Glaucoma in dogs, any advice?

maiko

Jedi Council Member
FOTCM Member
We have been on a little roller coaster with our dog’s health these last two weeks, and I was curious if others have dealt with glaucoma in their dogs before, to see if we are thinking in the right direction, and what we are possibly missing.

Our doggy is a very energetic, friendly Westphalian terrier, and he is turning 7 in October. Healthwise, we had an easy ride this far. He has been on a raw diet for most of his life and at roughly 8 kg he has been stable with his weight over the last few years. That just as background on him.

Two weeks ago, he started blinking both his eyes one afternoon, and I thought it was maybe due to the dry and dusty weather, because he was overall the same. The next morning, both his eyes looked inflamed, and he was very low in energy. I immediately went to the vet with him. Turned out, he had little scratches on the cornea of both eyes and the scratches showed bacterial infection. We went home with antibiotic drops, something to help heal the scratches and a moisturizing gel. When I went to his checkup, one eye had cleared up and healed, but his left eye still looked inflamed, and the vet said that the scratches healed but that he developed a new infection at the back of his eye. Back home, we went with a rather lethargic doc and Maxitrol eye drops for his left eye. The next day he had a severe reaction to the new eye drops, and we stopped them, I went back to the vet the next day. At that point and after reading a lot, I was quite worried, because I read that permanent damage to the eyes can happen very fast in dogs. And it wasn’t easy to see him in pain most all the time.

During the first two visits inner eye pressure was around 20, on this third visit, the pressure in both eyes was up to 63, and the vet diagnosed glaucoma in both eyes, she checked to make sure, that the lens in the eyes was still in place, and said the most important thing would now be to reduce the pressure and the resulting pain.

Since then, he has been taking COSOPT three times a day and XALATAN once a day. To reduce the built of liquid in the eyes and reduce the pressure. During yesterday’s checkup, the pressure in his right eye was down to 11, which is really good news, but his left eye was still between 44-49 and the lens seems to have moved, the eye is also slightly opaque. They vet prescribed Cimalgex (8mg per day) to give to him every day until the check-up next week, and she told us to monitor whether the painkiller makes him more comfortable. And we continue with the eye drops to reduce the pressure, of course.

The vet yesterday also recommended to at least meet a surgeon and get an idea whether removing the lens in the left eye could stabilize vision in that eye. He is still fairly young, and we want to preserve his vision as long as possible. And, most importantly, we want to keep him as pain-free as possible. Because these last two weeks were hard to watch, as he is normally full of energy and an anti-depressant on four legs.

Where we are at now and some of the questions we have:
I understand that the glaucoma will cause problems in waves, and it won’t be a steadily progressing illness.

The vet says the eye drops should now be part of his daily routine, as long as they work.
And that we should gather more information on the option of surgery. She will put us in contact with an expert in the region.

We will have the pressure checked regularly, that means for us, being careful to read the signs. Until now, it has been a slight feeling of emergency for the last two weeks because the dog was really not doing well.

With his pressure in the left eye at around 45 at the moment, and the lens displaced, is there even a possibility for the pressure to go down, or will he continue to be in pain unless he has surgery ? I am trying to figure out what the future baseline for his wellbeing is.

@Alana (thank you!) found me a plant-based supplement that I started adding to his meals to improve ocular health. And I was thinking of adding some more magnesium.

Also, we switched from a collar to a harness for his walks, to reduce pressure.

And I thought about trying acupuncture to reduce the pressure.

@Z... I found a post you wrote in 2020 where you had success with TCVM and acupuncture on a dog. Is there anything specific we should look into?

Please excuse the long post, it was also for clearing my head, because I got a bit in a reactive mode. Seeing your furry companions suffer is never easy. Any advice or experience others have made with glaucoma in dogs are very welcome!

Thank you

*edited for typos
 
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We have been on a little roller coaster with our dog’s health these last two weeks, and I was curious if others have dealt with glaucoma in their dogs before, to see if we are thinking in the right direction, and what we are possibly missing.

Our doggy is a very energetic, friendly Westphalian terrier, and he is turning 7 in October. Healthwise, we had an easy ride this far. He has been on a raw diet for most of his life and at roughly 8 kg he has been stable with his weight over the last few years. That just as background on him.

Two weeks ago, he started blinking both his eyes one afternoon, and I thought it was maybe due to the dry and dusty weather, because he was overall the same. The next morning, both his eyes looked inflamed, and he was very low in energy. I immediately went to the vet with him. Turned out, he had little scratches on the cornea of both eyes and the scratches showed bacterial infection. We went home with antibiotic drops, something to help heal the scratches and a moisturizing gel. When I went to his checkup, one eye had cleared up and healed, but his left eye still looked inflamed, and the vet said that the scratches healed but that he developed a new infection at the back of his eye. Back home, we went with a rather lethargic doc and Maxitrol eye drops for his left eye. The next day he had a severe reaction to the new eye drops, and we stopped them, I went back to the vet the next day. At that point and after reading a lot, I was quite worried, because I read that permanent damage to the eyes can happen very fast in dogs. And it wasn’t easy to see him in pain most all the time.

During the first two visits inner eye pressure was around 20, on this third visit, the pressure in both eyes was up to 63, and the vet diagnosed glaucoma in both eyes, she checked to make sure, that the lens in the eyes was still in place, and said the most important thing would now be to reduce the pressure and the resulting pain.

Since then, he has been taking COSOPT three times a day and XALATAN once a day. To reduce the built of liquid in the eyes and reduce the pressure. During yesterday’s checkup, the pressure in his right eye was down to 11, which is really good news, but his left eye was still between 44-49 and the lens seems to have moved, the eye is also slightly opaque. They vet prescribed Cimalgex (8mg per day) to give to him every day until the check-up next week, and she told us to monitor whether the painkiller makes him more comfortable. And we continue with the eye drops to reduce the pressure, of course.

The vet yesterday also recommended to at least meet a surgeon and get an idea whether removing the lens in the left eye could stabilize vision in that eye. He is still fairly young, and we want to preserve his vision as long as possible. And, most importantly, we want to keep him as pain-free as possible. Because these last two weeks were hard to watch, as he is normally full of energy and an anti-depressant on four legs.

Where we are at now and some of the questions we have:
I understand that the glaucoma will cause problems in waves, and it won’t be a steadily progressing illness.

The vet says the eye drops should now be part of his daily routine, as long as they work.
And that we should gather more information on the option of surgery. She will put us in contact with an expert in the region.

We will have the pressure checked regularly, that means for us, being careful to read the signs. Until now, it has been a slight feeling of emergency for the last two weeks because the dog was really not doing well.

With his pressure in the left eye at around 45 at the moment, and the lens displaced, is there even a possibility for the pressure to go down, or will he continue to be in pain unless he has surgery ? I am trying to figure out what the future baseline for his wellbeing is.

@Alana (thank you!) found me a plant-based supplement that I started adding to his meals to improve ocular health. And I was thinking of adding some more magnesium.

Also, we switched from a collar to a harness for his walks, to reduce pressure.

And I thought about trying acupuncture to reduce the pressure.

@Z... I found a post you wrote in 2020 where you had success with TCVM and acupuncture on a dog. Is there anything specific we should look into?

Please excuse the long post, it was also for clearing my head, because I got a bit in a reactive mode. Seeing your furry companions suffer is never easy. Any advice or experience others have made with glaucoma in dogs are very welcome!

Thank you

*edited for typos
I am sorry your dog is experiencing this, unfortunately Westphalian terriers have genetic predisposition to PLL or primary lens luxation and this may cause glaucoma.

Glaucoma is extremely rare and in all my years of practice I never had a case. However I treated similar complicated ocular conditions with TCVM and had great results. So it is definitely worth a shot in addition to what you are already doing- seems he is under very good care.
Just to illustrate the effectiveness I am attaching the pictures of a dog I treated for corneal edema that was persisting for months and was resistant to conventional treatment, it was resolved with only one acupuncture treatment and it never came back, we never needed to repeat the treatment, however the dog was young.

You can DM me your location and I will try to find a colleague who practices TCVM - ideally Balance Method.
 

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Thank you, @Z... I sent you a dm with our location. The improvement in the pictures is really impressive! When our dog was younger he was so nervous, and under so much tension that the muscles in his back would get really hard, and he would walk around on stiff hind legs. We had amazing results with just one osteopathic and acupuncture session, the dog looked like he was stoned afterward, but the stiffness never came back. That said, I saw the excerpt of a study on the promising results of acupuncture for lowering the pressure in the eye, I think that would be a good thing to implement while figuring out, which road to take.

I know dogs handle limitations very well, I used to train with our dog in a man trailing group and there were a deaf and a blind dog working with us, it was amazing to see how happy and eager they were, but if there is anything we can do to stabilize the situation, we'll try it. Especially since the retina in both eyes is still intact. And I am a convinced it needs a more holistic approach, more than just administering eye drops. The Balanced Method sound really promising.
Thank you! :flowers:
 
And you're right @Z... I know see the information on the genetic predisposition for PLL. When we researched in the past, we got the picture of a rather healthy, robust breed of little hunting digs. But then it is a relatively young crossbreed, and researching now, I find the predisposition for PPL in all the different terriers that went into that mix. Well, something new to learn. But we'll make him as comfortable as we can.
 
I wanted to give a little update on the dog. Yesterday, we finally saw an ophthalmologist specialized on dogs. As we already suspected, our dog is now blind on his left eye. As the eye still shows very high inner pressure, they will surgically remove the lens to manage his pain. His right eye still has vision, but the lens is in the process of dislocation as well, so that requires surgery too, to maintain vision on that eye. And if possible, the doctor will give him a lens implant. But that he will decide during surgery, there might some possible difficulty as he as old scar tissue from an accident he had as a puppy.

That said, next week Thursday we have an appointment for surgery, and they will work on both his eyes. I am grateful we can finally move towards improving his condition and not just managing the pain. Especially as the doctor said, it is important not to wait too long and risk complete blindness.

What is a bit worrying, is, that two years ago, the dog was diagnosed with interatrial communication, meaning there is a tiny whole between the chambers oh his heart. It doesn’t affect him in any way in his life, but we have to take that into account with regard to the anesthesia during surgery, but I guess there is always a risk.

It is good to have a plan of action, seeing him suffer for weeks has been pretty draining for us humans, too. Especially since the pain completely dampened his personality.

Aside from surgery, we will explore homeopathy and other holistic treatments for his healing. And I am planning on scheduling osteopathy and acupuncture to help him adapt after surgery.

Thanks for having a place to share this, and @Z... for looking into practitioners in our region.

I just leave that here in case one of you fellow dog owners gets a similar diagnosis.
 
I wanted to give a little update on the dog. Yesterday, we finally saw an ophthalmologist specialized on dogs. As we already suspected, our dog is now blind on his left eye. As the eye still shows very high inner pressure, they will surgically remove the lens to manage his pain. His right eye still has vision, but the lens is in the process of dislocation as well, so that requires surgery too, to maintain vision on that eye. And if possible, the doctor will give him a lens implant. But that he will decide during surgery, there might some possible difficulty as he as old scar tissue from an accident he had as a puppy.

That said, next week Thursday we have an appointment for surgery, and they will work on both his eyes. I am grateful we can finally move towards improving his condition and not just managing the pain. Especially as the doctor said, it is important not to wait too long and risk complete blindness.

What is a bit worrying, is, that two years ago, the dog was diagnosed with interatrial communication, meaning there is a tiny whole between the chambers oh his heart. It doesn’t affect him in any way in his life, but we have to take that into account with regard to the anesthesia during surgery, but I guess there is always a risk.

It is good to have a plan of action, seeing him suffer for weeks has been pretty draining for us humans, too. Especially since the pain completely dampened his personality.

Aside from surgery, we will explore homeopathy and other holistic treatments for his healing. And I am planning on scheduling osteopathy and acupuncture to help him adapt after surgery.

Thanks for having a place to share this, and @Z... for looking into practitioners in our region.

I just leave that here in case one of you fellow dog owners gets a similar diagnosis.
Indeed you are doing everything you can and your dog seems to be getting the best possible veterinary care.
In the worst case scenario if he completely looses his sight you should know that cats and dogs can live perfectly normal life without eyesight since they manage to compensate with other senses.
I know a blind cat that still manages to catch mice 😊
 
Thank you for the update, maiko. I can certainly understand your relief that your puppers will be getting something done to help with his pain. He is very lucky to have such good "parents" as you two.

Please keep us updated on his recovery and progression.
 
A little update on the puppa. Two weeks ago he had his first surgery. They removed the lens in his now blind eye to avoid further pain and replaced the lens in the other eye to maintain eyesight. I was very emotional around the time of his surgery, both Luc and I had fallen ill with what we both suppose was Covid, and I was very tired and felt like I was letting down the dog by not being present enough. I think I got a bit thin-skinned, as it is normally natural for me to be there for the ones who are important to me, and I didn't feel I could that. Luckily there is two of us and Luc took on all the driving to and from Toulouse and getting the meds sorted whilst I allowed myself a moment of self-pity and afterward we concentrated on getting the dog better. During the week to his follow-up appointment, healing didn't go well. We knew to expect ups and downs, but he seemed to be getting overall rather worse than better, and it was confirmed by the doctor during the followup. In his blind eye the stitches had ruptured and there was blood in the eye causing swelling and pain and the lens implant in the other eye had started moving. Apparently it's rare, but it happens. La totale, as the French say.

So, there was a second surgery on Tuesday, where they fixed the stitches and removed the implant and already the dog seems to be so much better compared to the first post-surgery. He is still tired and in a pit of pain, but it doesn't keep him from begging in the kitchen and there are already glimpses of his normal, energetic personality coming through, which is a joy to see.

Thank you again for all your thoughts and advice! :flowers:
 
So, there was a second surgery on Tuesday, where they fixed the stitches and removed the implant and already the dog seems to be so much better compared to the first post-surgery. He is still tired and in a pit of pain, but it doesn't keep him from begging in the kitchen and there are already glimpses of his normal, energetic personality coming through, which is a joy to see.

That's relieving to hear, maiko, and I'm glad your puppa is on the mend! Here's to his continued recovery. :hug2:
 
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