Wednesday, August 30, 2006

Jane Doe's eye. Update.

I am going to try to make this entry as un-fragmented as I can.. but I am so pissed really. I'm not sure I can be successful. I apologize for the length.

Quick background - Jane Doe is one our bunnies, and the girl has glaucoma. Blogged about it here. After being stable for 6 months with the glaucoma, around the end of July she started favoring the eye. For example, squinting, and not keeping the eye open. At the time I started preparing myself for the possibility the eye would have to be taken. You don't hear about many cases, but I have read rabbits can do fine with one eye. Me - still not crazy about the idea. Nor was my "been through hell with me" vet. Sometimes you trade one set of problems for another. Plus.. her glaucoma by any measure appeared to be under control.

Back to her favoring of the eye. Turns out she had the smallest perceptible ulcer. About the size of a sharpened pencil head. It is obviously enough to make her unhappy. Went to my "been through hell with me" vet, and she urged me to go back to the eye specialist. Al-right fine. At that time I just had a weird feeling about them. They just seemed a little eye grabby happy. You can see from my previous entry (link) about this issue the eye actually looks pretty amazing considering.

The eye specialist debrided the eye. But never actually said that was what they were doing. Even though I watch them like a hawk. You might think the MD would say something like.. this pet is going to be in pain for a little while. But no.. I guess I am being difficult for wanting to know such things. This is what prompted the oatmeal can collar. We put her on Metacam for a few days which is your basic bunny aspirin or aleive. She was put on an exhaustive routine to get the ulcer stomped down. When I say exhaustive, I mean medication every hour.

The truth is.. guilt kept me on the hourly doses. If she eventually had to get the eye taken, I didn't want it to be because I was too lazy, or life became too complicated to do the routine. If the eye was going to go, I wanted my head to say "you did everything you possibly could - there is no way that eye could have been saved".

Jump forward to the beginning of August. I was beginning to be really pleased about the eye. It looked shiny. Her white margins seemed normal. So we went back to the eye specialist for the routine checkup. Glaucoma... wow.. so under control. However the ulcer was still as big, just not as deep as it was previously. The specialist floated the idea of again debriding the eye, and putting a coating of surgical grade super glue over the ulcer to protect it and promote vascularization. Not many sites talk about this procedure, but you can read about it here and here. I was told it would be less invasive than the original debradment, but it gave a 90% chance of knocking the ulcer out completely. Otherwise it might take 4 months of antibiotics. The specialist made it seem like "no big deal". My bad though.. I should have played 700 questions instead of 500 questions.

I had been in the waiting room 3 hours by the time I was able to be seen by the eye specialist the first time that day. They had an emergency. I completely understand. Now I am a total pet person, but by this point if I had to hear another story about how smart everyones pets are, I am going to throw myself down a flight of stairs. This was an emergency room atmosphere. Completely packed, standing room only, and everyone wanted to tell you stories. Which is great.. for like two hours. Not only that.... these people were the kind that wanted to talk baby talk to their pets in the waiting room. Now... e-v-e-r-y-o-n-e who has a pet does that. At home, so no one can see your tard ass. Each time I have been there, it is just this surreal experience. Queue the crazy cat woman on the Simson's. But only it is really tiny dogs with cones. Like all of them. And at least one eye is bulging out.

The other thing I didn't really appreciate...some woman walks in complaining about a leak. There lots of businesses in a fairly large - really old complex. Even (shudder) restaurants. Which didn't seem like a big deal, until this women walks in. I thought it was a neighboring business who shared a wall, and they had a leak together. Seems common. Oh... no.. the woman leaves, and the receptionist who I would say is a fairly simple person, tells everyone in the waiting room she has already told that woman she needs to contact management. That the woman is from the Chinese food restaurant underneath the eye specialist office. Okay....I know I probably look like super bitch because I constantly complain... but come on.. who of you out there doesn't think that is f-ing creapy weird?

I go back a couple hours later to get the super glue thing done, and spend another 2 hours there. Another woman and I talk about the whole experience at the office. I then realize she had been in the waiting room the whole time I was that morning. Off in a quiet-ish corner. Her first appointment was right before mine that morning. I'm pretty memorable.. because I don't have a tiny dog with a giant cone like everyone else. My new temporary friend has a giant dog, with a giant cone. I get home, and prepare to put the oatmeal collar on. The specialist at least says Jane will be in discomfort for 1-2 days. But still makes it seem like no big deal. Let me tell you... after about 4 days I am becoming a super pissed, because the girl went from an eye that looked good, and didn't hurt, to an animal that was bordering on inhumane treatment. I think I have royally f-ed up for making the choice to do this procedure.

I am absolutely not being dramatic or exaggerating. The eye was so inflamed I was sure she would loose it just based on trauma. I didn't want to go back to the specialist because I think they suck for not having any clue about pain management. They are only pets after-all. I figure, what can they do at this point except take the eye or put her through more pain. None of my options are good ones. I start resigning myself to having fought like crazy for this eye, only to have all that work reversed in one full swoop.

About four days ago I think I see the ulcer getting worse. The eye looks like crap, but honestly a million times better than it looked for two weeks. I take a flashlight to the eye, and wouldn't you f-ing know it...her eye is filled with veins. The area in the lower half of the eye that looks like a wave is nothing but blood vessels.

Today was Janes checkup, and I was totally conflicted. The treatment actually worked, even though it was my own little bit of hell. And hers. I got into see the specialist fairly quickly. While she was looking at the eye, as delicately as I could I admitted it was sort of hard to complain because of the results. But their pain management was non existent. I mean... come on. Scrape your eye, then put super glue on it and tell me that isn't painful. I have to be careful though, because these people are my only chance, unless I want to drive to UC Davis. Hours away. She looked directly at me and said "well, we don't have a lot of choices". Then said very little.

Um... okay. Not a "not a lot of choices" and "no choices" are at the opposite ends of the spectrum. And let me tell you.... not one of the three doctors ever brought up pain management. I kept choosing a different specialist at the office hoping I just got one of the sadistic ones. How about saying anything so your regular vet can help you manage pain! Finally after about day 10 and my girl still has not opened her eye, but she seems less painful and stable. I called my own vet an just pleaded for the future. Please I ask... even if I have to drive in every day so you can administer it, if this ever happens again, can you do something. Did I mention this was suppose to be minimally invasive? The thing is.. if my vet would have done surgery, Jane would have gotten immediate pain control. A narcotic, not bunny asperin. Because the specialist is really handling the eye issue, most vets defer to the specialist. The good news is Jane has turned a corner. Her Galcoma is in the range of a completely healthy eye. The ulcer is healing because of the new blood-flow. I am doing everything in my power so I don't have to see those f-ing people for a very long time, and my normal vet can take back over.

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