Thoughts on a diabetic atopic westie with dry eye

RE: Thoughts on a diabetic atopic westie with dry eye

David Mills — Wed, 06 Jun 2018 19:42:17 GMT

Yep there are some papers out there showing insulin resistance with systemic Cyclosporine. I spoke to a tech dept about it and apparently not as bad as preds but still can be significant.

RE: Thoughts on a diabetic atopic westie with dry eye

Edward Jones — Wed, 06 Jun 2018 19:07:11 GMT

Sorry for the short message above, I was between consults. I've found the following in the Atopica datasheet:

"In laboratory animals, ciclosporin is liable to affect the circulating levels of insulin and to cause an increase in glycaemia. In the presence of suggestive signs of diabetes mellitus, the effect of treatment on glycaemia must be monitored. If signs of diabetes mellitus are observed following the use of the product, e.g. polyuria or polydipsia, the dose should be tapered or discontinued and veterinary care sought. The use of ciclosporin is not recommended in diabetic cats and dogs."

"Very rarely diabetes mellitus has been observed, reported mainly in West Highland White Terriers."

As I understand your post, this dog hasn't yet been on ciclosporine so it's certainly not caused the diabetes but it might worth consider the first part above.

RE: Thoughts on a diabetic atopic westie with dry eye

Anthony Dennison — Wed, 06 Jun 2018 10:12:40 GMT

[quote user="David Mills"]Re eyes, is it bilateral or unilateral?[/quote]

[quote user="Noweia"]t is left eye currently but had fluorescein in today to check for healing of an ulcer so didn't do STTs, may well be early dry eye on the right also.[/quote]

If it is unilateral, could it be related to the aural surgery? Damage of the facial nerve or the branch of the trigeminal (can't remember it's name...)

RE: Thoughts on a diabetic atopic westie with dry eye

KMurphy — Wed, 06 Jun 2018 09:45:12 GMT

I have a JRT patient with the same set of diseases! Cytopoint for skin, optimmune for eyes, caninsulin for diabetes. We manage (now much rarer) ear flare-ups with topical treatments including Cortavance and so far these haven't affected his diabetes.

RE: Thoughts on a diabetic atopic westie with dry eye

Edward Jones — Wed, 06 Jun 2018 09:42:27 GMT

Is there something in the Atopica datasheet about it's association with diabetes?

RE: Thoughts on a diabetic atopic westie with dry eye

Julie Innes — Wed, 06 Jun 2018 08:38:56 GMT

No great ideas, but commiserations as I've had to try to manage a fair few diabetic- atopic westies! I have used apoquel, and it didn't seem to interfere. Could you try just lubricating the eyes initially?

RE: Thoughts on a diabetic atopic westie with dry eye

Laurence Webb — Wed, 06 Jun 2018 08:01:43 GMT

I think that ciclosporine antagonises insulin, although nothing like glucocorticoids do, but could interfere with the diabetes a little.

RE: Thoughts on a diabetic atopic westie with dry eye

Gillian Mostyn — Wed, 06 Jun 2018 07:20:23 GMT

If funds allow might be worth giving cytopoint a try? No side effects so nothing to lose? I've only used it once and had a 100% success rate!

RE: Thoughts on a diabetic atopic westie with dry eye

Noweia — Tue, 05 Jun 2018 23:39:55 GMT

Thank you for your reply! It is left eye currently but had fluorescein in today to check for healing of an ulcer so didn't do STTs, may well be early dry eye on the right also.

RE: Thoughts on a diabetic atopic westie with dry eye

David Mills — Tue, 05 Jun 2018 23:31:18 GMT

Re eyes, is it bilateral or unilateral?

Cyclosporine will help in autoimmune kcs, bu lt unilateral may be something else.

Tear replacement is benign and can be effective. Viscotears during day, lacrilube at night. Likewise some pred forte which can be lacrimogenic