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Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 19294
Experience:  DVM, Emergency Veterinarian, BS (Physiology)
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My dog has glaucoma and is being treated for it, his eye pressure

Customer Question

My dog has glaucoma and is being treated for it, his eye pressure still 31, but a week ago when illness was discovered was 48. Vet also said her good eye has hereditary glaucoma, so she put the dog's good eye on preventive care for glaucoma, but told me she has a black point in the back of the eye and it's melanoma.
She said if the eye pressure (the one with glaucoma) doesn't go down, she needs to take the eye put because glaucoma is very painful. But my dog doesn't seem in pain.
What should I do? I love my dog, but I don't want to put her in the misery of having her eye removed and then put her down in four months because she had the melanoma spread.
Thank you
Submitted: 4 years ago.
Category: Dog Veterinary
Expert:  DrChristineM replied 4 years ago.
Hi--was this a veterinary ophthalmologist who diagnosed the melanoma, or a general practice vet?
Expert:  DrChristineM replied 4 years ago.
Hi--please respond here. If you post a second question, it will be deleted. Thank you!
Customer: replied 4 years ago.
It was diagnosed by a veterinary ophthalmologist.
Expert:  DrChristineM replied 4 years ago.
Ok, thank you. The melanoma is very concerning. This is a very tough situation. I don't envy you in this.
If there is any way you can get a second opinion from another ophthalmologist, I would suggest doing this. They may suggest other, more aggressive options for the glaucoma so that we can get that pressure down. Or they may have a different idea about what that black spot may be. Getting a second opinion doesn't mean you have to go along with what they propose, it just allows you to get more ideas, or to confirm that you have all the available information.
If you are faced with resistant glaucoma, and the melanoma is definite, then what to do? Removal of the eye with the melanoma may actually be a good idea--in dogs, metastasis of ocular melanoma is not that common (far more common in cats). Again, another reason to confirm that this is really what we have, and get a good idea what our other options are.
Let me know if this helps, or if I can answer any other questions.
Customer: replied 4 years ago.

So what are you saying is to remove both eyes? I thotugh you wee an expert and could tell me if there where other solutions. I know I can go to another ophthalmologist, I don't need to pay a fee for you to tell me that

Customer: replied 4 years ago.
Relist: Other.
I'm asking a question regarding a professional opinion, not a question where someone will tell me that he/she thinks I should get another opinion from an ophthalmologist. I thought she was the expert and it's not.
Expert:  Dr. Gary replied 4 years ago.

First off, Christine did give some good advice. I'll try to help out a little further.

I would try to get a needle aspirate of the black spot to confirm the melanoma before removing the eye. She can be anesthetized and use magnification or even ultrasound to guide a needle into the black lesion. If that can be done, then you'll know what you're dealing with. If it's Melanoma, then you take out the eye. No question about it, you want to prevent metastasis. You can then give the Melanoma vaccine to help prevent spread. If you want to just go with the vaccine, that's an option as well but you may end up with a metastatic cancer if it doesn't respond. The response rate with the melanoma vaccine is ~ 60%.

With the glaucoma, you need to get the pressures down. If you cannot effectively bring the pressures down < 30, then I would remove the eye. I know she's not acting painful, but we know from people that glaucoma is incredibly painful. One thing that many ophthalmologists will tell you is that owners are always happy with the results after removing a chronic glaucoma eye or eyes. These guys act like new dogs again when you get rid of that chronic pain. It's amazing.

Worst case here is that you end up with a dog that needs both eyes removed. This is something that we do a lot in glaucoma dogs. It's not uncommon at all as glaucoma is hard to manage and many dogs don't respond. She can still have a good life. Blind dogs compensate very well to being blind.

In the mean time, I'd have her on Cosopt in the glaucoma eye and also think about systemic diuretics as conjunctive therapy.

I hope this helps, let me know if you have any other questions.