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HELP ME: glaucoma and retinal detachment

Question:

Just a question out of curiosity. How common is acute angle closure glaucoma in animals? In humans, it’s one of few truly ophthomologic emergencies, but quite rare. Gregory Nee ms-4 "I’m not a doctor, but I play one at home." (Looking for a new signature line) http://marlin.utmb.edu/~gnee

Response:

– Hide quoted text — Show quoted text – Ciao everybody. My name is Vittoria, I live in Italy and I own 4 Chinese Crested bitches, all hairless. I went to Rome, to my ophthamologist vet in Italy, and I found out that one (Cookie) has a retinal detachment (complete, to her right eye) and another (Piccolina) has a glaucoma (wall-eye), to her right eye. Unluckly, this breed is rare in Italy, and vets don’t have direct experiences about its particular deseases. I’m collecting some info, like the typical deseases for Chinese Cresteds and addresses of ophthalmologist that know well this breed. Can anyone help me? Cookie can’t see with her right eye (but she feels no pain, luckly), and there is no vet who can recover her retina. Now I must check, as often as I can, her left eye: the gel that glues the retina to the wall of the eye is not in perfect conditions, so it’s in danger too. Moreover, retinal detachment could cause glaucoma too, so I must keep low her eye-pressure. The detachment probably happened very recently, since her sensibility is not completely gone. I heard about a laser procedure to her good eye, to be sure that the retina won’t detach. Does anyone know about this procedure? About Piccolina: she felt pain, and she can’t see with her right eye. If the glaucoma was cared within 48 hours, she could recover the sight. But I took her from her previous owner about 1 week after the glaucoma appeared (TOO LATE!). Moreover, the glaucoma also caused a crystalline lens luxation. Now, for her, I must choose among: – eye removal (100% of success, but it won’t sure be my choice!) – injection in her eye to decrease the eye pressure (66% of success, the pressure could increase again, her eye could become soft or too small, different from the other) – silicone prosthesis to replace her globe, her front of the globe will be kept (95% of success, the eye will be like the other) – laser surgery (to "kill" the cells that produce the aqueous humor, and also to preserve her good eye) –but I’m not sure if my ophthalmologist does it– Of course, I must pay attention to her left eye too, and also to her daughter’s eyes because it could be inherited. By now, I’m using medicines to lower the eye pressure, waiting the day of the surgery, and Piccolina seems to feel better (her pressure was 83! She had a super-headache, probably.) Which solution would you try if they were your dogs? Do you know if there is any vet who recovers retinal detachment in Europe? Thank you in advance! Vittoria

Greetings. Vittoria: I am writing as a veterinary student in hope of assisting you and your dogs.  Regarding Piccolina, the veterinary ophthalmologists here usually recommend, for a painful eye which can never see again, to make the dog comfortable.  This means, in practice, that one must remove the eye or replace it with a prosthesis, two of the procedures you listed.  While the dog will live just fine lacking a globe (eyeball), the aesthetics are less than acceptible to many people, and you may have a happy animal and the owner may be happy, but the owner has to endure the (seemingly) constant barrage of disparaging comments and fear/loathing from friends, neighbors, and passers by that an unattractive, obviously disfigured, pet seems to engender.  On the other hand, animals which have a prosthesis implanted generally have relatively normal appearance after surgery.  Occasionally, the cornea discolors due to corneal edema, but even in these cases the result is generally acceptible:  in most cases, the result is attractive and does not leave the dog looking "defective".  The ophthalmologists here generally do not try to manage the blind glaucoma eye in any other way, as the chances for success (=nonpainful) are not good in the long term, and require a great deal of management.  The first glaucoma eye (usually lost as you describe due to not being aware or capable of obtaining qualified veterinary care fast enough…our people indicate that as narrow a window as perhaps 6 to 8 hours exists in which an acute glaucomic eye might be saved) must be considered to be the warning that another case of acute glaucoma is likely, and requires much more attentive monitoring of the remaining healthy eye searching for early warning of glaucoma.  A device called a "tono-pen" is recommended for practitioners to use to monitor the eye’s pressure, and is far superior to the Schiotz Tonometer which was formerly recommended.  Drugs and/or surgery (often the laser procedure you mentioned) are used as needed to try to balance the production of aqueous humor (the fluid material filling the front chamber of the eye) and the drainage of the aqueous humor, to prevent the acute sharp rise characterizing acute glaucoma. In the case of Cookie, I have heard of human physicians using a laser procedure to "tack down" a loose but not-yet detached retina.  Again, time is of the essence, as the retina, once detached, loses function (and thus vision) very quickly.  I have no experience regarding this procedure in dogs, however. My best wishes to you and your dogs… good luck managing their conditions.  If you need additional help, you may be able to find assistance at a nearby college of veterinary medicine or a large referral center. Sincerely, Ronald D. Clise, VME III Ohio State University College of Veterinary Medicine Please Note:  I am NOT a veterinarian.  In the absence of a traditional veterinarian-client-patient relationship, this information should be taken as a friendly opinion, not as an official clinical recommendation. Commercial/bulk/solicitation email <spam unwelcome.

Response:

Ciao everybody. My name is Vittoria, I live in Italy and I own 4 Chinese Crested bitches, all hairless. I went to Rome, to my ophthamologist vet in Italy, and I found out that one (Cookie) has a retinal detachment (complete, to her right eye) and another (Piccolina) has a glaucoma (wall-eye), to her right eye. Unluckly, this breed is rare in Italy, and vets don’t have direct experiences about its particular deseases. I’m collecting some info, like the typical deseases for Chinese Cresteds and addresses of ophthalmologist that know well this breed. Can anyone help me? Cookie can’t see with her right eye (but she feels no pain, luckly), and there is no vet who can recover her retina. Now I must check, as often as I can, her left eye: the gel that glues the retina to the wall of the eye is not in perfect conditions, so it’s in danger too. Moreover, retinal detachment could cause glaucoma too, so I must keep low her eye-pressure. The detachment probably happened very recently, since her sensibility is not completely gone. I heard about a laser procedure to her good eye, to be sure that the retina won’t detach. Does anyone know about this procedure? About Piccolina: she felt pain, and she can’t see with her right eye. If the glaucoma was cared within 48 hours, she could recover the sight. But I took her from her previous owner about 1 week after the glaucoma appeared (TOO LATE!). Moreover, the glaucoma also caused a crystalline lens luxation. Now, for her, I must choose among: – eye removal (100% of success, but it won’t sure be my choice!) – injection in her eye to decrease the eye pressure (66% of success, the pressure could increase again, her eye could become soft or too small, different from the other) – silicone prosthesis to replace her globe, her front of the globe will be kept (95% of success, the eye will be like the other) – laser surgery (to "kill" the cells that produce the aqueous humor, and also to preserve her good eye) –but I’m not sure if my ophthalmologist does it– Of course, I must pay attention to her left eye too, and also to her daughter’s eyes because it could be inherited. By now, I’m using medicines to lower the eye pressure, waiting the day of the surgery, and Piccolina seems to feel better (her pressure was 83! She had a super-headache, probably.) Which solution would you try if they were your dogs? Do you know if there is any vet who recovers retinal detachment in Europe? Thank you in advance! Vittoria

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