Wednesday, January 6, 2016

2906. INTERN. Saving the eye of a 14-year-old Silkie - 3rd eyelid flap and tarsorrhaphy

Jan 5, 2016 (10th day of surgery)

Dogs suffer from injuries to the eye. In this dog, he had a deep corneal ulcer (deep ulcerative keratitis).

All vets have their own techniques and ways to treat deep ulcerative keratitis in the dog. In this case, the vet advised total removal of the eyeball (enucleation) as the dog had been suffering for around one month of eye injury and pain.  The owners sought me for a second opinion and to perform the enucleation.  I advised a 3rd eyelid flap and tarsorrhaphy to save the dog's eye. As eye injuries are emergencies, this operation will have been most successful if performed within 24 hours.

But the corneal ulcer was deep and had extended for the past month.

Day 1. The dog was present as in this image. I gave the dog an injection of antibiotics and anti-inflammatory.

Day 2. The dog's eye before surgery (3rd eyelid flap and tarsorrhaphy). You can see much inflammation of blood vessels radiating into and surrounding the corneal ulcer.

Video of surgery

Day 14.  The eyelid stitches are taken out.

The dog is at home after 10 days of in-patient. The son wanted the dog home on the 3rd day but finally decided not to as the stitches will breakdown due to rubbing. The dog will be rubbing his eye against the bed and table legs when at home moving around. In the surgery, the dog's eye is checked twice a day, eye drops are applied, antibiotics and painkillers Rimadyl tablets are given for 4 days.

Unless the owner is skilful in nursing, an excellent outcome can only be achieved by in-patient treatment for 10-14 days. 

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