Eye ulcer not getting better

Hi
We've got an elderly bun who has had an eye ulcer for weeks now.
Vet started her with clinagel. No improvement so moved to Exocin eye drops & corneal gel. After a week of that vet said it had gone.
But then it came back, did 5 more days of Exocin before next vet trip. She wasn t happy with it so has put her on serum drops. It's day 3 of the serum and it just looks worse today.

Has anyone had any success treating eye ulcers?

Hi Squizz, I had one like this several years ago in an elderly bun. It went on for weeks and weeks, eventually I got a referral to an ophthalmology specialist and he diagnosed dry eye - basically her tear production had stopped working properly because of her age, so her cornea kept on getting ulcered. He said you can use all the antibiotics in the world and it will never clear up until you also treat the underlying cause - otherwise it's like watering a plant but keeping it in a cupboard...you could water it as much as you like but it still won't grow because it doesn't have other things it needs like daylight. He added hyabak eye drops to the treatment regime (you have to give these or similar drops half hr after the antibiotics otherwise they'll coat the cornea and the abx won't get to where they need to) and it cleared up lovely. The eye drops were for the rest of her life. I think there is an animal version now, called something like remend. I see you're in Essex, it might be worth getting your vet to do you a referral to Martin Lawton in Harold Wood, he is both an exotics and an ophthalmology expert so he has all the right equipment to do a really thorough look and diagnosis. All the best.

Santa said:

Hi Squizz, I had one like this several years ago in an elderly bun. It went on for weeks and weeks, eventually I got a referral to an ophthalmology specialist and he diagnosed dry eye - basically her tear production had stopped working properly because of her age, so her cornea kept on getting ulcered. He said you can use all the antibiotics in the world and it will never clear up until you also treat the underlying cause - otherwise it's like watering a plant but keeping it in a cupboard...you could water it as much as you like but it still won't grow because it doesn't have other things it needs like daylight. He added hyabak eye drops to the treatment regime (you have to give these or similar drops half hr after the antibiotics otherwise they'll coat the cornea and the abx won't get to where they need to) and it cleared up lovely. The eye drops were for the rest of her life. I think there is an animal version now, called something like remend. I see you're in Essex, it might be worth getting your vet to do you a referral to Martin Lawton in Harold Wood, he is both an exotics and an ophthalmology expert so he has all the right equipment to do a really thorough look and diagnosis. All the best.

Click to expand...

http://www.animeddirect.co.uk/remend-dry-eye-lubricant-drops-10ml.html

Thank you so much for your replies. I will order the Remend and see if I can get a referral to Harold wood.
Poor old bun, she really does seem to get all the ailments.

Could tear duct problems be related to abscesses? She's had one on her jaw line that the vets been keeping an eye on. Plus she has dental issues, for some reason she lost her bottom teeth so now I have to get her top teeth trimmed regularly.

Squizz said:

Thank you so much for your replies. I will order the Remend and see if I can get a referral to Harold wood.
Poor old bun, she really does seem to get all the ailments.

Could tear duct problems be related to abscesses? She's had one on her jaw line that the vets been keeping an eye on. Plus she has dental issues, for some reason she lost her bottom teeth so now I have to get her top teeth trimmed regularly.

Click to expand...

Has your Vet taken skull radiographs to determine the exact extent of the tooth root/abscess problems ?

If the tooth roots become elongated then they can press on the nasolacrimal ducts (tear ducts) which prevents the ducts from draining. So the Rabbit has constantly 'runny eyes'. The ducts can also become infected and the eye discharge then becomes creamy as opposed to watery and antibiotic treatment is then needed.

Dental abscesses occur as a result of infection in a tooth root. Elongated tooth roots are more likely to lead to the development of an abscess. So yes, it is possible that tear duct problems and Dental abscesses are related.

This is an informative article about Dental Disease in Rabbits :

http://www.medirabbit.com/EN/Dental_diseases/Differential/Rabbit_dentistry.pdf

Thanks for the link, that is an interesting article. I think all her issues must be linked. Including the mysterious disappearance of her lower teeth.

She is nearly 10 and already disabled from EC. Im reluctant to put her through too many procedures and tests. I think a proper radiograph of the jaw might be worthwhile though.

Thinking further about the Remend drops..im guessing that's what the cornea gel my vet gave me is for, as I have to put that in 20 minutes after the eye drops. But if I can order Remend on line that will be an easier alternative.

What's the name of the gel you've got? It possibly is something similar. I tried other artificial tears but had much better results with the hyabak. Although it's thinner drops so doesn't seem as if it will work as well, it really does! If you're not that far from Lawton's, I'd say it's probably worth a visit. When I went to see him, the consultation was a good 45 mins or so long and he covered pretty much everything during it. He's got all the fancy equipment to take a detailed look in their eyes without being invasive or requiring sedative or similar, so it's not too stressful for the bun and could make life a lot easier if he can work out what is going on.

Does your bun get gloopy, gunky eyes sometimes, as that could well be related to tooth roots.

Santa said:

What's the name of the gel you've got? It possibly is something similar. I tried other artificial tears but had much better results with the hyabak. Although it's thinner drops so doesn't seem as if it will work as well, it really does! If you're not that far from Lawton's, I'd say it's probably worth a visit. When I went to see him, the consultation was a good 45 mins or so long and he covered pretty much everything during it. He's got all the fancy equipment to take a detailed look in their eyes without being invasive or requiring sedative or similar, so it's not too stressful for the bun and could make life a lot easier if he can work out what is going on.

Does your bun get gloopy, gunky eyes sometimes, as that could well be related to tooth roots.

Click to expand...

A few years ago didn't William Lewis do some research into Rabbits with exposure to EC and a link with Dental Disease ?

ETA- Yep, in 2010 in the Veterinary Record. Access to the article has to be paid for unless you are a VR subscriber

http://veterinaryrecord.bmj.com/content/166/26/832.2

Santa said:

What's the name of the gel you've got? It possibly is something similar. I tried other artificial tears but had much better results with the hyabak. Although it's thinner drops so doesn't seem as if it will work as well, it really does! If you're not that far from Lawton's, I'd say it's probably worth a visit. When I went to see him, the consultation was a good 45 mins or so long and he covered pretty much everything during it. He's got all the fancy equipment to take a detailed look in their eyes without being invasive or requiring sedative or similar, so it's not too stressful for the bun and could make life a lot easier if he can work out what is going on.

Does your bun get gloopy, gunky eyes sometimes, as that could well be related to tooth roots.

Click to expand...

I am so ditzy!! I just looked at the cornea gel....its called Remend! I hadn't even noticed name on it I thought it just had corneal on the tube. It's quite a thick gel, easier to get in her Eye than drops which sometimes bounce out.

I'm not particularly near Harold Wood...but it's not a problem to get there. Do you know if have to have a referral or if you can book to see him directly?

I can't read the full article..but the fact that one has been written suggests there must be a pattern of this happening.

Santa said:

Does your bun get gloopy, gunky eyes sometimes, as that could well be related to tooth roots.

Click to expand...

Yes, but only one eye. The eye that is the side of the access on her jaw. It was the gunky eye that first alerted me to the problem. At that stage the vet diagnosed blocked year ducts but the ulcer wasn't picked up (she may not have had it yet)

Squizz said:

Yes, but only one eye. The eye that is the side of the access on her jaw. It was the gunky eye that first alerted me to the problem. At that stage the vet diagnosed blocked year ducts but the ulcer wasn't picked up (she may not have had it yet)

Click to expand...

Obviously without full diagnostics (ie skull radiographs) it's impossible to say for sure but it sounds as though all the eye problems are linked to Dental Disease.

This link provides information about corneal ulcers

*Warning- Some Graphic Images*

http://www.medirabbit.com/EN/Eye_diseases/Disorder/Ulcer/Ulc_en.htm

Squizz said:

I'm not particularly near Harold Wood...but it's not a problem to get there. Do you know if have to have a referral or if you can book to see him directly?

Click to expand...

You'd need a referral, he's very particular about following the correct protocol on that - not least because he wants the full relevant veterinary history transferred across. He'd normally be able to fit you in within a few days but with Christmas coming up that could well take a bit longer. How funny that you've already got the remend! I wonder if Lawton uses that now it exists or whether he still goes off-label to other products. He's very experienced with eyes so will know what the most appropriate product will be for whatever the situation is found to be.

Hi:wave:

I have an elder bun who is 12 and has complicated glaucoma and now also has reoccurring ulcers in both eyes - these ulcers do change in that they come and go and change in shape. He is under midland ophthalmic vets and is prescribed metcam, false tears, Hycare gel which is the same make up as Remend and chloramphenicol - he has had ointment and drops for chloramphenicol - but is presently on drops which in his case do seem to work better even though they are reduced strength to the ointment and I find the drops easier to apply.

My bunny is monitored and has regular check ups with the ophthalmic vet and in his case as there is no connection with teeth issues we have found that contact lenses have helped his ulcers - with a bad flare up he has them in for around 4 weeks ish.

Eye ulcers can be very painful so worth checking correct levels of metcam is provided for pain relief.

Good luck with your bunny and I hope your able to get to the bottom of the cause as I think this greatly helps with your options going forward.

Hope this helps.

:wave:

Contact lenses?? Human ones? I've never heard of This!! Sounds interesting. Is it hard to get them in?

My bun is currently on some serum...I have no idea what it is except that my vet made it up with blood from her dog to make it more effective?! I'm not seeing any improvement with it, and it's been a week. I've still got the antibiotic drops so might go back to them.

I wondered about pain relief. My vet (who I do rate) hasn't suggested it. I've got metacam in so can give her some. And will mention it on our next check up.

Santa said:

You'd need a referral, he's very particular about following the correct protocol on that - not least because he wants the full relevant veterinary history transferred across. He'd normally be able to fit you in within a few days but with Christmas coming up that could well take a bit longer. How funny that you've already got the remend! I wonder if Lawton uses that now it exists or whether he still goes off-label to other products. He's very experienced with eyes so will know what the most appropriate product will be for whatever the situation is found to be.

Click to expand...

Thank you. I will ask my vet then.

Squizz said:

Contact lenses?? Human ones? I've never heard of This!! Sounds interesting. Is it hard to get them in?

My bun is currently on some serum...I have no idea what it is except that my vet made it up with blood from her dog to make it more effective?! I'm not seeing any improvement with it, and it's been a week. I've still got the antibiotic drops so might go back to them.

I wondered about pain relief. My vet (who I do rate) hasn't suggested it. I've got metacam in so can give her some. And will mention it on our next check up.

Click to expand...

Not sure if you have already seen these:

http://cal.vet.upenn.edu/projects/ophthalmology/ophthalmo_files/Tools/ComplicatedUlcers.pdf

https://www.ncbi.nlm.nih.gov/pubmed/17324465

Thank you for those links jacks-Jane. The second article make a sense of the latest serum she's on. Sadly I think she will be in the group showing no improvement.