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               Canine Pannus               

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chronic superficial keratitis is a progressive cellular infiltration with vascularization and eventually pigmentation of the cornea that usually commences at the temporal (lateral) quadrant and advances towards the center. The whole cornea may become involved. It occurs in dogs, particularly German shepherd dogs. The cause is unknown, but exposure to ultraviolet light may be a factor. Cellular infiltrates suggest immune mechanisms are involved in the pathogenesis. Called also CSK, degenerative pannus, Uberreiter's syndrome
http://medical-dictionary.thefreedictionary.com/interstitial+keratitis

German Shepherd Pannus is a non painful, autoimmune disease of the cornea and conjunctiva of both eyes. Small white opacities appear on the surface of the cornea, often in both eyes and will slowly enlarge and become more opaque. Changes deep in the cornea as well as the third eyelid may occur in time. Sometimes chronic irritation may produce a similar lesion, but these tend to resolve and not recur when treated. Diagnosis is based on direct examination.  Affected dogs suffer from a misdirected immune response to their own corneas that manifests itself as blood vessels, pigmentation, and scar tissue in the cornea. Over a period of time, the normally clear corneas opacify, and some dogs eventually go blind.

Approximately 90% of dogs diagnosed with pannus are German shepherds. Other affected breeds include Belgian tervuerens, Siberian huskies, border collies, and greyhounds, although other breeds may be affected.

Pannus cannot be cured and for this reason, the key to the long-term preservation of vision is faithful, uninterrupted medication of the eyes and regular evaluations by a veterinarian.  The corneas will clear significantly after 1-2 months of diligent eye drop application. Some dogs respond best to corticosteroid eyedrops, while others respond best to cylosporine ointment. More severe cases require treatment with both types of eye drops.  Additionally, your dog may require a corticosteroid injection around the eye to augment your eye drop treatments.

If the eye drop treatments fail, your dog may benefit from a local application of Beta-Radiation with or without surgical excision of the corneal scar tissue. Under a general anesthesia, a radioactive probe is placed upon the cornea, and a specified dose is delivered. The remainder of the eye and body is unaffected due to the poor penetration of the low energy beta particles. Beta radiation will not cure pannus, but in most cases will augment your efforts with the eye drops. Beta radiation slightly injures the normal cornea. Thus, a dog may withstand 2-3 applications over a lifetime. For this reason, beta radiation is reserved for the dog who fails maximal medical treatment.

The most important factor in preserving your dog's vision is diligent, uninterrupted eye drop treatments.





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What is Pannus?
Chronic Superficial Keratitis

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What is pannus?

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related terms: chronic superficial keratitis (CSK), German shepherd pannus, Uberreiter's syndrome
Pannus, or chronic superficial keratitis, is a condition of ongoing inflammation of the cornea (the surface of the eye). Pannus begins as a grayishpannus haze. Gradually blood vessels and pigmented cells move into the normally transparent cornea. As the inflammatory changes spread across the cornea, vision is affected. The condition gradually worsens and usually affects both eyes.

In atypical pannus, the third eyelid is affected rather than the cornea. This is most common in German shepherds.

Pannus appears to be caused by an inappropriate response of the immune system. It occurs more frequently and is harder to control in dogs that live at high altitudes and/or are exposed to increased levels of ultraviolet radiation.

How is pannus inherited?
The mode of inheritance is unknown.

What breeds are affected by pannus?
This condition is seen most often in purebred and crossbred German shepherds and in the Belgian Tervuren.  It also occurs in the Belgian sheepdog, border collie, dachshund, greyhound and Siberian husky

This is a disorder primarily of middle-aged dogs (4 to 7 years) and there is an increased incidence in dogs that live at high altitudes and/or are exposed to increased levels of ultraviolet radiation.

For many breeds and many disorders, the studies to determine the mode of inheritance or the frequency in the breed have not been carried out, or are inconclusive. We have listed breeds for which there is a consensus among those investigating in this field and among veterinary practitioners, that the condition is significant in this breed.

What does pannus mean to your dog & you?
If untreated, the blood vessels and inflammatory cells will spread over your dog's normally transparent cornea, gradually darkening and scarring it, and causing visual impairment. This can occur slowly over months or years, or it can occur rapidly to involve the whole cornea within a few months. The condition does not appear to be painful.

Lifelong treatment is required to control this disorder (see below). Usually pannus can be well-controlled, although it is harder to control in dogs living at high altitudes (above 1500 metres). Sometimes lesions will worsen in periods of environmental irritation or increased ultraviolet exposure, or if medication is given irregularly.

How is pannus diagnosed?
Diagnosis is made based on the signalment (breed and history) and the typical changes in your dog's cornea.

FOR THE VETERINARIAN: You will see bilateral lesions consisting of vascularization, pigmentation, or a combination - usually starting in the temporal or inferiotemporal quadrant and progressing centrally.  Atypical pannus may affect the nictitating membrane without affecting the cornea. The leading edge of the nictitans is depigmented and the palpebral surface is red and thickened. Treatment is similar to that for typical CSK.

How is pannus treated?
Usually pannus can be well-controlled. However treatment must be lifelong and consistent, or the lesions will return and worsen.

The goal of treatment is to prevent vision loss, or to return as much vision as possible if there is loss. This is done with the use of anti-inflammatory drops in the eye. Drugs used alone or in combination include corticosteroids and cyclosporin A. Your veterinarian will make specific treatment recommendations based on the severity of the changes to your dog's eyes, and the response to therapy. Usually therapy begins with 4 treatments a day. As the size of the area affected decreases, treatments will be decreased to the lowest frequency that controls the condition.

Once effective treatment is established, your veterinarian will evaluate any changes once or twice a year, or if you notice a worsening of the condition as may occur in periods of environmental irritation or increased ultraviolet exposure.

Breeding advice
Affected dogs should not be used for breeding. Breeding of close relatives should be avoided as well.
FOR MORE INFORMATION ABOUT THIS DISORDER, PLEASE SEE YOUR VETERINARIAN.

Where to find more information?
Roberts, S.M. 1995. Pannus. In J.D. Bonagura and R.W. Kirk (eds.). Kirk's Current Veterinary Therapy XII Small Animal Practice. p. 1245-1248. W.B. Saunders Co., Toronto.  - This has good information on treatment, including for advanced or refractory lesions.
Copyright © 1998 Canine Inherited Disorders Database. All rights reserved. Revised: April 11, 2000.
reprinted with kind permission from:-
 Alice Crook, DVM,Coordinator, Sir James Dunn Animal Welfare Centre, Atlantic Veterinary College,University of Prince Edward Island, 550 University Ave.Charlottetown, PEI C1A 4P3
http://www.upei.ca/cidd
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CHRONIC SUPERFICIAL KERATITIS

(PANNUS)

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This information is provided by Provet for educational purposes only.
You should seek the advice of your veterinarian if your pet is ill as only he or she can correctly advise on the diagnosis and recommend the treatment that is most appropriate for your pet.
Note for Pet Owners:
Always give the medications that your veterinarian has prescribed at the correct dose and at the correct times
The condition may not be confirmed as genetically inherited in your animal - but you should assume that it could be, and so you must prevent your animal from mating and passing on the defect to another generation.

Topics on this Page:
Description
Cause
Breed Occurrence
Age
Signs
Treatment

Description
Both eyes are affected with this condition which looks like a fleshy growth or pigmented growth on the surface of the cornea. Sometimes a lot of small new blood vessels can be seen growing across the cornea (called neovascularisation) . The growing lesion is slowly progressive and can become pigmented with black melanin.

Cause
Unknown but it is thought to be an autoimmune disease in which the animals own immune system reacts against something in the surface of the eye (the cornea) causing inflammation.

Breed Occurence
Pannus is most often seen in German Shepherd Dogs, but it also occurs in Greyhounds and Border Collies, as well as crossbred offspring derived from these breeds. There may therefore be a genetically inherited predisposition for the condition in certain lines in these breeds.

Age
The disease usually occurs during the middle of adult life - when the dog is 3-7 years of age.

Signs
The lesions look unsightly but many dogs show no signs of discomfort and there is usually no discharge from the eyes. Vision can be impaired if the lesion covers a large area of the corneal surface of the eye.

Treatment
Because the underlying cause of the disease is not known the condition is likely to recur even if it responds initially to treatment. Initial treatment is usually medical involving the administration of anti-inflammatory drugs such as corticosteroids (by injection or administration onto the surface of the eye). Recently success has been claimed for the use of cyclosporin.

If the cornea becomes heavily pigmented the area may have to be removed by superficial keratectomy to restore sight.
Copyright (c) 1999 - 2009 Provet. All rights reserved. mailto:info@provet.co.uk   
reprinted with kind permission from Mike Davies Provet Limited

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German Shepherd Pannus Pannus Pannus
 Chronic superficial keratitis
Pannus
 Pannus
 Pannus
 Corneal Inflammation in The GSD


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The above information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinarian for confirmation of any diagnosis. Your pets life may depend on it.