From 20:20 Vision to 0:0 Overnight—What Happened?

Buffy, my brown cocker spaniel, who many of you met at BlogPaws has a health issue. I don’t know if I could have done anything to stop what happened, but I could have reduced her suffering last weekend—if I had only paid more attention and done a bit of research.

We all get busy, and I thought I did the right thing, but I didn’t.

Let me backtrack. In the middle of April, Buffy went in for her annual appointment at her veterinarian, who had recommended that I take her to a veterinary ophthalmologist. My vet said something didn’t quite look right, and I should get it checked out. “Better to be proactive,” she said, “than to eventually have a blind dog.”

I teach college classes and it was the hectic end of the semester, plus my consulting job developed its usual spring business, so I waited until June 1^st. Buffy didn’t have any issues and I even wondered why I brought her to an ophthalmologist since she was fine. He said she had some cataracts developing and he recommended a homeopathic supplement, which could slow it down. Come back in six months for a recheck.

That was Thursday morning.

On Friday morning when I brushed Buffy’s teeth, I noticed she held her right eye closed and her other partly closed—very unusual for her. When I pried her right eye open, I saw her nictitating membrane mostly covering her eye and the whites of her eyes were quite red. Very shocking. She never had any problems before.

Unfortunately, I was late for work and I had a project due. I decided to call the ophthalmologist, and remembered to do so at 10 a.m. By 2 p.m. he still hadn’t called, so I called again, and the receptionist told me they had several emergencies. The ophthalmologist finally called me at 5:05 p.m.  He said she most likely scratched her cornea, even though Buffy hadn’t been out in the yard much that day. He said unless it is oozing a yellowish liquid, then it’s not an infection. If it gets worse, visit my vet on Saturday or another ophthalmologist an hour farther away.

On Saturday, Buffy seemed a bit better with her right eye only partly closed. I did notice that she didn’t want me to touch it, since I had wiped it once a day with a damp cotton ball to remove any gook—there wasn’t any. She also wasn’t too excited to go for walks or play ball—but wouldn’t you feel a bit listless if your eye hurt?

Sunday and Monday had no real change, which seemed unusual for a scratched cornea. So I called my vet on Monday morning to find out if she wanted to see Buffy or if I should go to the ophthalmologist. She told me to come in at 3:45 p.m.

She took a quick look at Buffy from across the room and said this was not what she had expected. She took photos and sent them to the ophthalmologist. He asked her to check Buffy’s eye pressure. Buffy’s right eye was 37 and her left was 22. “Buffy may have glaucoma,” she said. She prescribed several medications and the ophthalmologist wanted to see Buffy the next morning.

Tuesday morning, the ophthalmologist said Buffy had rapid onset glaucoma and had lost her vision in her right eye. What?  Did I hear him right?

He showed me by cupping his hand over Buffy’s left eye and moving his hand quickly toward her right eye—no reaction. Her left eye responded by watching his hand and blinking. She obviously had lost her vision in her right eye.

Last Thursday, Buffy had perfect eye pressures of 10 and 14 in her right and left eyes. Her eye pressure may have swelled to well over 40 by Friday and gone down a bit by the time she was evaluated on Monday. After starting  pressure reducing eye drops, Buffy’s right eye went down to 32, while her left was still at 14 after only a half day.  A normal pressure is between 10 and 20.

He said it was very coincidental that her exam the day before was fine and then this rapid onset glaucoma occurred. But it is very common in dogs for glaucoma to come on rapidly.  According to Pet MD dogs can become permanently blind within a few hours of having a very high eye pressure. This isn’t how glaucoma typically progresses in people, where glaucoma usually progresses more slowly.

Prognosis

Not good. Buffy may have permanently lost her vision in her right eye. The ophthalmologist said it might come back, but only for a short time.

He ran a test for a genetic predisposition, which involved putting a contact lens in her good eye and shining a light to look at the drainage canal. He couldn’t see the opening, which means she had  fluid (aqueous humour) blocking it and she had a hereditary predisposition. American cocker spaniels are high on the list of breeds that tend to have eye issues.

He decided to treat both eyes with glaucoma drops to try to slow the progression in her left (good) eye. It may only help by a few months, although this informative website states it could help for an average of 31 months.

Ultimately, Buffy is likely to become blind in both eyes. Apparently the eye drops only work for a limited time, unlike in humans, so then the pressure will build up again. Once the eye pressure goes above 40 or so, the eye hurts and the dog feels like she has a headache, similar to a migraine. This would have explained Buffy’s listlessness over the weekend. She’s more active now that the pressure has gone down with the eye drops.

Once the eye drops stop working, then the most humane thing is to surgically remove the eyes and sew the eyelids shut.

So not only is Buffy likely to become blind, she won’t have any eyes! Hopefully that is far, very far, into the future.

There are prosthetic eyes, but the surgery is about a grand more and problems can occur with the implants.

Lessons Learned

• I should have just gone to either my regular vet or the ophthalmologist office on Friday and waited until they could see me. But life happens and it may have already been too late. If your dog’s eyes look blood shot and she is holding it closed, see your vet immediately.
• Since Buffy just had a clean bill of health from the ophthalmologist, the ophthalmologist thought possibly she had scratched cornea or an infection—not the case. Glaucoma comes on very rapidly in dogs.
• Buffy was showing me her pain by hiding in her cage and in corners of the room with a “don’t bug me” expression. I didn’t really listen to that. She ate normally and followed me around. She went for walks, although she lagged behind. I figured I’d feel the same way if my eye hurt. Dogs often don’t show us their pain very well.
• Since Buffy has a genetic predisposition for glaucoma, I don’t think there is anything that I could have done to prevent this. It was just coincidental that it happened the day after a visit to the ophthalmologist—at least that’s what the vets tell me.

Symptoms

• Pawing at the eye—Buffy did very little of this, just once in a while.
• Listlessness
• Bulging eye
• Reddened eye.
• Squinting or holding one eye closed
• One pupil is larger than the other

Many dogs don’t do a good job at showing us they have a problem and often by the time the vet sees the dog, the glaucoma has already caused blindness in one eye. Dogs compensate well with only one eye to see and often you won’t notice.

I did notice a few tiny quirks over the weekend with Buffy that I just didn’t pay attention to. She eats in her cage and I noticed a few times that she moved her head to the side to find her dish. I thought it was due to something above her cage that was hanging down, distracting her. I also noticed this head turn to find treats that I tossed at her. These were things she did to compensate for the loss of vision in her right eye.

Prevention—yes it is possible

Glaucoma comes in two forms primary and secondary. Primary is usually hereditary and is unusual in cats, while secondary may result from an eye infection.

• Both websites mention to not use a collar, but to use a harness on the dog to prevent excess pressure in their eyes and jugular veins due to pulling. I had never heard of this and I am still a bit old school, since I have always used a collar. Buffy would occasionally (a few times a year), pull hard enough to start a snorting fit.  She did this a few times over the weekend when she was not pulling hard, which I thought was unusual—another subtle sign. I need to find my harness for Buffy, starting with tomorrow’s morning walk.
• Antioxidant supplements may help for dogs with a hereditary predisposition. The ophthalmologist had recommended Ocu-glo which is a homeopathic supplement during the Thursday visit. I ordered this but haven’t received it yet.
• If your vet recommends to visit a specialist, don’t wait months to do it. This may not have changed Buffy’s outcome, but maybe it would have.
• The articles cited make recommendations to reduce stress. Maybe I shouldn’t have brought Buffy to the BlogPaws conference. She had been to one before in Nashville, but meeting so many people and being out of routine is stressful. Otherwise I don’t think hanging around the house and sleeping much of the day is very stressful—I wish I could have that life!

Please respond if you have had a pet with glaucoma or if this has provided good insightful information for you. I’d love to read your comments. Please subscribe to my posts or visit my contact page.

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