Toa Payoh
Vets Clinical Research Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures
EYE-BALL IS BADLY DAMAGED IN A CHIHUAHUA
Enucleation surgery
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written:
03 March, 2010
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129
The mother and
teenaged daughter adopted the abandoned Chihuahua. For
the past 2 weeks, the dog was rubbing her eyes. Dirt and
bacteria get trapped inside the eyes, irritating the
dog. So, she rubbed more. When I was consulted, the eye
cornea was
deeply
ulcerated. A 3rd eyelid flap would be the surgery and
would have saved his eye sight if the owner had not
delayed seeking vet treatment.
In addition, this Chihuahua had a serious heart disease.
Panting when at rest. More panting when excited. A
pre-anaesthetic sedation using Domitor might be too
risky.
Therefore, I did not proceed with the surgery as she
would likely just die on the operating table. A 90%
chance of dying. The owner accepted the risk but since
this is a very high risk, I did not want to risk my
reputation in handling this case.
The dog went home with heart drug medication,
antibiotics, eye ointment and an e-collar. It was better
to have a live pet as the teenaged daughter was attached
to her. No vet wants a dead dog as a result of
anaesthesia. No owner wants that too.
One week later, the eye ulcer had perforated. A white
plug of gel oozed out. What to do now? Bacteria would
get inside the eye causing enopthalmitis. Uveitis was
controlled by eye drops. There was one solution. Surgery
to remove the whole eyeball (enucleation).
Performance counts. In this case, a good performance is
a live dog at the end of the surgery. The following
management of this case is shared with readers and vets:
1. Dog was already on Fortekor for the past 7 days. She
was no longer panting but dislike direct mask isoflurane
gas. Struggled. I did not risk masking her since she
might just collapse of heart failure during the fight to
get out of the mask. So, a sedation injection was
needed. Domitor or zoletil? Which is safer? Does
Domitor cause heart rate to slow down? How about
xylazine? It causes hypotension. Eventually, I used
Zoletil. But how little that can be effective is needed
for this 2.5 kg dog?
2. Pre-anaesthetic dextrose saline 20 ml SC and
antibiotics.
3. Weight was 2.5 kg. Thin.
Pre-anaesthetic dose of Zoletil 50 @ 0.2 ml IM.
Atropine 0.65mg/ml @ 0.2 ml IM to prevent salivation,
neck twisting from Zoletil injection.
Isoflurane gas mask and then intubate.
4. The dog's eyelids were shaved fast. The eyeball was
taken out in <10 minutes.
5. The teeth were scaled. 4 loose ones extracted.
6. The dog was on <1% isoflurane gas and was
anaesthesized without problems. For a short
period, I disconnected the gas and the dog was not
awake. So, I could continue surgery. When the dog moved,
I re-connect the gas. This close observation and not
giving too much anaesthesia ensures the survival of the
patient.
7. Post-op dextrose saline 20 ml SC, antibiotics and
tolfedine painkillers.
8. Dog went home on Day 2. No problems. Everybody is
happy when a dog is alive at the end of surgery and
anaesthesia. If the dog had been operated earlier, she
would have had died on the operating table as she never
had been checked up for heart disease and was not
stablised on heart medication. Pictures of the eye
injuries are below.
EYE INJURIES ARE EMERGENCIES
SEEK
TREATMENT WITHIN 24 HOURS, NOT
AFTER 14 DAYS
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129
TOA
PAYOH VETS
