When I first met Arturo, he was a small growling lump hiding under a thick purple blanket. He had come for a second opinion on an infected corneal ulcer of his right eye. Arturo had already seen 2 veterinarians in 3 days, and the owners were told that since the ulcer was deepening quickly, Arturo might lose the eye. In the exam room, we peeled back part of the fluffy purple blanket to reveal a tiny, grizzled Chihuahua that glared balefully at us from inside his plastic e-collar.
Sure enough, the ulcer on his cornea had deepened enough to become a full-thickness perforation of the cornea. A thick fibrin clot and part of the iris were plugging the hole, but the eye had indeed ruptured; we could see aqueous humor continuing to leak out. I discussed with the owner that while a conjunctival graft could seal a small perforating corneal ulcer, Arturo’s perforating ulcer was too big for us to effectively repair. The best option at this point would be to remove the source of pain and enucleate (remove) the eye.
After deciding what drugs and doses I wanted to use for my grumpy Chihuahua friend, I reviewed the two main enucleation surgical techniques as I waited for Arturo to get sleepy. With the supervising veterinarian acting as my assistant, I scrubbed in, gowned up, and took a deep breath. This was my first surgery that wasn’t a spay or neuter, and I was nervous because of the anesthetic risks to my patient—this surgery would take longer with me performing it than if someone more experienced did it, and Arturo’s elderly age already put him at higher risk for anesthetic complications.
Despite nervous sweat that made my glasses constantly slip down my nose, the enucleation surgery went well. It was more difficult than I thought to figure out which tissue layer I should be cutting—the conjunctiva and subcutaneous tissue blurred together, and it was hard to stay in the subcutaneous layer for the transpalpebral technique. But I enjoyed the chance to practice the subcuticular suture pattern again on my final closing layer—I feel like I’m finally getting better at it! I was proud of the way Arturo looked post-op: he seemed so much more comfortable without a ruptured eye, and there was only very mild swelling. I returned Arturo to his very thankful owners and listened with relief as his growls faded into the distance. Perhaps I imagined it, but I thought his growls were a little quieter now.