So a lot has been going on at Riverside Veterinary Clinic these last few weeks. We are getting settled in, meeting lots of great people from the community, and working out all the little kinks that go along with a new business. Since there is not a lot of new issues to report, I haven’t been writing any new blogs, but I realized I need to get back in the swing of things.
I am diverging a little from my usual blog post. I thought it might be interesting to talk about an ongoing case I have been working on for almost a year. In one regard, I want people to be aware of this disease, but on another hand, it is quite uncommon. Also, I am not going into too much detail like a case report since I don’t have her old records in front of me. I am going off what I remember, so I may be off a little bit, which I still blame on “mommy brain” for some of my cognitive losses over the last 4 years :)
As you can tell, Lexi has lost both of her eyes, and she is only 3 years old. She was adopted as a rescue and we think she is part Afghan. She was very shy when I first met her, but over time and with lots of treats, she really opened up at the office visits.
This is Lexi before she started having issues.
She presented to me in August of 2016 for a fever, decreased appetite, and squinting of the left eye. Within 24 to 48 hrs on medication, she was getting worse, and she developed inflammation within the eye, which led to glaucoma. She consulted an ophthalmologist from the University and we sat on pins and needles waiting for her Blastomycosis test to come back from the lab. Luckily her blood work was relatively uneventful and there was no evidence of the fungus in her lungs. She remained painful, lethargic, and febrile for days. After a lot of discussion, we decided to move forward and remove her left eye. She did well with surgery, Blastomycosis was confirmed on the urine test, and we started systemic anti-fungal treatment. She started to eat a little more and seemed more comfortable.
Unfortunately, before we could even remove the sutures on the left side, she started showing similar symptoms in the right eye. We tried to hold off, but unfortunately, surgical removal of the right eye was now needed. After another long discussion, we decided to move forward with a second surgery. Very quickly, we started to see improvement in her appetite and comfort level.
With Blastomycosis, there is no guarantee for a cure with aggressive treatment. She contracted the fungus from sniffing the dirt, and luckily her house mate, who is in the same environment, has not shown any problems. In August, we will be coming up on 1 year of oral medication. Last month, her urine test showed she was negative, but we are going to continue medicine for a couple of months beyond resolution. Lexi has been extremely strong and yet so sweet through this entire process. She has adapted well to being blind and has a wonderful quality of life at home.
Her fight is not over, but, she has been comfortable and happy for the last year. She is an amazing pup, and her owners are so dedicated to her care and happiness. They are both extremely luckily to have one another.
Although I am not able to express how difficult it must have been for the family to opt to make their dog blind to save it’s life (and even then, it wasn’t a guarantee that she would pull through), but at some point all owners of a pet are going to have to make a difficult decision regarding their well-being. We hope as veterinarians, that we can make these decisions easier.
Dr. Leah Wulforst, DVM. Riverside Veterinary Clinic. Knoxville, TN.