The Eyes Have It

I was able to observe a double enucleation on a boston terrier a couple of weeks ago. He had severe glaucoma, was already completely blind, and in considerable pain. His eyes were swollen (even more so than in unaffected boston terriers who are pretty pop-eyed to begin with) and milky white; the tissues around them were red and inflamed.

I know the vet who did the procedure and she allowed me to lurk in the operating room and bug her with as many questions as I dared. She also allowed me to cut open the eyeballs after she removed them--a perk of shadowing!

Normal eyeballs should be filled with a clear gel and have several distinct layers. This dog's eyeballs were filled instead with a small volume of opaque liquid. The layers inside were abnormally thickened. The black layer you see in the photo above is the choroid. It is normally dark in color but I don't think it is supposed to be black like this. The retina lies over the choroid; you can see some sort of rumpled, lumpy stuff in there--not a functional retina, to be sure. The lens should be clear but in this eyeball, the lens is the yellowish round object. The other eye didn't have an identifiable lens.

Even though this operation seems like an extreme solution, it was in fact the only solution. Once healed, the dog will be pain-free for the first time in years, and he will be able to live a relatively normal lifespan. I don't believe this is a common solution for humans with glaucoma though it could be. By necessity, vets are often far more practical about the gap between treating symptoms and finding cures. Vets will probably be pretty darned useful to have around when the zombie apocalypse comes.

There are plenty of intersections between animal and human medicine. Vets use lots of human drugs to treat Fluffy, off-label of course, and surgical techniques pioneered and perfected for one often smoothly translate to the other. While it depends on the vet and the details of the clients, vets have told me that between 30 and 70% of the drugs they use for animals were made and tested only for humans. But it goes the other direction as well. While shadowing with the dermatologist specialist, I learned about a remarkable new animal allergy drug that is becoming available. Since the development of a new drug costs many millions of dollars regardless of whether it is for Jane or Fluffy, the company (Zoetis, the animal side of Pfizer) obviously decided there was a significant market for it and that they would not only recoup their R&D investment but make a profit. I have no doubt that there will soon be ongoing human trials with the same drug or something like it.