Winnie’s Story

Winnie - dog cataracts

Winnie, 2009, 4 year old English Cocker Spaniel

A dog has to be pretty extraordinary to have an entire website devoted to her story.

Pet parents know of what we speak – dogs are our children, our friends, our companions and supporters when the days get long and difficult.  Sometimes, a dog is the glue that holds your life together when all else is coming apart.

When things started going wrong for Winnie we went to the ends of the Earth to find a solution.

 

May, 2013 – Cataracts Appear

Winnie had endured a pretty rough period from August, 2012 through November, 2012. Her dog brothers, Tucker and Rocky, both died of old age (and cancer) during that period. They both made it to 16 years old, pretty amazing for English Cocker Spaniels. Winnie had been their eyes and ears for their last 4 years and she did her job with grace and dignity.

Her normal vet check-up was in March of 2013 and despite the trauma of losing her brothers, she was in good health. By May, however, things started to go terribly wrong. She had developed cataracts that had rapidly grown in just six weeks time. When she walked off the left side of the pier at a lake during a Memorial Day outing not once but twice, we knew that something needed to be done, and quickly.

June, 2013 – PRA Diagnosis

We made a vet appointment quickly after returning home from Memorial Day.  He noticed that the cataracts had developed a bit unevenly with the left eye much more advanced than the right eye.  (This is why she walked off the left side of the pier.)  Our vet recommended that she see a veterinary eye specialist who could determine whether or not Winnie would be a good candidate for cataract surgery.  There was a veterinary eye clinic relatively close by, and we made an appointment.

The clinic specializes in cataract surgery for dogs.  The doctor was quite experienced and the clinic had all the diagnostic equipment necessary for an accurate diagnosis (our regular vet doesn’t have the proper equipment for these procedures.) Although we had been told that cataract surgery on dogs enjoys a good success rate, it was comforting to hear from another pet parent in the waiting room that his American cocker spaniel was seeing very well after surgery just 8 weeks before.

When it was Winnie’s turn, we took her into an examination room where the assistants prepared her eyes for the doctor’s exam.  Because her cataracts were pretty well developed, it was hard for him to see Winnie’s retinas at the back of her eyes.  After a more thorough procedure (ERG), the doctor informed us that he suspected that Winnie had a hereditary eye disease that affects English Cocker Spaniels called PRA, or progressive retinal atrophy. One of the side effects of PRA is quickly developing cataracts.  Unfortunately, he saw no point in doing surgery to remove the cataracts because in his opinion, the retinal disease would cause complete blindness in 4 to 6 months.  PRA is a condition where the rods and cones that make up the retinas in dogs, like in humans, were dying off rapidly. There is a test for PRA which we could have performed to confirm his diagnosis which we later did.

We were then treated to pamphlets on living with a blind dog which was very kind, but not the outcome that we were either expecting or hoping for. The doctor also recommended that we give Winnie a dog nutraceutical that would support her eye health, or what was remaining of it, with vitamins, antioxidants and lutein. Having a 9 year old dog with perhaps 7 more healthy years ahead of her (like her brothers Tucker and Rocky) spent in total darkness was unthinkable.

Shock. Heartache.

 

July, 2013 – Second Opinion, Disappointment, and Hope

We actively sought out a second opinion. After another referral from our regular vet, we took Winnie to a nearby veterinary hospital at a state university. We were looking for a second opinion from a teaching hospital that might have more experience with PRA, hoping they could come up with a solution for Winnie.

The outcome was not much different. The doctor advised against cataract surgery because he thought wasn’t worth the money to extend her sight for what could be just 6 to 9 months. Cataract surgery for dogs at the state vet school hospital was going to cost around $3500 for both eyes. The funny thing was, we never said we would not pay for it; it was just their conclusion that it wasn’t worth it. Admittedly, this made is pretty mad as we don’t like other people telling us what to spend our money on. Further, telling us that dogs get along pretty well without eyesight because their other senses are so acute didn’t help either.

The doctor also recommended the same antioxidant that the previous vet had recommended. At this point, Winnie had been taking this medication for two weeks as we put her on it as soon as it arrived. This particular nutraceutical is only available online.

At this time, two puppies that we had reserved from a litter born in May were ready to come home and join our family.  We were very worried that Winnie would not be able to see her new brother and sister. Already we were seeing the frustration she experienced when she bumped into something. We could only imagine how frustrated she would get with puppies darting in front of her – puppies that she could hear and smell, but not see.

Obvious options for saving Winnie’s eyesight were dwindling fast. After several phone calls to other vet eye specialists, we discovered that most were unwilling to look at a dog that had been seen by two vet eye specialists and had been rejected as a surgery candidate. Towards the end of July, however, and after weeks of Internet research, a glimmer of hope was appearing on Winnie’s horizon.

Two vet specialists working at Cornell University had developed a cure for PRA – at least in some dog breeds. We discovered by reading their research, that dog and human eyes are very similar. PRA in dogs is identical to macular degeneration in humans. They found that if a dog breed with certain genetic markers responded to gene treatment, then a subset of humans with those same genetic markers could also be cured of macular degeneration with the same treatment. Different dog breeds have different eye genes, which match up with different people’s eye genes. After several phone calls, we found one of the researchers that was willing to see Winnie. The only appointment he had open in the next 2 months was in just 4 days and this doctor was 1100 miles away practicing at another university hospital.

August, 2013 – A Solution and a Plan

We set out on our eighteen hour drive from home early Monday morning to make a Tuesday morning 7:15 am appointment a thousand-plus miles away across 4 states.

On Tuesday morning at the university vet hospital, the tech assistant showed us to one of dozens of exam rooms. She put drops in Winnie’s eyes to dilate her pupils in preparation for yet another examination of her eyes.

This time, the doctor (a world authority on canine PRA disease) had better news for us. He explained that PRA progressed more slowly in  English Cocker Spaniels than in other dog breeds. English Cockers, in fact, were one of the few breeds that he recommends doing cataract surgery on because although the disease will progress, it doesn’t result in total blindness as quickly as in other breeds. At nine years old, he believed that Winnie could have functional vision for a few more years  instead of losing her eyesight completely by Christmas.

As this doctor no longer performs surgery, he referred us to a colleague  on the vet hospital staff who would eventually operate on Winnie. Because Winnie’s left eye was the worst with the most developed cataract, they decided to operate on that eye first. There was no risk to this surgery because by August, she couldn’t see out of that eye at all.

Although we were hoping for a cure, PRA treatments are breed-specific due to the genetics involved in the disease, and there is no treatment for PRA in English Cockers.  There is a treatment for many other breeds however. (See the link at the bottom of the page to see which breeds are affected by the disease and which breeds have a treatment.)

Lesson learned: Not all doctors have the same level of knowledge. Some spend their lives pursuing a cure for one disease. If you have a case where no one seems to be able to help you, find the doctor that has dedicated his or her life to a cure. They are out there if you look and they will know your options better than anyone.

We left the vet teaching hospital with new found hope and an appointment for her left eye surgery on October 1. Over the next 8 weeks, we would prepare Winnie for surgery with  bag full of eye drops and lots of TLC.  Our 1,100 mile drive home was filled with hope and appreciation.

October, 2013 – Cataract Surgery Day

We set Monday morning for our second  1100 mile drive to the vet teaching hospital and her surgery the following day.  We checked into a pet-friendly hotel late Monday night and delivered Winnie to the hospital early the following morning so that she could be prepped for surgery.

At 12:30 pm, we received a phone call from the vet assistant that surgery went well and that Winnie could be picked up at 4:30 pm when she woke up from anesthesia. The doctor would then have time to go over the details of the cataract surgery.

Cataract surgery for dogs involves removing the cloudy lens in the eye and replacing it with a clear, artificial one. It is delicate surgery to say the least and one that you want to have done by someone who has done it all and seen it all. This was especially true for Winnie as it wasn’t the easiest surgery due to all the other complicating factors. Her eye was pretty swollen when I picked her up due to all the trauma that surgery caused to the area around the eye. She was wearing an E-collar (E for Elizabethan, looks like a big cone) to keep her from touching her face or trying to scratch it. It would take a few days for the incision in her eye to heal and she needed to have lots of antibiotic drops to keep the eye free from infection. And the doctor wanted her to continue taking the eye nutraceutical that she had been taking for the past 3 months for the rest of her life. The good news was that her retina wasn’t completely gone yet and she would be able to see out of that eye for quite a while. The nutraceutical would slow the progression of the PRA disease so that we could extend the useful life of her retinas as much as possible.

On the drive home, Winnie negotiated herself well in unfamiliar territory – namely the pet relief areas on the highway. Bright light made her squint a lot as one of the problems she developed as part of her PRA disease is that her pupils do not completely open and close. But other than that minor issue, she was beginning to recover her ability to see well enough to get around. Which is all we ever really wanted and could hope for…

Epilogue

We nurtured Winnie’s left eye all winter and by Spring of 2014, she was ready for yet another 1100 mile trip to have her right eye operated on. This was the better eye of the two, and while no surgery is without risk, the fact that she now had vision out of her left eye meant that removing the cataract in the right eye would mean that she would have two functional, seeing, eyes. And this is precisely what happened – another successful surgery in April gave Winnie her best possible vision.

Winnie is very careful on piers and docks, but she can at least see where they end and places her feet very carefully. On very bright winter days, she does get a bit snow blind. She sees best when there is a lot of contrast. But she doesn’t walk off piers, or bump into walls, or misstep. She is now 10 1/2 years old and she isn’t blind. Her life has returned to normal.

The fact that she can see, and play with her brother and sister, is due wholly to a world-renowned animal eye doctor, a skilled surgeon, and the nutriceutical we will give her for the rest of her life. And that is a very happy ending.

You should know….

Because PRA is a genetic disease, the genetic markers for it are present in a dog’s parents. Breeders of dog breeds that are susceptible to PRA should have their dogs typed for the disease before mating. That way, you can be sure that there is no chance your puppy will develop the disease. The test for English Cocker Spaniels was developed after Winnie was born, so there was nothing our breeder could have done at the time to prevent this. A list of dog breeds that are affected by PRA can be found here.

Video of Winnie playing with Rugby and Ellie

This is all we ever hoped to achieve.