Got a hold of Rubys emerg exam papers...questions for you - Golden Retrievers : Golden Retriever Dog Forums
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post #1 of 13 (permalink) Old 12-28-2012, 03:24 AM Thread Starter
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Got a hold of Rubys emerg exam papers...questions for you

Okay, I checked over her paperwork that the emerg clinic emailed me. Theres two things I wanted opinions on.

Her tonometry results were

Pressure in OD (right eye) is 28mm repeat since high variation, on repeat it was 26mm

OS (left eye) was 19mm

Now, she told me her right eye was still within normal limits but I am reading normal is up to 25mm. She explained that her increased pressure could be from the ulcers on her eyes and the irritation. The notes also said Scope: retina NSF, Chambers clear, Iris a bit irritated but OD has no precipitates, surface of OD has two focal spots--rule out scarring, active ulcer.alert att, nice dog.. EENT WNL except OD is sclera congested, resists exam here, conjunctivae and third eyelid
inflamed, normal palpebral and menace, PLR. (not sure what the resists exam means as I never resisted anything)

rule out scarring, ulcer, immune/KCS, early glaucoma, anterior uveitis (mild)
infectious, sequestrum etc.

Now, her Schirmer test for her tears

OD (right eye) was 14mm in 1 minute
OS (left eye) was 17mm in 1 minute.

Vet paper work said both eyes were WNL (within normal limit) but, having Lincoln who has dry eye as well as Pannus/Plasmosa in both eyes I have experience. 10-14mm in 1 minute is borderline dry. 15mm and up is normal tear production and 10mm and below is severe dry eye.

Now, the diagnosed on the form was:

CORNEAL ULCER
EPISCLERITIS-injection

She only gave me a bottle of Tobrex for her corneal ulcers. Never gave me anything for the other condition

My questions are...

Should I push to re test her tears production and treat if its 14mm and below? because this is her second round of ulcers in 3 months. If her eye is dry, that could be whats causing it. She does get a lot of hair in her eye so that could be taking away moisture but I do my best to clean her eyes twice daily.
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post #2 of 13 (permalink) Old 12-28-2012, 02:28 PM
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Pretty sure the "resists exam" is not you, but that Ruby wasn't thrilled with them messing with her sore eye. The episcleritis is likely because of the corneal ulcer, not really a separate issue, so should resolve when the ulcers resolve. I would have her pressures and schirmer's retested once the eyes are healed.

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post #3 of 13 (permalink) Old 12-28-2012, 05:11 PM Thread Starter
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Originally Posted by IowaGold View Post
Pretty sure the "resists exam" is not you, but that Ruby wasn't thrilled with them messing with her sore eye. The episcleritis is likely because of the corneal ulcer, not really a separate issue, so should resolve when the ulcers resolve. I would have her pressures and schirmer's retested once the eyes are healed.
She was perfect for the exam the vet even said she was one of the best patients shes had . She didnt growl, snap, bite nothing. She was all over the vet asking for love. She may of flinched a couple times but if someone was poking and pushing on my ulcerated eye I think I would flinch a bit...oh well

Anyway, for the pressure, I cannot do that for another month or so because my clinic does not have the equipment to do so and in order for me to have to do that I would need to get it done at a clinic who has one. They would want me to pay an exam and the test so thats going to be about $200 to do. So that one may need to wait a bit. The vet said her chambers or whatever in the eye were clear and looked good and that she said it likely was not glaucoma and it could be the inflammation from the ulcer. Will call around to see what vets carry the thingy to test for that.

When I go in next week I was planning on retesting her tears and check the ulcer with the stain. If her tear test falls between 10mm-14mm again should I push to treat it as dry eye?
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post #4 of 13 (permalink) Old 12-28-2012, 06:21 PM
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I would recheck once her eye is healed. I hope Ruby is back to normal soon.

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post #5 of 13 (permalink) Old 12-28-2012, 07:03 PM
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I agree, treat her for dry eye if it is in that range....

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I agree, treat her for dry eye if it is in that range....
Okay, thanks. I just wanted to make sure I was doing the right thing. I wonder if the ulcers shes been getting is from dry eye. I know her hair tends to get onto her eye and that must be taking away some moisture though I do my best to keep her eye clear.

What about her IOP? It was 28mm but the second time was 26mm. She does not show other symptoms of glaucoma. Her eyes are clear etc. She said the iris was a bit irritated. I did find a clinic that was willing to just allow us to use their tonometry pen to recheck her pressure and charge only that so $80. But we still dont have the money for that for at least another month. We will be paying $50 to redo the eye stain and tear test, plus we need another $55 to recheck her liver values and possibly an additional $66 to test for Cushings. Then any meds additional. So I need to figure out whats priority and whats not right now .
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post #7 of 13 (permalink) Old 12-28-2012, 08:28 PM
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Frequently ulcers are related to dry eyes...

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Originally Posted by Sally's Mom View Post
Frequently ulcers are related to dry eyes...
So should I retest her tears or just go ahead with treatment? I just dont want to test her tears and it be normal that time I test but its not normal any other time
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post #9 of 13 (permalink) Old 12-29-2012, 02:54 PM
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What I understand from what I was taught is that "normal" tear production for an at risk breed should be higher than a breed not at risk. So where 15 might be considered fine for one of my Goldens, you might like it to be higher in a bulgy eyed shih tzu(for example).

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post #10 of 13 (permalink) Old 12-29-2012, 03:06 PM Thread Starter
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Originally Posted by Sally's Mom View Post
What I understand from what I was taught is that "normal" tear production for an at risk breed should be higher than a breed not at risk. So where 15 might be considered fine for one of my Goldens, you might like it to be higher in a bulgy eyed shih tzu(for example).
Okay, so I may just go ahead and treat her for dry eye. I do not wish to risk anything. What is the common treatment for that? Lincolns on Optimmune but he is on it for Pannus it just so happens to work for low tear production but is there anything to give for just the tears aspect? Her eye looks like its healing, against the light I do not see indents anymore it looks a bit raised/glassy (sealed) and shes no longer squinting. Her eye is still red though...it comes and goes with the redness
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