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!
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.