Left eye ulcer has healed after tarsorrhaphy done some weeks ago.	Fluorescein eye stain did not show the ulcer as bright green as it is healed	The right eye has ulcer now and tarsorrhaphy would be done by my associate vet soon

When the right eye was injured and treated by tarsorrhaphy by my associate vet, the owner wanted the dog home against medical advice. On day 2, she phoned me to say that the eye was swollen and bleeding. I advised bringing the dog to Toa Payoh Vets immediately for me to check. She did not do so. Around Day 7, she said the suture had broken down and the eye was swollen and bleeding. This time she brought the dog down and was very unhappy as the first left eye with tarsorrhaphy recovered without problems. The owner understood that she had not been able to confine the dog and give the proper eye care and that she had taken the dog back immediately post-tarsorrhaphy against medical advice.

4840 - 4845.  Right eye ulcer. The stitches were rubbed off at home as the owner did not confine the dog in a small crate. She did not want the dog warded for at least 3 days at Toa Payoh Vets after surgery, unlike the tarsorrhapy done for the left eye done. Left eye healed ulcer. She was pleased with the good ulcer healing of the left eye after tarsorrhaphy done by me.
	Repeat tarsorrhaphy. It is best to ward the dog for at least 3 days as most owners are unable to confine the dog at home and provide post-op eye care. In some cases, I ward the dog for 14 days, but many owners do not accept this advice and want the dog home immediately.

"There is no guarantee that every surgery is going to be successful every time," I said. "I do have cases where there are similar problems. In the first case of the injured left eye, I did advise NOT taking the dog home for 3 days but you did not accept my advice."

There was a lot of unhappiness and blame onto the operating vet when the owner does not heed medical advice. Vet 1's competence was suspected and this was not right. The dog's eye was not well cared for post-op by the maid and mother but the owner denied it. "Can you watch over the moving dog 24 hours a day?" I asked.

The dog was not confined as would be done at Toa Payoh Vets if warded. But he was permitted to wander around the house and could have rubbed his eyes against sofa sides and beds, leading to stitch breakdown and bleeding.

I advise a repeat tarsorrhaphy as the ulcers were deep and would need to be covered up to heal. Or a second opinion from another vet as to whether to leave the eye alone. If the owner has her way, she would rather not have tarsorrhaphy. If the eye cornea subsequently ruptures or get pus infection, she would again blame the consulting vet for not having given proper advice! All advices must be RECORDED in the medical records nowadays although sometimes my associate vet just will not do it. I will be performing tarsorrhaphy on Dec 14, 2011 and will follow up on this case.

Update 7 months after tarsorrhaphy in Jul 2012: The right eye ulcer healed as in the left eye as the dog was warded for a few days at Toa Payoh Vets and could be given proper post-op nursing. 

 

5518 -5519. Follow up 7 months later. The ulcers of the right and left eye had healed well. The owner complains about itchy ears now.

More info at: Dogs or Cats. To make an appointment: e-mail judy@toapayohvets.com
tel: +65 6254-3326 or 9668-6469

To make an appointment: e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326