Optimmune SID

Re: Optimmune SID

Glenn Hodgson — Fri, 21 Sep 2012 15:23:07 GMT

Thanks for your thoughts all.

I particularly like "Murphy's law of compliance".

I'll stick to prescribing BID as a routine but useful to know experiences on SID, wont discount SID if the discussion arises.

Re: Optimmune SID

Bob Russell — Fri, 21 Sep 2012 15:10:50 GMT

I would be pretty impressed to find my clients were genuinely using it once daily! Some make a tube last an insane amount of time but surprise, surprise STT results are disappointing or the client drops off the face of the map for months until the dog comes back 10 times worse!

Re: Optimmune SID

patrick murphy — Fri, 21 Sep 2012 15:09:05 GMT

eye vet clinic used to have a good section on there web site that I felt increased compliance and did explain why drug is darn expensive, and how to eck it out

Re: Optimmune SID

Hannah Wynne Richards — Fri, 21 Sep 2012 14:30:38 GMT

Iain -and you then tell them to give digitalis tid,and that's the one owner who does exactly what he/she is told

Wynne

Re: Optimmune SID

toby travis — Thu, 20 Sep 2012 17:35:39 GMT

One ophthalmologist told me it usually works for about 18 hours, hence BID is better (especially to prevent longer term progression of the condition) although you will obviously get plenty of dogs where SID appears to work fine.

Re: Optimmune SID

Rob Loxley — Thu, 20 Sep 2012 17:01:24 GMT

Reducing to SID can appear very cost effective if it adequately controls the underlying problem, but I have one case where poor compliance over a number of years (as far as I can tell, though it might have happened anyway...) has led to ongoing tear gland destruction to the point where neither optimmune BID nor tacrolimus would get any tear production, and it's had to go off for PDT.
I'd try to keep on BID unless finances are such an issue to absolutely preclude and ongoing monitoring is very close.

Re: Optimmune SID

Iain McAllister — Thu, 20 Sep 2012 15:55:43 GMT

I always apply Murphy's Law of Client Compliance - tell them to do it 3 x day they will do it 2 x day tell them to do it 2 x day they do it once a day etc etc -

...so tell them to do it once a day...

I would stick to bid - a lot of the clients would reduce the dose even further if you give them the "idea" that the dose can be reduced - the problem with KCS is that visual exam can be very misleading - have seen a lot of quite normal looking eyes come up with with low STT scores

Re: Optimmune SID

Martin Atkinson — Thu, 20 Sep 2012 14:15:07 GMT

[quote user="Stephen Courtney"]Also using it once a day means the tubes last longer than 28 days...is a calculated risk. Personally I would just use up each tube quite happily but i am a maverick on use by issues.[/quote] Given Schering Plough/Intervet said that Optimmune was safe to use for at least 6 weeks when it had a supply crisis speaks volumes!

Re: Optimmune SID

Stephen Courtney — Thu, 20 Sep 2012 14:09:43 GMT

^^ Concur with Mr A

You have to do regular STTs though because requirements can creep up.

The clients motive is usually to save money and this can mean reluctance to have things checked / do what they are told etc.

Also using it once a day means the tubes last longer than 28 days...is a calculated risk. Personally I would just use up each tube quite happily but i am a maverick on use by issues.

Re: Optimmune SID

Martin Atkinson — Thu, 20 Sep 2012 14:03:36 GMT

Yes in cases where I've improved the STT to near normal 12-15, I may well reduce it to sid but monitor.