If you believe in Divine Powers playing fun and games with vets, this
case must surely be one of them.
The puppy was purchased with no obvious eyelid growths. Then the puppy
started rubbing her eyes all day long as 3 large eyelid growths
appear. Why? There is no rational explanation. Tearing stained the
left lower eyelid.
Electro-excision is the cure.
As the puppy is a
high anaesthetic risk, two
vets prescribe eye drops.
Vets seldom do anaesthesia in puppies, not even once a week, as there
are usually no indications. The same applies to Toa Payoh Vets and I
am sure for the other 40 veterinary practices.
But these eye drops would not reduce the large inflamed
granulomas and will not resolve
the puppy's problem of itchy
eyelids and continuous
scratching. A puppy in
distress worries the
owner as a puppy can easily
die if not treated. What to do?
"Give an eye ointment and ask her to come back one month later," my
assistant suggested. I said: "The lady had seen two vets and had got
an eye drop. This growths need to be cut off. Preferably by
electro-excision. However, the puppy may die under anaesthesia and
then we get a big problem. Some owners demand compensation. New puppy
deaths are extremely emotional and unpleasant."
I did not further stress the lady by requiring her to sign the consent
form for anaesthesia as I noted that she had many questions with no
answers from the vet. Why did the eyelid growths occur? What is the
cause? Will a new eye drop work? What is the best drug? Why is the paw
itchy? For the paw itchiness, I could tell her the cause was ringworm.
Will the itchiness disappear with this Surolan ear drops given by Vet
So, I used electro-surgery, a bit of Zoletil IV and isoflurane gas to
excise 3 eyelid granulomas (histological confirmation). Then 7 days
later, the owner returned. "The puppy is still scratching the eye
(despite wearing an e-collar). I found a tick in the face." Therefore
the tick must be from the vet. It was likely but it is hard to prove
its origins. So I said: "It is possible that the tick came from the
grooming as the puppy was clipped bald all over."
"What to do with the open wound? One stitch had come off," the owner
pointed to the medial canthus (see picture). The correct method would
be to re-stitch under anaesthesia. But that would mean another risk to
be taken. Eye drops again? It would not help. I noted a 4th eyelid
swelling on the upper eyelid to the right of the previous one. "There
is a 4th eyelid growth," I said. "It is best to remove it as it may be
the cause of eye rubbing."
This time, I just gave isoflurane gas and excised the big granuloma.
Stitching should be from muscle to upper eyelid edge rather than lower
eyelid edge to upper eyelid edge to prevent ectropion. The puppy went
home with no complaints for the next 10 days. I hope all would be
Through my 30 years of small animal practice, I had not encountered
this problem in such a young puppy. So, was it Divine play? It is hard
to say. I doubt other vets all over the world encounter such a
problem. The eyelid granulomas appear some days after purchase, as if
BE KIND TO OLDER DOGS & CATS --- GET TUMOURS
REMOVED EARLY --- WHEN THEY ARE SMALLER.
More case studies, goto: