Beethoven is one of my proudest surgical moments in veterinary medicine.
In January of this year Beethoven was left here at Saga Humane Society. A big wrinkly mastiff mix, he was surrendered due to chewing the golf cart seat one too many times. When I met Beethoven he was at least 30 lbs underweight and suffering from tick fever (ehrlichiosis). His biggest problems though, were his eyes. He was born with excessive face wrinkles as well as a condition call entropion, in which all 4 of his eyelids were rolling in so his lashes were rubbing on the front of his eyes (corneas). His eyes themselves functioned normally, but he really couldn’t see anything as they were covered up and in pain.
Beethoven on Arrival.
His eyes were swollen with lots of discharge. I knew we would have to do something major to make this right. A simple eyelid surgery would not be enough. I consulted with my friend Dr Brooke Burkhalter and she agreed that indeed Beethoven would need a face lift in addition to eyelid surgeries. I had never done either surgery myself. I then consulted with my previous employer Dr Alicia Emerson and she kindly looked at my photos and wrote me both advice and some diagrams to help me along. So with encouragement from both women and after a few deep breaths I started the first of what would be 4 surgeries. At the initial surgery I did a large brow lift and also neutered Beethoven. Basically, I cut out a huge piece of his forehead (with skull showing) then put him back together. There was a lot of bleeding due to his tick fever and my lack of cautery.
Before and After the Brow Lift.
You can see in the photos that there is also a huge wrinkle between each eye and his nose. So a week later, while the first incision was still healing, I removed both of those. I also fixed a small amount of damage he had caused himself when he got his E-collar off (ugh!).
Wrinkle Removal Medial to Each Eye.
Things were looking very good, so it was on to the eyes. The more difficult would be the right, as the lower lid was not only curling in but also had so much extra skin that it had it’s own wrinkle. I did entropion surgery on the top and bottom lid, basically making a horizontal crescent moon shape incision and removing the moon shaped piece of skin, then sewing it up to make the lashes come away from the eyeball. I also did a wedge to remove the extra wrinkle on the bottom lid. For reasons of time constraints and anesthesia safety I did just one eye that day. After a brief time I went back to do the left eye. This was a little easier than the right as he needed both lids corrected but no wedge.
Before and After Entropion Surgery to Right then Left Eye.
During most of this time Beethoven had to live with a large cone collar on so that he could not scratch at his incisions. He hated me cleaning out the debris and picking out his sutures, but was always a gentle giant. The whole staff played a huge part in all of his care.
At a recent adoption drive Beethoven came out and a couple living here in San Pedro fell in love with him. Although he was not yet ready to go to a new home, they persisted in visiting him and walking him. I knew that they would be a great family. Finally, I was able to remove the last of his sutures and he was ready. He looked like a new dog…that could see!
No Surgery on the Left, Completed on the Right.
So, as you might imagine, it was very hard to say goodbye. As is his usual custom, he held out his paw for me to hold.
Now though, he has a new home with a loving family. I’m so happy that he will have many years of pain-free vision ahead! He taught me so much, it’s cases like this that help to fulfill the reason I came.
Time to Go Home
We can’t wait for a visit Beethoven!