Showing posts with label glaucoma. Show all posts
Showing posts with label glaucoma. Show all posts

Friday, February 23, 2018

Mason's eye removal (enucleation) and teeth extraction surgery: Days 8 - 14 (two weeks) post op

 Everything's been pretty much the same. The eye wound continues to look better each day.  Around day 7 I noticed he started doing normal full yawns again.  Before that he was only half-opening his mouth. His fur is really starting to fill in, too.  Around day 10 I suspect most of the swelling went down enough for him to begin to get the caved-in look (you can see where his skull's eye socket ends and the void begins), but the "lips" of the wound are still sticking out, so the overall look is pretty weird.  On day 12 Mason got his stitches removed!  Read more about that below.

Day 8:

Day 9:

Day 10:
We were supposed to be going on "short leash potty walks" according to the vet instructions, but instead we went on an overnight canoe camping trip! His eye wound started to get the caved-in look, but right around the incision site it was still coned out, so it's looking pretty weird right now.


 Mason found his sacred orb in the van.



Day 11: We returned from our canoe camping trip and I forgot to take photos of his eye, but here is a photo of him between two canoes.

Day 12: Stitches got removed today so that means no more cone! There are some photos of before the stitches came out and after photos.  Mason had 4 external stitches and a couple of layers of stitches under his skin.  The stitches came out easily and quickly and I don't think Mason even felt it.  The vet also said the stitches in his mouth are healing well (those will dissolve).  She even gave him permission to eat his hard kibble again and she said I could start brushing his teeth in a week.  For an hour or so after the stitches came out I could actually see the hole that the stitches left (it was very small, the exact gauge of the thread that was used) and then later in the day I noticed some reddish clear liquid in the hole, and then even later there were small scabs there.  He has one scab near the center of his eye that I probably didn't notice before because a stitch was covering it.



 Mason hates the vet (even more so now!) so this is my special technique to keep him calm while we are waiting at the vet.
 After the stitches came out:

 13 days post op:
His fur is mostly growing back but there is still a weird bald patch right above. You can also see the scab in the center.

You can see stitches where his little loose tooth was pulled on the top.
Mason's teeth after they were cleaned and six were pulled. 

14 days (two weeks) post op:

Everything is pretty much same as usual.  Last night he had a small amount of bleeding as if he had rubbed off a scab.   






Monday, February 19, 2018

Mason's eye removal (enucleation) and teeth extraction surgery: some bad news

I got the histopathology ("the microscopic examination of biological tissues to observe the appearance of diseased cells and tissues in very fine detail") results of Mason's removed eye today.  The vet said it looked like he had primary glaucoma, and his ophthalmologist confirmed it.  His ophthalmologist suspected he had secondary glaucoma caused by the mature cataract in that eye, so she was surprised to hear it was primary.  She told me to use the left over Dorzolamide eye drops from his other eye on his one remaining eye twice a day to help delay the inevitable (my wording, not hers).

The ophthalmologist mentioned Endolaser surgery being an option in his remaining eye (...for $8,000).  It has an 85% chance of saving whatever vision he has left and a 95% chance of keeping his eye pressure low.  She doesn't perform it until after a spike in pressure because the other 15% is the chance that she accidentally blinds him, which is less horrible when you already know he's definitely going to go blind from glaucoma.  She also said that when his pressure spikes it is very important for him to see an ophthalmologist in 1-2 hours.  They could then add drops to his routine or use a needle to remove some of the fluid in the eye to relieve the pressure and hopefully save his vision.

Thursday, February 8, 2018

Mason's eye removal (enucleation) and teeth extraction surgery: day of and 1 day post op



 Mason at the vet before the surgery

Day of Surgery:
I dropped him off around 8am at Northern Liberties Veterinary Center and cried when doing so.  They said he was Dr. Draper’s only patient today.  The woman at the counter said she could call me after they do the dental X-rays to let me know how many teeth would need to be pulled and that put me at ease.  I was expecting three, including one tiny really loose tooth he’s had for a couple months.  The nurse who took him in the back said she should be done around noon.  At noon I had still not received the X-ray phone call so I was hoping she had finished the surgery and not had to pull many teeth at all and just did it without calling.  At 12:30 I got the call that she thought he really needed six teeth pulled.  If she was being aggressive she even could have pulled two more.  This blew me away and shocked me!  I knew his teeth were pretty bad but I’m pretty good at brushing his teeth daily.  I got extremely anxious because he didn’t have that many back teeth to begin with and I thought he would never be able to eat kibble again.  I thought his life would change more significantly with that many teeth being pulled than losing an eye he was already blind in.  She said there was significant bone loss around the teeth because of pockets of infection that ate away at it. He had to get two teeth pulled on the bottom and I thought all his bottom teeth looked great.  All of the teeth were molars or carnassial teeth – large teeth with three roots.

I got a call from the vet at around 2:45 to let me know his surgery was completely finished. He was just starting to wake up from anesthesia and was looking around.  That was a relief.  The vet said he did great and handled being under anesthesia for that long well.  They wanted to watch him for a little while longer and I could pick him up at 4.

When I picked him up he was pulling on the leash to get to me and was wagging his tail a little.  On the walk to the car he crashed into walls with his cone a lot trying to sniff them.  His walking was slow and seemed a little off, too.  When we got home he was mildly happy to see my boyfriend – wagging his tail just a little again.  Many of the blogs I read about eye removal recovery said their dog was so happy to see them and didn’t seem any different when they picked them up after surgery.  Unfortunately, this was not the case for Mason.



His face has a lot of extra skin so those wrinkles are normal, normally just hidden under his fur.
At home I fed him his new canned food and he scarfed it down! He hadn’t eaten since the night before so I’m sure he was hungry.  It made me feel better that he was interested in eating his food. The vet recommended I give him half what he normally would eat, wait 2 hrs to make sure he kept it down, and then give him the other half if he readily ate the first half.  He ended up eating both halves. I gave him his antibiotic and pain pill with peanut butter and he drank an obscene amount of water. 

I sat next to him and pet him for a couple of hours.  I couldn’t tell if he liked it or not.  He never wags his tail when you pet him and the only way you know he likes it is if he paws at you to continue or moves his front leg so you can reach his belly better.  He did move his leg a little for me to scratch his belly, but he wasn’t acting like he normally did.  Also, I don’t know if it’s because he only has one eye now or because his good eye is a little droopy from the anesthesia or pain meds, but he looks a little pissed off all the time now.  Usually his token look is “concerned”.  He also is doing a lot of grunt-sighing.  He would sigh pretty regularly before, but this is different.

He wouldn’t sleep, which was very weird for him.  Sleeping is his #1 favorite activity.  He looked really tired and I would see his eyes get heavy and just when I thought he would fall asleep he would change positions. My boyfriend thinks its because the last time he fell asleep he woke up with six less teeth and one less eye and he didn’t want anything like that to happen again while he was sleeping.

I took him out to pee without the cone.  He sniffed a little and he peed quickly and then led me back to the house.  Normally, he’s very picky about where he pees and will take forever to find “the perfect spot”. When I took him out to pee before bed we were crossing the street and a cat was crossing the street at exactly the same time only 10 feet from us but he didn’t see it because it was on his no-eye side!  That made me feel pretty sad for him.

I was told by the vet that I can take his e-collar off him if he’s being supervised and I’ve been doing that.  He has no interest in scratching or pawing at his eye, but I put the cone on when I leave the room just in case.  He definitely prefers it off.

I also spent the evening making him a soft e-collar.  It was good to take my mind off the pain he was in and it made me feel like I was doing something to help him. He really hated the plastic cone the vet gave him and I couldn’t imagine him getting any sleep in it.  I went to Petco before to buy wet food and the soft cones there were $40! I wasn’t about to spend that on something he would only need for a week after dropping the money I did on his surgery.  I used the plastic cone as a pattern. I made the cone out of canvas, some bias tape, cut up plastic clothes hangers and velcro.  I ran the bandana he usually wears through the loops to tie around his neck because it was soft and thick and probably wouldn’t dig into his neck. I don’t think it bothers him to wear it. 


 The e-collar in progress.

He slept on his bed on the floor by our bed the first night.  We didn’t want him in the bed because he isn’t supposed to jump and we didn’t want to bump him in the face by accident in our sleep.  He seemed to sleep through the night.

Day 1 Post op:
I got up while he was still lying in his bed and went to the kitchen to prepare his food.  I was so happy to see him walk into the kitchen wagging his tail.  He ate his food quickly again.  He still has an odd walk, like a limp.

He’s been sleeping a lot today.  He left his bed to come sit on the couch with me, which is something he normally does, so that was good.

He was very happy when my boyfriend got home.  He let out one small bark (usually he barks a few times when people come to the door) and got up off the couch to greet him and was wagging his tail a lot.  That was reassuring.  But shortly after that he vomited just a little bit.

He woke up in the afternoon from sleeping and I took him outside.  When he got off the couch I discovered he had some poop mooshed under his tail.  He still hasn’t had a bowel movement, but the vet said it could take 24 hours because of the anesthesia .  This time he led me around the whole park we live across the street from, and his ears perked up when he saw a squirrel.  He is still walking slow but normal now.  When we got back inside I cleaned up his butt and then when I went to put on the e-collar he had a nice long  grumble about it.  Then he seemed like he was going to vomit again and he probably swallowed some.

 Sleeping on the couch on Day 1 post surgery in his home-made e-collar

Late afternoon was a huge turning point for Mason: He pooped (after almost 48 hours) and more importantly he seemed like he was himself again! We had a couple of friends visit and he got up to bark at them when they were at the door, and then seemed very happy to see them! Whole hearted tail wagging and everything!  His good spirits lead us to give him some roasted chicken from our dinner, which we NEVER do! I went to bed feeling so much better about this decision after seeing his personality come back for a few hours.


 Mason's eye is very red, has some swelling, and you can start to see the development of a massive bruise that takes up almost all of the shaved fur area

Mason's eye removal (enucleation) and teeth extraction surgery: History


I, of course, had a freak out the night before my 8 year old dog Mason’s surgery.  I was unsure if I was making the right decision.  It’s a lot of pressure making a big decision like that for another being. I was put at ease after I did a couple hours of late-night Google searching and read so many amazing recovery stories of dog eye removal, however, I found very little about tooth removal and nothing about getting both surgeries done at once.  I wanted to be that resource for other anxious dog moms and dads.


Mason's History:
I adopted Mason when he was 3 years old from a rescue in Delaware, but he is originally from Taiwan.  His pregnant mom was abandoned in an apartment.  The rescue took her in and she gave birth to mason and his sister.  They were in people’s homes until Mason was adopted out to a family in Taiwan.  They kept him for 1.5 years, until they had a kid.  That’s when he was flown to the US to the sister shelter in Delaware.  I think his temperament has a lot to do with the fact that he’s never been a shelter dog. I would argue that he’s the best dog I know, and I think many friends and anyone he’s met him for at least 5 minutes would support that claim.  He’s relatabley awkward, charms people by scratching his mustache on their legs, doesn’t beg (unless he knows you are weak), and loves getting pets although he won’t wag his tail to show it (a clear sign of weakness).  His striking good looks are only out shined by his good behavior.  He’s very low energy aka chill, and we bring him everywhere – from local bars to friends’ parties to weddings to art studios, and even on long canoeing and camping trips.

 Mason as a puppy in Taiwan

  

Mason on the nose of a kayak

 Mason being zip lined over a treacherous river during a camping trip

Mason on one of our many canoe and camping trips
Mason (in his altered tube with a plywood floor) and I tubing the Delaware River

Mason wearing his backpack on a hiking/camping trip with a similar sized buddy
 Mason with me at work



Mason’s eye history:  Mason has had a cataract in his left eye (from here on out referred to as his “bad eye”) for at least the past couple of years.  His eye looked really white and cloudy.  We’ve always figured he didn’t have very good vision even before the cataract. He ran into a fence once, and he loses track of his ball (excuse me, I meant sacred orb) when we throw it often.

A stupid alley cat really threw this story off.  There’s a stray cat who has a litter of 7+ kittens every season and likes to give birth to those kittens in our neighbors alley, which is adjacent to our alley (We live in Philly – everyone has an alley!).  Mason and our friends’ dog Banjo were of course out in the alley trying to see the cat and kittens through the fence.  Apparently Banjo’s owner discovered a scratch on her eyebrow the next day and thought it was probably from the momma cat. I figured Mason must have gotten whacked too. He had a few days of squinting in his bad (left) eye.  After that eye started to get better his third eye lid would show in the evenings when he got tired on his right eye.  Another few days after that both his eyes weren’t looking very good – constant squinting and the third eye lid showed up in the evenings still.  I started doing hot compresses on his eyes (he had eye problems before and the vet recommended this and it really help) for a couple of days and when that didn’t help anything I scheduled an appointment with the vet.

 Mason's eyes after the cat incident
 Mason's third eyelid showing

I started going to a new vet with this appointment (explained later) and she definitely wasn’t an ophthalmologist.  She did all the eye tests and everything was normal except he had a mature cataract (duh) and had high eye pressure.  Her pressure readings were all over the place from 21-50 I think because she wasn't the best at taking the readings. In comparison, his other healthy eye has consistently had the pressure of 9.  His weird eyes were not a result of the cat.  They were caused by glaucoma. The vet recommended I see an ophthalmologist in the next two weeks and she sent Mason home with a glaucoma eye drop.  I found three doggie ophthalmologists in the Philadelphia area: Upenn in Philly, VSEC in Levittown, and Center for Animal Referral and Emergency Services (CARES) in Langhorne all had a range of wait times for new patients from 3-12 weeks.  I scheduled a far-out appointment for two of them and told them to call me if anything opened up.  CARES called back with an appointment for Mason after a week.  I was thrilled because I had scowered the internet for info on these doctors, and the CARES ophthalmologist had great reviews mentioning her. Dr. Martha Lowe gave him a full exam for $135 (half the price of the other two ophthalmologists) and I was, and still am, very impressed with her.  His pressure measured 21, but he still was able to see light and shadow in that eye. She prescribed him with two glaucoma eye drops:  Cosopt (dorzolamide/timlol) and Prednisolone acetate.  On the following visit his pressure was still high and she said he had lost the ability to see light and shadow.  She also prescribed a third eye drop, Latanoprost, and that’s when I noticed an improvement in Mason’s eye.  It started to look less blood shot and he started chewing rawhides again.  His pressure ended up stabilizing in the low-mid 30s for a few visits and then it got very high again.  The ophthalmologist said that a pressure in the 30s can be comfortable, but it’s likely the pressure spikes and drops throughout the day, so it’s possible he’s in pain at times.  With the pressures like 50, he definitely has a constant headache.  His eye was always bloodshot, was visibly bulging, and started to get a blueish tint to it.  The vet said the blueness was because the pressure was so high.

 Mason's bad eye with mature cataract
 Mason hates the vet.  Leaving the door open while we waited for the doctor helped his anxiety a lot, which helps keep his eye pressure from spiking.

Here is a list with the date and Mason’s eye pressure measurement:
  • November 22nd, 2017: 21-50. prescribed Cosopt (dorzolamide/timlol) eye drop
  • November 28th: 21. prescribed 2 eye drops: Cosopt (dorzolamide/timlol) and Prednisolone acetate
  • December 12th: 50. prescribed a third eye drop (Latanoprost), declared blind in bad eye
  • December 28th : 33
  • January 12, 2018: 67. ran of Latanoprost so he missed a few doses which explains the very high pressure
  • January 19th: 50
  • February 2nd: 49
  • February 6th: eye removed
 Mason also has the very beginnings of a cataract in his good eye.  This was pretty sad to hear, but I saw how slowly his bad eye went from being an immature cataract to a mature cataract.  It took around 2-3 years.  The ophthalmologist said there is nothing you can do to prevent a cataract, but she did recommend Ocu-glow.  Ocu-glow is a pill with antioxidants that are supposed to benefit eye health.  It is the most researched dog eye vitamin on the market.  They have done more clinical trials than any of its competitors.  And no, I am not sponsored by Ocu-glow, but man, do I wish I was because it costs $75 for 90 pills, and at 35lbs Mason has to take two a day, so they go fast.  As this is the only hope for his good eye, I am throwing all my money on this product. Fingers crossed! 

Mason’s mouth history:  When I adopted Mason at three years old he had already had his teeth professionally cleaned once.  I go through periods of brushing his teeth for 2-3 months and then I’ll get out of the habit and not brush them for a month.  His bottom teeth look very white and clean and his top back teeth weren’t looking too hot. The ones in the way back had a lot of yellow tarter and it was even brown in some spots.  His breath was bad, bad enough to earn him the nickname “Mr. Stink”.  I noticed his breath would improve a lot when I would brush his teeth often.  He is a slow eater.  It would take him 3-4 minutes to finish a bowl of kibble.

 Mason's teeth.  That small tooth next to his canine has been pretty loose for a couple of months and I knew it would have to be pulled.




Information about Glaucoma and bad teeth
There is a wealth of information about Glaucoma on the internet and I recommend you read that.  It’s even better if you get a good vet/ophthalmologist and ask them a ridiculous amount of questions. This is just how I understand it – in layman’s terms as they say.

“Dr. White” checking in! (I am not any sort of doctor, this is just a funny joke – my last name is White and I’m giving medical advice, get it)

“DR.” WHITE’S FACTS ABOUT GLAUCOMA:  
 The eye is filled with clear blood that is constantly circulating through the eye.  My dog’s ophthalmologist described the eye as having a faucet and a drain that facilitates the movement of this clear blood.  When a dog has glaucoma, it’s like the drain is filled with a bunch of rice (presumably from when you washed out the rice pot and didn’t empty the drain catcher – c’mon I hate that!).  It will still drain, but it will drain slower than it should and the eye’s pressure will rise as a result of this slow draining.   Mason was prescribed two eye drops at first. I don’t remember which does which but one of them was to slow down the rate of the “faucet”, and the other was to prevent any other “rice” from building up in the “drain”.  Fun fact: I asked the ophthalmologist where it drains to and she said it is reabsorbed by the body.  No, your dog isn’t crying tears of clear blood.

There is primary and secondary glaucoma.   Primary is genetic, and secondary is caused by something else. Primary is often caused by the dog having too sharp of angle to their drain and is more common in specific breeds. Secondary is often caused by diabetes, as blood sugar levels can cause the pressure to spike so high that the dog can go blind in a number of hours.  ***Glaucoma is also caused by cataracts*** This is something I had no idea of and was never told.  Signs of glaucoma are squinting, watery eye, bloodshot eye, and bulging.  If your dog has cataracts and then you notice these signs you need to act quickly!!  If the pressure gets high enough it will cause permanent blindness. Another fun fact: Vets refer to the eye as the “globe”.

There is no cure for glaucoma in dogs.  Human glaucoma eye drops are prescribed but they become ineffective in a matter of months to up to two years if you are lucky.  Even glaucoma surgery doesn’t offer a permanent solution.


“DR.” WHITE’S FACTS ABOUT BAD TEETH:
This is loosely what my vet said interpreted by my bad memory:  Pockets below the gum line form when the gum disconnects from the tooth.  Bacteria can get inside these pockets and eat away at the tooth and at the jaw bone that holds the tooth. The result is bone loss and the tooth becomes unstable because its roots/support system are compromised.  This can cause pain that your dog just learns to deal with.  If bad teeth are left in for a long time the bone loss will continue.  This can eventually lead to the jaw bone being broken easily because of the weak points in it!!  Someone I know even has a dog that's teeth got so bad that they just cut the front half of its bottom jaw right off! And its happy as can be. The vet said the body is able to refill the lost bone once the teeth are gone.  She also said that she knows of dogs with no teeth that are still able to eat dry kibble!  Dogs really are amazing and resilient and that’s a fact that both certified veterinarians and “Dr. White” can agree on!

And if you would like to read a more professional description of glaucoma and it's treatments, I recommend this website: www.animaleyecare.net/diseases/glaucoma/