This is why we do this.
The eye exam today made clear that Briggs was definitely a dog in pain. He has been suffering for a long time. And now he’s finally going to get help.
First, a brief explanation of glaucoma.
The eye is constantly producing an internal fluid called the ‘aqueous humor,’ which normally drains out through a part of the eye called the ‘drainage angle.’ This balance of fluid production and outflow is what maintains a steady pressure inside the eye. With glaucoma, the fluid can’t drain out and thus continues to build up inside, causing the internal pressure to rise dramatically. The increased pressure damages both the optic nerve and the retina. Eye pressure — called intraocular pressure, or IOP — is measured in
millimeters of mercury (mmHG), and the normal range in a dog is 15 to
25 mmHG.
In the photo above that I took this morning, our vet Dr. Brenda Culver is measuring Briggs’ eye pressure using a diagnostic instrument called a Tono-Pen while vet tech Heather holds him. In his left eye, the pressure was a stunning 80 mmHG. This was compounded by the fact that his lens had detached and was pressing on the inside of his cornea. His right eye was 35 mmHG, but Brenda thinks the lower IOP is only because the pressure had been so high for so long that it had finally started to kill the cells that produce the fluid in the first place.
In humans, glaucoma is reported to cause constant head pain as bad as a migraine. Because dogs with glaucoma typically have higher IOP readings than humans with glaucoma, some veterinary ophthalmologists believe that this condition is even more painful in dogs. And with pressures as high as 80 mmHG, I can only imagine how much pain Briggs has lived with … and for how long.
In this next photo, Brenda is looking at his eyes using an ophthalmic microscope called a slit-lamp, which magnifies all the internal structures:
Then Brenda stained his eyes with a dye strip and turned on the blue light setting on the slit-lamp for another look. This would reveal whether there were any ulcers or other damage to the cornea:
The condition of his corneas is important to know because of the surgery Brenda is going to perform. Rather than enucleate, or remove, his painful blind eyes — there’s no way to restore vision, so our only goal now is to eliminate his pain — we’re going to try and save his eyeballs and thus his ‘natural’ look. This is done with a two-part procedure called ‘evisceration and intrascleral prosthesis.’
In this operation, Brenda will make an incision at the top of the eye, remove the internal contents, and place a silicone ball — the prosthesis — inside the globe. Then she will suture up the incision site. The cornea keeps the prosthesis in place. So the eye will look relatively normal … not compared to a typical healthy eye, but it will still look like an eye. Briggs will be able to blink, move his eyes around, and otherwise look like himself. You can read more on this procedure here.
We have done this on several animals, including Widget and Dusty. There are risks that the body will reject the prosthesis as a foreign object, but so far we haven’t had that happen. If it does happen and we can’t save it, then we will end up removing the eye after all. We have not been able to do this procedure on all of our blind dogs who’ve had eyes removed because the cornea has to be healthy and in good condition, and also because some eye diseases make this procedure simply not feasible.
Brenda is planning on doing Briggs’ surgery tomorrow, but only after we get his blood work back and after Brenda’s husband, Dr. Britt Culver (our internal medicine specialist), does a neurological evaluation. Because of Briggs’ neurological deficits — he wobbles — he could be at slightly higher risk for anesthesia, so we want to make sure we minimize those risks as much as possible before proceeding.
At the top of this post I wrote, "This is why we do this." But we couldn’t do this alone. As I mentioned when I wrote about Pepper last week, all of our animals get the best veterinary care possible because of the sanctuary’s amazing friends. In the wake of Pepper’s loss, we had a number of wonderful gifts to help pay for her care at WSU. And this afternoon, shortly after I got back from Helena, we had another example of how blessed we and these animals are. One of the kindest, most generous individuals we have ever known called Alayne to make a gift that will cover the entire cost of Briggs’ surgery and hospital stay.
That kind of compassionate, generous spirit is how we do this.
Rolling Dog Farm Blog 
Leave a comment