Keep safe!

Keep safe!
You are responsible for your own safety and that of your dog. The walks listed in this blog are not detailed guides. Plan your route! Click the landrover image for safety advice from Bowland Pennine MRT.

Friday, June 16, 2017

What to expect the the first few days after dog cataract surgery

I'd never expected this blog to be a record of major medical events in the life of our dog,  it it seems to be working out that way at the moment.  My motivation, after hours of googling to find snippets of advice or reassurance to help me make my own mind up on whether to go ahead with treatments and, just as importantly, to be able to plan well for the days which follow.

If you have read earlier posts you'll know the last choice was a hard one, to elect for cataract surgery for our 11 year old springer spaniel or not, following just 3 months after a second cruciate operation.  The initial tests indicated some fairly significant retinal degeneration, which essentially means that the retina itself stops working, and eventually is likely to lead to total and irreversalble blindness.  The initial signs include poor vision at night, which I had noticed over the winter, and general clumsiness (harder to tell as he's never been the most sensible dog).  The cataracts themselves can be a by product of this disease, so whilst cataracts are the obvious outward sign, they are not necessarily the primary cause of blindness.  If the retinal degeneration has progressed significantly there may be no point in cataract surgery, as removing the cataracts doesn't fix the retina.  However, there may be a chance that removing the cataracts gives enough vision for the dog to have some vision back, albeit not perfect and maybe just of a limited time until the disease of the retina progresses. It seems like it is relatively easy for a an opthalmic vet to conclude whether there is some retinal degeneration. What is harder is to know how much sight might still be there, and for how long, if cataracts are removed.

All of the above was the subject of a consultation and subsequent phone call to our ophthalmic  referral centre. They were very good, talking through the issues, making sure I understood there were no guarantees but ultimately making it my decision, which was hard, but armed with a head full of some facts, masses of emotions, a pretty good cost share insurance policy and a credit card, I opted for surgery.

One of the things that I had wondered about was aftercare, particularly planning for how much time to have off work.  In fact, aftercare started 5 days pre op, with some drops to administer 5 times a day.  These didn't need to be spread perfectly evenly so I was able to do a drop around 6 am, just before leaving for work about 8.00 then again at about 5, 8 and 11 before bed. I also managed to call home on a couple of days to spread them further.  We do have a dog walker who comes when we are out all day so could have asked her if it had been a problem.

On the day of surgery I left him about 11.30 then hung around in the Penrith area for the day, waiting for the call to say he was ok.  The call came earlier than expected, as he was still on the operating table, to confirm the retinal degeneration in one eye and to ask whether to proceed to the next.  Again, a hard choice, but to some extent thought through in advance, so I stuck to the plan of seeing what was possible.  To be fair the next hour or so was agonising, knowing that he could by then have been out of surgery and recovering.  The call to say he was ok did come though, thankfully, but retinal degeneration could be seen in the other eye too.

At this point it was all sounding very pessimistic to me in terms of whether he would see again, so As I headed home I was really just relieved he was through it and convincing myself At least we'd done what we could to help give him some sight back.

Next morning I arranged to pick him up around lunchtime.  He had had some pressure spikes in his left eye, which were now controlled.  I was greeted by a friendly nurse and an array of drops, medication and instructions.  There is one 5 times a day (as pre op), 3 drops three times a day, 2 once a day, tablets once a day and his usual metacam once a day.  You have to leave at least 5 minutes between drops so a 'medication session' can last half an hour or so.  His cone of shame has to be on every minute of every day.  The medication did seem a bit daunting at first, but a few days later it already felt more manageable.  That may be in part because was the weekend, so no issues fitting it round other daily chores like going to work!

The instructions given on discharge were very clear, particularly in terms of things to watch for. And so it was that the day after discharge, when one eye looked cloudy, I made a call to the out of hours service and, after giving telephone advice a go, headed back up the M6 Motorway to Veterinary Vision to get it checked out face to face.  The was 'a lot going on' in his left eye, so after a good examination, more drops and an injection we were done. The lesson here is try to get a referral centre you can get to, if needed, within a few hours. I was so happy we got there on the Saturday as I have no idea if it might have resulted in more significant complications if left a few days.

So, you'll still be wondering if he could see post op....YES!  I wasn't too sure when I picked him up but by the time we got home after an hour and a half drive it was AMAZING to see him lead me through the front door, to when his food bowl used to be before blindness set in, the out to the garden.  Yes he was a little shaky, but could obviously see. Now, two weeks later, all is still good. The moment he sees another dog on walks is brilliant. The way he comes up and stairs for attention is wonderful. Of course retinal degeneration is still there, so I doubt his sight is perfect, and I can tell it's not so good in the dark, he is far from blind. Whist of course he would have coped with no sight, life is just so much better for all of us. I have no idea how long it will last. Maybe a few months, hopefully for the rest of his lifetime, but at this point I'm just happy we had it done.

Next checkup is at three weeks when hopefully some of his (expensive) medication will start to reduce. From today the cone of shame is hopefully off much of the time which is great!

There are various videos on my YouTube and Instagram feeds if you want to see before and after.

No comments: