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A year old small mix breed has had a deep eye scratch.

A year old small...

A year old small mix breed has had a deep eye scratch. Treated for months with ointments. Eye still not healed and has lost vision in eye. Eye has discharge that is cleaned frequently. Our vet recommend a specialist now. Tight budget.What will heal eye?

Veterinarian's Assistant: I'll do all I can to help. What is wrong with the dog?

Deep eye scratch that hasn't healed. She now blind in eye. How do we heal so she can live and adjust. Treated with ointments from vet for months.

Veterinarian's Assistant: Where does the dog seem to hurt?

No pain eye closes and has discharge.

Veterinarian's Assistant: OK. What is the dog's name?

Berdie

Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about Berdie?

Year old belongs to grandchildren. Seem healthy otherwise. Took to vet the first time a couple days after got her for this eye problem.

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Answered in 1 hour by:
3/22/2018
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,848
Experience: Over 20 years of experience as a veterinarian.
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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I'm sorry to hear that Berdie has a deep scratch that has been treated for months, yet is not healing which has led to vision loss.

Corneal ulcers that don't heal normally and quickly are called indolent ulcers. There can be indications that this may be an indolent ulcer. We can see flaps of corneal tissue at the edges of the ulcer rather than a sharp edge that indicate an ulcer that may have trouble healing, or the ulcer may be deep or larger than normal, or she may have blood vessels forming on the cornea indicating the ulcer isn't a simple one.

With an indolent ulcer the best chance we have of getting it to heal properly as quickly as possible is to debride the lesion and then protect the ulcer with a temporary third eyelid flap or a soft contact lens.

If we don't treat indolent corneal ulcers aggressively they can turn into a melting corneal ulcer and the eye can rupture.

In some cases dogs have to have an even more aggressive surgery called a conjunctival flap to treat indolent ulcers and save the pup's eye.

If referral to a veterinary ophthalmologist is not an option due to finances then another option is using oral nonsteroidal anti-inflammatories for pain and inflammation, antibiotic eye medications to prevent secondary infections and eye drops with hyaluronic acid to help protect the eye while it is healing and keep it moist. She should be rechecked in 5 days and if the ulcer isn't gone or almost cleared with that protocol then you can decide to go ahead with more aggressive therapy at that time.

I think that your veterinarian is doing their best to get her eye to heal as quickly as possible on a limited budget, but as you are aware that may not work.

Of course ideally because she isn't healing we want to make sure that there isn't an underlying reason for the ulcer, like hypothyroidism.

The likelihood of rupture depends upon how deep her ulcer is, whether her eye becomes secondarily infected with bacteria which leads to a melting ulcer and whether her eye gets further traumatized.

She doesn't have to go blind permanently unless the ulcer continues to worsen and the eye ruptures or becomes infected.

In most cases if she is no better or is worsening after a week's time then even with more aggressive topical treatment she is not going to get better without some sort of debridement.

Here's how I handle corneal ulcers once we know there is one because his eye took up stain.

Immediately start antibiotic drops to prevent secondary bacterial infections and recommend using it 4 to 6 times a day for 5 to 7 days until the pup is rechecked.

Use atropine ointment to reduce eye spasms and pain for a few days.

Recommend artificial tears 4 to 6 times daily to keep the eye hydrated, especially in dogs with big eyes like Chihuahuas.

In dogs that I have concern about healing (large ulcers) I recommend eye drops with hyaluronic acid to help protect the eye while it is healing and keep it moist.

Oral nonsteroidal anti-inflammatories (carprofen, meloxicam) to reduce inflammation that interferes with healing and for pain.

Keep the dog calm and out of bright light.

Use an elizabethan collar if the pup is rubbing her eye.

In dogs with a high percentage of indolent (non healing) ulcers I tell people that surgery may be needed. That can vary from a topical anesthetic and debridement with sterile cotton swabs, to grid keratotomy, with or without a contact lens or third eyelid flap, to a conjunctival flap (usually done by a veterinary ophthalmologist).

If the pup is relatively well behaved and calm and the ulcer is fairly small then they usually tolerate a topical anesthetic and debridement with a sterile cotton swab because they cannot feel what we are doing with the application of a topical anesthetic.

If the ulcer is large then that likely is not an option.

I would not recommend a grid keratotomy on an awake dog because that has potential for disaster if the dog moves.

I would talk with your veterinarian, ask for more specific information about your pup's particular case and if they are amenable to at least trying an anti-infalmmatory and additional topicals first for another 5 days or so, or if they are comfortable trying a topical anesthetic and debridement with no third eyelid flap to see if that works. Make sure that they understand that you want your dog happy, comfortable and healing but finances are holding you back.

In some cases where the eye is so compromised the pup becomes blind due to retinal damage, and the eye starts to collapse and becomes a nidus of infection (called pthisis bulbi) it may be better to remove the eye surgically.

It has been my pleasure to help you today, and I hope that I have earned my 5 star rating. Please remember to rate my service by selecting the 5 stars at the top of the screen (rating me now does not close your question). You are welcome to ask follow up questions about my response here until you are satisfied, simply use the reply box and let me know. Thank you!

Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,848
Experience: Over 20 years of experience as a veterinarian.
Verified
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Customer reply replied 4 months ago
Thank you . Berdie has had numerous rounds of ointments and rechecks. The eye has dulled and appears slightly smaller now. So I know she will never see in it again. We will follow up with a different Vet locally. Could cleaning aggressively harmed her eye?
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