Boca's Ocular Ordeal: Part I

I love you even when you have a cone on your head.

I've been putting off writing this post. I thought if I waited long enough, I could tell the story start to finish and it would have a neat resolution and only one installment. It's been a month, and this will now be part one of Boca's Ocular Ordeal. Since adopting her officially last May after fostering her for three weeks, Boca has had a spot in her right eye. It is a tiny, jelly-bean shaped opacity that did not cause her any apparent problems and was diagnosed by our regular vet as a Florida Spot.

Toward the middle of January, I noticed that Boca was squinting quite a bit and her right eye was frequently tearing. Our regular vet prescribed eye drops and thought it could be allergies or some mild inflammation. We went back for a second visit in less than a week when I did not see improvement. While they did not see much uptake of the stain (which is a neon yellow liquid picked up by any abrasion on the cornea), they changed medications and said we would treat as a superficial corneal ulcer. Normally, these will heal within a few days on their own. 

Unfortunately, Boca's eye was still squinty and watering the following week, so I took her to a canine ophthalmologist at an emergency and specialty clinic where I've spent many hours with Freya, Lasya, Nina and Ruby. This was Boca's first visit. The ophthalmologist thought the spot was possibly scar tissue from past trauma and did not agree with the Florida Spot diagnosis. She did see a corneal ulcer with the fluorescein stain and recommended a procedure called diamond burr debridement, which was described as a tiny dremel that would create a new surface on the cornea to promote healing. It is a common and fairly succesful mode of treatment and although it sounded terrifying to me, only required a numbing drop. When I picked Boca up she was happy and seemed more comfortable, but in the weeks following she has still not improved. Her eye now has a large cloudy area extending over the pupil and despite being on pain medications it is clearly very irritated and continually teary. This is what is known as a 'complicated' or 'indolent' corneal ulcer. In my research I learned that they are frequent enough in Boxers that they are sometimes called 'Boxer ulcers.'

We've had several more visits to the ophthalmologist and have tried several medications including a very expensive, very heavy-duty antibiotic eye drop, all with disappointing results. Last week we tried a steroid drop but the results were not dramatic enough to warrant continuing. I can tell that the vet is as frustrated as I am and we just seem to be on the unlucky side of the statistics for this condition. Tomorrow we will see the third of three specialists at the clinic, and we are hoping for a fresh approach or new idea. There are several different surgical options and I think we may be at the point of discussing them. Because Boca already had an abnormality in that eye, it will not be covered by insurance, even though the vet wasn't able to say definitively whether the spot is the proximate cause of the issue.

The worst part of this has been seeing my poor, sweet Boca in pain and not being able to solve this and help her. Overall, I think she is handling things better than I am. She is wonderful about her three-times-daily eye drops and has a wonderful, joyous attitude. She loves getting breaks from the Cone of Woe when we go on walks and have cuddle time on the sofa. She has even figured out how to chew on Benebones and antlers with the cone on. The staff at the specialty clinic all adore her (one declared Boca her "favorite dog ever") and I've been extolling the virtues of Potcakes on the heels of her charm. The waiting game is a tough one when it comes to our beloved pets, and a medical mystery is not the prize you want to win from the veterinary grab bag. I'll continue to update as I know more, and if any of you have dealt with this eye condition I'd love to compare notes. In the meantime, I'll try to take inspiration from my easygoing island girl and keep my chin up through our latest challenge.

Further Reading:

Corneal Ulcers from Eye Care for Animals