The Cavalier King Charles
with a sticky right eye was
brought into the Surgery
around noon time and I asked
the owner to wait for Dr
Daniel who arrived shortly.
"What's the problem with his
right eye?" the slim young
lady in black dress and
holding a fluorescent pink
sling bag asked me. "No
tears are formed and so the
right cornea is stuck with a
thick secretion. I suspect
corneal ulcer," I handed the
case to Dr Daniel to do. As
this lady had consulted me
before, I was present at the
consultation room too.
"How did this dog get two
corneal ulcers?" the lady
asked me. "In most cases, it
is due to the dog scratching
the eyes all the time while
scratching the itchy ears.
So the eyes get damaged and
ulcerated. It is difficult
for the owner to link the
two. Many vets will diagnose
an eye problem and treat
accordingly." I
palpated both ears. The dog
screamed when I palpated the
left ear. He screamed again
as I repeated the procedure
to confirm but the right ear
was OK.
"Do you clean the floppy
ears weekly?" I asked.
"My father does it." she
said.
"The ear canals are quite
clean as the cotton buds are
not stained much," I said.
"Does the dog use the hind
legs to scratch the face
daily?" I asked.
"Yes, yes," the lady
confirmed my hypothesis that
this act caused eye injury.
Dr Daniel sedated the dog
and cleaned the eyes. I took
the images after that, as
shown below.
Corneal ulcers
Right eye - dry eye with
opaque cornea & new blood
vessels
Left eye ulcer with new blood vessels
The new blood vessels to
both eye corneas are
prominent in the images.
What's the next step? Dr
Daniel said that the right
eye would heal with time and
medication.
I have a different opinion.
The eyelids need to be
stitched up to prevent dusts
and light hurting the eyes
and causing eye rubbing at
home. "There is the e-collar
worn round the neck," I said
to the owner. "However, the
dog can rub his eyes
directly against the sofa
and further damages his eyes
which are too itchy to
ignore. The eyeball may
rupture and in this case,
the whole eyeball must be
removed as it becomes
infected. The dog may become
a one-eyed jack."
The owner agreed to the
surgery to sew up the
eyelids for the next 7-10
days. I will do it the next
day. So it is hard to know
whether Dr Daniel's opinion
not to operate will achieve
a good outcome. Will the dry
eye start producing tears
with the surgery? It is hard
to say as the problem
existed for over 10 days. "I
thought it is normal for
dogs to have some eye
problem," the lady said to
me.
Today, Wednesday Sep 18,
2013, I will sew up both
eyelids. Dr Daniel said that
the dog would not be able to
see. But I find that such
cases have no problem if the
dog is hospitalised and
observed closely. The left
eye should heal very well in
10 days resulting in a white
spot where the cornea was. A
lot of post-op care is
needed to achieve a good
outcome and so I don't
permit the dog to go home
for at least 7 days.
I welcome diverse opinions
of care from Dr Daniel as I
cannot know every aspect of
veterinary medicine and
surgery.
In this case, it will be in
the best interest of the dog
in this case to perform the
surgery as healing is
faster. There is a slim
chance that the right eye
may start producing tears.
The keratitis covers almost
90% of the right eye as I
showed the owner the images.
Digital images are really
great for show and tell as
compared to 10 years ago!
If the ulcers are smaller,
there is no need to do it.
In this case, if the owner
did not seek vet treatment,
the right eye cornea will
blacken with
hyper-pigmentation and the
dog will be blind with black
corneas in the following
years as you can see in many
Shih Tzus whose owners
neglect taking vet advices
or did not follow up owing
to financial constraints or
lack of time or interest.
TOA
PAYOH VETS
