Thursday, June 28, 2012

Background - Part One: It's "Only" Anterior Uveitis

It’s hard to believe it was only less than one month ago (the first week of June, 2012) when I first noticed something was wrong with Lexie’s left eye.   She happened to turn to look at me while her third eyelid was covering her eye, which was something I’d never seen her do before.    As soon as I jumped up to get a closer look, though, her eye went back to normal and she seemed to be perfectly fine.  I thought that maybe it was just a fluke, but it became obvious the next day that it wasn’t.   Her eyes were becoming increasingly red, so I made an appointment at the vet the next morning.  I thought that she was maybe having an allergic reaction to something, or perhaps had been scratched by one of the feral cats that sometime seek shelter under our deck.  I figured the vet would probably prescribe some medicine, which we’d probably have to give her for a couple of weeks, and then Lou would be back to normal in no time.

My boyfriend, Justin, and I took Lexie to see Dr. Ginger Ellis at Animal Care Clinic in Huntington, WV that Saturday.  I could immediately tell by Dr. Ellis’ concerned expression, however, that Lexie’s eye condition was something worse than I had anticipated.  She measured Lou’s eye pressures and was very relieved when her pressures were low, because she said that meant that this was not glaucoma.  After further examining her, Dr. Ellis said she believed Lexie had anterior uveitis, which is an inflammation that affects the front, or anterior, part of the eye.  She prescribed a steroid eye drop to give Lexie every six hours, along with an antibiotic, and told me that Lou’s eyes should start looking better by the next day.  If it didn’t, Dr. Ellis recommended I take her to the emergency vet, since it would be on a Sunday, in order to have blood work done because eye inflammation can also be a sign of something going on internally, like cancer.  I asked Dr. Ellis if we could just go ahead and do some blood work that day, just to save myself a little bit of worry.  She agreed, and thankfully Lexie’s blood work came back normal.

We immediately started administering the antibiotics and steroid drops to Lexie’s eyes as prescribed, but she did not look better the next day.   I didn’t rush her to the ER, though, because her blood work had come back normal at Dr. Ellis’ office.  So, I just continued to administer her medications over the next several days, thinking that eventually they would kick in and she’d start to look better, but she didn’t.  In fact, after a full week of treatment, Lexie’s eyes were starting to look worse.  Her left eye was noticeably worse than her right, but they were both very red, and she was holding them shut most of the time.   However, despite the fact that she was starting to actually look like a blind dog, she could obviously still see because she wasn’t bumping into anything, which I took as a positive sign.

At her follow-up appointment (one week after her initial diagnosis), Dr. Ellis frowned when she saw that Lexie’s condition had worsened, and after giving her a brief examination, she asked if she could refer us to an eye specialist in Ohio.  She said that she was afraid Lexie may be developing retinal detachment and could go blind very quickly, but because Dr. Ellis is not a veterinary ophthalmologist, she said she couldn’t really be sure.  That is why she wanted to make us a referral to a place called MedVet in Worthington, Ohio, which is a three-hour drive from Huntington.  I couldn’t believe we were actually discussing the possibility of my Lou going blind!  I was immediately in tears  because I wasn’t sure I would be able to afford any kind of extensive treatment that Lou may need.  Dr. Ellis and her assistant were both very sympathetic and talked to me about some possible financing options through Care Credit, if it came to that.  Her assistant held my hand and told me that dogs adjust very well to being blind, and told me about how her own dog adjusted very well after he had to have both of his eyes removed.  So, basically, I went home from the vet that day thinking that Lexie was most likely going blind, but still holding out hope that the specialist in Ohio would have better news for us. 

A few days later, my roommate, Ashley, accompanied me and Lexie on our road trip to see Dr. Corbett, a veterinary ophthalmologist, at MedVet.   (Thankfully, I have a very nice boss who allowed me to take some time off from work in order to make the trip to Ohio.)  I was very impressed when we arrived at MedVet because it was SO much bigger than the little old Animal Care Clinic back home.  It felt more like a hospital, which was comforting in a way. 

Dr. Corbett and her vet tech were both very nice.  After a thorough examination of Lexie’s eyes, Dr. Corbett told us that Lexie’s retinas looked fine.  She then went on to explain anterior uveitis to us, which was Dr. Ellis’ original diagnosis, but I still wasn’t 100% sure if Lexie was in danger of going blind.  Finally, I mustered up the courage to ask, “Just to be clear, are you telling me that Lexie is NOT going blind?”  Dr. Corbett replied, “Correct.  She is not going blind.”  Ashley and I both cheered, and Ashley immediately began texting the good news to all of our concerned friends back home as I continued to listen to Dr. Corbett. 

She explained that anterior uveitis can be caused by a number of things, including tick bite, cancer, eye injury, a disease of the internal organs, fungal infection, or it could possibly be autoimmune-related.  She was able to rule out eye injury during Lexie’s exam that day, and I could have paid to have blood work done that would have definitely told us if it was caused by a tick bite, but when Dr. Corbett said that we were basically treating her for a tick bite anyway, I decided to save some money and not order that test.  So, that left cancer, internal organ disease, fungal infection, and autoimmune disorder as the remaining possible causes for her uveitis. 

Dr. Corbett recommended we treat Lexie’s condition as though it was caused by tick bite or an autoimmune disorder.  If her condition worsened or did not improve after two weeks of treatment, then she would order a chest X-ray and abdominal ultrasound to look for cancer, etc.  So, I was told to continue giving Lexie the same steroid eye drops and antibiotics she was already taking, but Dr. Corbett increased their dosages and added another ibuprofen-type medication to her regimen.  She told me that Lexie wouldn’t look better immediately, but after about a week I should start to see an improvement. 

Needless to say, I went home the happiest dog owner in the entire world that afternoon because I had been told by an actual veterinary ophthalmologist that Lexie was NOT going blind!!!!

If only I had known the heartbreak that lay ahead…

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