Signalment & History
- Spayed female
- Terrier mix
- Diet: Blue Buffalo BID; HW Preventive: Interceptor monthly; Flea/Tick Preventive: none; Fecal/Parasite Exam and Tx: none
- Has had genetic screening; GP discussed with owner this dog’s predisposition to PLL, and that in the case of any eye abnormalities the dog should go directly to a specialty ophthalmologist to try and prevent the need for enucleation.
- Squinting, scratching at eyes (onset earlier today); eyes now teary and red; “Doesn’t look right”; O suspects PLL based on previous conversation with GP about genetic screening results.
- Temp: 102.5 F; Pulse: 150 bpm; Respiration: 42/min; MM: pink/moist CRT: 2 sec; BCS: 5/9; Eyes: Anterior lens luxation in right eye; Ears: wnl; Mouth: Dental Disease = Grade 2; LN’s: wnl; Cardio: wnl; Resp: wnl; Abd: wnl; GI: wnl; MS: wnl; CNS: wnl
What is your plan? How will you follow up with this patient?
- Emergency lens replacement procedure
- Referral to ophthalmologist recommended.
- Exams recommended every 6 months, with IOP checked every visit. Follow up appointment in two weeks.
- Vet communicates the risk that this condition is nearly always bilateral.
How would your treatment plan change if lens replacement surgery was not financially practical?
- Sedation can be done to medically widen the pupil, then push the lens into the back of the eye. Dog will need “life-long at least twice daily treatment with a drug that keeps the pupil small – which in turn ‘traps’ the lens in the back of the eye. This treatment approach is believed to be working in 8/10 patients – with an average chance of 50% that the eye will retain sight 12 months down the line,” according to the Eye Veterinary Clinic in Herefordshire, England.
- Glaucoma secondary to PLL diagnosed @ 7 years-old; IOP in range of 30-35 mmHg (monitored every 6 months by GP)
- Latanoprost, applied topically BID (this is a prostaglandin analog.
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