Tale of Tails: Tino Part 6
Chapter 6 – Strength
The art of life is a constant readjustment to our surroundings.
Strength does not come from physical capacity. It comes from an indomitable will.
One day I noticed what appeared to be a scratch on Tino’s eye – just a little cloudy grey spot on his pupil. It didn’t seem to bother him, but I took him to the vet the next day. The vet ran tests and concluded that Tino had glaucoma and suggested we see a specialist. We knew nothing about glaucoma, what it meant or how to treat it. Some quick research on the internet caused me great concern. Fearful of Tino losing his sight, we quickly took him to a veterinarian who specialized in animal ophthalmology.
The news was not good. The glaucoma in his left eye was beyond repair. The ocular pressure was over 50 (normal pressure in dogs is 10-15). The vet stated Tino’s sight in that eye was irreparably damaged due to the raised pressure. In addition, it was likely that Tino was in moderate to severe pain due to the elevated pressure. At this advanced stage of the disease, the only treatment was removal of his eye.
Glaucoma in dogs can be genetic or can be a secondary affliction caused by other diseases of the eye. Just as in humans, a dog has certain cells within their eyes that produce fluid to help keep the eye irrigated. In the eye, there is a network of drains (Iridocorneal angle) that allow excess fluid to drain away. Glaucoma develops when these drains become blocked and the excess fluid does not drain from the eye and the dog’s ocular pressure builds. This build up causes the eye to stretch and enlarge resulting in damage to the optic nerve, decreased blood flow to the retina and ultimately a loss of vision.
There are medical and surgical treatments for glaucoma in dogs and the obvious logical solution in my mind was to repair these drains. Unfortunately, surgical procedures to accomplish this in dogs are unreliable and the drains frequently just scar over and block again. The typical treatment is with medication to help stem the flow of fluid in the eye and delay the build-up of ocular pressure. There are also several surgical options including implanting a shunt to shunt the fluid away, or laser treatment to open the blockage of the drains.
Tino’s case was genetic and the vet told us it was only a matter of time before his other eye was affected. In addition to the removal of his left eye, she also recommended laser surgery on his right eye to delay the development of glaucoma in that eye for as long as possible. It sounded like a reasonable plan, although the vet warned us that sometimes the trauma of the laser treatment may actually bring on a glaucoma attack in the ‘good’ eye and there was a chance that Tino could lose the sight in that eye immediately. We felt the odds were in our favor so we opted for the removal of his left eye, replacing it with a prosthetic eye and the laser treatment for his right eye.
Given Tino’s high pressure and the Dr.’s concern over the pain he was in, the surgery was scheduled for the next day. Tino would go in the
morning and then come home with us in the late afternoon. Tino is a strong dog. Over the years, he had more than doubled his weight to about 68-70 lbs. and stood just a bit taller than our Lab Sally. He ran a mile or two with me each morning and was pretty fearless. Nothing ever seemed to faze him. Previously, he had surgery on his leg to repair the cartilage tears from his early life on the streets and he had a few other minor scrapes with the vets for various growths and common ailments. He bore all of these trials with a steadfast stoicism. If his eye hadn’t clouded over, we would never have known there was an issue – it certainly wasn’t from any change in his behavior or demonstration that he was in pain.
When I picked Tino up the next day he seemed a bit groggy and disoriented, but that was to be expected from the anesthesia. We took him home and tried to make him as comfortable as possible. The vet armed me with a supply of medication, eye drops and pills that Tino would be required to take daily in an effort to prevent, or at least delay the glaucoma’s progression in his right eye.
Over the years, Tino’s evening sleeping situation had evolved. Initially, when we first got him and his brother Bernie, they slept outside on an old comforter. But slowly and surely Tino had weaseled his way into the mudroom of the house and then upstairs to the sofa and finally into our bedroom. Sally slept on the bed with us, although Tino had yet to take that liberty. He was content to sleep in a comfy dog bed by my side of the bed.
The morning after Tino’s surgery, Steve awoke and went to the kitchen to fix his coffee and feed the dogs. Sally jumped off the bed and trotted after him. I heard Tino rustling around and felt some relief that he was interested in eating. But the rustling didn’t stop…I heard him walking around, and then walking around some more. I sat up in bed and saw him standing still – stuck facing the corner next to my dresser. He couldn’t find the doorway. I jumped up and turned on the lights, thinking that it was just a residual reaction to the surgery of the day before. It didn’t help, Tino could not see. His left eye was gone and the laser surgery we hoped would buy us some time instead resulted in our biggest fear – a glaucoma attack in his ‘good’ eye.
I gulped back my tears knowing that I had to be calm and composed so as to not frighten Tino more than he already was. As his mom, I had to show him that everything would be fine. I held his collar and led him to the kitchen. Steve felt no compulsion to buck it up like me and broke down into tears. Tino would barely move – he couldn’t see, he didn’t know where he was or what was in front of him. I grabbed his leash thinking that might soothe his fears knowing that I was leading him and sure enough it did. He cautiously moved forward towards his breakfast bowl while I had Steve call the Doctor.
The night before, they had given us some ‘emergency’ medication for this exact scenario, eye drops to put in his eye every 30 minutes until they could see him. We started the drops immediately. I brought Tino back into his bed and settled down to wait for the vet to open. After four doses of Xylatan, Tino seemed to be regaining some vision. He was able to navigate his way out the front door and over to his favorite tree for his morning break. When we got to the vet an hour later, he seemed almost normal. We had caught the glaucoma attack early and were able to reduce the pressure in his eye before too much damage had been done. For now, Tino’s sight in his right eye was intact. For how long we didn’t know. The vet kept him for the day and sent us home with some additional medication, all designed to keep that pressure as low as possible.
All of this happened within the space of just a few days so we weren’t really prepared for a blind dog. I immediately started researching how to cope, what special needs he would have and how do we best deal with them. Given Tino’s propensity to spend his day outside monitoring our neighborhood, sleeping, digging and patrolling his yard scouting for unwelcome critters, I wasn’t sure how he would navigate. Our yard was big – over an acre – with lots of trees and bushes and obstacles for Tino to run into. I was afraid for him. He had already overcome a huge hurdle in his life – the distemper – he certainly didn’t need more drama & trauma.
Most of what I read said the same thing – dogs are remarkably adaptive to losing their sight. They are not as reliant on sight as humans and their other senses of smell, hearing and even taste take over. They advised us to apply scent to doorways and other obstacles in the house so that Tino could become accustomed to their smell and how to avoid or find them. They suggested wind chimes and other sound making clues to help him orient outside and inside the house. But most of all they said to remain calm and treat him normally. We read as much as we could find and outfitted our house to ease his transition as best we could.
A month later, Tino got stuck in the bedroom again. We went through the same exercise, pumping him full of Xylatan and rushing to the vet. Tino’s pressure was in the 30’s. It was way higher than normal, but it seemed as if we had caught it in time once again, and Tino’s vision returned, although the glaucoma was beginning to take its toll on his vision. We began to notice Tino’s peripheral vision was impacted. He bumped into things more frequently, jumped onto the wrong side of his chair so that he fell off the other side and unless the treat was right in front of him, he did not see it. The vet put us on an even stronger regime of medication.
Tino was receiving four different eye drop medications 2 times a day as well as pills in his daily food. We discussed alternatives with the vet. There were other surgical options available including a shunt which was designed to ‘shunt’ the fluid away from Tino’s eye but none of the surgical options seems viable enough to us. We settled in to wait it out. The medicine seemed to work. His pressure appeared to stay pretty stable around 15 which was fine according to the vet.
Tino adapted once again. He still chased rabbits, monitored the neighbors, scouted for animals in the yard and met the UPS guy at the gate whenever he arrived. The loss of his left eye didn’t seem to impact his ability to enjoy his life and all the things he normally did each day. Would that last when his sight was completely gone?
During that summer, we took the dogs to our favorite vacation spot, Big Bear Lake. We rented a cabin on the lake and settled in for a relaxing week of hiking, biking and fishing. We had been to Big Bear twice before, taking the dogs with us. They each loved the outing. Sally loved the lake and the ability to jump in the water and swim side by side with Steve. Tino loved the hiking and wandering in the forest. We all enjoyed relaxing on the dock while Steve pretended to fish.
Steve was a big fishing fan and looked forward to renting a boat and sitting out on the lake quietly fishing. He would do it all day long. Sally loved going with him and would sit next to him looking longingly out the back of the boat at the water wishing that we would allow her to jump in right off the back of the boat. (see photo) Tino however, was not a fan of the water. We had reached détente when it came to baths and he would quietly submit to the washing and spray of the water. But being out on a boat, surrounded by the water accompanied by the loud noise of the motor was not his idea of a relaxing afternoon. He would nervously sit by my side refusing to settle or enjoy the day. He couldn’t wait to get off that boat.
The second time we went out, as we neared the dock, he twisted loose of my steadying hand and bounded off the boat – jumping across to the dock while we were still a good three feet away. He bolted down the dock as fast as he could, dodging and weaving the other fisherman and strollers at the marina. He didn’t stop running until he reached dry land. Then he calmly put on the brakes, nonchalantly wandered over to a tree, relieved himself and then sat down to wait for me to catch up. I refused to put him through a boat trip again.
Tino had other ‘run-ins’ with water that left us hysterical. One day, we were hanging out on the dock at Big Bear waiting for Steve to return. I watched Tino as he would wander on and off the dock, sniffing the ground looking for something interesting to distract him. I watched him peering over the edge of the dock into the water (this was before he lost his sight). It wasn’t very deep there, but was heavily overgrown with seaweed. Tino must have mistaken the seaweed for grass and calmly walked off the edge of the dock head first into 2 feet of water. He bounded up covered from head to toe with seaweed. But he froze in place and would not be coaxed out – he wasn’t going to trust his footing again, he’d rather just stand there. I had to don my shoes and wade in after him to drag him out of the water.
That year, on our Big Bear trip, Tino experienced another glaucoma attack. On our usual nightly walk, I noticed that Tino could not navigate the stairs of our cabin. I attributed it to the strangeness of the environment and grabbed a bigger flashlight to light the way. It didn’t seem to help and I realized what was happening. I dosed him up with medication again and waited till morning. By then, he seemed to have recovered once again, although it was evident that with each attack, his vision was slowing deteriorating.
When we returned home we took him to the vet once again. His pressure was elevated – up to 34, although it was apparent that he still retained some vision in his eye. Our options were limited. The shunt surgery or continued medication. We agonized over what to do. The surgery just seemed to ‘iffy’ and may cause more discomfort and gain us very little. One of the drawbacks to the shunt was that it was short-lived and usually had to be redone on a regular basis. I hesitated to put him through more surgeries at his age. But it was also becoming apparent that the pain and discomfort of the glaucoma was taking its toll on Tino’s enjoyment of life and his cheerful demeanor.
He had become quieter, he slept more and more and a pained expression had come to his face. He spent more of his day inside the house on his chair. He frequently rubbed his head against the floor or would come up next to me and rub his eye against my leg – sure signs that his eye was bothering him. I knew we had to do something and soon.
There was another option to removal, a procedure called Intravitreal Gentamicin Injection where they inject the eye with a toxic substance that stops the fluid production, but kills his eye. We knew this was the path to take even though it meant total loss of sight for Tino. It had been just over a year since the initial attack. Over that year Tino’s sight had slowly deteriorated but he had time to adjust and so did we.
We had his pressure checked regularly and it steadily increased to 40, then 45 than 50. We didn’t want to perform the injection until we were sure that his sight was totally gone – it was the last resort. But over the past year, as Tino had slowly adapted to less vision, it was honestly hard to tell whether he could see or not. I held out hope that he could still see something!
The vet likened it to looking through increasing thick gauze. He could still navigate the house pretty easily. He could find his way off his couch, navigate several 90 degree turns, and get down a small set of stairs, two hallways and out the dog door in record time when he heard the UPS guy coming – how bad could it be? The vet explained that Tino was probably in great pain. The pressure of the fluid build-up causes headaches similar to migraines, but I ‘knew’ he could still see and was just reluctant to take that step – it was so final. To prove her point, she simply waved a big piece of white gauze in front of his face and he had absolutely no reaction. Then I knew his sight was really gone. We scheduled the procedure and when we brought him home the next day, he was completely blind.
Part 7 – How Tino Adapts to his Blindness.