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  #31  
Old 02-19-2015, 07:58 PM
jaw444 jaw444 is offline
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Default Re: Warning: Risk of Deafness from Ear Medications

Hi. I found this forum last night as i was googling hearing loss and ear medications because this has happened to my dog. My dog is Zack, a 9 year old Cavalier King Charles spaniel.

Googling led me to this thread, which i read through. I see that the main or only medication discussed here is gentamycin, an aminoglycoside.

My dog was given EKT 2 1/2 weeks ago. It is a triple medication including antibiotic, steroid and anti fungal. It was given in the form of a thick oil apparently plunged into his ear canals.

The antibiotic in EKT is enrofloxacin. It is a flouroquinolone, not an amino glycoside. The brand name is Baytril, made by the Bayer company.

The vet was treating Zack for a respiratory condition, for about 2 weeks at that point, Zack was taking two antibiotics and prednisone. One of the antibiotics was oral Baytril. Baytril is only for animals, not for humans, according to what i've read in the past couple of days.

I was going out of town, with Zack, by plane, on 1/30. On that morning he barfed his breakfast just after i gave him his three pills with Pill Pockets. He never barfs. It was emphasized to me that if he wanted to get over his "serious" (i am now questioning this after talking to another vet) respiratory condition, he must not stop taking his antibiotics until medically advised. So, i rescheduled my flight to the next day and took him to the vet.

The vet said the respiratory condition was doing really good. I could see that. He wasn't coughing at all anymore. He said the Clavamox caused the vomiting and he took him off it, continuing the Baytril and giving him a shot for an antibiotic called Convenia which he said would last for two weeks. He took Zack into the back to do X-rays to check his progress. i heard Zack shriek while i was waiting in the exam room. (btw, after reading up on Convenia, i would not consent to it, instead asking for a daily dosing medication because a medication that stays active in the body for 2 weeks does not give you the option to stop giving the medication if there is an adverse reaction. It was mainly invented to insure that doses would not be skipped. i don't tend to miss doses so for me, i don't see a reason for it).

when he brought Zack back to me, he said he had done something to his ears, i think. It's really foggy in my memory, so much was going on, and i said "Is that why he shrieked, and he said "no, that was the shot we gave him." And so then the subject was changed from the ears as he told me about the shot, and the ears didn't come back up. i just wish he had examined the ears when he was in the exam room with me and told me what he saw and what he wanted to do.

I went out of town to my daughter's with Zack for a week and we both kept noticing there was some kind of thick goop in his ears, and i didn't know what it was so i called the vet office. They looked at the chart and said it was BKT (same as EKT but the B is for Baytril, the brand name). I told them it was causing his hair to mat inside his ears and was greasy, a week after he got it. They said i could bring him in and they would wash it off.

I noticed while i was away that Zack's hearing seemed to not be as good as before, and i thought maybe it was from flying in the plane, though we had flown other times without that happening. He could still hear me if i called him or gave him a command, 'sit,' 'stay,' 'come.' But when i would walk by if he was sleeping he wouldn't wake up, which is very unusual. He just about always would wake up and follow me around if i walked past him when he was sleeping. I am not saying his hearing was perfectly fine before. i had noticed some hearing loss in previous years, showing up mainly in his not waking to noise when he was sleeping on his left side if i called him. And i believed that the right ear was not as good as the left. But that seemed to fluctuate and showed up sometimes more than others. Maybe it's that it was getting better over time. i wonder what caused it in the first place. I just thought it was aging, though he wasn't very old, 6? Now, after what is happening from BKT, i have to wonder.

When i got back from my trip, a week later, i took him in, choosing to see a different vet because of trust issues i was having with the first one, related to communication problems. I was supposed to bring him in after 2 weeks for a follow up on the respiratory thing. I told her the history when she asked why i was there, i told her i was there for a follow up. I told her the whole kind of odd story of the respiratory thing. She was examining him and was looking in his ears. I said that he had some goop in his ears and that i thought it was an antibiotic and i was told if i brought him in, they would wash it off. She said it was BKT.

She said they would wash it off. I said that since the goop was put in his ears, his hearing was not as good. It had been getting seemingly worse in the previous week. She immediately said, about the antibiotic he was given, "That causes temporary deafness." I asked "Will his hearing come back?" and she said yes. She also said she would not have given him that medication.

The next day, i was talking to neighbors who came to my front door. Zack ran out the door. He will run when he gets out, he doesn't just hang around, he takes off, he loves the feeling of freedom, and it used to be a major problem, but then he learned to respond to the Come command, so, i followed him, he was going fast, half way down the street, which is what he does. Usually if i yell "Zack, Come!," he stops in his tracks and turns around and comes running back, just as fast and happy as when going the other direction. this made me feel really good. But on that day, a couple of days ago, when i commanded him to come, he didn't hear me, he just kept going. That is not like him, he always comes. Always. He likes to come. He was trained with treats (by a pro, i had failed so i paid someone and it was worth every penny). So i watched him getting farther and farther away, and then he turned a corner and went out of sight, my neighbor ran after him. i'm recovering from major abdominal surgery so i wasn't able to do much. My neighbor said he caught up with Zack when he stopped to pee on something.

I am really mad about him being given this medication, without discussing it with me first, without telling me the risks and letting me have a role in the decision, i don't even know that there was anything wrong with his ears. The vet who saw him three days ago said his ears looked great. i told her that as far as i know, there wasn't anything wrong with his ears in the first place. At least, no one examined him in front of me and said "He has inflammation in his ears. We treat that with EKT. i need to tell you there are some risks but they are very rare." And then tell me about the ototoxicity and let me decide. Even if i didn't know about ototoxicity, if he hadn't told me, and maybe he doesn't know, i still would've said "He is already on 3 or 4 other antibiotics for the respiratory thing, is there anything urgent about the ear thing because i haven't noticed any ear symptoms," and i don't think he would've said it was urgent. Even if he had, i already had some trust issues related to the several interactions i had with him about the respiratory thing, and i am sure i would've said "First i want him to finish his treatment for the respiratory thing and then i will come back and see about the ears." because i don't like mixing a lot of potentially toxic medications and then not being able to know what is causing what, and how the meds interact, etc. But i never knew he was being given that medication, i wasn't told there was anything wrong with his ears, and it was just given to him and now he has major hearing loss. He's not totally deaf but if he's sleeping just a few feet away from me, if i call him, loudly, he doesn't hear me. His hearing is not functional if i can't call him when he is doing something he needs to stop, like running down the street, he could've run out into a busy street if he had turned the other way when he turned the corner.

So, i've been researching the medication he had and deafness caused by medications, and i found this page.

I wanted to share my experience so that others will know that there are other antibiotics, not aminoglycosides, that are toxic to the hearing nerve.

In reading about this, i was looking for some medical or scientific information about ototoxicity with this medication, and whether the hearing loss is temporary and what the prognosis is, and if it's temporary, how long? But i couldn't find anything like that, and there is very little on it. I wouldn't have a clue if that second vet hadn't said "it causes temporary deafness." I have found several sources on the web where hearing loss is mentioned as a side effect, just briefly, in blurbs about side effects on websites that sell it.

http://www.svpmeds.net/ekt.html

I was reading about flouroquinolones in general, including treatment of humans, to see if it there's info on ototoxicity. What i found is that it's considered to not be ototoxic in humans by the medical establishment, these are drugs like Cipro and Levaquin. They are touted as a safe alternative to gentamycin which they report has caused hearing damage. So now, they say, these quinolines can be used in ear drops. Also, mainly what i've read about gentamycin is it's usually said to be associated with perforated ear drum, but i am really doubtful about that. Would people know if their dog had a perforated ear drum? Anyway, there are websites discussing serious side effects of quinolines, which include tinnitus and hearing loss. I didn't find any that were scientific, it was people sharing experiences like here.

anyway, i am going to include a link i found on PubMed which is a site with lots of medical articles. i found one titled Ototoxicity in Dogs and Cats. It's old, 1993, but there were a couple of things i wanted to share.

One is that there was someone who posted on this thread who said she had read some place that taking aspirin might help restore the hearing and she tried it and it did seem to help. I was hopeful about that, i haven't had a chance to study it yet, but in this short abstract of the article i'll include a link to, they say that the toxicity seemed to be made worse when salicylic acid was given to the animal. I think Aspirin is salicylic acid, or that is a main component of it. I don't know what this means but the abstract says "...The administration of salicylates and loop diuretics may potentiate the action of ototoxins, especially aminoglycoside antibiotics, probably by increasing the levels of these toxins in the endolymphatic fluid…" I don't know what it means.

The other thing i wanted to share about it is that it says there is a possible treatment of the hearing loss if detected early. It says "...Early detection is especially important because early changes can sometimes be reversible. Cavinton (apovincaminic acid) and fosfomycin represent examples of experimental agents being evaluated in laboratory animals for application as potential treatments to limit the ototoxicity associated with various drugs…"

i need to keep studying this and maybe get Zack in to see a specialist if i can find one, someone who would know about treatment to reverse it. My daughter was doing a lot of googol research and she said one person reported their dog's hearing got better after 5 months.

http://www.ncbi.nlm.nih.gov/pubmed/8456203
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  #32  
Old 02-20-2015, 07:28 AM
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jesse girl jesse girl is offline
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Default Re: Warning: Risk of Deafness from Ear Medications

another thing you might take into consideration is the plane flight . if the ears were gunked up during the flight the pressure may not have been cleared on landing

if you ever went on a flight with ear or sinus problems and if the ears did not clear it could be a few days till hearing can come back

i have used a basic home remedy for jesse ears which is just vinegar and isopropyl alcohol . zymox has some useful products

i agree a vet needs to discuss with the animals caretaker before giving any medication or perform any procedure

hope your pups hearing returns soon
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  #33  
Old 03-07-2015, 07:19 AM
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Default Re: Warning: Risk of Deafness from Ear Medications

THANK YOU!!! I JUST TOSSED IT IN THE TRASH!!!
I only used it once. Thank god.
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  #34  
Old 08-23-2015, 10:08 PM
jaw444 jaw444 is offline
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Default Re: Warning: Risk of Deafness from Ear Medications

Jesse girl
thanks for the reply. i just discovered it. i know it's been many months. I have thought about the plane ride combining with the medication to damage my dog's hearing. They washed the stuff out of his ears at the vet.

He is still not hearing functionally. He can hear if i shout really loud. When i do it outside, at first he acts like he doest hear, probably to him it sounds like far away background noise. And when he does hear, even though i'm must feet away from him, behind him, he doesn't know where the sound is coming from.

he can't respond to verbal commands, the most important being come and stay. Stay can be given as a hand signal. But come is needed when he is running away with his back to me and he does not hear it at all. He was very responsive and obedient to 'come,' he would stop in his tracks and run back to me. Now, he appears to be a disobedient dog, but he just can't hear. He's at risk because of that, when he manages to slip outside unauthorized.

He's very cooperative and loves to please. It's so sad. I grieve every day. What i have lost is, what we have both lost, is me being able to talk to him. And him being able to enjoy and be stimulated by sounds. i live alone with him, and he was the only person i could talk to and i got a lot of pleasure and comfort from that. It's gone now. He can't hear me. He liked being talked to, he was comforted and enjoyed praise and obeyed commands and was reassured if i was leaving him temporarily.

He loved to run and bark at the doorbell, things like that. Now, he doesn't hear the doorbell. He used to run and bark at the door when a door bell would ring on the TV. This kind of thing stimulated him to be active. He would always wake from sleep if i got out of my chair and went anywhere and he would follow me. I know it doesn't sound like much but compared to how passive and inactive he is now, it was much more healthy for him, for his circulation and his joints and all those things that benefit from activity and movement. When we are out on daily walks, if another dog on the other side of the street is barking at him, as dogs sometimes do, he doesn't hear them, he doesn't know a dog is there. His experience has become so much more limited, things he used love are gone for him. I'm heartsick.

I was googling about what can done, to see if there could be any kind of treatment for lost hearing in a dog, depending on the cause. I learned that there are hearing aids for dogs. Only certain dogs are suitable candidates, some won't tolerate having something in their ear, and there is a training of both the dog and owner involved. I am in the process of trying to learn more about this. I want to find a dog hearing specialist in the area where i live, Los Angeles, but so far, from googling, i can't find anything. The only place i can find that specializes in this, in hearing aids for dogs and in testing and assessing hearing issues in dogs and other animals, is at the University of Cincinnati, it's called FETCHLab, Dr Scheifele, he's an MD with 30 years of experience in animal bio-acoustics. There's a full staff of audiologists and other experts, and they do a very in depth and advanced assessment. I'm not sure what that means, i put in a call to them yesterday, to try to find out more information and if it's realistic to look into this solution for Zack. I'm hoping they know of someone in my area that has experience and interest in this.

I learned there are also cochlear implants for dogs. Both of these treatments for deafness are expensive, but i don't have any recent information on that. I would really be happy if there as a way to help Zack have improved hearing. So i have to look into this. He has health insurance with good coverage--he can get up to $6000 for each disease category and he hasn't used any ENT coverage. i only have to pay a $100 deductible, but i have to pay up front and get reimbursed.
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  #35  
Old 08-24-2015, 06:13 AM
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Default Re: Warning: Risk of Deafness from Ear Medications

yes it would be nice to assess if there is any hearing present and if so what levels in each ear

your doing your research and you got the pet insurance i guess there is no rush . i guess hearing is very specialized for dogs because they cant tell you how much they can hear

we have seen a return of sight to pups why not hearing

anytime we loose a sense or something that may restrict it will be different . i do think they can read our lips and do get and understanding though our touch . it may never be the same but it finds a new path for both of you to explore together
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  #36  
Old 10-15-2015, 03:15 AM
minimay minimay is offline
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Default Re: Warning: Risk of Deafness from Ear Medications

Quote:
Originally Posted by jaw444 View Post
Hi. I found this forum last night as i was googling hearing loss and ear medications because this has happened to my dog. My dog is Zack, a 9 year old Cavalier King Charles spaniel.

Googling led me to this thread, which i read through. I see that the main or only medication discussed here is gentamycin, an aminoglycoside.

My dog was given EKT 2 1/2 weeks ago. It is a triple medication including antibiotic, steroid and anti fungal. It was given in the form of a thick oil apparently plunged into his ear canals.

The antibiotic in EKT is enrofloxacin. It is a flouroquinolone, not an amino glycoside. The brand name is Baytril, made by the Bayer company.

The vet was treating Zack for a respiratory condition, for about 2 weeks at that point, Zack was taking two antibiotics and prednisone. One of the antibiotics was oral Baytril. Baytril is only for animals, not for humans, according to what i've read in the past couple of days.

I was going out of town, with Zack, by plane, on 1/30. On that morning he barfed his breakfast just after i gave him his three pills with Pill Pockets. He never barfs. It was emphasized to me that if he wanted to get over his "serious" (i am now questioning this after talking to another vet) respiratory condition, he must not stop taking his antibiotics until medically advised. So, i rescheduled my flight to the next day and took him to the vet.

The vet said the respiratory condition was doing really good. I could see that. He wasn't coughing at all anymore. He said the Clavamox caused the vomiting and he took him off it, continuing the Baytril and giving him a shot for an antibiotic called Convenia which he said would last for two weeks. He took Zack into the back to do X-rays to check his progress. i heard Zack shriek while i was waiting in the exam room. (btw, after reading up on Convenia, i would not consent to it, instead asking for a daily dosing medication because a medication that stays active in the body for 2 weeks does not give you the option to stop giving the medication if there is an adverse reaction. It was mainly invented to insure that doses would not be skipped. i don't tend to miss doses so for me, i don't see a reason for it).

when he brought Zack back to me, he said he had done something to his ears, i think. It's really foggy in my memory, so much was going on, and i said "Is that why he shrieked, and he said "no, that was the shot we gave him." And so then the subject was changed from the ears as he told me about the shot, and the ears didn't come back up. i just wish he had examined the ears when he was in the exam room with me and told me what he saw and what he wanted to do.

I went out of town to my daughter's with Zack for a week and we both kept noticing there was some kind of thick goop in his ears, and i didn't know what it was so i called the vet office. They looked at the chart and said it was BKT (same as EKT but the B is for Baytril, the brand name). I told them it was causing his hair to mat inside his ears and was greasy, a week after he got it. They said i could bring him in and they would wash it off.

I noticed while i was away that Zack's hearing seemed to not be as good as before, and i thought maybe it was from flying in the plane, though we had flown other times without that happening. He could still hear me if i called him or gave him a command, 'sit,' 'stay,' 'come.' But when i would walk by if he was sleeping he wouldn't wake up, which is very unusual. He just about always would wake up and follow me around if i walked past him when he was sleeping. I am not saying his hearing was perfectly fine before. i had noticed some hearing loss in previous years, showing up mainly in his not waking to noise when he was sleeping on his left side if i called him. And i believed that the right ear was not as good as the left. But that seemed to fluctuate and showed up sometimes more than others. Maybe it's that it was getting better over time. i wonder what caused it in the first place. I just thought it was aging, though he wasn't very old, 6? Now, after what is happening from BKT, i have to wonder.

When i got back from my trip, a week later, i took him in, choosing to see a different vet because of trust issues i was having with the first one, related to communication problems. I was supposed to bring him in after 2 weeks for a follow up on the respiratory thing. I told her the history when she asked why i was there, i told her i was there for a follow up. I told her the whole kind of odd story of the respiratory thing. She was examining him and was looking in his ears. I said that he had some goop in his ears and that i thought it was an antibiotic and i was told if i brought him in, they would wash it off. She said it was BKT.

She said they would wash it off. I said that since the goop was put in his ears, his hearing was not as good. It had been getting seemingly worse in the previous week. She immediately said, about the antibiotic he was given, "That causes temporary deafness." I asked "Will his hearing come back?" and she said yes. She also said she would not have given him that medication.

The next day, i was talking to neighbors who came to my front door. Zack ran out the door. He will run when he gets out, he doesn't just hang around, he takes off, he loves the feeling of freedom, and it used to be a major problem, but then he learned to respond to the Come command, so, i followed him, he was going fast, half way down the street, which is what he does. Usually if i yell "Zack, Come!," he stops in his tracks and turns around and comes running back, just as fast and happy as when going the other direction. this made me feel really good. But on that day, a couple of days ago, when i commanded him to come, he didn't hear me, he just kept going. That is not like him, he always comes. Always. He likes to come. He was trained with treats (by a pro, i had failed so i paid someone and it was worth every penny). So i watched him getting farther and farther away, and then he turned a corner and went out of sight, my neighbor ran after him. i'm recovering from major abdominal surgery so i wasn't able to do much. My neighbor said he caught up with Zack when he stopped to pee on something.

I am really mad about him being given this medication, without discussing it with me first, without telling me the risks and letting me have a role in the decision, i don't even know that there was anything wrong with his ears. The vet who saw him three days ago said his ears looked great. i told her that as far as i know, there wasn't anything wrong with his ears in the first place. At least, no one examined him in front of me and said "He has inflammation in his ears. We treat that with EKT. i need to tell you there are some risks but they are very rare." And then tell me about the ototoxicity and let me decide. Even if i didn't know about ototoxicity, if he hadn't told me, and maybe he doesn't know, i still would've said "He is already on 3 or 4 other antibiotics for the respiratory thing, is there anything urgent about the ear thing because i haven't noticed any ear symptoms," and i don't think he would've said it was urgent. Even if he had, i already had some trust issues related to the several interactions i had with him about the respiratory thing, and i am sure i would've said "First i want him to finish his treatment for the respiratory thing and then i will come back and see about the ears." because i don't like mixing a lot of potentially toxic medications and then not being able to know what is causing what, and how the meds interact, etc. But i never knew he was being given that medication, i wasn't told there was anything wrong with his ears, and it was just given to him and now he has major hearing loss. He's not totally deaf but if he's sleeping just a few feet away from me, if i call him, loudly, he doesn't hear me. His hearing is not functional if i can't call him when he is doing something he needs to stop, like running down the street, he could've run out into a busy street if he had turned the other way when he turned the corner.

So, i've been researching the medication he had and deafness caused by medications, and i found this page.

I wanted to share my experience so that others will know that there are other antibiotics, not aminoglycosides, that are toxic to the hearing nerve.

In reading about this, i was looking for some medical or scientific information about ototoxicity with this medication, and whether the hearing loss is temporary and what the prognosis is, and if it's temporary, how long? But i couldn't find anything like that, and there is very little on it. I wouldn't have a clue if that second vet hadn't said "it causes temporary deafness." I have found several sources on the web where hearing loss is mentioned as a side effect, just briefly, in blurbs about side effects on websites that sell it.

http://www.svpmeds.net/ekt.html

I was reading about flouroquinolones in general, including treatment of humans, to see if it there's info on ototoxicity. What i found is that it's considered to not be ototoxic in humans by the medical establishment, these are drugs like Cipro and Levaquin. They are touted as a safe alternative to gentamycin which they report has caused hearing damage. So now, they say, these quinolines can be used in ear drops. Also, mainly what i've read about gentamycin is it's usually said to be associated with perforated ear drum, but i am really doubtful about that. Would people know if their dog had a perforated ear drum? Anyway, there are websites discussing serious side effects of quinolines, which include tinnitus and hearing loss. I didn't find any that were scientific, it was people sharing experiences like here.

anyway, i am going to include a link i found on PubMed which is a site with lots of medical articles. i found one titled Ototoxicity in Dogs and Cats. It's old, 1993, but there were a couple of things i wanted to share.

One is that there was someone who posted on this thread who said she had read some place that taking aspirin might help restore the hearing and she tried it and it did seem to help. I was hopeful about that, i haven't had a chance to study it yet, but in this short abstract of the article i'll include a link to, they say that the toxicity seemed to be made worse when salicylic acid was given to the animal. I think Aspirin is salicylic acid, or that is a main component of it. I don't know what this means but the abstract says "...The administration of salicylates and loop diuretics may potentiate the action of ototoxins, especially aminoglycoside antibiotics, probably by increasing the levels of these toxins in the endolymphatic fluid…" I don't know what it means.

The other thing i wanted to share about it is that it says there is a possible treatment of the hearing loss if detected early. It says "...Early detection is especially important because early changes can sometimes be reversible. Cavinton (apovincaminic acid) and fosfomycin represent examples of experimental agents being evaluated in laboratory animals for application as potential treatments to limit the ototoxicity associated with various drugs…"

i need to keep studying this and maybe get Zack in to see a specialist if i can find one, someone who would know about treatment to reverse it. My daughter was doing a lot of googol research and she said one person reported their dog's hearing got better after 5 months.

http://www.ncbi.nlm.nih.gov/pubmed/8456203


Hi, i know its been a while since you wrote this but I'm wondering if you found a solution or your dog improved? in recent days i have found myself in the same situation after having used Otomax drops for over 2 weeks! di you get your dogs ears flushed?
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  #37  
Old 11-17-2017, 03:41 AM
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Default Re: Warning: Risk of Deafness from Ear Medications

Just saw the posts about otomax- CJ was on it and he’s gone deaf. I just thought it was old age but obviously not . I will tell my vets- not much help to CJ now but at least other owners know now and can use something else.

Thanks for the info and sad that so many dogs have lost their hearing like CJ.

Anne Marie and CJ
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  #38  
Old 11-23-2017, 08:18 AM
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Scooterspal Scooterspal is offline
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Default Re: Warning: Risk of Deafness from Ear Medications

Quote:
Originally Posted by amholmesy View Post
Just saw the posts about otomax- CJ was on it and he’s gone deaf. I just thought it was old age but obviously not . I will tell my vets- not much help to CJ now but at least other owners know now and can use something else.
Scooter is also deaf although it has not been much of an issue.

He was on Otomax for an ear infection a few years ago. The hearing was fine after that but another infection came up earlier this year, prior to the diabetes. I had seen the warnings about Otomax and brought it up at the vet (not our regular vet) visit. I asked for something else. Her reply was "there is nothing else" and conceded she was aware of the deafness issue for some dogs. I took the Otomax but used it for only a few days. Whether that was the cause of Scooter's deafness or just another issue of the diabetes, I cannot say.

Zymox, sold without a script, may help to prevent bacterial infections but I'm not convinced it will do much once there is one. The trick is to keep their ears clean and dry. Not getting water inside while bathing helps a great deal.

Ear infections can be serious so early treatment is recommended and that means getting to the vet and clearing it up with no delay.

Back to life with deafness... I use eye contact and hand signals and we get by just fine. Most dogs will interpret our body actions quickly and respond as if they could still hear us. It was a while before I realized he did not hear me at all.

Scooter always did have a habit of not paying attention to me unless he wanted something : )

It's not the end of the world. I'm more concerned about him losing his vision so keeping his levels under that dreaded # of 250 is my main goal, now.
__________________
Diagnosed 9/15/17. A 17 lb. terrier mutt, 15 years old. My bestest friend. Novolin N 6U, Novolin R 3U, 2X/day. Cesar Classics 3.5 oz. packets w/ 4 tbsps of old fashion Quaker Oats, 2x day. Probiotic every 3 or 4 days. Omega 3, two 300 mg. capsules 1X/day for skin. Occuguard Plus, Billberry, Lutein, Vit E, Vit C every meal for eyes.

Last edited by Scooterspal; 11-23-2017 at 08:26 AM.
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