March 9, 2015

Boca's Ocular Ordeal: Part II

Poor squinty girl.

Sadly, Boca's eye issue continues and this will be an ongoing series - Part I can be found here. It's hard to believe that Boca has been squinty and uncomfortable for about 7 weeks now, and I've lost track of how many appointments we've had with the specialist. On Thursday we had another re-check appointment and surgical options were discussed. The first of these is a thermal keratoplasty, in which heat is applied to the cornea and a series of shallow incisions are made to create a surface for better adhesion. Due to Boca's poor (and unusual) response to the diamond burr debridement, the confidence level for this procedure is much lower than it would normally be. The second, more serious and more costly procedure is a conjunctival graft, in which a flap of inner eyelid tissue is bonded over the eye. This introduces a blood supply to the cornea and promotes healing. Vision can be impaired depending on the size and thickness of the flap, but it is the surest way to retain the eye and restore comfort, with a very high success rate. Because it's likely we may arrive at the graft if the keratoplasty failed, the specialist is more strongly recommending it as the primary option. 

A soft contact lens was placed in Boca's eye at Thursday's appointment, with the hope that it would provide her some relief and even allow some additional healing, but unfortunately even wearing the cone collar, we lost the lens within 24 hours. It was a cool idea - the lens had four black dots around the edge so I could easily see when it was in her eye and I think it did help for a short time. We did not find the contact, but I didn't spend a lot of time looking since putting it back in was not a possibility anyway. 

 Still loves her walks!

At first I was really upset about the idea of the graft surgery, because it will permanently change the appearance of Boca's eye, but I have a fairly short time-to-acceptance phase, and after having my little cry, I think I am prepared to move forward once some other things are in place. She will be my beautiful Boca Face no matter what, and dogs are the very best example of unconditional love. As long as she is comfortable and can hopefully keep her vision for the most part, I will be happy. At this point, the main thing I am waiting for is for the decision on my pet insurance appeal. This will determine if they will pay for the cost of the surgery and the treatment to date (minus deductible, which is high but has already been met and exceeded). I want to also touch base with my regular vet to get a non-specialist perspective. Several people have asked why the eye cannot just be removed - my understanding is that since Boca is not blind in the eye, enucleation is not the best option - its only benefit to my knowledge would be economic. I have also reached out to the shelter director in The Bahamas, to see if she may have some vet connections that might know of some tropical condition that the vets here could be missing. As it is, Boca has been seen by two regular vets and three accredited veterinary ophthalmologists, so we have gone above and beyond second opinions. Still, I think the more information I can gather the better, before making any big decisions. The graft is done under general anesthesia which is always a worry; however, Boca did fine with it when she had a tooth extracted shortly after I adopted her.

As for the Potcake herself, she is doing well under the circumstances. I have been trying to give her breaks from the cone collar which she is very appreciative of. She did grouch at Ruby this weekend because Ruby tried to lick her eye and I'm sure it is painful (as well as unsanitary). She is getting twice-daily eye drops and Rimadyl and maintains her great appetite and cute cheerfulness on walks. She still hoards all the toys and bones on her bed. She had everyone in the waiting area at the vet's office laughing because as I was checking out, she was sprawled out on the floor with her frog legs and her tail wagging. Such a delightful girl. We appreciate your good thoughts as the pieces come together for an eventual resolution to this prolonged problem.

UPDATE 3/10/15 - This morning I received notification that Boca's pet insurance has reversed their denial and has accepted the appeal of our corneal ulcer claim. This is the best possible news and I am incredibly grateful to our ophthalmologist for her influence on the insurance company's decision. 
 
Still hoards all the stuff!

26 comments:

  1. You are such an amazing mom. I know it's hard to hang in there but you are doing the best you can. Boca couldn't be in a better situation with you!

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    1. Thank you so much for the kind words, Amanda!

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  2. Poor Boca. I hope the insurance appeal works! :(

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    1. I think you already saw the news but it did!

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  3. Oh, Boca Face! I teared up a little at that, and then laughed at Ruby trying to lick her eye. Your girls are so adorable and you are such a good mom. No matter what, it will be fine. Whatever the surgical procedures necessary, whatever the cost, Boca will come through and so will you!

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    1. Thanks so much, Kari. I got great news from the insurance today and feel very hopeful that Boca will be on the mend soon.

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  4. You are such an outstanding Mom. Boca is so lucky to have you. All the choices you're making are such difficult ones. I keep thinking about what I'd do and really, I have no idea. It's such difficult decision.

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    1. Thank you, Z. Great news today so hopefully we'll be moving forward soon.

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  5. Poor baby. Hope everything works out
    Lily & Edward

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  6. Poor Boca. I hope the appeal and surgery go smoothly! Which insurance company are you working with?

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    1. I got great news this morning that the claim has been accepted. Boca is insured with Embrace and Ruby with Healthy Paws. I plan to do a post about pet insurance soon.

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  7. You're the best for taking care of Boca like this; it's so tough to see our pets go through discomfort - especially something as puzzling as this medical issue. I hope that your insurance appeal goes through; I don't even want to imagine how much this has already cost (and what it will amount to when all is done). Wishing you both the best.

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    1. Another of life's little lessons...anything can happen! Here I thought Boca was my "low risk" dog so I put her on a high-deductible plan. Great news today so hopefully Boca will be on the mend soon.

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  8. Boca is such a trooper! Hope everything works out.

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    1. Thank you! Updated the post with some good news.

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  9. So sorry there's not a simpler solution! Hope that the insurance works out in your favor--I'm glad to hear that Boca's handling things so well!

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    1. We got some great news this morning and hopefully Boca will be on the mend very soon.

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  10. Sending good thoughts your way for Boca and the insurance appeal. It's so hard when you're dealing with something like this, hang in there and I hope it's all resolved soon. Hugs to Boca :)

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    1. Thank you so much! We got some great news this morning and I have updated the post.

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  11. I am SO happy to see the insurance appeal. I'm also glad that, for the most part, Boca is acting like her typical self. Reaching out to the director in the Bahamas was such a great idea to try and get as much info as possible. I honestly don't know if I would have thought of that. Positive thoughts coming your way as you, Boca, and Ruby go through the healing process. Boca will be feeling great in no time <3

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    1. I'm kind of a nut about information-gathering - it's one way I can avoid feeling helpless in these situations! Thanks so much for the kind thoughts and words, I am feeling hopeful and relieved today!

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  12. I was thrilled to read on FB that your insurance appeal was approved! I think that Boca will keep a lot of her vision in her eye. Even after my dog had a BIG flap of red tissue covering her corneal ulcer, she could still snag treats out of the air that I tossed to her. That told me that she still had really good depth of field, which meant that she was seeing well out of both eyes.

    I'm so glad that you can move forward with this now!

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    1. Thank you, that is so encouraging! I feel such a sense of relief knowing that a solution is on the horizon.

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  13. Feel better Boca! So glad the insurance reversed their decision and decided to cover it. One less worry for Mom! Wishing you both the best and a speedy recovery.

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  14. Glad the insurance company came through. Hope Boca is feeling better soon! :)

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