Comprehensive Guide to Pannus (German Shepherd Keratitis) in Dogs

English translation of the Rex Specs Blog " A Comprehensive Guide to Pannus in Dogs , July 06, 2017"

by AKF Medical Language Services

"Since publishing our first article on German Shepherd Keratitis in dogs, many dog ​​owners have shared their stories of dealing with German Shepherd Keratitis/ Pannus in their own dogs. While everyone has their own story, one comment we hear over and over again is, "I just wish I had known what it was sooner so I could have taken precautions." Yes, we know the feeling - our own little spinner Tuckerman (German Shepherd mix) developed pannus at age 2. And while many of us may be frustrated that we didn't know sooner, we can still help inform others and spread the word so that German Shepherd Keratitis becomes as well known among dog owners as, say, tick checking. So get to work! But first, a disclaimer: If you suspect your dog may have German Shepherd Keratitis , please make an appointment with your veterinarian or veterinary eye specialist to get the correct diagnosis. Keratitis is easily confused with numerous other eye conditions, all of which require different treatment; the only safe way is to seek professional medical care.

What is German Shepherd Keratitis ( keratitis superficialis chronica) ?

Pannus, also known as chronic superficial keratitis (CSC) or German Shepherd keratitis, is an autoimmune disease of the cornea (the clear part of the eye). If left untreated, the damage can become so severe that vision is severely impaired or the dog becomes blind.

OK, so what exactly is an autoimmune disease? Our immune system (and your dog's too) has the job of keeping us healthy: It fights infections and tries to protect the body. However, there are some diseases (actually, more than 80 are currently known) that are referred to as autoimmune diseases. Essentially, it's about the immune system being misled and mistakenly attacking healthy cells. This means that the immune system doesn't attack the "bad" cells, but normal, healthy cells. The job of the immune system is to monitor all healthy cells so that it knows when foreign cells are entering the body. In autoimmune diseases, the immune system is disrupted and unintentionally damages healthy parts of the body.

Unfortunately, there is no definitive answer to the question of what causes autoimmune diseases. Let's look at some possible causes one by one; however, the official scientific answer at this time is "We don't know. "

German Shepherd Keratitis is a progressive disease, but it can progress more or less rapidly depending on many factors, especially genetic predisposition and UV exposure. Therefore, it is important to detect the disease as soon as possible and begin treatment .

While it's often thought that keratitis is common in German Shepherds, Greyhounds, and some other breeds due to a hereditary predisposition, it's important to remember that other dogs can't be affected. Pannus can occur in any breed and in dogs of any size.

What causes German Shepherd Keratitis?

As previously stated, we currently don't know exactly what causes autoimmune diseases . There is evidence that some breeds, such as German Shepherds, Border Collies, and Greyhounds, have a hereditary predisposition to developing German Shepherd keratitis.

Veterinarians and scientists agree that the disease is worsened by increased exposure to UV light and may also be a triggering factor. Dogs living at higher altitudes are more susceptible to the disease due to increased UV radiation.

There are also studies suggesting that environmental allergens can cause some dogs to experience some kind of allergic reaction with the cornea. Additionally, some holistic doctors and therapists treat keratitis with dietary interventions, arguing that there may be a connection between food allergies and disease progression. However, this has not been scientifically proven .

How do I recognize German Shepherd Keratitis in my dog?

While it is helpful to be able to recognize keratitis or at least have a suspected diagnosis of the dog's eye disease, the only sure way is to see a veterinarian or veterinary ophthalmologist for professional care . According to Dr. Cassandra Bliss, pannus is easily confused with other eye problems, such as keratoconjunctivitis (also known as "dry eye"), Dr. Bliss runs Bliss Animal Eye Care in Central Point, Oregon (Disclaimer: We are huge fans of Dr. Bliss and have written a hunting article about her and her award-winning bird hunting dogs).

There are a few common signs to look for in your dog that may indicate a diagnosis of German Shepherd Keratitis. Because the disease affects the cornea, changes in pigmentation (the coloring matter in the eye) typically occur. You'll notice cloudiness and often visible blood vessels in the cornea. With pannus, this change usually begins at the outer edge of the cornea and then spreads inward. If you look at your dog's face and imagine the eye as a clock, you'll most often notice these changes at the 3:00 and 9:00 o'clock positions.

In case you didn't know, dogs have a third eyelid (we humans only have two) that serves several purposes. These include removing mucus from the cornea, protecting the cornea, and producing one-third of the tears in dogs. If you look closely at your dog's eye, you'll see this third eyelid (also called the nictitating membrane) in the nasal corner of the eye (see image 5, image taken from http://www.animalplanet.com/pets/healthy-pets/why-do-dogs-have-a-third-eyelid/).

Dr. Bliss writes in her blog, "Redness, thickening, and loss of pigment of the third eyelid are features of a subclass of CSC [pannus] called plasmoma." Excessive mucus discharge from the eye can sometimes be a sign of a plasmoma. So, again, seek specialist evaluation.

It's especially important to watch for these signs during the summer or if your dog spends a lot of time outdoors. "I see more cases during the summer," agrees Dr. Bliss. "UV exposure certainly plays a role . I always check my CSC [pannus] patients in the spring to determine how they fared over the winter and then discuss any changes in treatment frequency; I repeat this in the fall to ensure there hasn't been any deterioration during the summer and the disease is well controlled."

Dogs who live and play at higher elevations should also be carefully monitored. As discussed in our previous article on Pannus, dogs who live at higher elevations or spend time outdoors can sometimes be much more difficult to treat. This doesn't mean you need to relocate to a lower-elevation area, but it does mean you should take additional precautions in addition to carefully monitoring your dog's eyes.

If you notice any of the signs described above in your dog, please schedule an appointment with your veterinarian as soon as possible. Without treatment, the immune system will continue to attack the cornea, causing scar tissue to form. This can lead to severe vision impairment and ultimately blindness.

What treatment options are available?

There is no cure for German Shepherd Keratitis, but there are several treatment options.

• The most common treatment is medication to control blood vessel growth and clouding. These anti-inflammatory drugs usually include corticosteroids, tacrolimus or ciclosporin. They are most often given in the form of eye drops, but there are also ointments or even injections. These drugs must be given for life, but the amount can usually be reduced over time.

• Share your experiences with us! Many veterinarians now recommend using Rex Specs in conjunction with medication to prevent the condition from worsening. See below for more information from dog owners who have used Rex Specs and found that using the glasses significantly reduced the amount of eye drops needed to control pannus.

• In severe cases, your dog may need surgery to remove or reduce the scarring and pigmentation in the cornea that are causing the visual impairment . It's important to note that this does not cure the condition and is likely to recur if other treatment options are not continued after surgery.

• There are some cases where a change in diet, along with conventional treatment (medication), has reportedly slowed the progression of keratitis . In all the cases we've read about, treatment also includes an anti-inflammatory diet or the evaluation of food allergies that could be contributing to the progression of the disease. We're not experts, and you should discuss this with your veterinarian, but here are a few references for you to consider:
• Dr. Cathy Alinovi, specialist in holistic animal health (we have no connection with Dr. Alinovi)
• Dr. Jeffrey Feinman, who suggests supplements as part of a homeopathic approach in an article for Dogs Naturally Magazine (https://www.dogsnaturallymagazine.com/holistic-care-of-pannus/) (we have no affiliation with Dr. Feinman).

Is Rex Specs really helpful in preventing German Shepherd Keratitis?

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While we try to avoid blatant self-promotion for the Rex Specs, the truth is that we developed them specifically to combat keratitis in our German Shepherd mix, Tuckermann. Since then, many veterinarians and dog owners have told us that the glasses are a vital tool for preventing and treating pannus. Here are a few more testimonials from customers who have purchased our glasses as part of their treatment plan:

• "Our German Shepherd has pannus, and all the vets have said the problem would be solved if we moved away from Denver (which is quite high up). But we don't want to move, so we need the Rex Specs. Our eye vet was thrilled at the annual checkup and said he wishes all his clients were this well. Drops twice a day and glasses when he's outside during the day." - Jodi from Colorado, USA

 

• "Johan now, a year after we found the Rex Specs. A few spots are still there, but the corneas are crystal clear, and we've been able to reduce the frequency of eye drops to once every three days (originally, we were using two to three times a day before the Rex Specs). It really makes a difference. Thank you." - Cheryl

 

• "I LOVE Rex Specs!! I won't lie and admit I hesitated for a few days before deciding when I saw the price. And now I'm so glad I bought them for my boy!!! The price doesn't seem high when you open the package and see the quality. And once you put them on your dog, you wonder why you ever had any doubts! I will have a pair of Rex Specs for every dog ​​that comes into my life again. Lance can finally have fun outside in the sun, and I don't have to worry about his eyes getting sunburned. Thanks so much, Rex Specs K9, for such a fantastic product!" - Kaitlyn

 

• Three years ago, Kane was diagnosed with atypical pannus. This is especially bad in Colorado because of our very high UV levels, and the higher elevation is an additional risk factor. Since Kane's diagnosis, I've tried various types of eye protection, but they all broke easily and nothing fit him properly. Last weekend, Kane made his first appearance wearing the Rex Specs at the water jumping event in Deadwood, South Dakota, USA. Although he needs more practice jumping with the goggles, he accepted them without issue, and I'm very pleased with the fit and comfort while jumping. We also made sure to inform spectators that these aren't just a fashion accessory, although he does look really stylish in them. I can't wait to use them when we go running together and whenever he's outside. I'll also show them to Kane's veterinary eye doctor so he can pass the information on to other clients." - Heather from Colorado, USA

 

• "We have been using your product for about a year now. The glasses were recommended to us by our dog's eye vet because he had no pigment in and around the eyelid. I work in the field of visual rehabilitation and was immediately hooked!! We followed your protocol and after about 4 weeks Bogey was wearing the glasses with the mirrored lenses. I find the glasses to be an excellent way to educate people not only about our own eye health but also that of our dogs!" - Sharon

Translation from English by

First, talk to your veterinarian to get as much information about pannus as possible. And then, if YOUR dog has pannus, share your story in the comments. Your experience can help others! Here are a few more links if you want to know more.

L INKS