I took our new arrival, blind Avery, over to Burlington, Vermont yesterday to see some specialists. First was a stop at our internist, Dr. Bryan Harnett, at Vermont Veterinary Internal Medicine, for a look at his heart, and then in the afternoon we saw our ophthalmologist, Dr. Sarah Hoy at Vermont Veterinary Eye Care. Although Avery had some mild right-side heart enlargement, Dr. Harnett thought he was actually in pretty good shape. But Dr. Hoy confirmed what I had suspected, that his left eye was very painful from severe glaucoma.
That's Dr. Hoy in the photo above, testing Avery's eye pressure with her Tono-Pen while her vet tech Amy holds our boy still. His intraocular pressure in that left eye was 45 mmHg (millimeters of mercury, the unit of measure); normal ranges from 15 to 25 mmHG, though lower than 20 is preferred. His right eye measured a very low 9 mmHG, a sign that glaucoma had essentially "killed" the eye and it was no longer producing fluid. So he has already suffered all the pain associated with runaway glaucoma in one eye, and now was going through it all over again in the second eye. His lens had detached in his right eye as well, and it barely had any tear function left.
Here's Dr. Hoy using her slit lamp to examine his eyes:
We made the difficult decision after Avery's exam to proceed with surgery to remove his eyes. I say "difficult" because of the risk from his heartworms; removing his eyes was the obvious choice in his case, but surgery was definitely risky. Yet we wouldn't have been able to significantly reduce the pain from his glaucoma with topical medications, given the high pressure in that eye, and waiting for months to complete his heartworm treatment before proceeding with the enucleation meant leaving him with the pain. He had already suffered enough, and we elected to have Dr. Hoy take him to surgery today.
We had a lot of specialists helping on this one: Dr. Harnett had a radiologist review the images of his heart and lungs, and Dr. Hoy consulted further with a cardiologist about the risks. All the consultations left us feeling as comfortable as we could that proceeding with surgery was the best course for Avery.
Nevertheless, last night Alayne and I worried ourselves sick, wondering if we had made the right decision … and wondering how we would be feeling if we lost him during surgery. This is the kind of stuff that just haunts us.
Dr. Hoy called this morning to let me know she was prepping him for surgery, and then we anxiously waited for the post-surgery "he's up and doing fine!" phone call. I had just gotten off the tractor and was talking with Kate when my cell phone rang at 12:22 p.m. today. I was so nervous I almost couldn't get the phone open in time. It was Dr. Hoy, and the news was fantastic — he had made it through surgery in great shape! In fact, she told me, "he did better with the anesthesia than any healthy 2-year old dog I''ve ever worked on!"
Whew.
Alayne is heading over to Burlington on Friday to pick up Avery and bring him home. I'll post an update on him for Monday.
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