Visiting Veterinarian : Eye-popping affenpinschers
The affenpinscher is an adorably funny-looking breed whose German name translates as "monkey terrier." The French call them "diablotin moustachu," which means "mustached little devils." Google "affenpinscher images" and you'll see why. Famous for their bushy eyebrows and monkey-like expression, you can find them depicted as early as the 15th century in European artwork by prominent painters such as Van Eyck and Durer.
Affenpinschers were originally used to rid kitchens and stables of rats, but because of their spunky attitudes and engaging personalities they soon became popular as companion pets. Known for being feisty and curious, they have been described as "comically serious"and were even used by organ grinders in Europe as stand-ins for real monkeys, standing on their hind legs and dancing to entertain the public.
Filbert is a typical energetic, eight-year-old affenpinscher. Maybe that's why she got herself into a spot of trouble on Columbus Day. Her mother had to go off-Island, leaving her home with two other affen buddies. When mom returned that evening, she was greeted with a rather disturbing sight — one of Filbert's eyes had popped out of the socket.
It's called proptosis — the forward displacement of the eyeball until it protrudes beyond the eyelids. Displacement can be partial, with the eye bulging noticeably, but not all the way out of the socket, or it can be a total displacement, the globe literally dangling onto the cheek. Google "proptosed eye images" for pictures befitting the Halloween season — but only if you're not faint of heart. Even for jaded veterinarians like me, the sight of an animal with an eye popped out like a cartoon character can be unsettling. The most common cause is trauma. Now it's not hard to understand how an eye might get dislocated if a dog is hit by a car or in a fight, but Filbert had been safely ensconced at home all day. How could this have happened?
It's a matter of simple mechanical principles. Let's talk anatomy. The portion of the skull that surrounds the eyeball is called the orbit, and is usually a deep, cup-shaped socket. Skull conformation dramatically affects the odds of proptosis. The shallower the cup, the more easily the contents can be dislodged. Now let's talk brachycephalics. That's the technical term for pooches with short noses and smooshed-in faces and includes breeds like Pekinese, pugs, Shih Tzus, and our "monkey-faced" affenpinscher. Having been intentionally bred for generations to have flattened faces, it follows that brachycephalics therefore also have flattened eye sockets. They also have unusually wide eyelid openings, giving them that big, childlike, "wide-eyed" look people find so appealing. In some individuals, the socket is barely more than an indentation in the skull, rather than a deep cup, and the eyeball is barely held in place by just the muscles and lids. The amount of pressure needed to cause proptosis in these dogs can be ridiculously small. It can even happen spontaneously during play, simple restraint, or moments of stress. Filbert was probably just wrestling amicably with his friends and then — POP.
So what should you do if your little brachycephalic, Pecan the pug, has a proptosed eye? First, call the vet immediately. I guess that's obvious, but the faster you get help, the greater the chance of saving his eye. Drape the eye gently with a clean piece of gauze soaked in contact lens solution, artificial tears, or plain warm water to keep it moist until you get to the veterinarian's office, where you will likely have two options to consider. If the damage to the eye is so extensive that it is clearly beyond saving, it should be surgically removed. The lids are then sewn shut permanently, or you can go to a veterinary ophthalmologist and get Pecan a prosthetic eye.
Usually, however, it's worth trying to replace the eye in the orbit. It is impossible to tell for sure at this stage whether Pecan will ever have sight in that eye again. Statistically the odds are only around 25 percent chance that the eye will regain function, but there is a chance. And even if he ends up blind on one side, most people think Pecan looks more handsome with both of his eyeballs in place.
After being placed under general anesthesia, gentle pressure is applied to the globe. Sometimes it slips right back into the socket. Other times it's not so easy, especially if there is a delay in treatment or significant swelling. Sometimes the surgeon will need to make a small incision at the corner of the eyelid to facilitate replacement.
Once the globe is back in the orbit, the eyelids are sutured shut temporarily to give all the tissues time to recover and lessen the risk of immediate recurrence. The sutures are usually left in place for two to three weeks. Long-term complications can occur. Nerve and muscle damage may affect his ability to close his eyelids all the way, produce tears, and move the globe normally. This can result in corneal disease, chronic "dry eye," and deviation of the eyeball, giving Pecan a "wall-eyed" appearance. He may be prone to glaucoma or the globe might simply atrophy and shrivel up. If complications are severe, it may ultimately become necessary to remove the eye anyway. Most cases, however, have few major problems other than loss of vision.
Filbert's globe was replaced in the orbit, her lids sutured closed. The veterinarian on call did a stellar job, and Filbert's mom knows the risks and the prognosis. It's been almost two weeks and, so far, things are looking good. We will know more once the sutures are removed and we get a good look at the condition of that eyeball and assess Filbert's vision. In the meantime, the little nut is almost back to her normal antics, despite having one eye sutured closed and an enormous Elizabethan collar 'round her neck. Ah, affenpinschers.