Latanoprost in dogs

Re: Latanoprost in dogs

Robert Lowe — Fri, 11 Oct 2013 16:39:09 GMT

[quote user="robloxley"]

[quote user="Robert Lowe"] treatment with topical carbonic anhydrase inhibitors and prostaglandin analogues according to manual. i.e. dorzolamide tid / brinzolamide bid and latanoprost or travoprost bid[/quote]

So would you always use a combination of latanoprost AND dorzolamide (or similar) together, longterm?

[/quote]

For cases where a single drug won't control the glaucoma then yes absolutely. We have plenty of cases on combination brinzolamide/timolol and travoprost twice daily. (Some might be on 3-4x daily) We tailor medication to the intraocular pressure and if above 15mmHg at a review then increase frequency or add a drug type in. My target intraocular pressure is 10-12.

If we are failing to control effectively on medication then we look at surgical intervention but that is another topic altogether.

Re: Latanoprost in dogs

Rob Loxley — Fri, 11 Oct 2013 13:43:11 GMT

So would you always use a combination of latanoprost AND dorzolamide (or similar) together, longterm?

Re: Latanoprost in dogs

Robert Lowe — Thu, 10 Oct 2013 23:14:00 GMT

This is my approximate algorithm for emergency glaucoma. Feel free to pick and choose. Bearing in mind that most glaucoma is much more chronic than we realise.

1. Glaucoma confirmed on tonometry.

2. Assess visual responses - specifically presence of dazzle and consensual pupillary light reflex.

3. Assess other eye. Most cases I see the effort needs to be made on the second eye as the first is too far gone

4. Rule out lens luxation, intraocular tumour based on exam, signalment

5. If lens luxation then surgery

6. If not lens luxation my next thought is vision salvage and comfort. However once the pupil is constricted on topical prostaglandin analogues then assessment of the posterior segment is more awkward.

7. Prostaglandin analogue every 15 minutes for 1 hour and monitor pressures.

8. If pressure not back to <25mmHg after 1 hour then alternative treatment. We needle decompress rather than Mannitol but that is personal preference. (If finances are tight then you can skip this step as if non responsive to Step 9 then not going to be good outcome anyway). I really don't care if the eye is uveitic as although the prostaglandin analogue does induce a mild uveitis the eye is not going to be lost because of a minor increase in inflammation. It will be lost if the pressure is not reduced.

9. Start treatment with topical carbonic anhydrase inhibitors and prostaglandin analogues according to manual. i.e. dorzolamide tid / brinzolamide bid and latanoprost or travoprost bid,

10. Work up for underlying cause of glaucoma

11. Cross fingers.

Re: Latanoprost in dogs

Martin Atkinson — Thu, 10 Oct 2013 18:29:35 GMT

Also have used this for ongoing treatment for glaucoma on the advice of an ophthalmologist and works well. Maybe not quite the holy grail but something that seems to work better than pissing in the eye which most things don't!

Re: Latanoprost in dogs

Rob Loxley — Thu, 10 Oct 2013 17:06:50 GMT

Works very well, avoid if anterior luxation. Buy the generic stuff, way cheaper than Xalatan.