Case Solved: Retrobulbar abscess
To be a dog is to love to chew—and most anything will do. But when Deb Dutkiewicz noticed that her Golden Retriever puppy, Lola, had a penchant for rose bushes, thorns and all, she thought it was a little peculiar and perhaps attributable to an under-sensitized mouth.
Then she noticed her food-motivated puppy had lost interest in favorite treats like dog biscuits and popcorn. “She was still eating and drinking but I just felt that something was off. Then one day, Lola tried to open her mouth and yelped in pain. I thought that eating sticks and roses had maybe caught up with her so we brought her in to see our veterinarian right away,” said Dutkiewicz.
Anyone familiar with the popular television show House has seen the twists and turns that a medical condition can take but for the Dutkiewicz family, the drama was real life. “The issues started with her mouth but it wouldn’t be until nearly a month later that we’d find out it was a problem with her eye. We saw our local veterinarian and some specialists before coming to Tufts, and it was there that doctors confirmed she had a retrobulbar abscess.”
Dogs have an area behind the eye known as the retrobulbar space. If the tissue in this area becomes infected, an abscess can develop, and this is known as a retrobular abscess. The condition is relatively uncommon and isn’t typically associated with vision loss, although in Lola’s case she did experience the loss of sight in her left eye.
When Dutkiewicz first brought Lola to her local veterinarian for the mouth pain, a test was run to rule out a neuromuscular disease called masticatory myositis, a canine condition where attempting to chew or moving the jaw is painful. But after a blood test came back negative for that condition, Lola was anesthetized for a skull x-ray to see if there was another reason behind the pain, such as a foreign body or a jaw fracture. The veterinarian was surprised by what happened next on the exam table. When Lola’s body was turned to a different position, her left eye suddenly appeared to bulge forward.
“When we picked her up later that day, her eye was protruding from her head,” said Dutkiewicz. “It was really upsetting because that morning she was her happy self, taking walks and running around. Our veterinarian was so apologetic and shocked. She had never seen something like this happen.”
While the experience was challenging, Dutkiewicz said it might have actually sped up the process to discover what was really going on with Lola. The family brought Lola to an emergency veterinary hospital in their area, but as her condition worsened, it was recommended that Lola be taken to the Tufts Foster Hospital for Small Animals at Cummings Veterinary Medical Center so a CT scan could be performed.
“A CT scan showed that Lola had a fluid pocket behind the eye that was displacing the eye forward, causing it to protrude,” said Dr. Kara Gornik, an ophthalmology resident at Tufts Foster Hospital for Small Animals. “The abscess extended down the side of the face to the jaw, which explains why she had pain opening her mouth. She also had blindness in her left eye as a result.”
With the medical mystery solved, Foster Hospital’s veterinarians drained the abscess to relieve the discomfort and placed Lola on a long-term course of antibiotics to help fight any remaining infection. After six weeks, Lola’s eye returned to a normal position, her left eye had full vision, and she could fully open her mouth, said Dr. Gornik.
“Lola responded so well and bounced back quickly,” said Dutkiewicz. “Her care was really excellent and thorough, and we are happy to have her home.”
While Lola still likes to chew and her appetite has returned to normal, the family keeps a close eye on her to make sure she doesn’t put everything she encounters into her mouth—especially the rose bushes.