Entropion

Re: Entropion

Braden Collins — Wed, 13 May 2015 02:46:40 GMT

As Martin said, dump these clients. They are going to cause you so many headaches that they won't be worth any money you get out of them. If there is permanent corneal damage, you won't make them happy whatever you do.

Re: Entropion

Martin Atkinson — Tue, 12 May 2015 10:03:49 GMT

In answer to your question: when it needs doing.

However Kirsten, this sounds like the dog and client from hell - well a normal Shar Pei and owner then! Why do dick-head clients with no money always get high maintenance pets? (answers on a postcard). Life is too short for this and I would be heading them towards the door permanently.

Option one (easy option): tell them it is beyond your area of expertise and offer to make a referral which of course will be very expensive, with a bit of luck they then will go somewhere else.

Option two (the more satisfying one): tell them that it is clear that they don't have faith in your ability and that you cannot work with them if they don't allow you to do your job properly so they are better finding another vet. Do it by letter if you can't summon the balls to do it face to face.

Either way, bye bye.

Re: Entropion

Kirsten Simpson — Tue, 12 May 2015 09:18:38 GMT

Sorry to hijack this thread!

History - saw a 4 month old Shar Pei with heavy facial folds, checked eyes then, fluoro -ve, heavy skin but not touching eyes just yet, adv to O may need tacking +/- entropion in the future but to keep an eye on things and come back asap if any signs pain etc. Saw him back at 6 months old, severe blepharospasm in both eyes, epiphora, L eye worse than R, couldn't even visualise the eyes to stain them, adv tacking as still young (and has grown quite a bit). Tacking done, dogs eyes looking better, but corneas quite damaged by now owner now complaining that her pal got her dogs entropion operated on at 8 weeks old so why tacking til older then surgery (I suspect her "pals" shar pei was tacked at 8 weeks thus fixing the problem before it really started, wheras this hasn't). I was always taught that Entropion was best to do when near a year old (depending on the breed) and with his eyes and the fact he has grown so much in 2 months, I'd be loathe to operate on him til he was older. He is a nice dog but was super aggressive immediately post op (dog catcher to kennels). We haven't seen these clients before until 2 months ago with this pup, they are a little...dodgy...don't make post op check appointments, don't turn up for surgery, don't ring to tell us these things until we listen, and don't have much money at all.

What age does everyone else do entropion?

Re: Entropion

Gareth C. — Fri, 08 Aug 2014 16:41:22 GMT

atropine itself will reduce salivation, but the eye drops are very bitter and trigger salivation +++ if run down the n-l duct into the pharynx.

you can (accidently) create quite a Halloween monster by giving a cat flourescein then atropine. I cant remember the case details but the fountains of green froth emenating from the cat's mouth was spectacular.

Re: Entropion

Martin Atkinson — Fri, 08 Aug 2014 14:19:11 GMT

[quote user="mariette asselbergs"]The only problem was salivation as side effect. [/quote]Odd that as I occasionally give atropine to reduce salivation in a drooling animal.

As for the OP I would just get on do the surgery. I agree its a bit of an art getting right it but I had one Sharpei owner say to me after her dog's surgery was so successful that when she needed a face lift for the bags under her eyes she would come to me!

Re: Entropion

Ida Louise Gilbert — Thu, 07 Aug 2014 21:46:17 GMT

Atropine is a cycloplegic, which relieves ciliary spasm. It will therefore give indirect pain-relief, but it is not a local anaesthetic per se. It is only useful as an analgesic when the pupil is miotic therefore. Atropine should be used to effect only (ie to achieve and maintain mydriasis), but avoid in KCS cases. So in other words, a drop of atropine can give considerable relief in an entropion case if there is trichiasis/corneal ulceration and reflex uveitis/miosis. I hope that helps clarify!

Re: Entropion

Emily Rainbow — Thu, 07 Aug 2014 18:01:49 GMT

It's used in horses with ERU to prevent miosis which is perceived to be painful?

Re: Entropion

mariette asselbergs — Thu, 07 Aug 2014 17:04:34 GMT

Taught by Frans Stades, European Specialist in Ophthalmology, you can Google him.

Mariette

Re: Entropion

mariette asselbergs — Thu, 07 Aug 2014 17:00:04 GMT

Atropine drops for eyes " I assume that's tongue in cheek or a wind up? " No no, seriously, we were taught that it was the first line anaesthetic for sore eyes. If necessary in combination with antibiotic eye ointment. The only problem was salivation as side effect.

Mariette

Re: Entropion

Gareth C. — Thu, 07 Aug 2014 16:25:03 GMT

I did my spaniel when spayed her at about a yr. Spaniel do get entropian.

Re: Entropion

Michael Woodhouse — Thu, 07 Aug 2014 13:41:10 GMT

Taking sutures seemed to irritate so took them out, let skin settle down and operated today.

Re: Entropion

Anthony Todd — Tue, 29 Jul 2014 17:52:24 GMT

[quote user="mariette asselbergs"]

Anthony,

in your "olden days" did you use atropine drop for that? We were taught that in Holland, but nobody uses atropine as a sort of local anaesthetic nowadays.

Mariette

[/quote]

I assume that's tongue in cheek or a wind up? I thought vet training in Holland was excellent, the dairy vets I worked with in Manaia knew their stuff.

Mind you standards can drop.

Re: Entropion

mariette asselbergs — Tue, 29 Jul 2014 17:39:37 GMT

Anthony,

in your "olden days" did you use atropine drop for that? We were taught that in Holland, but nobody uses atropine as a sort of local anaesthetic nowadays.

Mariette

Re: Entropion

Anthony Todd — Mon, 28 Jul 2014 18:14:35 GMT

[quote user="Michael Woodhouse"]Appreciate all replies[/quote]

Trouble is entropion is sort of self-exaggerating in that the pain of the contact of hair etc. with the cornea makes the dog close the eyes more firmly thereby rolling the eyelids in more, aided by the gripping effect of the hair and eyelashes on the cornea.

What a blood hound breeder and I found was that if you have the time and patience [Michael, you may] and just roll the eyelids out as often as you can the condition sometimes disappears.

Test it; hold the lids under tension and you'll find they'll close with no "entropion".

Sort of manual, intermittent, tacking sutures if you like....

One time where steroids are a total waste of time; local anaesthetic might be more effective in that it would reduce or eliminate the "clenching" of the lids as there'd be no pain.

Re: Entropion

Michael Woodhouse — Mon, 28 Jul 2014 14:02:43 GMT

Two tacking sutures done on both eyes. Will see how she goes and if it recurs I have no problem operating - would just rather not if I don't need to!

Appreciate all replies

(I used 3 metric monofillament nylon - not sure what I should have used)

Re: Entropion

ChrisBVSc — Mon, 28 Jul 2014 13:00:19 GMT

Just to hijack this thread slightly (although hopefully in a useful way Michael!) what are peoples preferences on how long to leave temporary tacking sutures in, and do you have a suture material of choice? Just out of interest as I rarely have to do them (we don't seem to get many affected dogs).

Re: Entropion

Robert Lowe — Mon, 28 Jul 2014 08:57:00 GMT

Sounds like she has been borderline entropion for a while and 10 days ago the lids rolled in enough to cause a conjunctivitis or a bout of conjunctivitis tipped the eyelids over. However the predilection for entropion is there and at 11 months old I would reach for the scapel blade rather than temporary tacking sutures as a more guaranteed fix. However, Braden's advice is also sensible as the scarring from tacking sutures may be enough to hold the eyelids in place long-term.

Re: Entropion

Braden Collins — Sun, 27 Jul 2014 23:35:03 GMT

If she hasn't had entropion before I would start off with some temporary everting sutures to ensure it's not a secondary enropion.