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  #1  
Old May 12th, 2007, 10:02 PM
Singhji Singhji is offline
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Lens removal - Dog has cataracts - Answered by Dr. Van Lienden

Hello,
I am new to the board. I have an 11yr old Golden with Cataracts and a 20 year Old Cat. I love all animals and am a pure vegetarian.

Today I took my Golden (Brandy) to the Dog Othamologist to se what could be done about her Cataracts. They are quite thick.

The Othlamogist was very very nice. I wish I meet more people like him.

He gave Brandy a checkup including measuring her IOP. it was 9 and 11

He used the same equipment that my Opthamologist uses on me. I have had Cataract, Detached Retina and Glucoma surgery in both eyes. (So I know some medical terminology)

The Vet Opthamologist advised my wife and I that the left eye was to thick and hard, but the right eye was a candidate for Cataract surgery.

I asked some questions that I had asked my opthalomigist. He gave me straight answers (I liked him even more)

We agreed to the surgery and he gave us a prescription for 3 different kind of drops to be started 5 days prior to surgery.

There was one answer that he gave that puzzled me, but seeing he was so nice , I didn't persue it. However it has bugged me all day and I decided to solicit other opinions.

He said that he would remove the cataract lense and then close the opening. I asked him as to what type of lense he would be replacing Brandy's right eye with. He said none.

My wife asked how Brandy would see without a lense and the Vet said she would see welllenough to catch a ball. I must admit I to was puzzled as to how she is going to see without a lense. But I did not persue this line as he was so very nice.

I would be very grateful if the members could explain to me how a dog who has had cataract surgery and no replacement lense will be able to fetch a ball. The vet also told us that ther was a 10% chance of things going wrong , but a 90% chance of things going well.


I hope my post makes sense and I look forward to reading your posts.

Best Wishes.
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  #2  
Old May 23rd, 2007, 08:57 AM
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petdr petdr is offline
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Allow me one sentiment before answering the technical part of his question. As a concerned client with a sick pet, it is always good to ask questions, no matter how foolish you may think the questions are. If something puzzles or bugs you, then get that resolved by the person who put that concern into you.

Now on to your question. It is common to use artificial lenses in human cataract surgery, but not so in animals, particularly dogs. The canine immune reaction is much stronger in any ophthalmic surgery then it is in human beings. Scarring is a major concern to the the vet eye surgeon, and if an artificial lens were placed, the very real possibility of blindness brought on by surgical scarring is manifest.

Certainly in the future there will be material improvement in artificial lenses that would allow implantation without scarring, but we are not there yet. Dogs do not rely on fine focusing such as is required in reading, threading a needle, etc. Dogs rely on movement and intermediate field of focus. Distance and close vision is good, but not essential. Ever notice how dogs are very keen on dealing with rabbits,deer,cats/etc/ whenever these are flushed from cover, and how the dog will pursue them? And yet that same dog will easily pass by a still little beastie that may or may not be hidden.

Once the lens is removed, this leaves the dog with intermediate field of focus. Your dog will still be able to fetch a ball, and this has been demonstrated in many eye patients post-operatively. Now it is not realistic to think that your dog can fetch a small ball thrown half a kilometer, but certainly five to ten meters.

Reminds me of the old joke: the patient asks his doctor, "Doc, can I play guitar after the shoulder surgery?" Doc answers, "Sure, why not?", patient answers, "Because, Doc, I couldn't play anything before".

Dr. Van Lienden

Dr. Raymond Van Lienden DVM
The Animal Clinic of Clifton
12702 Chapel Road, Clifton
Virginia, U.S.A. 20124
703-802-0490
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  #3  
Old May 23rd, 2007, 01:41 PM
Prin Prin is offline
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teeheehee, I like the joke.
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Old May 23rd, 2007, 06:33 PM
Singhji Singhji is offline
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Thank you

Thank you for your excellent explanation regarding Cataract surgery in dogs. I feel so much better and now understand why the Opthamologist in Toronto (Dr. Goldstein - Forest Hill Animal Hospital )has indicated in his Post-ops notes that the eye drops continue for 6 months. 4 times a day.
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Quote:
Originally Posted by petdr View Post
Allow me one sentiment before answering the technical part of his question. As a concerned client with a sick pet, it is always good to ask questions, no matter how foolish you may think the questions are. If something puzzles or bugs you, then get that resolved by the person who put that concern into you.

Now on to your question. It is common to use artificial lenses in human cataract surgery, but not so in animals, particularly dogs. The canine immune reaction is much stronger in any ophthalmic surgery then it is in human beings. Scarring is a major concern to the the vet eye surgeon, and if an artificial lens were placed, the very real possibility of blindness brought on by surgical scarring is manifest.

Certainly in the future there will be material improvement in artificial lenses that would allow implantation without scarring, but we are not there yet. Dogs do not rely on fine focusing such as is required in reading, threading a needle, etc. Dogs rely on movement and intermediate field of focus. Distance and close vision is good, but not essential. Ever notice how dogs are very keen on dealing with rabbits,deer,cats/etc/ whenever these are flushed from cover, and how the dog will pursue them? And yet that same dog will easily pass by a still little beastie that may or may not be hidden.

Once the lens is removed, this leaves the dog with intermediate field of focus. Your dog will still be able to fetch a ball, and this has been demonstrated in many eye patients post-operatively. Now it is not realistic to think that your dog can fetch a small ball thrown half a kilometer, but certainly five to ten meters.

Reminds me of the old joke: the patient asks his doctor, "Doc, can I play guitar after the shoulder surgery?" Doc answers, "Sure, why not?", patient answers, "Because, Doc, I couldn't play anything before".

Dr. Van Lienden

Dr. Raymond Van Lienden DVM
The Animal Clinic of Clifton
12702 Chapel Road, Clifton
Virginia, U.S.A. 20124
703-802-0490
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  #5  
Old May 27th, 2007, 08:17 PM
Singhji Singhji is offline
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How long does it take for eye drops to permeate the dog eye

Dear Doctor Van Liended:

We are in the pre-op phase of Brandy's cateract operation which involves 3 different drops 4 times a day. 10 minutes apart

My question is that once we administer the first drop we give her lots of loving, however as soon as the loving stops, she shakes her head. We are worried that she is dislodging the drop.

We are ignorant as to wheather the drop immediately permeats the eye and if her head shaking is or is not a concern. How long does it take for an eye drop to permeate the eye and not fly out ?

Should we keep up the rubbies and kisses for 10 minutes and not let her shake her head however we could let down our guard and she could still shake her head,

I will be looking out for your response and please accept my thanks in advance.

I wanted this to be a private message as the rest of the members may not be interested in my eye drop issue. I couldn't figure out how to send you a private message.

Regards,

Brandy's Daddy, Singhji
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  #6  
Old May 27th, 2007, 08:26 PM
joeysmama joeysmama is offline
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I'm glad that you didn't send this as a PM. While this isn't pertinent to us right now I'm curious about the answer. Our last dog had a lot of issues with his eye and we had to administer ointment, and at times, drops.

I think it's always good to have this sort of knowledge.
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  #7  
Old May 28th, 2007, 11:50 AM
Singhji Singhji is offline
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Private Message

I am very careful when posting on message boards. Some don't like messages that appear private. It is always a toss up on how to reply.

I too hope the good doctor answers my post

Singhji
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  #8  
Old April 7th, 2008, 11:37 AM
dcapper dcapper is offline
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Sorry to reply to such and old post. I am new to this forum and was wondering about the cataract surgery. My Yorkie is 16 1/2 yo and is in absolutely incredible shape. He only has gray hair around his snout and has no pain whatsoever. BUT... He has mature cataracts. I was wondering if surgery can be done on a dog of his age. Mostly, can the vet remove cataracts without putting the dog to sleep? I'm really not worried about the cost but more the safety of my dog.

Last edited by dcapper; April 7th, 2008 at 11:38 AM. Reason: wanted to subscribe
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  #9  
Old July 8th, 2008, 08:06 AM
Mflinchem Mflinchem is offline
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Hi There,

I also am in the same place that you are - My Yorkie is 15 and a half, she has no grey hair, very healthy and still loves to play - although this has now been limited as her sight is very limited. Some days seem better than others.

Its breaking my heart that my little girl struggles through the day and I have to carry her outside and put her in the grass. I had no idea that she could even have the surgery as my vet never mentioned it. She now has a screening appt on thursday and I am very excited at the thought I may be able to get her sight back.

I asked for a guesstimate for price - starting at 1500.00 for one eye and worst case 3500.00 for both. This is pretty amazing! The price scares me a bit - but how selfish would I be to keep this from the little girl who has given me so many years of unconditional love - and so much free therapy?

Anyhow - just wanted to share where I am in this process and I will kepp you posted. As a single guy though, it will be tough to make sure she gets her pre treatment drops as I work and have no family or friends in the area I live as I only recently relocated here.

Matt
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  #10  
Old July 8th, 2008, 08:43 AM
dcapper dcapper is offline
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Let me know how you make out. In Canada we only have a vet college in Saskatoon. I was going to start looking for a vet in Minneapolis to do the surgery. I'm in the same boat though. I wonder if they can do the surgery while the dog is awake and lightly sedated. Please keep me up to date.
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  #11  
Old July 8th, 2008, 10:46 AM
Mflinchem Mflinchem is offline
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I certainly will keep you posted. I am in Philadelphia PA, Taking her back to my hometown of Baltimore for the Cataracts.

you can email me if you like - my username at yahoo.

Matt
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  #12  
Old July 8th, 2008, 06:12 PM
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Sylvie Sylvie is offline
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Not sure where you are located in Canada. There is also the Guelph University,
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  #13  
Old July 8th, 2008, 09:43 PM
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Dr Lee Dr Lee is offline
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Different on the west coast?

Quote:
Originally Posted by petdr View Post
It is common to use artificial lenses in human cataract surgery, but not so in animals, particularly dogs.
It may be regional but here in Arizona our veterinary ophthalmologists (Eye Care for Animals - four locations in Arizona) actually do implant an artificial lens as a replacement when removing the cataract affected lens. They state that about 95% of their patients receive the artificial lens. I called their facility today and asked the material of the artificial lens in cataract surgeries used in dogs, they said it is acrylic. They have different sizes for various sized eyes.

Here is an excerpt with regard to the quality of vision with the lenses from
Cataract Surgery
British Small Animal Veterinary Congress 2006
M. Davidson, DVM, DACVO
College of Veterinary Medicine, North Carolina State University
Raleigh, NC, USA


Prosthetic Intraocular Lenses

Implantation of prosthetic intraocular lenses (IOLs) in dogs following cataract surgery was introduced at approximately the same time as phacoemulsification. Most veterinary ophthalmologists currently implant a 41 diopter IOL in dogs to correct the refractive error induced by removal of the lens, and placement of an IOL in dogs is becoming the standard of care. Without an IOL, dogs have a hyperopia (farsightedness) of approximately 15 diopters. This has been estimated to correlate to a visual acuity of 20/200-20/600 on the Snellen eye chart commonly used in people. Retrospective studies have documented similar success rates with and without use of an IOL, and placement of an IOL in the capsular sac has been shown, in humans, to reduce the severity of capsular fibrosis, a common postoperative complication. Until recently, the standard design of a canine IOL was 'one-piece,' constructed of polymethyl-methacrylate (PMMA), with an optic and haptic portion, and designed to be implanted through a 7-8 mm incision. A second wave of development of canine IOLs has resulted in the design of 'foldable' intraocular lens constructed of soft acrylic materials and designed to be implanted through a 3-4mm incision. In addition to offering the advantage of a smaller incision, many of these foldable lens have a 'square-edge' posterior optic configuration, which has been shown to reduce the likelihood and severity of posterior capsular opacification.
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  #14  
Old July 9th, 2008, 11:06 AM
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Sabine Sabine is offline
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A few years back I had a poodle with juvenlie cataracts and he was operated on at the NC State University in Raleigh. He was operated on both eyes and artificial lenses were put in. The operation was quite successful and healed without any complications.
I also had a dachshund suffering from age related cataracts and I decided NOT to have the surgery done. She adjusted wonderfully to the situation and went about her business as always. Dog learn to cope with it better than humans and don't seem to be too handicapped by a clouded vision. I don't know if I would put a senior dog through surgery.
I don't want to criticize your decision - just wanted to share my experience.
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Old July 9th, 2008, 02:09 PM
Mflinchem Mflinchem is offline
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Hi Sabine,

Thanks for your input. I am not sure and that is why I am taking her for professional advice. She is no different now than she was 10 years ago, she still very very active, loves to play, and the regular vet is always amazed at her bloodwork. We have had no health problems.

I certainly am very very attached to my little girl and want only the best for her. These are times when I wish she could talk to me. We all know that for must of us, our pets are so much more than just a dog or cat. They are our children. We want them around as long as possible. I will forever feel guilty if I dont check out the opportunity, I dont want to wonder "what if". I would feel very selfish for not having this option checked out.

Do i want to spend this kind of money? NO! But then I also think of how selfish I am being, if they were my eyes, I would want them fixed, she has given so much over the years, I do owe her this. Right now she is bumping into doors and furniture and it is obviously having an effect on her, I certainly see the difference in her moods.

Thanks for your advice and everyones, This is why I came here, I dont want to do this alone....

Thanks,

Matt
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Old July 15th, 2008, 11:53 PM
dcapper dcapper is offline
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I'm in the same boat. My Yorkie is turning 17 and thats his only ailment. I'd love for him to see properly again. I think he would be much happier even though he's adjusted.
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Old July 16th, 2008, 12:44 AM
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Nicker Nicker is offline
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UofS

dcapper:

Dr. Grahn at the UofS did my dog's cataract surgery. It will be 7 years on August 13th. The care he got there was great. He still sees to this day.

He does have aritificial lenses and there are mineral deposits around them which limits his peripherial vision. He can fetch his toys quite fine now and doesn't have to sniff to find his food or treats anymore.

My dog was only 5 when he has surgery though. Remember when they get to be elderly the anesthetic may be very hard on them. We lost a dog to anesthesia once. He was 11 and getting his teeth cleaned.

Dogs do cope amazing well with cataracts. I had my dogs repaired because he was so young and young dogs need to play which he couldn't do. I didn't feel he had quality of life then. I don't think I would do it now with an elderly dog. His life is too precious to risk and he is content with sleeping and going for walks now. Those things he can do blind.
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Old July 16th, 2008, 07:22 AM
Mflinchem Mflinchem is offline
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I know have little macy's surgery scheduled for 8/4. They will keep her overnight and I will pick her up after 4pm on the 5th.

The Vet was amazed at her health and 'alertness'. She is very active and to see her running into things breaks my heart. She came running at me the other daya nd misjudged and hit the doorway. She was ok - but a little shaken up. The Doc is only treating one eye as she still has some vision in the other. Her name is Janet Isherwood and she is located just outside of Baltimore. She says that its not the age, its the health of the dog. She thinks Macy will have many years of new life ahead.

I will keep everyone reading the board posted as we complete the surgery and the recovery. She will have to wear a collar for 2 months which I know she will hate, so Ill be using my sewing skills to create her a jacket with a nice big collar to replace that uncomfortable piece of plastic.

Thanks again for everyone's input - I have approached this with caution and taking the risk will be worth it as the quality of her life is not good.
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Old July 16th, 2008, 08:08 AM
dcapper dcapper is offline
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You are correct. At Toby's age its a major risk. Thats why I was asking if there is a vet that can do it while the dog was awake. Litely sedated. Like they do with humans.
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Old September 19th, 2008, 10:35 AM
Mflinchem Mflinchem is offline
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Finally Surgery

Well - Its been a while since my last post. I had to take little Macy in for a Chest Xray and Urine Test prior to surgery and the chest xray revealed an enlarged heart. After mailing the xrays to her regular vet and the eye dr, they recommended a Heart visit was in Order I took little Macy to the University of Penn and had her Heart Checked out, after an exam and echo test, it was determined that 15 year old little Macy has a strong heart and was not likely to develop any heart disease. This was great news for me and also gave the go ahead for the Cataract Surgery which is now scheduled for Monday. I cannot pick her up until Tuesday afternoon but they promised to call me with updates.

I must say that the office of Dr Janet Isherwood in Baltimore MD has been awesome through all of this. Not only was I impressedwhen I visited the office but I have also received phone calls from the office just checking in on Macy and making sure that she was okay and this is before they have done the surgery. No wonder her office is filled with thank you cards and pictures!

As soon as the surgery is complete I will post again -

Matt
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  #21  
Old September 19th, 2008, 11:10 AM
kandy kandy is offline
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Good luck with the surgery! I hope everything goes well!
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  #22  
Old September 23rd, 2008, 08:09 AM
Mflinchem Mflinchem is offline
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Surgery Complete

Good morning, I am happy to report that little Macy's surgery went well. The doc was not able to put a new lens in as Macy was not 'behaving' well under the anestesia and doc decided to wake her up. The cataract was removed and Macy was up and alert. I am picking her up tomorrow and will be able to report later on my impression of the results.

She still has some vision in one eye and the left eye she had none, now she should have better vision in the left.
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Old September 16th, 2009, 02:06 PM
angelafurg angelafurg is offline
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My dog had cataract surgery with artificialf lenses inserted

With regard to Dr. Van Lienden response to cataracts. I am slightly confused. 4 years ago my jack russell terrier (female) woke up one morning and couldn't open her eyes. I rushed her to the vet and was told to take her to a Veterinarian Opthamologist. The opthamologist examined her and suggested that in order for her not to go blind she would need to have surgery. This surgery involved replacing her natural lens with an artificial lens. It was her left eye that had the inflamed cataract but the Dr. suggested that the surgery be done on both eyes. We did so because that was the only option we were given if we didnt want her to go blind. I give her a drop of Apo Ketorolac every night in both eyes. Every year she returns for a check up. She is currently 9 years old. She was five when she had the surgery. Her checks were always good. This year, unfortunately is not the case. Her left eye (which was the one that initially gave her the problem) has an IOP reading of 21. Her other eye had an IOP of 13. Basically we were rushed through the appointment and told that she may need surgery (again) this time for glaucoma. He gave us a prescription of Duo Trav and instructed us to give her one drop twice daily and that we are to return after two weeks. Will this medication stabilize the problem for some time. I got the impression that our only choice is surgery again and I do not want to subject her to that again. I really want her to enjoy the rest of her life. She has food allergies so she has had many visits to the vet until we go that under control. Will this Duo Trav be able to be used to control this problem? I need to know what my options are and educate myself a little bit so that I am not bamboozled into making her go through another surgery. I would prefer the option of medication for the remainder of her life is this possible?

If any one can help me because I am completely overwhelmed for her. She is such a sweet dog and I want to reduce her stress level by avoiding another surgery.

Thank You

Angela
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