Monday, April 7, 2014

1350. Tarsorraphy in 2 Shih Tzus

Some vet books, vet professors and vets are not in favour of tarsorrhaphy. I encountered a recent Murdoch Univ vet graduate who said to me that it is a waste of time.

In this case, Shih Tzu (Shih Tzu 2), male, 10 years, first time corneal ulcer went home on the same day. Today, the 7th day, I noted that the tarsorrhaphy procedure seemed to be successful for the following reasons:

1. Early detection. Probably one to two days when the parents came back from overseas and saw the 10-year-old Shih Tzu with right eye closed. The dog was cared by the daughter.

2. Keratitis traumatic - 3 classifications. Superficial, penetrating and perforating. This case is penetrating unlike the first Shih Tzu (Shih Tzu 1) which is perforating as I saw some anterior chamber watery liquid squirting out and the red basement membrane bulging out, a Descemetocoele.
Both dogs were operated by Dr Daniel.

3. Shih Tzu 2 was closely supervised at home by the retiree parents unlike Shih Tzu 1 who was left alone. He was crated on the first day. Cried to get out. So, the next 6 days, the elderly parents stopped their taiji exercise to take care of him while he roamed around the apartment. They complied with nursing instructions to give eye drops 2- 3 x/day, painkiller tolfedine 60 mg (1/2 tab /day),  vibravet 100 mg (1/2 tab/day 14 days) and multi-vitamins.

4. So, today, they came for a review at the  7th day. Eyelids still closed by stitches. A 2-mm gap is seen rather than loose sutures.

5. The dog was examined and there was no pus inside the eye. A small gap on the medial side allowed eye drops to be instilled. I prescribed Rimadryl 75 x 2 tablets at 1/2 tab per day from tomorrow. Another bottle of eye drops. 2 bottles have been used.

6. The final proof of good surgical outcome will be at the 14th day. Another 7 days later, the stitches were removed. His central ulcer was healed. However he had a fluorescein-green ulcer from 4 to 7 o'clock and pigmentation on the lower left quadrant. "He must be wiping his e-collar on the floor," I said to the retired couple. "He  was supposed to be crated for at least 10 days, but he was free to roam." In tarsorrhaphy cases, it is best to hospitalise the dog but tnis owner wanted the dog home.  

In Shih Tzu 1, the dog was warded for 7 days and crated. Nursing care was given as above. The stitches came loose around the 7th day and were taken out. There was cloudiness in the central corneal ulcer due to corneal edema. This was part of thel corneal healing process. .

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