Alayne took a truck full of dogs over to our vets in Helena at Montana Veterinary Specialists today. On board were Shiloh, for his repeat chemotherapy (it went well); blind Dusty, to have sutures removed from the surgery to resect a tumor on his lip (healed up fine); blind and deaf Blanca for a recheck on a skin condition (getting better but needs another lime sulfur shampoo, which leaves her and us smelling like rotten eggs); and little Ellie May, the blind and deaf Cocker I wrote about yesterday.
In the photo above, Dr. Brenda Culver is using a slit lamp biomicroscope to examine Ellie May’s eyes. The slit lamp is a specialized microscope that allows the doctor to have a three-dimensional, magnified view of the structures inside the eye. There are very few regular vets who would have this kind of ophthalmic instrument; typically it’s only veterinary ophthalmologists who have it. Although Brenda is our primary care vet, she has a special interest in ophthalmology … which is why she is so good at it!
As we expected, Ellie May’s eyes are indeed painful. Brenda used a Tono-Pen to check the intraocular pressure, or IOP, in each eye. That’s what she’s doing in this photo. Normal eye pressure in a dog is between 12 and 25 mm Hg (units of mercury), and Brenda found Ellie May’s readings were in the 40s. (This is what I got when I used our own Tono-Pen on Tuesday to check her eye pressure.) That is painful. Brenda compared it to living with a throbbing, permanent headache that just keeps pounding away.
Although I suspected Ellie May had glaucoma — and she does — what surprised me was Brenda’s diagnosis of why she has glaucoma. It turns out that Ellie May’s longstanding (or "hypermature") cataracts are starting to break down. Ordinarily you’d think this might be a good thing, but it’s not. As Brenda described it to me tonight, "When this process takes place, it causes a severe inflammatory response (lens induced uveitis). The inflammatory cells circulating in the anterior chamber start to clog up the filtration angle and cause a secondary glaucoma." Because the fluid in the eye can no longer drain out through the filtration angle, pressure builds and builds inside the eye … and that’s when you get glaucoma. So now you have three problems in the eye … cataracts, uveitis, and glaucoma.
Because Ellie May is blind and because those eyes are painful, the best course of treatment is to surgically remove them. We ran blood work today and everything looks good, including her kidney values. Her heart sounded fine. Her urinalysis also came back normal. Ellie May’s teeth were in bad shape, so she’ll get a dental, too. The best news is that Brenda thinks Ellie May is younger than we thought … perhaps only 10, rather than 14. All in all, Brenda believes Ellie May is a good candidate for surgery, and so we have her eye operation scheduled for tomorrow, Friday.
Of course, we’re going to be total nervous wrecks until we get the phone call saying Ellie May is out of surgery and awake … so please keep your fingers crossed for this adorable little Cocker.
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