Precious Kate 🧸 has been with us 2 weeks now and had a recheck vetting appointment as well as a consultation with our ophthalmologist.
Her spay and mouth have healed well following her surgery and big dental. While her ears are far better than they were 2 weeks ago when they were nearly swollen shut, there is till some yeast and bacteria and needed to be retreated. She is also down 3 pounds from 32 to 29 and is already moving and breathing better with some extra pounds off.
Her eyes are a different story- we did not like how her eyes looked on intake and still don’t like how they look after 2 weeks of medication. She has severe dry eye (producing no tears) and as a result has developed a lot of pigment which is negatively affecting her vision. She also has secondary infection and inflammation which is not responding well to medication. Today we have added two more antibiotic drops to her regimen in hopes of something being effective to clear the infection. She also received subconjunctival injections (into the tissue when you pull down on bottom eyelid) to help reduce the inflammation. These injections bypass several layers and thus increase penetration. If things are not looking better by the end of the week we will need to move forward with a culture to identify exactly that is growing, which will be the first time we’ve had to do that with an eye. As for the tear production, we feel that the tear gland is too damaged to be stimulated and that surgery on both eyes will be inevitable. Before surgery though, we need to have the infections cleared and inflammation managed which is our current goal.
Kate comes from a breeding kennel notoriously known for severe eye issues. In fact, you may remember Sable and Goldie who came through our rescue last Summer. They were also from the same breeding kennel with a song similar to Kate’s - no tear production, battling secondary issues, too damaged of a tear gland to stimulate, not responding to medication, and required Parotid Duct Transposition (PDT) eye surgeries. While “dry eye” is definitely a common congenital issue in the breed, the eye issues the Cavaliers from this kennel are experiencing is something more than that. We aren’t sure if something is being put into their eyes, or if there is a chemical they’re being exposed to, or 🤷🏼♀️, but something is turning off their tear production and making their eyes extremely resistant to medications. This is causing these poor babies a great deal of discomfort, pain, and suffering, and a long road of medical care.
It’s going to be a process, but like all the others before her, we will get this straightened out and well managed so she can go on living a comfortable and quality life with better vision
If you’ve ever had something in your eye for even a day you can really empathize with Kate who tolerated YEARS of this discomfort and irritation. We are very, very happy to be able to give her this relief today! She will return to our wonderful ophthalmologist in 2 weeks to ensure her lids have healed and discuss next steps to her eye care. Kate is now back in her foster home in Birmingham, Alabama resting and recovering
Her post-op recheck revealed that her eyes were still dry and despite our best efforts to try to stimulate her salvary gland with tasty food and treats 🐠🥩🥘 , there was no saliva making it to her eye. We were hopeful that post-operative inflammation was to blame and that swelling was closing off the flow of saliva. We started her on anti-inflammatories but unfortunately we saw no improvement. So yesterday she underwent another procedure to try determine where and what the blockage is that is preventing the flow to the eye and open it back up.
The procedure did indeed give us answers but not what we were hoping for. There was no blockage rather it was discovered that her salivary gland was not secreting well enough for the saliva to make it upstream to the eye, which is extremely rare. Therefore, her eye is not able to be lubricated in this way. While under, she did get a ‘tear stimulant implant’ put in her eyes which will slowly release the tear stimulant medication with the hope that between that slow release implant and her tear stimulant drops that we can get her tear gland activated and see some improvement.
Worst case is that despite the slow release implant and tear stimulant drops that her tear gland is just too atrophied and too far gone to stimulate, and that her eyes will need to be manually lubricated through ointments and gels. There will likely be secondary issues, mostly infection, that will arise and would need to addressed along the way. While she was under yesterday we did collect and send off for a culture and sensitivity test so we could learn what medications she is most sensitive to so that any infections down the road can be best handled.
This is the same bacteria that all other dogs are coming into contact with but the difference is that their eyes act like a “flushing mechanism” 💦 to continuously flush out this bacteria. Kate’s eyes don’t produce any tears though and because this bacteria isn’t being flushed out, it’s harboring in her eyes. So her foster mom has been her “flushing mechanism” and is flushing out her eyes around the clock so that hopefully this bacteria doesn’t get a chance to grow. Tomorrow she returns to the ophthalmology where we will re-culture and see if all these efforts are paying off 🤞🏻 Visibly her eyes are looking so much better and more comfortable
Last year, Kate underwent parotid duct transposition surgery (PDT) to reroute her salivary gland to her eyes in effort to provide lubrication to her severely dry eyes. While saliva isn’t the same as tears, it does the same good work to keep the eyes lubricated and prevent detrimental secondary issues from dryness from occurring like infection, ulcerations, and vision loss. While this surgery is widely successful, unfortunately it was not for Kate. While she was flowing immediately post-operative, the flow stopped soon after. While we don’t know for sure why this occurred, efforts at that time turned back to drop therapy to try to keep her eyes free from infection, to manage inflammation, and maintain her vision and comfort. Her eyes are flushed, medicated, and lubricated literally around the clock but even with those efforts we have continued to fight infection, inflammation and dryness.
She met with her ophthalmologist last week and we have decided we would like to now go back in surgically to explore her salivary gland more and see if it is still viable and if so, if we can’t open back up that channel to her eye. We aren’t quite sure what we are going to find but we feel it’s now worth exploring and giving it a second shot 🙏🏻 Kate will undergo this explorative PDT repair surgery in late February and we will be sure to keep you posted 💜