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Thread: Eye removal surgery

  1. #1
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    Default Eye removal surgery

    My 11 year old squirrel is having her left eye removed tomorrow. That is the plan anyways. She started last week very lethargic. Not really interested in eating and had a huge swollen neck on the left side. Per my vet we started on Clavamox twice daily for 10 days and meloxicam for 3 days. The swelling started to go down after a few days but she still didn't have much appetite. I was syringe feeding critical care and I had to do SQ fluids. After a week I brought her back because she had a horrible ulcer on her eye. I had been putting neo poly bac on it twice to three times daily with no improvement. We added another antibiotic drop to see if that helped as well as switching to TMS and stopping the clavamox. Unfortunately it has not so we came to the conclusion she needed the eye removed. My vet has never done this on a squirrel so I'm a little nervous. I'm not sure the exact plan yet. We did discuss doing and x Ray prior to try and rule out a tumor but even if it is a tumor the eye still needs to come out. I would love to hear if anyone has had a similar situation and what was done to treat. They haven't really been able to check her teeth out either which I'm sure will be done once she is sedated tomorrow. What sedation is normally used for surgery? Her appetite has come back some but she is still only interested in soft foods. I'm hoping her body can handle the anesthesia. The photos are a progression of the swelling in the neck going down and the eye ulcer getting worse.
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    Default Re: Eye removal surgery

    Poor ol girl, she is lucky to have you, I'll be sending many thoughts of a good outcome.

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    Default Re: Eye removal surgery

    Quote Originally Posted by Cmiddl3 View Post
    My 11 year old squirrel is having her left eye removed tomorrow. That is the plan anyways. She started last week very lethargic. Not really interested in eating and had a huge swollen neck on the left side. Per my vet we started on Clavamox twice daily for 10 days and meloxicam for 3 days. The swelling started to go down after a few days but she still didn't have much appetite. I was syringe feeding critical care and I had to do SQ fluids. After a week I brought her back because she had a horrible ulcer on her eye. I had been putting neo poly bac on it twice to three times daily with no improvement. We added another antibiotic drop to see if that helped as well as switching to TMS and stopping the clavamox. Unfortunately it has not so we came to the conclusion she needed the eye removed. My vet has never done this on a squirrel so I'm a little nervous. I'm not sure the exact plan yet. We did discuss doing and x Ray prior to try and rule out a tumor but even if it is a tumor the eye still needs to come out. I would love to hear if anyone has had a similar situation and what was done to treat. They haven't really been able to check her teeth out either which I'm sure will be done once she is sedated tomorrow. What sedation is normally used for surgery? Her appetite has come back some but she is still only interested in soft foods. I'm hoping her body can handle the anesthesia. The photos are a progression of the swelling in the neck going down and the eye ulcer getting worse.
    This sounds more like the possibility of an odontoma which is a tumor of odontogenic origin. I would definitely take a hard look at her teeth.
    An odontoma is a tumor which may become aggressive in the involved area. A spreading untreated infection from a dental abscess can involve
    tissue near the jaws, around the sinuses and most often the eyes.

    Most vets will use isofluorane gas to anesthetize small animals such as a squirrel.
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    Default Re: Eye removal surgery

    Quote Originally Posted by stepnstone View Post
    This sounds more like the possibility of an odontoma which is a tumor of odontogenic origin. I would definitely take a hard look at her teeth.
    An odontoma is a tumor which may become aggressive in the involved area. A spreading untreated infection from a dental abscess can involve
    tissue near the jaws, around the sinuses and most often the eyes.

    Most vets will use isofluorane gas to anesthetize small animals such as a squirrel.
    Just to clarify, you're suggesting they rule out an odontoma before committing to eye removal, right? The thought of an 11-year-old having her eye removed unnecessarily makes my stomach queasy. Although if it's odontoma, that surgery is probably way trickier and more involved. Sheesh, I hope it's a dental abscess!

    Cmiddl3, prayers for you and your precious girl!
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    Default Re: Eye removal surgery

    In the first six pictures, it looks like severe swelling on the front of her face between her eyes and her nose, then that seems to have gone down as the eye got worse. Maybe the corruption moved to the eye? Maybe if it's something else that can be found and fixed she can keep her eye?
    "I hope everyone got or gets their Baby Love today"~Shewhosweptforest

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    Default Re: Eye removal surgery

    Before you remove her eye, PLEASE try clindamycin as an antibiotic if you haven't already. It specifically t reats the area above the neck and the head, and can work miracles where Clavamox is useless. Please try it; an 11-yur old squirrel deserves a chance to avoid such radical surgery which ay not even treat the problem.
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    Default Re: Eye removal surgery

    I appreciate everyone's input so much! I wish I had thought to post here a week ago! The eye is so swollen and almost necrotic looking at this point that I'm not sure it can be saved. It is bulging out her head to where she can't even close her lids. The eye became more of an issue once the neck swelling went down. I'm going to share this thread with the vet. I have read about an odontoma and that seems like it could be! I did notice a little lump on her bottom jaw near where a tooth root would be so I'm going to pint that out to her as well. I'm on my way now and super nervous and afraid! I don't want to loose her in surgery. We probably should have been more aggressive with the eye in the beginning but whatever is going on is causing a lot of pressure causing it to not be able to close. I believe that's what caused so bad of an ulcer from it getting so dry.

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    Default Re: Eye removal surgery

    Odontomas form on the roots of the top front incisors. Your don't see them on molars. Odontoma surgery is a very special deal unfortunately. Because the root of the tooth has a big calcified mass attached to it, you can't just grab and yank it out through the mouth like any other tooth. Odontoma surgery is done through the top of the muzzle which means literally going through the skull to access it. Most vets honestly don't know how to do this surgery. There is a vet in Port Orange, FL named Dr. Alician Emerson who does. But getting a bunch of head x-rays so you know what is happening is pretty important. I will cross my fingers that you are looking at a bad molar which can be resolved with relatively simple surgery and follow up with meds (Recommend Clavamox - Amoxicillin clavulanate - for after care.

    Eye removal isn't that unusual of a surgery - it is probably harder emotionally on the owner. That eye is probably quite painful - once it is not there all of that will be gone.

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    Default Re: Eye removal surgery

    The vet didn't see anything associated with bone in the xray. She thinks there is a tumor behind the eye but they don't have a small enough tube to incubate. I'm trying to see if another vet in the area may or if one can be ordered. She is worried the eye will retire soon but agrees it does need to be taken out. Would an odontoma show up on x ray?

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    Default Re: Eye removal surgery

    What size intubation tube would be used in an enucleation? My vet did they didn't have anything small enough. She said a 2inch but I'm not sure what she means. I left a message for her to call me back. I was going to place an order for one but I need to see the exact one I need.

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    Default Re: Eye removal surgery

    Quote Originally Posted by Cmiddl3 View Post
    The vet didn't see anything associated with bone in the xray. She thinks there is a tumor behind the eye but they don't have a small enough tube to incubate. I'm trying to see if another vet in the area may or if one can be ordered. She is worried the eye will retire soon but agrees it does need to be taken out. Would an odontoma show up on x ray?
    Yes odatomas will show on an x-ray and many times it's the odatoma that causes bulging eyes, if unteated they can end up losing the eye.
    When she breathes does she sound wheezing or sneezing? That also are signs of odatomas as is a redish appearance around eye.
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    Default Re: Eye removal surgery

    No sneezing or wheezing at all! So maybe it's not an odontoma. I'm hoping that with the eye removal the issue will be solved. I found a 1.5mm endotracheal tube so I'm going to order and have it rush shipped.

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    Default Re: Eye removal surgery

    I just had time to get on TSB for a few minutes and noticed this thread. Please, please, please, Cmiddl3; get your Squirrrel seen if at all possible by a Veterinarian familiar with Squirrels or at least rodents. There are a few issues that I would like to comment on and I hope it's not too late to at least consider these!

    1) The administration of anesthesia is NOT something that can be done properly and optimally if adequate training and supervised experience does not come before doing this on one's own. If this individual is not certain as to the size of an endotracheal tube necessary for a Squirrel, IMHO, they should seek a more experienced associate. Also, not all anesthesia is necessarily administered through an ET. It goes without saying that the animal also must be safely sedated and relaxed to permit intubation with the ET. Anesthesia is very critical because of it's risk and also to ensure all of it's benefits come into play. In regards to the benefits of General Anesthesia; your Squirrel (and any other living being) should be able to benefit from all of the advantages of General Anesthesia which include freedom from operative pain, amnesia (the absence of memory of the procedure), and muscle relaxation! Again, I would recommend that if surgery is truly needed and this is the next step, someone with experience with both anesthesia and understanding of the particular pathology involved should be the only one performing surgery.
    2) In medicine, there are certainly coincidences but how likely is it that your Squirrel has both an ulcer on her eye AND now a tumor behind her eye, both of which followed significant swelling of the neck region? In the practice of medicine, veterinary or otherwise, it is best to try to find a single common cause for a particular localized condition as that method has through time proven to be the best way to start because IF a single cause can be conscientiously identified, it far more likely that this is the case than multiple coincidental disease conditions! On this line of thought; it appears that original swelling of the neck may very well have been from an infection but a tumor or abscess and other causes are also in the running. Going to the eye ulcer; a true ulcer of the cornea (the clear part of the eye) can be and often is from infection. Also, of note is that Neomycin which is one of the constituents of the eye medication being used is also one of the most allergenic of all of the topical antibiotics. Sometimes an allergic reaction can be so pronounced as to resemble an infection!. On the photos it appears that the eyelids are swollen. Eyes themselves do not ordinarily swell because they are a relatively firm capsule. There can be swelling behind the eye which can cause protrusion of the eye but it is unlikely that a tumor just coincidentally began there while all the other issue were going on and unrelated! From a standpoint of what is most likely from a medical standpoint, the process (tumor, infection, etc) that caused the original neck swelling is most likely also responsible for the swelling around an behind the eye. I would certainly give Island Rehabber's suggestion some serous consideration. In regard to the corneal ulcer, I suspect this was not associated with the original cause of the neck, head and eyelid swelling but was caused by the little Squirrel inadvertently scratching her eye with a claw in response to the irritation from the cause of the swelling and the swelling itself. I really believe that further focused and competent diagnostic endeavors should be expeditiously utilized before enucleation (removal of the eye) is further considered!

    Again, if at all possible please have your Squirrel seen ASAP by a Veterinarian familiar with Squirrels or second best, with other small rodents such as rats which are common enough pets!

    Best regards to your little Squirrel and to you as well, Cmiddl3!

    SamtheSquirrel

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    Default Re: Eye removal surgery

    Since you are close enough, consider taking her instead to be seen by Dr. Emerson in Orange, FL. An exotic certified Veterinarian, she is she is highly experienced and especially skilled in treating tree squirrels with medication and with surgery when needed; this including eye removal, and related issues which may involve an underlying cause beneath the eye where things can get dicey for vets not having the experience she has to support. It really can make a big difference whether a squirrel survives or not; especially when it comes to anesthesia as others here have pointed out.

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    Default Re: Eye removal surgery

    I'm going to see if they can email me the rads in the morning. They sedated her today to do a dental exam and file her teeth and she did well. I ordered a 1.5mm tube for intubation. They do have experience with rats at the clinic. I could see if going to Florida is feasible. I would have to find out if they will see an out of state squirrel. I wasn't sure if that would be an issue. I could stop the neo poly bac and just do the other drops. It starts with an O but I can't remember the name right now. She feels it's a tumor behind the eye. I want to do what's best for her. Even though she is 11 I feel she could have a longer life. She was very lethargic and not feeling well but she seems to be getting her appetite back now and more active. The eye is just still very painful for her. I'm giving her meloxicam and they gave her an injection today that's for pain. Starts with a B. I don't have the paper with me but I'll upload pictures of both invoices from the last two visits.

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    Default Re: Eye removal surgery

    Quote Originally Posted by Cmiddl3 View Post
    I'm going to see if they can email me the rads in the morning. They sedated her today to do a dental exam and file her teeth and she did well. I ordered a 1.5mm tube for intubation. They do have experience with rats at the clinic. I could see if going to Florida is feasible. I would have to find out if they will see an out of state squirrel. I wasn't sure if that would be an issue. I could stop the neo poly bac and just do the other drops. It starts with an O but I can't remember the name right now. She feels it's a tumor behind the eye. I want to do what's best for her. Even though she is 11 I feel she could have a longer life. She was very lethargic and not feeling well but she seems to be getting her appetite back now and more active. The eye is just still very painful for her. I'm giving her meloxicam and they gave her an injection today that's for pain. Starts with a B. I don't have the paper with me but I'll upload pictures of both invoices from the last two visits.
    I'm glad that there is time to consider all realistic alternatives. As far as going to Florida to see Dr. E; there are a number of Squirrel Board members who have driven considerable distances from outside of Florida with their Squirrels to see Dr. E so there is precedent for this. As far as the eye medication, all of the aminoglycosides (Neomycin is in the aminoglycoside family of medication) are known to be allergenic but Neomycin is probably the worst in that regard and perhaps Gentamycin is among the least likely in that family to result in an allergic response. The "O" drug is probably ofloxacin which is in the fluoroquinolone family of medication as is another common veterinary medication called Baytril (enrofloxacin).

    It is certainly possible that your Squirrel has a tumor behind her eye but again, it unlikely that that there are coincidences when there is a reasonable single explanation for both the neck swelling, eyelid and head swelling and the swelling behind the eye. A tumor is definitely in the differential (the prioritized list of possibilities) but so are infection, abscess and a number of other things. CT's are a great help oftentimes for better visualizing what is going on. Another important benefit that takes into account the wisdom of looking for a single cause that could explain all that is going on; is that in some cases, it is not necessary to remove an organ such as the eye to determine what is going on behind it; we can instead (as an example only as the options and plan must be made by you and your Vet), very carefully the region on the neck that is swollen (under anesthesia!) and find out the cause is "remotely" without having to deprive your Squirrel of her eye to make the diagnosis! Also, please consider that if there is a tumor behind the eye, removing the eye doesn't do anything to treat or negate the tumor! If a tumor, we don't even know where it originates or what other areas of the head and neck might be involved, although if this is a tumor it must be fairly large because it already involves the Squirrel's head and neck. Further, if this is a tumor, it may not be resectable (removable) and probably is not! This is why in human medicine, an enlarged lymph node if available is often biopsied rather than surgically entering into the chest as an example as this is much safer and will clinch the diagnosis as if we cut into the primary involved organ or region itself. I would opt for trying to save the eye but that is my opinion only! Usually a rapidly growing mass such as this is not cancer and infection seems to me to be more likely but if this is determined to a cancer after removal of the eye or a biopsy of the mass on the neck (or elsewhere); I would ask a rhetorical question and that is; would it be enhancing your Squirrel's quality of life to have removed her eye while the cancer continues to progress. Again, I suspect this is infection but serious none-the-less. If this truly is tumor and it extends from the neck to the head and behind the eye, it would seem that ending any suffering should, when that becomes clear, become the primary objective. We can do for our animals what we can't do for our human loved ones!

    I hope this has not been too negative a post but I'm just not convinced about the plan for enucleation at this point in time.

    Regards,
    SamtheSquirrel

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    Default Re: Eye removal surgery

    Quote Originally Posted by Diggie's Friend View Post
    Since you are close enough, consider taking her instead to be seen by Dr. Emerson in Orange, FL. An exotic certified Veterinarian, she is she is highly experienced and especially skilled in treating tree squirrels with medication and with surgery when needed; this including eye removal, and related issues which may involve an underlying cause beneath the eye where things can get dicey for vets not having the experience she has to support. It really can make a big difference whether a squirrel survives or not; especially when it comes to anesthesia as others here have pointed out.
    I've seen Dr. E save many a squirrel. She is your best bet in this situation.
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    Default Re: Eye removal surgery

    I will get a better photo of the eye today. It can't be saved at this point. It actually looks like it's about to rupture and when I was putting the antibiotic drops and eye lube in it this morning there was pus coming out of the corner. They gave her Buprenex yesterday and she was feeling great after that. She is dumpy this morning now that it's worn off. I contacted another vet that sees my exotics and has seen my degu. I'm waiting on a call back from her. She enucleated the eye of my friends hedgehog so I would feel more confident using her. I'm hoping she gets back with me today. It's so bad being a holiday weekend. If she gets to the point where she needs to be put down I will absolutely make that call but right now I don't feel that is necessary.

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    Default Re: Eye removal surgery

    She can take INFANT IBUPROPHEN for pain, and it is remarkably effective on them. Give me her weight and I can dose this for you. Any drugstore will have it. Make sure it is the infant strength and that it is ibuprophen, not acetaminophen. If she has seen the vet her weight should be on your paperwork.

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    Default Re: Eye removal surgery

    She has been getting meloxicam for pain. She is around 420 grams. I weigh her twice daily. She has lost a little weight. Yesterday she was about 410 before she ate.

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