Savanna is a bouncy black 14 month old Pug who presented due to discharge and a glazed appearance in her left eye. As a typical young dog she is lively and loves playing so her owner suspected she had caught it on a toy.  With this history however it was important to look for a corneal ulcer. 

A corneal ulcer is a term used to describe damage and destruction of cells on the surface of the cornea. The damage can be very small and superficial but some ulcers can extend deep into the cornea and involve a large proportion of the corneal surface. Treatment is needed straight away as some corneal ulcers can be problematic to heal and deteriorate quickly. Unfortunately, this can be very true for certain breeds and Pugs are one of them!

There are lots of reasons for their occurrence; trauma/abrasion or ocular foreign bodies, chronic irritation from face hairs or abnormal eyelashes, structural issues with the eyelids, reduced production of tears and many more! It is important that in the diagnosis of an ulcer that any of these issues are looked for and addressed; without this the ulcer will struggle to heal as hard as we try! 

Savanna did have a corneal ulcer in the centre of her left eye. No other structural issues were identified which was good. Breeds with prominent eyes are naturally at higher risk of catching the surface on objects so it was possible this was the case for Savanna.

Initial treatment of an ulcer involves supporting the eye and patient whilst the eye itself heals naturally. This involves antibiotic eye drops to prevent and protect from infection, lubricating drops to help keep the ocular surface healthy and oral pain relief as corneal ulcers are very painful. Lastly, a cone of shame is needed to prevent patient interference as our furry patients are prone to rubbing and scratching their painful eyes. Pugs have been described to have poor corneal sensation so even simple traumatic corneal ulcers like Savanna’s can have poor healing and response to medical therapy.

Some seemingly simple ulcers can also develop into what are described as ‘melting ulcer’s’. This is when the ulcer deteriorates rapidly and the surrounding cornea becomes soft and jelly like. They are usually associated with specific bacteria, Pseudomonas. They require aggressive medical management and can quickly result in rupture of the eye. Any untreated or complicated ulcer can in fact lead to perforation/rupture of the cornea which is why timely diagnosis and treatment is important. 

Savanna started medical management that evening on the caveat should the eye deteriorate we may need to change our medical approach or that in some cases surgery is required.

That evening the eye became suddenly more painful and seemed to leak fluid. Her owners followed our advice and contacted our emergency line. We decided to see Savannah straight away as we were worried about rupture. Our concerns were confirmed and we admitted Savannah overnight for lots of additional pain relief and ongoing assessment. In some of these cases the eye can be salvaged with specialist and intricate surgery and Specialist ophthalmologists are best placed for this type of surgery.  However, surgical repair isn’t always possible or successful and in some cases surgical removal of the eye is required.

As Savannah was so young Richard and her owners decided to try and salvage the eye with ophthalmic surgery here at Hollybank and if this failed to work remove the eye as a last resort. The surgery is described as a conjunctival pedicle graft which means a shallow piece of conjunctiva is taken from the side of the eye and placed like a graft over the perforation (hole) in the cornea.

The surgery went successfully and Savanna’s eye began to show signs of healing. Despite a surgical approach Savanna still needed ongoing medical management (as described above) and this took lots of time, patience and dedication from her lovely owners!

Despite some shrinking and mild detachment of the graft Savanna’s eye continued to heal and over the next 4-6 weeks she made a full recovery with full vision! In some cases there can be residual scarring which can interfere with the visual axis but as you can see Savanna’s eye looks no different! We are delighted that we were able to save Savanna’s eye sand we hope she stays out of further trouble!

In the last few months Hollybank have been lucky enough to have an upgrade in some of our laboratory equipment. The huge advantage this brings Is the ability to offer the most accurate and quick in-house results for our patients. 

Blood Machines: we have recently invested in a brand new haematology machine. This is what we use to measure the levels of red blood cells, white blood cells and platelets. It provides results as reliable to those from an external lab and  it requires a smaller blood sample which can make things easier for our nervous or more wriggly patients. 

Urinalysis Machines: commonly a ‘dipstick’ test is carried out which gives an overview of important features in the urine. This includes the presence of red blood cells, white blood cells, protein and glucose. Generally, the result of this test is based on colour change and interpreted visually by a member of staff. The interpretation therefore can be subjective. We now have a specific machine which interprets these results which creates consistency across the board.  An innovative machine has been developed to run alongside this information; it screens a sample of urine and takes pictures of all the components within it, for example urinary crystals. The physical images of these cells are available alongside the dipstick result giving us a complete set of information to evaluate.

Urine Culture Facilities: When we are suspicious of a urine infection it is beneficial to prove its presence and then determine which antibiotic in particular it is sensitive to. This allows appropriate and accurate use of antibiotics which in turn allows the fastest and most effective treatment for your pet. Previously we have had to send these to an external lab. This has a number of limitations; it can take time for a result and some bacteria may grow during the transit time increasing the potential for miscellaneous results.  We now have an incubator and special urine culture plates to provide this facility in-house. It means that the urine is put directly onto the plate increasing the reliability of the bacteria grown and yielding these results within 24 hours. 

Microscope: Having access to a microscope allows us to evaluate samples from lumps, bumps and bodily fluids. By looking down the microscope we are able to identify cells that are associated with inflammation, infection and cancers. This information helps us to decide with what we may be dealing with and whether it is prudent for an expert to also examine the slides. There is huge variation in the types of cells however so the large display screen allows multiple people to see the same image at one time. This helps interpretation but can also aid learning and development