How Is Pannus Treated in Dogs?

Pannus otherwise known as Chronic Superficial Keratitis, is a progressive, immune-mediated condition that affects the cornea in dogs. Characterised by inflammation, pigmentation, and thickening of the corneal surface, this condition can cause discomfort, impair vision, and may lead to blindness if left untreated. While there’s no cure, regular and early treatment can significantly slow its progression, allowing your dog to maintain a comfortable, high-quality life.

In this article, we’ll explore the primary treatment options for pannus in dogs, including topical medications, immune-suppressing treatments, and potential surgical interventions. We’ll also cover long-term management strategies, the importance of protecting against UV exposure and maintaining regular veterinary care to help control symptoms.

1. Corticosteroid Eye Drops

Corticosteroid eye drops are typically the first line of treatment, effectively reducing inflammation and immune activity in the cornea. These drops work to minimise the swelling, redness, and cloudiness. 

Types of Corticosteroid Eye Drops:

• Prednisolone Acetate: A common corticosteroid prescribed for moderate to severe pannus cases.
• Dexamethasone: An alternative for dogs that may not respond well to prednisolone or experience side effects with it.

Administration: Corticosteroid eye drops are usually administered multiple times per day initially, with frequency tapering as the condition stabilises. The dosage and frequency will depend on the severity and your vet’s recommendation.

Possible Side Effects: While generally safe in the short term, long-term corticosteroid use can lead to side effects, including an increased risk of corneal thinning, ulcers, and secondary infections. Corticosteroids can also raise intraocular pressure, possibly leading to glaucoma, so regular check-ups are essential.

Long-term Management: Once your dog’’s pannus is under control, your vet may recommend tapering to the minimum effective dose to reduce side effects. For many dogs, corticosteroid eye drops become a lifelong requirement to maintain corneal health and control symptoms.

2. Cyclosporine and Tacrolimus Eye Drops

For long-term immune suppression, cyclosporine or tacrolimus eye drops can be used in dogs with pannus. These drugs directly target immune cells in the eye, helping to manage inflammation without the complications often associated with long-term corticosteroid use.

How Cyclosporine and Tacrolimus Work: Both medications work by suppressing the immune cells that attack the cornea, effectively slowing down the immune response without corticosteroid-related risks. Cyclosporine is typically the first choice, with tacrolimus reserved for cases where cyclosporine proves ineffective.

Administration: These drops are generally administered twice daily, though frequency can vary based on the dog’s response. Cyclosporine or tacrolimus may initially be used in combination with corticosteroid drops, with the corticosteroid dosage reduced gradually as the immune-suppressing treatment takes effect.

Possible Side Effects: While generally well tolerated, cyclosporine and tacrolimus can sometimes cause mild irritation or redness. They are, however, much safer for long-term use compared to corticosteroids and are often central to a successful pannus management plan.

Long-term Management: Cyclosporine and tacrolimus eye drops are often the cornerstone of pannus treatment, helping maintain symptom control. With consistent application, most dogs can live comfortably with manageable vision impairment.

3. Advanced Treatment Options

In rare cases, advanced interventions may be considered, particularly if other treatments have proven ineffective or if pannus has significantly impaired the dog’s vision. These procedures are generally reserved for severe cases to address complications rather than directly treating the underlying immune response.

Types of Procedures:

• Superficial Keratectomy: This procedure involves removing the outer corneal layer to reduce pigmentation and scarring. While it can improve comfort and vision, keratectomy doesn’t prevent future immune responses, so it’s typically combined with ongoing medical management.
• Cryotherapy: This involves the application of extreme cold therapy to remove affected corneal tissue. However, cryotherapy is less commonly performed due to its lower success rates and risks associated with corneal healing.

Risks and Considerations: Advanced procedures carry risks, including infection, corneal ulceration, and potential further vision complications. Post-operative recovery may require intensive care, with frequent check-ups to monitor healing. Most vets recommend exhausting all medical options before considering surgery.

Long-term Management: Advanced procedures do not eliminate the need for ongoing treatment, as pannus is an immune-mediated disease with the potential to recur. However, surgical intervention may improve comfort and vision, particularly when combined with medical therapy.
 

4. Long-Term Management Strategies

Lifelong management is essential for keeping pannus symptoms under control. Successful long-term care relies on establishing a consistent treatment routine, regular veterinary check-ups, and limiting UV exposure.

Creating a Treatment Routine: Consistency is key to successful management. Administer eye drops at the same times each day and keep your dog’s environment calm, as stress can sometimes exacerbate immune conditions. Keeping a calendar or setting phone reminders can help ensure you don’t miss a dose.

Avoiding UV Exposure: Exposure to ultraviolet light is known to worsen pannus symptoms. Minimising your dog’s time in bright sunlight can be helpful. Specialised dog sunglasses are available to provide UV protection, which is especially beneficial for high-risk breeds like German Shepherds, Greyhounds, and Border Collies.

Monitoring for Flare-Ups: Regular veterinary visits are essential for monitoring pannus, as symptoms may fluctuate over time. If you notice any changes in your dog’s eyes such as increased redness, cloudiness, or discomfort, contact your vet promptly. Early intervention during a flare-up can prevent complications and help maintain eye health.

5. Importance of Early Intervention and Regular Veterinary Care

Pannus is a progressive condition, making early diagnosis and intervention critical to preserving your dog’s vision. Regular veterinary check-ups are essential, especially in the early stages, when finding the right combination of treatments and dosages is crucial for symptom control.

With early and consistent treatment, many dogs maintain good vision throughout their lives. Delayed treatment, however, can lead to irreversible corneal changes and significant vision impairment.

Tips for Pet Owners Managing Pannus

• Stay Consistent: Adhering to the treatment plan is vital, even if symptoms appear under control. Stopping medication can cause rapid flare-ups, requiring stronger interventions to bring symptoms back under control.
• Prioritise Sun Protection: Minimise UV exposure whenever possible. Consider dog-specific sunglasses or limit outdoor time to early morning and late afternoon when UV levels are lower.
• Keep a Medication Log: Recording your dog’s medication schedule is useful, especially if your vet needs to make adjustments or if you’re monitoring for side effects.
• Follow-Up Visits: Routine veterinary visits allow early detection of progression or complications and enable your vet to adjust treatments as needed.

Conclusion

While pannus is a lifelong condition, consistent treatment and regular veterinary care allow most dogs to live comfortably with manageable vision. Medications such as corticosteroids, cyclosporine, and tacrolimus eye drops form the foundation of treatment, with surgery as a last resort in severe cases. By maintaining a treatment routine, protecting against UV exposure, and staying vigilant for signs of change, you can help manage pannus effectively. Early intervention, coupled with regular follow-ups, is essential to keep pannus under control and help preserve your dog’s vision for years to come.