So we had another incident with Mac's eye last week.
Starting last Monday night, whenever I administer Mac's daily eye drops he would wince, tried to paw his eye and started keeping his eye close for a bit. Those are all bad signs. By Tuesday night Mac would just close his eyes after I give him his daily eye drop, it was as if the drops were made of acid. I have a suspicion that there is something in the eye drop that's irritating his eye or something in his eye is being irritated by the eye drop.
While his eye pressure level was just checked two weeks prior and showed fantastic score, Glaucoma is always still a possibility so I made a call to his local eye doctor Dr. Smith and they suggested I take him in as emergency right away. Thankfully it turned out to be a small scratch on his cornea and as a result, he is now sporting this goofy cone that would keep him from scratching his eye while it heals.
It has been almost a week since Mac has been sporting the Cone of Glory, below is a video of him in all his grace and glory. Doesn't he look like a four legged lamp?
Things have been slowly getting back to normal at the house. Mac is still on his various eye drops twice a day (most likely for the rest of his life) but he is back to his old active and jolly self again. Recently though I started notice that his left eye (Glaucoma eye) is becoming bigger than his right eye, worried that it may be another pressure spike I felt his eyeball through his eye lidâ€¦ still soft and the edge of the iris looked normal. After a more careful comparison between the two eyes it was actually the right eye (good eye) that seemed smaller. Actually, as it turns out, it was actually Macâ€™s left eye lash that is getting longer and fuller an
d blocking more of his eye!
Oh myyy, when did Mac grow those luxuriously long eye lashes??
I do remember reading somewhere that some entrepreneurial doctors noticed human Glaucoma patients would start growing long and thick eye lashes from using certain eye drops, so they repurposed the eye-drops for cosmetic use. Geniuses. Just like the marketers repurposing random rag dolls for 20x the cost and sell them as pet toys.
So there you have it, Mac is now looking fabulous on his left side!
With the immediate concern of eye pressure addressed Sunday night, I went home for a quick nap before going back to the emergency clinic to pick Mac up bright and early on Monday. Even with the catheter still in his leg, Mac was in good spirit. I told the vet tech that I will be taking Mac to an Ophthalmologist the same day as they recommended so they left the catheter in. The drive home was great, Mac was feeling great, I was feeling great, it appeared the end was in sight.
To my horror all the Ophthalmologists were fully booked for the day. I was digging deep and was finally able to squeeze in an appointment with Dr. Hyman of Eye Care for Animals in Annapolis (she was the Ophthalmologist that operated on Misiu). We were there promptly at 2:30pm that afternoon.
Dr. Hyman of Eye Care for Animals
After an hour drive we arrived at a complex housing 6 â€“ 7 different animal related specialists. While it sounds like a mad-house, the entire operation was run very smoothly and the environment was very clean, pleasant and bright - a tier or two above your average veterinary clinic. We were greeted by friendly staffs and the entire visit was extremely pleasant.
A bit about Dr. Hymanâ€™s practice: her style is very clinical in the sense that she is very methodical, thorough, definitive with a hint of detachment to the patient; very similar to a lot of seasoned medical doctors when they diagnose for problems. The vet techs on the other hand balanced her out with an abundant of compassion and empathy, the team members balance each other extremely well and I would highly recommend them.
The medical diagnosis of Mac was serious. While his right eye is perfectly healthy, his left eyeâ€™s optical nerves are damaged and Dr. Hyman believed he has severely diminished vision in his left eye. The first order of business was to get the eye pressure under control and reduce the inflammation, with that Mac was prescribed the following:
Xalatan (Latanaprost) â€“ 1 drop left eye 2x a day â€“ keeps eye pressure down
Dorzolamide â€“ 1 drop right eye 2x a day â€“ preventative for the good eye since Glaucoma could move lateral
Pred Forte â€“ 1 drop left eye 3x a day â€“ Steroid to combat infection
Tramadol 50mg â€“ Â½ tab by mouth 2 â€“ 3x a day â€“ Non-addictive pain killer
Doxycycline 25mg â€“ 2 capsules 2x a day â€“ Anti-bacterial
Namenda 5mg â€“ Â½ tab 1x a day â€“ human grade drug for Alzheimer, using it to protect optical nerve damage. $100 to fill!
During the examination, Dr. Hyman noted cataract (which I knew about) and some sort of tick/heartworm-related issue that she could tell from the eye examination (this actually blew me away, I had no idea and donâ€™t even know how she could see that), she made a note for Nebel St Animal Hospital and we focused on dealing Glaucoma. After prescribing the drops and oral medications Dr. Hyman educated me on the finer points of Glaucoma, the drugs she prescribed and possible surgical options if things continue to go downhill. She even explained the percentage of success and the possible gruesome result of a failed operation (something along the line of, â€œthe eyeball would shrivel up and die, it only happened a few timesâ€¦â€)â€¦ yep, just like a regular medical doctor, no sugar coating. Overall it was a great visit and the level of professionalism by the staffs inspired a lot of trust.
One odd thing that Dr. Hyman pointed out was that during the light sensitivity test, she covered Macâ€™s good right eye and shined a light into Macâ€™s left eye, if everything is working right, the right eyeâ€™s pupil should constrict too because optical nerves are wired together. However, Macâ€™s right pupil did not constrict meaning the left eyeâ€™s optical receptors may not be gathering enough light to register (bad); however, during motion test Mac clearly reacted like he could see with his left eye, so this inconsistency left us scratching our head.
Dr. Smith of Animal Eye Care
One item on the To-do List Dr. Hyman gave me was to arrange for an eye pressure check mid-week with Nebel St. Animal Hospital before a follow-up the next week. It turned out Nebel St. does not do eye-pressure check because they do not have the tool (receptionist said they could borrow one from the emergency clinic next door but seemed a bit reluctant so I did not press for it). So I gave Dr. Smith, the Ophthalmologist Suki goes to, another try. After explaining Macâ€™s situation, the receptionist explained that while they usually have a 2-3 weeks wait time there happened to be a cancellation the next day so I immediately took it. The extremely knowledgeable receptionist stayed on the phone and we discussed all the medication Mac is on right now and their effects. She mentioned that if the Pred Forte (steroid) seems to hurt Mac then I should immediately stop, because it would seriously sting if Mac does have an eye ulcer.
Wednesday came and I was in the lobby of Dr. Smithâ€™s clinic - it is definitely not as fancy as Eye Care for Animals but I was there for the medical care so the ability of the doctors and staffs are more important. Dr. Smith has a very different medical style compared to Dr. Hyman - he is much more down to earth, talkative and hands-on with Mac; although his answers usually come in the form of a discussion and not as definitive as Dr. Hymanâ€™s, they are equally sound and informative, just a very different style of patient interaction. I would also highly recommend Dr. Smithâ€™s clinic, so it would be a toss-up between geological location.
During Macâ€™s visit, Dr. Smith first stained Macâ€™s eyes to check for scratches (none, ulcer healed!) and then he performed similar eye motion and light sensitivity checks and came to the same conclusion as Dr. Hyman â€“ inconsistent reaction from light sensitivity / motion test. So he went one step further and put an eye patch over Macâ€™s good right eye and had Mac navigate through a make-shift obstacle course with just his left. I was standing at the other side of the obstacle course and called Mac overâ€¦ and of course, darn dog just stood there calmly sniffing around. Finally after a few tries his Highness Mac decided to mosey his way through the course with his left eye, yep he can see!
During the examination Dr. Smith also took reading of Macâ€™s eye pressures (right: 15, left: 9) and they looked good, he then examined Macâ€™s optical nerves and surprisingly they looked healthy as well - which did not add up because Dr Hyman said Macâ€™s optical nerves looked quite damaged and they typically do not grow back. I mentioned this to Dr. Smith and he took another look and again they looked fine. He did mention that though even though the optical nerves look fine at the moment, they may already be damaged and degenerate over the weeks so we will just have to keep the eye under observation.
This follow-up visit left me with more questions, but it is great to finally hear some good news and reassuring to see that Mac is much more comfortable and has enough sight in his left eye to navigate an obstacle course. He is still on 6 different medications though and outsmarting him on the oral medication has been a challenge, but I happy to report that we are on the road to recovery!
The last few days had been a blur, things have finally slowed down enough for me to organize my thoughts and put them all down in writing.
Our story left off after Macâ€™s visit to Nebel Street Animal Hospital for keeping his left eye closed. Afte
r two days of eye ointment there was no visible improvement, so I planned to make a follow-up appointment with an Ophthalmologist the following day on Monday. That was when I received a detailed Facebook message from the owner of Misiu (Macâ€™s relative) describing very similar symptoms Misiu had before and it was due to eye pressure. Completely convinced and half way freaked out, I quickly made an emergency appointment with the Metropolitan Emergency Animal Clinic (not even sure how the receptionist was able to make anything out, I just remember blurting out a string of unorganized thoughts) and was half way out the door when Rodel Shiba checked in to make sure I am taking Mac to the emergency vet.
Night at an emergency animal clinic is a pretty depressing place, or maybe it was just that night. While I was there I listened to a sobbing couples deciding whether to give their cat a private or mass cremation. I knew they both wanted to just go with mass cremation but it was hard to say it without feeling a sense of betrayal to the pet. Ultimately the husband mustarded up enough courage to utter the words.
Finally it was Macâ€™s turn to be seen, Dr. Mosier was extremely upbeat and engaging, which really helped in this situation. First they did a quick full body checkup, then they stained Macâ€™s left eye to check for abrasion. There were superficial splash damage across the cornea similar to what Dr. Weiss mentioned previously, except this time the entire eye took up the stain. It was good and bad, bad that the damage was broad, but good that the eye took up stain so there was tissue there to regrow properly. Dr. Mosier continued to explain that their emergency clinic gets most of these cornea injuries from when pet owners apply aerosol bug spray around their dog or when a dog got too close to a fire place. After Mac got his cornea checked out, we moved on to the eye pressure test. They took Mac to the lab in the back as I waited nervously in the examination room.
15 minutes later Dr. Mosier pushed open the labâ€™s double door with a serious faceâ€¦ ruh-oh.
Turns out Mac had extremely high pressure in his left eye, a normal canine eye runs the range up to 20, his left eye was at 60! High eye pressure (Glaucoma) is an inherited condition that occurs in many breeds of dogs, this diagnose did not come as a complete surprise as I was informed by Rodel Shiba last year that they found out Macâ€™s mother has eye issue, so him and all his siblings went in for a vision check-up. At the time Mac was determined to have narrow angle (slow drainage from the eye, which could lead to pressure build-up), but it was nothing serious. I was definitely caught off guard by how quickly and viciously this pressure spike came about, and was left with a spinning head.
Dr. Mosier immediately administered Xalatan (Latanaprost) to his left eye in order to lower the pressure. Some more time passed to observe the eyeâ€™s reaction to the drop and thankfully the pressure was lowered to 48. Dr. Mosier then recommended to keep Mac for the night in order to administer IV drip to further lower his eye pressure, I of course agreed and was at least relieved that the immediate situation seems to be under control.
As I was checking out for the night a vet tech came in with the bill â€“ I was bracing myself for this - it was a range of $680 - $960 (turned out to be $860). I thought I was prepared but I was still stunned - the thought of the follow-up Ophthalmologist visits threatened to double that amount quickly. Thinking back to that moment now, I am very glad that skimping on treatment never once crossed my mind. Instead, my brain was racing onto things I could skip buying during Cyber Monday (â€¦ everything!) or ways to earn more income to help recuperate this expense. I am glad to see that I was not bitter, but saw it as something I just had to pay and moved on from it. I remember awhile back one of my co-worker spent up to $20,000 on all his dogâ€™s cancer treatments, I asked myself if I would ever be capable of doing the same thing. At the moment I honestly did not think I would, but now I am pretty certain I would do the same.
Just before I left the emergency clinic I asked to see Mac one last time. He was housed in a top bunk cage surrounded by medical equipment. For the first time since the beginning of this ordeal he looked comfortable - standing tall with a huge grin across his face and twinkles in both his eyes - his happy look.
It was worth it.
PS - Many, many thanks to Misiu's owners for making it such a priority to reach me in time and offered extremely valuable advice and support. It is not an exaggeration to say that they may have saved Mac's eye given the volatile nature of Glaucoma.
Things had been quiet and well at the Chow Household, hence the lack of update (no news is good news, right?). Unfortunately the peaceful streak ended two days ago when Mac started wincing / closing his left eye.
While over at my parents' place f
or Thanksgiving night dinner, Mac started to wince his left eye a lot, this concerned me so we bowed out a little early to let him rest at home. The next day it progressed to him wincing a lot more and started to keeping his left eye close, this was when I took him to the vet.
Unfortunately no animal Ophthalmologist was available it being the day after Thanksgiving, so I took Mac to his regular vet at Nebel St. Animal Hospital. We lucked out that there was one time slot available and Dr. Weiss examined Mac. At this point Mac kept his left eye closed and would paw at it and without a doubt I was freaking out a bit.
Dr. Weiss examining Mac's left eye - I did not know a dog has three eyelids!
During the examination Dr. Weiss noticed a small cloudy spot on the pupil. After cotton swab, saline flush, chemical stain to check for scratches the cloudy spot was the only possible culprit. At the end of the visit Dr. Weiss sent us home with a tube of Poly Neo Bac eye ointment to be applied twice a day for a full week - it is anti-bacterial and will keep the pupil dilated to keep from painful contractions. She also explained that while cornea injury is painful, it also heals the fastest so if we do not see improvement in two days we should go back for a more thorough examination - they will have to put Mac under to check under all eyelids to make sure there is no foreign object.
Today is day two and while Mac is starting to open his left eye a tiny bit from time to time, for the most part he still kept it closed and would paw at it from time to time. My plan is that if there is no drastic improvement tonight, I will be making an appointment with Suki's Ophthalmologist when they re-open tomorrow. Fingers crossed.
Mac bummed out having to miss the Thanksgiving long weekend fun.
With the temperature hitting 100+ here on the East Coast, my friend shared the above image with me and his fellow dog friends. It is something us dog owners don't normally think about with our nice thick sole shoes. Great to be reminded during this unseasonably hot month!
We tried to do a little hiking yest
erday afternoon around Lake Needwood since most of the mountain trail was shaded and water is close, but for whatever reason the park entrance was closed. As we drove around we discovered this huge field of undeveloped land filled with tall grass; with no other alternatives in sight, we just ran through the field and called it a day.
Monday was an intense vet visit for Mac. The primary objective was to remove the black mole on his head with secondary objectives of teeth cleaning and three vaccination shots. You can say Mac was getting "The Works" - everything rolled into one day!
The decision to remove the mole was an easy one. This year it increased in size and we immediately decided to remove it just in case. I am curious to hear the result once it has been analyzed - hopefully it is nothing serious.
I dropped Mac off at Nebel St Animal Hospital bright and early around 7:30am, worked from home the rest of the day and picked him up around 3:30pm.
The good news is that Mac's troubling mole is now cleanly removed, he has whiter teeth,
and good on his shots for a few years. Bad news is he will be temporarily bald until his fur grows back in. The stitches look a bit gruesome but thankfully Mac did not seems to be bothered by it in the least bit. If he starts scratching though a cone of shame may be in order. For now he is on pain med and he seems a bit dopey, it has been an interesting challenge to find new ways to trick him into eating his pills!
I brought Mac to Dr. Hambright at Nebel Animal Hospital this afternoon for an evaluation of the black mole on his head. Mac has always had that mole, but earlier this year it seems to have gotten a little bit bigger and more pronounce. Not wanting to take any chance I made an appointment and took him in.
Dr. Hambright came highly recommended by Rodel Shiba and had extensive experience with the breed, in fact,
two other Shibas were there earlier today (Yoshi and Kenji?). While there, Dr. Hambright gave Mac a physical and everything looked great except for a little mineral build-up on Mac's back teeth. I am also happy to report that Mac is back down to 25 lbs, ideally he should be 23 lbs but we will slowly work on the remaining 2 lbs!
Upon hearing that the black mole changed in size, Dr. Hambright recommended taking the mole out just to be safe. We made plan to perform the operation in April along with a small laundry list of maintenance (teeth cleaning, tests, shots). With the bill pushing $800, it looks like my living room will have to sit without a TV for just a little bit longer! (it's okay, I still love you Mac!)
Btw - did I mention that Mac will have to shave part of his head for the mole removal? We were joking how they should just shave the other side so Mac has a mohawk!
Not sure when it happened, but sometime
between the last month and now Mac's winter coat came back fully - he is once again fluffy / porky! It is funny to compare him now versus a month and a half ago, Tracy's comment last month saying that Mac looked like a starving homeless dog was not that far from the truth! It's not going to be fun when his winter coat comes off during Spring...
Nail clipping has been one of the biggest challenges I have with Mac but I think we are finally getting a handle on it!
It has been my fault. When Mac first came to us he would just sit there and take whatever punishment I dealt out, whether it be clipper, grinder, or a combination of both. I would take my sweet time and made sure I did it right. Somewhere along the line I did it wrong and did it for too long, and his Royal Highness deemed me no longer worthy as his pedicurist. That was when I enlisted CZ's help and with our power combined we were able to get some wins under our belt. Each nail clipping session would be a small battle of wit, strength, and heart.
Fast forward to a couple months ago I visited Rodel Shiba with Mac. After telling Tom & Sandie my challenge with nail clipping, Tom put Mac on his lap while Sandie manned the clipper. Mac began to put up a fight but a firm "NO!" from Sandie was more than enough to put him right back in his place. In fact, after clipping Sandie decided to take it one step further and used the grinder to smooth out all his nails! Not one peep from Mac! My jaw was on the ground!
Tom & Sandie gave me some tips include holding Mac a certain way so he does not have leverage to kick (he was viscous with those donkey kicks!), hold him tightly when he struggles but relaxes when he stops, and most importantly, be firm and not let him know that he could get away with rebelling! The last part was the most important piece of information - it was something I already knew, but when you have a squirming and kicking Shiba in your lap it was difficult to be stone cold. This experience clearly demonstrated to me the difference between being firm vs. too lenient. Lesson learned.
Today I am happy to report that we are finally able to go through the entire nail clipping process with little to no struggle. I believe we learned to do things comfortably for each other and finally come to a mutual understanding - the Royal Pedicurist is back, baby!