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), I came home..his left eye and it seemed to be bothering him..rushed…

On June 11th (15 days...
On June 11th (15 days ago), I came home and discovered that Blizzard was squinting his left eye and it seemed to be bothering him. I also noticed some discharge from the eye and some tearing. I immediately rushed him to the vet and the doctor performed an eye stain. The doctor said that no evidence of corneal scratching was present. The doctor prescribed Neo Poly Dex for the weekend (this visit was on Friday) and we started the treatment. The condition seemed to improve a bit for the weekend, but then seemed to stop improving. I returned to the vet on Tuesday (3 days after starting the drops) and we saw another doctor. She tried to do another eye stain to make sure that nothing had changed, but Blizzard was still squinting and was in discomfort. On a side note, he is comfortable going to the vet and always seems happy. He is not fearful of the vet. She used some drops to numb the eye and he almost immediately opened it up. He let us perform the eye stain and no corneal scratching.


Since we were concerned and Blizzard wouldn't let the doctor look at the eye, she provided some options. We decided to sedate him and she had a chance to look at eye. She did the Schrimmer Tear Test while he was sedated and measured tear production in both eyes. The problem eye (left) had significantly little to no tear production. After he woke up, she said that it looks like he might have dry eye. She prescribed 5 Novox tablets (1/2 a tablet every 12 hours) for pain/inflammation, Tobramyacin, and Optimmune. I started the medications and he has been taking them since June 15th (11 days).


Within a few days, his condition improved significantly. No longer was his eye shut. On Thursday of this past week, I brought Blizzard in for a follow up. The doctor said she saw a significant difference in the shininess of the eye. However, the pupil in the eye was dilated. She said to continue the medicine since we don't want to change anything since it appears to be helping. However, in his eye, the dilated pupil takes up most of his eye. She said that he doesn't appear to have lost any vision in that eye, but was hoping that the pupil would return to it's normal size.


I started doing some research and started reading about glaucoma and that he might have suffered some type of brain injury since the pupil is dilated. There is a lot of information on the Internet and now I'm starting to be concerned. I have taking a very proactive approach to treating this issue and have stayed on top of his medications. Blizzard seems himself, he's happy and playful. Eating and drinking okay. However, I am just extremely concerned with the fact that the pupil is dilated. I am not sure if it takes a few weeks to see improvement with the medication that was prescribed. I also failed to mention that I have also been giving putting in artificial tears with no preservatives in his eyes. When we were there last week for his follow up, she did another tear test and both eyes were well within normal range. We were very excited about this. However, again I'm extremely concerned about his dilated pupil. On a side note, the cloudiness that we saw in the blue part of his reduced as well when we started the medication.

Any feedback, answers, comments, would be greatly appreciated.
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Answered in 8 minutes by:
6/27/2010
Dr Will
Dr Will, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 649
Experience: 35 years experience in clinical and surgical practice.
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Hi and Welcome to Just Answer!

 

Thank you for your post. I will try to help but first, let me ask, was atropine used at any point during an exam or to help with eye pain?

 

Dr. Will

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Customer reply replied 8 years ago
Dr. Will,

Thank you for the prompt response. Glad to hear that you're a fellow Texan. From my understanding, Atropine was NOT used. It is to my understanding that its purpose is to actually dilate the eye. However, I do not believe it was used. Another vet in the doctor's office asked me the same question. I apologize for the lack of paragraphs in the question, but the system doesn't support multiple paragraphs on my end. I just looked over all my invoices and do not see any charges for Atropine.
Customer reply replied 8 years ago
Dr. Will, I answered your question above. But after reading about Atropine, I learned that it can take up to 2 weeks for it to wear off. I'm really hoping that's what happened and the doctor just failed to make notations in her notes about it. If that's the case, then the pupil should return to its normal size?
Customer reply replied 8 years ago
I also failed to mention that while he was sedated, she checked his 3rd eyelid to make sure no foreign body was present. Hoping you can provide some insight based on your experience.

Hi again,

 

Well, it is common to use atropine in a painful eye and that would be my first thought. Perhaps a dose was applied as a single treatment and not charged for. It is also common for a single dose of atropine to cause dilation of the pupil in excess of 7 days.

 

If it not dilation due to atropine, then yes, you should keep a watch out for glaucoma. The first thing to do is request glaucoma testing (measurement of the eye pressures). Even if they are normal, it gives you a baseline to see any changes.

 

A nerve injury or brain injury ONLY effecting the pupil of one eye would be hard to explain. There are cranial nerve injuries described but they will effect the eyelids (drooping) and face as well (horners syndrome).

 

The final consideration for an unresponsive pupil would be blindness -- retinal damage. This would be diagnosed with a retinal opthalmic exam (fundic exam), menace testing and possibly an ERG (electronic retina gram) -- usually performed by a veterinary ophthamologist.

 

If there is no progress over the weekend or no clear answers come Monday, you might request a referral to a veterinary ophthamologist. There are some excellent ones in Dallas and Houston --- depending on where you live.

 

Dr. Will

 

Dr Will
Dr Will, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 649
Experience: 35 years experience in clinical and surgical practice.
Verified
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Customer reply replied 8 years ago
Dr. Will,

Blizzard has been on the medication for 11 days now. If Atropine was used, in your experience, would the eye still dilated? Also, I live in Lubbock.

Hi again,

 

I have seen it up to 2 weeks, but usually it resolves in 7 to 10 days. That's why I think come Monday -- if he's still dilated, consider a referral to an opthamologist.

 

Hopefully, you will notice improvement tomorrow, but if not, start pursuing a diagnosis.

 

Dr. Will

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Customer reply replied 8 years ago
Dr. Will,

Thanks for the reply. I gave him his last dose of Optimmune ointment about 2 hours ago. It's about time for more artificial tears (every 4 hours), should I gave that to him now or will it interfere with the Optimmune? If so, I can wait until the morning.

Have a great evening.

If it has been 2 hours from the optimmune, then it's OK to give the artificial tears.

 

Dr Will

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Customer reply replied 8 years ago
Dr. Will, It looks a little better today. However, I noticed that when we were outside the dilation did not go away and it was sunny outside. I'm hoping and praying that we see significant improvement sometime soon. Do you think I should reschedule an appointment with the vet? Since we live in Lubbock, I don't think they are any opthamalogists around. Do you by chance know? If not, who in Dallas do you recommend?

Hi again,

 

First, before going all the way to Dallas, I would have your vet recheck Blizzard. He/she can do a pupilary light response test to see if the pupil is beginning to respond. If it is responding some, then give it a few more days and recheck.

 

IF there is no response or your vet thinks Blizzard should see an opthamologist, then the one I would see in Dallas is Dr. Bob (Robert) Munger, DVM. Your vet will be able to make the referral with Dr. Munger for you.

 

Just in case you need it, here is his contact and website: http://eyedvm.com/

 

I hope Blizzard gets better every day! Please keep me posted.

 

Blessings!

 

Dr. Will

 

 

 

 

 

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Customer reply replied 8 years ago
Dr. Will - I have an update for you. We travelled early this week to Dallas and met with the doctors at the office you recommended. Blizzard was diagnosed with primary glaucoma and secondary uveitis. He is on a few different drops to help keep the pressure down in his eye. Do you know if it's ALWAYS true that glaucoma will also spread into the other eye? I'm devastated by learning this information, but at least we are treating the eye to keep him comfortable.

Hi again,

 

Thank you so much for keeping me posted. I am sorry to hear about Blizzard's glaucoma. I was afraid of this, that's why I wanted you to see the ophthalmologist.

 

It is reported that primary glaucoma usually ends up affecting both eyes so be prepared for this. The goal of treating primary glaucoma is comfort. Be prepared for blindness. As hard as it is to accept, blindness follows on the heels of primary glaucoma in dogs. It is rare to be able to save sight. Therefore, the goal is to keep the patient comfortable and hopefully preserve the eye.

 

Dogs that go blind do far better than people. My associate has a Bassett with primary glaucoma that is now blind but he never misses a step. He goes on his daily walks and rarely walks into anything. Blizzard will be slightly handicapped, but you will be surprised at how well he gets along.

 

My heart goes out to you and Blizzard. Please keep me informed.

 

Dr. Will

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