Ok, that's it for anatomy! We weren't sure what to expect but it turns out that they do the same exams on dogs as they do on people, just with slightly different equipment. It would be hard to get a dog to put its chin on the chin rest, lean forward, and stay still, after all! The ophthalmologist uses hand-held versions of the people version and holds the dog's face still using the other hand.
One test that's different is that they check tear production by sticking a test paper under her lid. Apparently some people do get to have this particular test but it's not one that's done unless there are problems. Gozer's corneas were also dyed to check for damage to them and her pupils were dilated to see what's going on.
Her tear production is apparently normal and her corneas showed no damage at all. She definitely does have a cataract in her right eye located "medial equatorial and cortical (mainly posterior, though anterior also involved)" which I think means that it's in the cortex of the lens around about the middle mostly towards the back of the lens and spreading to the front. Since the cortex is composed of new-ish lens fibres, a cataract there means that it's new-ish and hasn't been there forever.
She has other issues with her right eye; in particular she has a "posterior synechiae at 3 o'clock and associated with a small hole in the iris at this point." The posterior synechiae is where the back (posterior) of the iris is stuck or adhered (synechiae) to the front of the lens capsule or membrane surrounding the lens. The ophthalmologist thinks that she had some kind of trauma to her eye when she was younger that caused the hole in the iris and the adhesion, and that these in turn somehow caused the cataract to form. I'm not exactly sure how that's possible but he's the doctor so he must know what he's talking about.
We've been given Ketorolac (0.5%) drops to put into her right eye twice a day forever to try to keep prevent the cataract from getting larger. Apparently as the cataract progresses it can leak lens fibers and that's bad. The ophthalmologist wants to see her in three months to see how she's doing. He didn't talk about surgery this time around.
I don't know if it helps, but here are diagrams of the canine eye and lens to help you visualize what's going on. Don't let the human-looking eye in this diagram fool you - this is definitely a canine eye:
And here's a picture of the structure of the lens itself. It's in the same orientation as in the diagram of the eye above. Notice that the curvature of the lens is different on each side - I didn't know that was the case, but apparently it is. It's amazing what a person can learn with a bit of research, huh?
The posterior (P) of the lens is the back of the lens facing the retina, the anterior (A) is the front of the lens against the iris, the equator (E) is the widest point from top to bottom of the lens, and the capsule contains the lens itself. The lens is made up of fibres that are constantly being replenished; as new ones are formed in the subcapsular cortex (SC), the older ones are compressed into the cortex (C) and the very oldest ones are compressed into the nucleus (N).
We also took a picture of Gozer's right eye:
The green is the reflection of the pupil through the dilated pupil and the brown ring is her iris. The extra bump on the iris towards the bottom of the picture (her inner eye) and the little brown streaks coming from that are the adhesions or synechaie, I think. I think the white are between her pupil and that extra bump in the iris might be the cataract but I'm not sure. I'm not exactly sure where the hole in the iris is located.
In other Gozer news, before this appointment the vet did a blood and urine work-up. Since we don't know anything about Gozer's history we elected to do the geriatric blood panel because it gives more information. Overall, everything is ok. However, there are two results that are concerning.
First, they found triple phosphate crystals (also known as struvite crystals or magnesium ammonium phosphate crystals) in her urine. It's possible that she has a few bladder stones but since she's not having any problems urinating we're just going to keep an eye on her.
Second and more concerning is that her thyroid levels were low. I'm actually not surprised about this since starting early last summer she started having problems going on long walks to the point of having to stop and rest after about 40 minutes and walking very, very slowly after that. She also starts panting after going up the stairs - she really doesn't have much stamina. And then there's the little matter of the weight she's gained that she hasn't been able to lose. She's lost and gained the same 0.3kg several times over the last few months. All these signs point to low thyroid levels, or hypothyroidism.
We could have done a more comprehensive thyroid panel right away but since we had planned to waist for three months to re-do the main thyroid test, I decided that it would be better just to wait and see what happens. If her thyroid levels are still low (and I expect they will be), then we'll do the more comprehensive panel. Even if she does have hypothyroidism, she's managing just fine right now.
So I think that's it for now - our little Fluffybutt has a cataract and some possible health issues. I wish she was perfectly healthy but how many dogs out there are perfectly healthy? Besides, it's good to catch these sorts of things earlier, when there might be something we can do about it, then wait until the issues were affecting her and any treatment is drastic.
1 comment:
sorry to hear Gozer has health problems! hopefully the eye drops will help the cataract from getting bigger.
love,
vicki
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