up.







I *can* be bought, SO easily! 

Here's what Bella's plasmoma looked like-I have more pictures of it, but I think this will give you an idea-let katieliz know if you can if that's about what you were seeing in your dogs.


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## debbiebrown

i am not sure Sera's got pannus, unless its early. its not the way typical pannus starts out. although they all can be different. don't forget there are two different kinds of pannus. third eyelid pannus and regular pannus which the cells grow on the eye itself.

usually early signs of pannus are cloudy eyes, maybe an opaque film over them. Sera's eyes don't look like that. but i can't see the thrird eyelid real well in the pictures.

debbie


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## katieliz

to summarize:

sera's initial diagnosis from the original specialty clinic where she was first seen for her symptoms (very red conjunctivitis, discharge), was plasmoma, i.e., pannus of the third eyelid.

her subsequent diagnosis six months later (with very minimal treatment in the meantime with cyclosporine) from michigan state university department of ophthalmology was cks, canine keratoconjunctivitis sicca (no tear production, inflamed conjunctiva, discharge...cause unknown, possibly drug reaction), no evidence of plasmoma.

opinions on which of the following might be realistic to believe happened please:

1) plasmoma was somehow reversed, or went into some sort of remission situation, by the short course of cyclosporine therapy.

2) first diagnosis of plasmoma was incorrect.

3) some other explanation...

thanks!


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## katieliz

ps...the thought just hit me...did i hijack this thread? sometimes net et escapes me! 'scuse me if i did!


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## debbiebrown

it could have been any of the above as far as any answers to the dogs original diagnosis. i think it will be a pretty good indication if it flares up again, and or is a cronic issue. pannus does not go away, so maybe the short term med did help, but pannus dogs really need lifetime management with eye meds. although alot of other eye issues could need lifetime attention with meds as well.
keep an eye on it, if it flares up again, i would get another opinion from an optimologist.

debbie


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## katieliz

re flares up again, she's always symptomatic. there are no better ophthy docs in michigan than msu dept of ophthalmology. for third opinion i'd have to go out of state.

thanks all.


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## debbiebrown

well, if these specialists are right, i would think they would have recommended ongoing eye meds to help prevent things from progressing any further.
hopefully, you can find some answers.

debbie


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## katieliz

that's the question i've not been able to answer...what is the correct diagnosis. both recommend ongoing eye meds, just differing courses and for differing conditions. it's so hard to know what the right treatment is when you're not comfortable that you know the correct diagnosis. 

about the ongoing meds...are cyclosporine drops an immunosuppressant and could using them contribute to the onset of bacterial infection. and, do you know if plasmoma (pannus of the third eyelid) and canine keratoconjunctivitis (dry eye), can both exist at the same time?


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## Julie'somom

I have been treating 4 year old Julie's pannus for nearly one year now with Cyclospone in a tube. I buy it from Entirely Pets. Julie has no problem with me putting this ointment into her eye. She sits and I put my one hand under her muzzle and the other places the ointment in. She has never acted like it bothers her. I don't enjoy this but I do love the dog. So we keep it up. I would really hate it if it bothered her.

julies'omom


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## katieliz

wow, thanks so much julie'somom for posting about the entirely pets site. what great prices they have! jean, cyclosporine ointment in a tube for less than $24./tube! that might solve the problem of the possibly leaking plastic bottle (and get back to the original question of the thread too!).


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## debbiebrown

the only problem with eye ointment is its only 1% cycolsporin, which isn't enough to address the problem correctly, according to my optimologist, also i don't like the idea of having to use my finger to apply ointments since there is a chance of getting bacteria into the eye, plus the hassel of getting it in properly. the drops are much more effective.

i don't know about long term use of cyclosporin and bacterial issues, i have never had any problems with toby, and he's been on it for 7 years now.

my question is why didn't they suggest steroid drops, since that is usually the proticol with cyclosporin when addressing pannus, or such flare ups., especially if there is redness present.

if its an issue with low tear production, you can also use regular peoples lubricating eye drops., and i would for a precaution.

i would say that both issues could very well be present at the same time, since those symptoms usually go together.

debbie


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## katieliz

no debbieb, that's what i found so interesting about the entirely pets site...it's optimmune and it's .2%. check it out and see what you think.

can you tell me what is the pharmaceutical name for "steroid drops", or are they just called steroid drops. i've not heard of those, but i'm relatively new to these eye problems.

i'm using gel tears regularly (several times a day and at night), and keeping her eyes clean, but there's still something going on. 

and thanks so much for the input.


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## jecg

“For those of you (and I know you are out there) who are giving your Pannus/Plasmoma dogs cyclosporine”


Can I join the group? Quid was diagnosed with Pannus last week. 

I was given Optimmune, 2% cyclosporine in a tube. 
It looks like the same ointment that Julie’somom posted from Entirely Pets. 

I squeeze 1/4 inch in each eye, twice a day. (every 12 hours) It’s easy to do, and so far, no “yuck factor” LOL 

Hopefully, the ointment will work and I won’t have to deal with the messy white bottle! 

Thanks for starting this thread.

Jennifer


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## debbiebrown

i a glad you are using the 2% cyclosporin.

there are different steroid drops. the regular drops from the vet are called steroid drops, the optimologist has different emulsions and kinds of steroid drops which are more tolerable for some dogs that might be allergic to the bases of some steroids. i use FML drops or fluorometholone. my dog was allergic to the regular steroid drops this FML i have had no problems with, and its from the optimologist. i actually see a bigger difference using the FML it clears up the eyes much better than the cyclosporin. although i have to use both regularly.

debbie


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## katieliz

jecg, is it 2% or .2%? thanks.


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## jecg

Ooops, sorry. It’s 0.2% cyclosporin. 

Thanks Debbie. He’s my first shepherd with eye problems, so I have a lot to learn. They said that the Optimmune might not be the answer, but they wanted to try it first. I’ve added the name of your FML drops to my long, long list of questions.

Thanks again,

Jennifer


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## debbiebrown

no problem!

keep us posted.


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## jecg

The Optimune appears to be working for Quid. (Fingers still crossed) He has “dry eye” and CSK. 

Two and a half weeks after starting Optimune, he was tested again with the “litmus paper” test. (Can’t remember the real name) It showed that one eye had gone up 8 points the other 6. The redness is gone from the whites of his eyes and the brown pigment is shrinking.

My vet was very pleased and said that Quid’s improvement had made his day! I guess I’m feeling cautiously optimistic. It almost seems too easy. I was all set to drive him to Tufts to see an ophthalmologist. 

Below are two pictures of my very biddable Quidditch wearing his doggles. So far, the longest I have had him wear them is about 5 minutes. I’m hoping that by the time winter/snow comes he will be comfortable in them for 30 minutes. 

And yes, he can catch his soccer ball with his doggles on!!! 

Jennifer

PS The family is not allowed to laugh at him...


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## debbiebrown

what a cool dude!









my toby wears them too! he has the harley goggles, very similar.

glad the drops are helping!


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