Natural treatments for immune mediated keratitis in a dog

[GinnyW]

We received this diagnosis for Yuji last week; he had issues dating back a year stemming from a foreign matter issue that went through three (not too slick) vets and left him with a cloudy cornea. The specialist we finally got to see has put him on Pred and Tacrolimus. I am not pleased. I had recently cleared an infective-looking condition with remedies, and was improving cloudiness with an NAC formula I have used for years. I don't want to believe he will need to be on an AB forever; just isn't right. There can't be anything here that is not also systemic and which cannot be touched by systemic remedies. Right? Right? BTW, he can see just fine, and the occlusion is minimal presently. But we can't risk his vision. So, use the drugs? Go back in six weeks as scheduled? Get him on the right systemic remedy? Anybody dealt with this before?

 

[Dr. Jeff]

Thanks for asking Ginny!

The first questions are about Yuji's BEAM, modalities and concomitants.

Also, please tell us more about what happened a year ago and what has been going on with his eye for the past year? How much pigment is visible on his cornea?

Is he on anti-biotics as well as the anti-inflammatories (pred and tacrolimus)?

Would you upload some eye pics and the eye docs. report?

Yes, there are always ways to stimulate healing by his vital force.

Yes, follow the eye docs recommendations until he heals homeopathically.

As his keratitis improves, you should be able to wean the meds.

Yes, this is a relatively common diagnosis and treatment FWIW.

 

[GinnyW]

Thanks for asking Ginny!

The first questions are about Yuji's BEAM, modalities and concomitants.

Also, please tell us more about what happened a year ago and what has been going on with his eye for the past year? How much pigment is visible on his cornea?

Is he on anti-biotics as well as the anti-inflammatories (pred and tacrolimus)?

Would you upload some eye pics and the eye docs. report?

Yes, there are always ways to stimulate healing by his vital force.

Yes, follow the eye docs recommendations until he heals homeopathically.

As his keratitis improves, you should be able to wean the meds.

Yes, this is a relatively common diagnosis and treatment FWIW.

Lots of this just went into my appointment questionnaire. BEAM is great! Over a year ago he got sand kicked in his face, originally, and a vet - no longer with the practice - cleaned him out and gave an ointment (which I have since learned is not recco'd for eyes these days) - it cleared, but then the eye continued to be irritated. I was advised to consult a nearby opthalmologist who treated him roughly but hosed the back of his eyeball and got more crap out. She gave her own formula of ofloxacin and HA. At this time the cornea was about 50% clouded, and I kept using the NAC drops along with the ABX. Once again, everything cleared and seemed healthy with no irritation, but months later the eye became inflamed, both the orb and the conjunctivae. I asked my dependable regular vet to look at it, and she immediately said we needed to see a specialist, and sent them all the files from all the vets. I had difficulty getting a timely appointment from the specialist, who was some distance away, and when they finally responded I judged this to no longer be an urgent situation - the reason being that my studies led me to dose with Hep Sulph, which very quickly cleared both the conjunctivae and the infective appearance of the eyeball. So, then a month later at the scheduled appointment this was the report:

<Puget Sound Veterinary Specialists
1730 Pottery Ave Suite #120 Port Orchard, WA 98366 (360) 871-9651
Immune Mediated Keratitis Discharge
Tuesday, February 23, 2021
Veterinarian: Danielle Boyd, DVM, MPH, DACVO
Yuji Wilken Ginny Wilken (360) 582-0688
Canine Terrier, AmericanStaffordshire Male 7 Yrs. 8 Mos. gwilken@fastmail.fm
Reason for Visit: Initial consultation for further evaluation of chronic inflammation OD and tearing OU.
Right Eye Diagnosis: Moderate immune mediated keratitis Left Eye Diagnosis: Moderate immune mediated keratitis
Instructions:
Please monitor for increased redness, squinting, cloudiness, discharge, or vision loss. If these develop please contact us immediately.
Medications:
**Please wait 5 minutes between eye drops and apply ointment (if applicable) after all drops have been administered.**
1. Tacrolimus 0.03% in MCT oil- Instill 1 drop in BOTH eyes every 12 hours until recheck. (Long-term medication) 2. Prednisolone Acetate 1%- Instill 1 drop in BOTH eyes every 12 hours for 2 weeks, THEN, instill 1 drop in BOTH
eyes every 24 hours until recheck.
Recheck:
Yuji is scheduled for a recheck exam with Dr. Boyd on Tuesday, April 20th, 2021 at 2:00 PM.
Discussion:
The cloudiness, discharge, and change in appearance in Yuji's eye is caused by immune mediated keratitis. This condition is characterized by multifocal subepithelial "white spots" distributed geographically around the cornea. Arborizing blood vessels are also present with immune mediated keratitis. The disease causes discomfort and often times corneal ulceration. Without treatment the condition can easily result in infection with secondary eye threatening infection.
This disease is a disease where the immune system attacks the cornea. Similar to other immune mediated diseases, the cause of the disease is unclear.
Our goal at this time is to control the keratitis with the above therapy. Provided this therapy is successful, we will then slowly decrease the level of therapy and determine the minimum level of medications required to prevent recurrence of the disease. Yuji's eye should become more comfortable and less cloudy during the next few weeks.
Control, not cure of the condition, is an important aspect to understand as most patients will require lifelong therapy. Please let me know if there is no improvement with this therapy or if Yuji is worsening.
Thank you for bringing Yuji in today. He is a very handsome boy and a pleasure to work with! I appreciate you entrusting me with his care. Please let me know if you have any questions or concerns prior to his next recheck.>

--at this time he is on the meds. Occlusion of the cornea is semi-transparent, covering the inside lower quadrant. It doesn't show straight-on but can be seen from an angle. It seems not to affect vision at all. Upon arising, the eye is a bit squinty, but soon is at full open, with no swelling of the tissues. Tacrolimus is an immunosuppressant; no ABX are being used at this time. No pics at this time; too hard for me - not a Smartphone user.

Thank you, and looking forward to my call with Christina.