Show him Sadie. See? Look! See how she can’t see her cookie? “I sat across from an 11-year-old snowy schnauzer who didn’t seem to know about the treat dangling in front of her. I’ve known Sadie for six years, since her family moved from the frigid New York state winters to the milder Carolina coastline I had seen this coming for a couple of years too (pun intended).
“No matter what I show her, she can no longer see it. She comes across things all the time. And her eyes are so cloudy. Can sadie see “
Though the answer may have been obvious, conveying the diagnosis to Sadie’s mother required a delicate touch.
“I think you are right. I’m afraid her cataracts have finally progressed to the point that they severely restrict your view. She may still see shadows, but I think it’s time we talked about cataract surgery again. “
What are cataracts?
Cataracts are one of the most common causes of vision problems or blindness in dogs. The most common reason dogs develop cataracts is genetic. Despite our best efforts, dogs born with a genetic predisposition are likely to develop cataracts if they live long enough. In these cases, many dogs develop early signs of cataracts in their late middle to early senior years (5 to 12). Other causes include diabetes, eye injuries or infections, or certain nutritional deficiencies in young puppies.
Cataracts are easy to spot because of the cloudiness and whitish opacity they cause due to the darker iris. In advanced stages, cataracts can look like a crystalline stone in the eyeball. Sadie was at an earlier stage, and her eyes had a soft curtain of clouds that covered her pupils. The cataracts now blocked much of the light her retina needed to “see” her surroundings – including the goodies her dog parents dangled.
We had recently done Sadie’s six month blood and urine tests and there were no signs of diabetes or other illnesses. Cataracts are usually slow to progress and based on my history with Sadie, she needed surgery.
In addition to blindness, a major reason veterinarians encourage surgical removal of a cataract is to prevent further eye damage. Cataracts can dislocate or float freely in the eye chamber, injuring internal structures, and causing severe pain and uveitis. Large or “slipped” cataracts can block the drainage channels and lead to excruciating glaucoma.
“What about eye drops? Is there any treatment other than surgery? “
She referred to some misleading websites that advertised “special cataract dissolving” eye drops. The primary chemical in question is N-acetylcarnosine (NAC), and unfortunately studies have shown no success in treating cataracts in dogs. While we may find that NAC has other benefits for our dog’s eyes, treating cataracts is likely not one of them. While these eye drops may not make cataracts go away, there are some other treatment options.
© iagodina; Kateryna Kukota | Getty Images.
Is an operation always necessary?
Dogs with a single, uncomplicated cataract may not need surgery as long as the normal eye can see. In mild cases, anti-inflammatory eye drops, usually a topical NSAID like diclofenac or ketorolac, can be used in combination with a lubricant to keep the dog comfortable and reduce the risk of agonizing uveitis. The goal of these drugs is to keep the patient comfortable and pain free. Many dogs can adapt to life with decreased vision or blindness and rely on their sense of smell and hearing to navigate and resume normal activities.
Surgical removal of the cataracts is preferred for dogs with bilateral mature or hyperripe cataracts, blindness, or those experiencing pain or glaucoma. Before the operation, the veterinary ophthalmologist will perform tests to ensure that the patient’s retina is healthy and can “see” again after the cataract is extracted. These tests are important because in some cases there can be hidden damage to the retina that either increases the risk of complications or does not restore vision after the cataract is removed.
The majority of dog cases undergo a quick and relatively low-risk procedure called phacoemulsification. This technique involves making a tiny incision in the cornea (the clear front part of the eyeball) and then inserting a thin, needle-like instrument. The device emits special high-frequency sound waves that dissolve the cataract and suck away the debris. An artificial lens is then placed where the cataract was and the cornea sutured.
The artificial lens improves eyesight and prevents the world from being inverted and blurred without it. It also reduces the risk of future glaucoma. Studies show that dogs have a 95% vision rate immediately after surgery and 80% report normal vision for life.
Since Sadie’s cataracts were mature and causing blindness, I referred her to my favorite veterinary ophthalmologist for surgery the following week. I checked her within 72 hours of surgery and she literally had a new outlook on life.
“Look! See how she follows the pleasure! Watch her walk across the room without bumping into anything! Your eyes are so bright! It’s a miracle, Dr. Ward! We’re so happy!”
When I saw the couple happily roam the room, I couldn’t help but feel like I was experiencing a small miracle. Restoring this older dog’s eyesight also restored hope and joy to her family. I wrote: “Excellent result. Sadie can see. “in her medical record, but that was just a glimpse of her story. As Sadie watched that day as she rediscovered the beautiful world around her, while her dog mom was delighted, she widened my eyes to the sacred bond that we have share with our dogs.
