Poor Enzo had the shortest consultation ever.
The little French Bulldog puppy didn’t even make it as far as my consulting room, as I whisked him away from his distraught owner and ran with him directly into theatre.
“Reception will sort you out with a consent form,” I shouted over my shoulder. “And I’ll give you a ring when I’m done.”
I felt bad and I felt a bit rude. I usually try to spend some time explaining to an owner the various options for treatment and possible complications, even in an emergency.
But in Enzo’s case there was no time and actually no need for such a conversation.
Another dog had attacked the little pup, who was just a few months old. His left eyeball had prolapsed – it had popped out of its socket. So, there was little need for discussion and a lot of need for action.
Even though it looks like something from a joke shop, a prolapsed globe is a genuine veterinary emergency and needs immediate attention.
Firstly, it is obviously very painful. The quicker it can be replaced, the sooner the pain subsides.
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Secondly, the longer the eye is out, bulging and swollen, with haemorrhage behind it and stretching of the optic nerve, the lower the chance of saving the eye.
So, I felt justified in being a bit rude. Enzo was under anaesthetic within minutes of entering the building. It was may be the shortest wait of all time!
As his anaesthetic stabilised, I ran through in my head what I needed to do. It is a horrible sight, and mercifully rather rare.
Cat and dog breeds with bulging eyes (and therefore shallow eye sockets) are more at risk, but any traumatic injury to the face or head can result in this horrendous condition.
Once Enzo was asleep, I made an incision at the lateral corner of his eye, where the upper and lower lids met. This is called a lateral canthotomy, which sounds very technical, but is actually just a small cut with a scalpel to create a bigger hole through which to replace the globe.
The next job was to place sutures in the eyelids, to allow them to be pulled upwards over the prolapsed eye. Then I applied gentle but firm and constant pressure to the globe.
The text books call this part retropulsion of the globe, which basically just means “pushing it back in”.
After several minutes of retropulsion of the globe, I felt happy that it was back in its normal position so fastened the sutures together to keep it in place.
Enzo was quickly round from his anaesthetic and sitting up, plastic cone on head, as if nothing had happened.
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I made the call to his owner, who I felt sure would be waiting anxiously, brandy in hand, by the phone.
“Hi, it’s Julian here, from the vets. Just an update about Enzo. He’s absolutely fine and ready to go home whenever is convenient.
“I’m fairly hopeful we have saved his eye.
“I must apologise for being so rude before. I felt awful that I just grabbed him from you without any discussion...”
I tried to explain and apologise at the same time.
When he was ready to go, I carried him out in just the same way he had come in, an hour earlier. Enzo wagged his stumpy tail with vigour.
It’s amazing how resilient dogs are. There’s no time for feeling sorry for yourself when you’re a dog.
His owner was altogether happier too. As I carried Enzo to the car, there were more tears, but this time they were tears of relief!