I finally stopped avoiding it and watched one surgery.
Then I did one.
Ready to teach one I suppose.
My entire career I have avoided enucleation, surgical eye removal to protect the health or comfort of the patient. As I am all for health and comfort, I am in no way opposed to this surgery.
The only eye surgery photo I will ever show you. You are welcome.
And it is well within the skill set of a general practitioner.
It’s just. Have you seen Robin Hood? The one with Kevin Costner and the pretty music? That one episode of My Name is Earl? Jeepers Creepers? (Don’t. The song is great though.) Have you read the original version of Rapunzel?? They all play on my inherent squeamishness, so I suspect it is not just me.
Eyes are amazing creations that showcase the mysteries of God in tiny, miraculous orbs. And eyes are gross.
For 25 years I avoided dealing with that.
Dr. Betts, our ISU veterinary ophthalmology professor, who, while scary, was one of my favorite teachers, would often say, “Enucleation is a sign of a bad vet!” His point, I think, was that sometimes vets jump to enucleation when medical treatment may help. At the time, it reinforced my fear of eye surgery. Now I believe this surgery may not be elected often or soon enough. Bad eyes hurt. Good vets help.
As Dr. Betts was prepping a cat with intraocular cancer for life-saving enucleation, I said (knowing, as we all did, not to speak to him when he was stressed), “Dr. Betts, do you know what enucleation is?”
He looked up, glaring. (It’s just how his face went.)
“A sign of a bad vet!” I said sternly. He laughed. Lucky for me.
Enucleation has saved the lives and well being of so many pets. And Dr. Betts saved the life and well being of that cat that day. Thank you Dr. Betts for being gracious. That was a jerk comment on my part. I was nervous. Eyes are gross.
We also had an excellent veterinary ophthalmologist in Littleton where I started my career, and we sure as heck have the best here in Omaha. So besides having the very best eye care available for our veterinary patients in Omaha, this has allowed me to continue to avoid ever being too close to eye removal surgery.
Years ago, my boss at the time did a surgical enucleation on a hamster whose eye had proptosed. (Do NOT look it up - just ask me). The hamster later died, as hamsters are prone to do. It was NOT surgery related. He had so many health issues. Dr. Tiemann did a completely badass job on the surgery. But at the time, I resolved once again to never do this surgery.
I had a patient a few years later with a traumatic globe rupture. Dr. McIlnay - Omaha’s amazing veterinary ophthalmologist - enucleated her eye on an emergency basis. (Thank you again Doc. I so appreciate you.) Instant relief. As I mentioned, Dr. McIlnay has saved me from needing to do this surgery most of my career. And if you want the best in all things eyes, you want Dr. McIlnay.
But eye removal is a mass removal. Very doable with my non-specialist skill set.
Our own Periwinkle Pug needed her eye removed fairly urgently in the fall of 2023, and Dr. Petersen, one of the most surgically skilled veterinarians I have ever met, kindly stepped up and helped her. “Do you want to watch?” he asked.
“No!” I yelled from around the corner. Because of Dr. Petersen and the team, she was able to once again reach her life dream, constant comfort. And I am so grateful.
Months later, another sweet patient developed very painful sudden glaucoma. His eye was non-visual and not responding to medical management. It was time to learn the surgery.
I scrubbed in with Dr. Petersen. “You suture the top and bottom lids together,” he began.
“So they can’t see into your soul,” I said, nodding wisely.
He stopped and looked up from his work. “To more safely manipulate the tissue with stay sutures.”
“Yes, that too,” I said. I was learning.
The dog did wonderfully.
The Mom of the next patient who needed this surgery on my watch looked at me tearfully and asked, “Will you do it?” That did it. After all these years, I took a deep breath and shakily said “yes, I will do it.”
I always tell clients if their pet’s surgery will be my first surgical procedure of that kind. And time and again they trust me with their pets, as did this Dog Mom. Thank you.
I researched and read and watched surgical videos and asked questions of the other docs on the team obsessively till all I had left was Real Life Experience.
And it was fun. And it went so well. And this dog will thrive too. I am so glad I got over myself and did it.
Jeanne kept him safe through anesthesia. And was my calm the whole morning. Dr. Kelly was right there and walked me through the procedure.
Dr. Grant checked in during surgery and said, “Don’t worry. It’s a fire sale.” I looked up. “Everything must go. You can’t make it worse!”
He did great.
Second best time to do something you should have done before is now.
I said then that splenectomies were my surgery of 2024, and enucleations are my surgery of 2025.
“Doesn’t have to be your only new surgery,” Dr. Petersen said.
When I got home, I said again to Russ that splenectomies were my surgery of 2024 and enucleations are my surgery of 2025.
“Doesn’t have to be your only new surgery,” Russ said.
Surround yourself with this. All of this.
Thank you team. Thank you all. Thank you Dog Mom for trusting me with this one.
It’s shaping up to be a great year.