What do I need to do for my pet before surgery?
Unless Dr. Low tells you otherwise, continue your pets medications as perscribed until you bring him/her in for surgery. On the evening before surgery, do not feed your pet after 10:00pm. Water is fine. Please bring all your pets medications with you. If your dog is a diabetic, Dr. Low will give you special instructions for feeding your dog and giving it's insulin the morning of surgery.
How will my pet adjust to being blind?
Blind dogs and cats can be very happy pets. Here are a few bits of advice that will make the transition easier:
1. Avoid changing your pet's environment, such as moving the furniture.
2. Encourage your pet to use his other senses to compensate for vision loss.
a. Provide toys that are noisy or have a recognizable odor.
b. Get a companion pet that your blind pet can follow around using hearing and smell.
3. If your pet is blind due to cataracts, it is wise to observe his eyes daily for changes that may be indicate glaucoma or uveitis, which are painful. These changes include bloodshot eye, increased size of eye, pawing at or rubbing the eyes and change in position of the cataract.
4. Encourage exercise, whether in a fenced yard or on a leash.
5. Teach your pet the location of the food and water bowls and keep their location constant.
6. Some behavior changes (aggression, depression, fear, etc.) accompany sudden blindness. Avoid stressing or startling your pet. Inform family members (especially children) of the new condition.
7. A good reference book is available called Living with Blind Dogs. Please contact Dr. Low for more information.
Does your pet have cataracts?
Cataracts are opacities (cloudy areas) in the lens of the eye. They can be compared to a window that is frosted or fogged with steam. The lens is the structure that sits behind the iris and pupil and is responsible for detailed focusing. Cataracts can be inherited or they can be age related, but they can also be caused by trauma, nutritional deficiencies, diabetes, infection or inflammation in the eye. Many of these will progress to the point of blindness but certain types can remain small for the entire life of the patient. Cataracts will appear bluish/grey or cloudy when you look through your pets pupil. You may notice that your pet is not seeing as well and may be bumping into walls or furniture. Cataracts can lead to inflammation inside the eye resulting in pain, glaucoma, and permanent vision loss. If you think your pet has cataracts, see your veterinarian or ask for a referral to see Dr. Low as soon as possible. Although there are no medications or dietary supplements that have been proven to prevent or cure cataracts, the inflammation caused by them can be treated to keep your pets eyes comfortable, or cataract surgery can be performed to restore your pets vision. Dr. Low can determine if your pet has cataracts and can perform specialized tests on the eye to determine if they are a good candidate for surgery. In most cases, the sooner cataract surgery is performed the better the outcome and prognosis for vision. Often, Dr. Low will remove cataracts in each eye during the same surgery. The surgery is performed in pets the same way it is done in people. Dr. Low has specialized training and modern equipment that uses a small probe to break up the cataract with ultrasonic vibration and draw out the particles. Many people believe that cataract removal is done with a laser, but that is incorrect. In most cases, once the cataract has been removed, a new synthetic lens is placed in your pets eye, restoring near normal vision. Approximately 90% of pets have excellent long-term vision after surgery.
How are cataracts treated?
Treatment for cataracts is surgical removal and may be done in one or both eyes depending on the specifics of each patient. There are on medications or dietary supplements that have been show to prevent or cure cataracts. Before surgery is performed, your pet may have two special tests beyond the full eye exam to check the health of the retina or nerve layer in the back of the eye. These tests, called the ERG (electroretinogram) and ultrasound are NOT PAINFUL and have virtually no risk associated with them. If your pet does not pass these tests, removal of the cataracts would not improve vision and therefore, surgery should not be performed.
Cataract surgery is elective and requires a significant time commitment on your part. Eyedrops must be administered several times daily before surgery and for a couple of months after surgery. The patient must wear a protective plastic e-collar for at least 2 weeks after surgery, and your pet will not be able to be groomed or vaccinated during the 6 week healing period. The postoperative checkups are usually performed the day after surgery and then one, four, and eight weeks after surgery. At that time, medications may be gradually discontinued and long term checkups are made about 6 months after surgery and then once a year. The success rate is OVER 90% but as with any surgery there are risks. Vision-threatening complications that may occur include glaucoma, retinal detachment, and scar tissue formation.
The surgery is performed under general anesthesia and depending on the specifics of the cataracts, age, and cause, Dr. Low may perform either a small incision technique (phacoemulsification) or a large incision method (extracapsular cataract extraction). The small incision technique is more common today and carries the benefits of shorter surgery and healing times. Phacoemulsification is the same technique performed for human cataract removal; the tiny probe breaks up the cataract with ultrasonic vibration and draws out the cataract particles. After removal of the cataract(s), Dr. Low usually suggests replacement of the lens with an artificial lens to obtain sharper vision as is the case in human cataract surgery.
My dog is having cataract surgery, what do I need to know?
In the past five years, specialized training and modern equipment have drastically improved the success rate of cataract surgery. Approximately 90% of dogs have excellent long-term vision after surgery.
As with any surgery, cataract surgery has potential complications. Some Complications are short term and resolve with treatment. Regrettably, some complications are severe and blinding. Very rarely eye removal or an intraocular prosthesis is necessary to resolve the complication. To minimize the complications, we request diligent administration of prescribed medications and frequent re-evaluations after surgery. Glaucoma, or increased intraocular pressure, may occur post operatively. Glaucoma may or may not be controllable with medication and can be vision-threatening. Uveitis, or inflammation within the eye, may occur and potentially require life-long medication. Retinal detachment is a possible complication due to the nature of the surgical procedure itself. Eye infection after surgery is rare because surgery is performed using sterile technique. Scar tissue formation around the intraocular lens and around the surgical incision are other possible complications. General anesthesia is a risk in itself. However, we take all precautions by performing complete pre-operative blood work, a thorough physical exam, employing the most current anesthetic protocols, and diligent anesthetic monitoring to ensure the safest anesthesia possible.
Getting Your Dog Ready for Surgery:
In the days or weeks prior to surgery you will be administering topical and oral medications to prepare your dog for surgery. It is very important to follow all instructions on these medications as they improve the success of surgery and keep your dog comfortable until surgery can be performed.
What Happens the Day of Surgery?
Please bring all of your dogs medications with you on the day of surgery, as we will need to use them throughout the day. If your dog is a diabetic, we will have special feeding and insulin instructions for you on the morning of surgery. Bring the insulin with you. We will closely monitor your dogs blood glucose before, during, and after surgery taking appropriate actions to maintain normal levels. We will administer pain control and sedative medications before surgery to help keep your dog calm. We will place an intravenous (IV) catheter in his or her leg to administer intraoperative antibiotics, anti-inflammatory injections, fluids, and other necessary medications. For surgery, we will place a breathing tube in his/her trachea (windpipe) to administer oxygen and gas anesthesia. We will closely monitor heart rate and rhythm, blood pressure, blood oxygen levels and blood carbon dioxide levels throughout the procedure. Cataract surgery takes approximately 2-3 hours. After your dog awakes from anesthesia we will closely monitor his/her comfort and vision will be evaluated. We will measure the pressure within the eye to ensure it stays within normal limits. Typically, your pet will be able to go home on the same day as the surgery.
What Happens After Surgery?
Your pet will go home the same evening but will need to return to our office the following day for a recheck. Frequent recheck exams after surgery are necessary to ensure proper healing takes place. We will need to see your pet 1 day, and approximately 1 week, and 2-4 weeks post-operatively. From there, the doctor will advise you on how frequently she would like to see your dog over the following year. At minimum, an annual exam will be required. Medications are a very important part of the aftercare. All instructions must be followed carefully for a successful recovery. If you have any questions regarding medications please call our office. It is extremely important that you call us immediately if you notice any change with the eye. For example: if the white of the eye turns redder, or if the surface of the eye becomes hazy or blue in color, or if your dog suddenly starts squinting. Any of these signs could indicate complications that require immediate medical attention. Restoring vision to a blind dog is a very rewarding part of our job. The tail-wagging and smiling that goes on when patients and clients see each other after weeks, months, or years of vision loss is a delight to see again and again.