Ophthalmology Team at Foster Hospital Helps Save Basset Hound’s Vision
"Glaucoma in dogs is very different from glaucoma in humans—it tends to be much more aggressive, dogs tend to lose their vision faster, and there are fewer available treatment options. Veterinary ophthalmologists from around the world, Dr. [Stephanie] Pumphrey and I included, have made glaucoma their area of research to try to find better treatments, earlier diagnoses, and novel surgeries," says Dr. Vanessa Yang, assistant professor in the Department of Clinical Sciences at Cummings School of Veterinary Medicine at Tufts University. She serves on the Ophthalmology team at Henry and Lois Foster Hospital for Small Animals (FHSA) and Hospital for Large Animals (HLA).
Basset Hounds, in particular, are prone to glaucoma, a disease that produces high pressure inside the eye caused by fluid not draining properly. A 10-year-old Basset Hound named Beatrice lost her left eye to glaucoma two and a half years ago. Her owner, Amy Herlihy, first noticed irritation around the eye. Their veterinarian suspected allergies. When Beatrice's eyelid swelled and the eye started turning blue, Herlihy took her to the emergency room at FHSA.
The clinicians at FHSA diagnosed Beatrice with primary angle closure glaucoma and initially treated her with eye drops to decrease fluid production and alleviate the pressure. Highly elevated pressure, even for a short time, can cause intense pain and irreversible blindness.
After a few days, the pressure was reduced but still high. Beatrice lost vision in one eye. Since she could no longer see out of the eye and the pressure was painful, the only option was to remove the eye. Yang performed the surgery and tested Beatrice's right eye. She found the right eye was also predisposed to glaucoma and prescribed preventative eye drops for Herlihy to administer daily in an effort to keep the disease at bay.
The quality of the doctors and the care provided by the staff there is just outstanding. It has helped Beatrice maintain a good quality of life, and that is the most important part. She can still have a very full life with that one eye. We've gained 15 months of her having sight in that eye. We are so grateful for everything Dr. Yang and her team have done for Beatrice.
Amy Herlihy
"While these medications can give us more time before the onset of a full glaucoma attack, they don't work forever," says Yang. "A little bit over a year after her left eye experienced glaucoma, her right eye also experienced glaucoma."
When Beatrice began behaving strangely one evening and not settling down, Herlihy checked her eye. It was not blue like the other had been, but appeared glazed over. Yang had also prescribed emergency eye drops in case of this situation, as time is of the essence in these high-pressure attacks. Herlihy gave Beatrice the emergency eye drops and brought her directly to the ER at FHSA. The Emergency Medicine and Critical Care (ECC) team administered additional drops to further bring down the pressure.
"Amy's a very attentive and very loving owner. Beatrice is lucky to have her. She noticed that something was wrong with the right eye right away," says Yang.
The eye drops could help for a short period of time, but would not resolve Beatrice's glaucoma. Yang recommended surgery to place a shunt in the eye to facilitate fluid drainage and relieve the pressure.
"Now that the glaucoma attack had happened, we knew that she had very limited time with vision in the eye she had left," says Yang. "Because we caught the right eye early, the pressure decreased with the eye drops, and she still maintained vision in that eye, she was a good candidate for glaucoma surgery."
Yang inserted the glaucoma shunt and also performed laser surgery that would enable the eye to produce less fluid.
"The hard part about this surgery is that it's not perfect, and it's not a one-and-done sometimes," says Yang. "Even after surgery, some patients may still lose vision. Every patient responds differently to this surgery. It's not a cure. We think of it generally as a last-ditch attempt to try to save the dog's vision and provide comfort for as long as we can."
The surgery and recovery went smoothly, the biggest challenge being Beatrice's adjustment to wearing a cone for the next month.
"Beatrice was a great candidate for the surgery because we caught her second eye very early, and she still had potential for vision in that eye, but also, she is just a really good dog. She's very easygoing, she's easy to handle in the hospital, and she's very patient. Personality-wise, she's always been a trooper," says Yang.
The shunt was expected to last six to 12 months—it's now at 15 months and counting. The entire Ophthalmology team has contributed to Beatrice's care.
“The quality of the doctors and the care provided by the staff there is just outstanding,” Herlihy says of their experience at FHSA. “It has helped Beatrice maintain a good quality of life, and that is the most important part. She can still have a very full life with that one eye. We've gained 15 months of her having sight in that eye. We are so grateful for everything Dr. Yang and her team have done for Beatrice."
Yang notes that Herlihy helped tremendously with Beatrice's success by consistently administering the Basset Hound's eye drops after the first surgery, responding quickly when the second attack came on, and providing diligent follow-up care after both surgeries.
"Beatrice's case is why we do this," says Yang. "Giving dogs the best chance at vision for as long as they can certainly improve their quality of life. I'm happy with how well she's done."
Source: https://vet.tufts.edu/
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