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What is Enucleation?

Enucleation is the surgical removal of an eye and its associated structures, e.g. eyelids. The procedure is undertaken in order to prevent pain or spread of disease, such as when an eye is irreversibly damaged, cancerous, or affected by non-responsive glaucoma.

Enucleation in dogs is often a treatment of last resort, when all previous attempts to salvage the eye have failed. The procedure is carried out under full general anesthetic and, although a major procedure, there is every chance of a successful outcome. This is not a specialist procedure and is commonly carried out at general vet practice. 

Enucleation Procedure in Dogs

Enucleation is never undertaken lightly and only after all other treatment options have been explored. For example with glaucoma, referral to place a surgical stent (drain) in the eye may be an option.

Enucleation requires full general anesthetic and may involve an overnight stay after the surgery, for additional pain relief and monitoring. Elderly patients may require intravenous fluids during the surgery to reduce the risk of kidney complications.

The procedure involves: 

  • Preparing the patient by withholding food overnight prior to the operation
  • A pre-op check, possibly including screening blood tests
  • A premedication injection and pain relief to prepare the dog for the anesthetic
  • The dog may be put on intravenous fluids at this point
  • The anesthetic is administered via a catheter in the front leg and maintained via gas delivered through a tube in the airway
  • A vet tech monitors the dog's vital signs 
  • Hair is carefully clipped from around the eye and face
  • The skin is made sterile with surgical scrub
  • The surgeon scrubs up, and then sutures the eyelids of the affected eye together
  • The surgeon removes the eye by careful dissection, and any bleeding vessels clamped and tied off
  • Skin is sutured over the empty socket
  • The dog wakes from the anesthetic and must wear a cone to protect the surgical site
  • The dog is discharged with pain relief and perhaps antibiotics
  • The dog requires a post-op check at two to three days
  • The sutures are removed 10 - 14 days later

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Efficacy of Enucleation in Dogs

Once the initial post-operative discomfort is over, enucleation is extremely effective at preventing ocular pain, without risk of relapse. Many owners who opt for surgery after a delay often notice their dog is happier than it has been some time, now the long term low pain has gone. In many cases, the alternative to enucleation is long-term management of a condition, which can be difficult or even impossible to achieve. This may require visits to specialists for repeated anesthetics to repair damaged corneal tissue or regular visits to have the pressure within the eye measured. Medical management of severe eye conditions is rarely successful, which leaves the possibility that the dog is in constant low-grade pain, so treatment decisions are best made with the dog's long term welfare in mind.

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Enucleation Recovery in Dogs

It is essential the dog wears a cone until the sutures are removed.

For the first two to three days postoperatively, the dog may be quiet from the anesthetic and experiencing some discomfort. The pain can be managed with medications, which your vet will supply. 

Following a check-up at the two to three-day point, the dog has gentle lead exercise until the sutures are removed at the 10 - 14-day mark. 

Complications are rare, but include hemorrhage or wound breakdown. If the bleeding is severe, revisional surgery may be required or the clinician may opt to pack the socket and use pressure to prevent further blood loss. However, the vast majority of patients make a full and uneventful recovery. 

Once the sutures are removed no further aftercare is needed and the patient signed off. 

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Cost of Enucleation in Dogs

The one-off cost of enucleation surgery must be balanced against repeated specialist visits, repeated anesthetics, and ongoing medication costs. At a general practice, the cost of enucleation surgery ranges from around $400 - $950 depending on the supportive care needed. 

Prescription eye drops for glaucoma cost around $15 -25 per bottle and may last around 2 - 3 weeks each. When a condition is managed medically the dog may need weekly visits initially and then three-monthly check-ups. The cost of these visits can be $25 - 50 for a regular vet, to $70 - $270 for a specialist veterinary ophthalmologist. 

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Dog Enucleation Considerations

There are many factors to consider with enucleation surgery. The procedure is permanent and irreversible, and the dog blind on that side afterward. However, many of the conditions for which enucleation is appropriate may have already resulted in loss of sight. The short-term discomfort of surgery is balanced against the long-term benefit of being pain-free. In addition, this surgical option can be cost effective as the results are permanent. The risks of surgery are low and relate to hemorrhage and any anesthetic risks for that individual patient. However, good surgical technique and pre-op screening minimizes both of these factors.

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Enucleation Prevention in Dogs

Many of the health conditions that result in enucleation being an appropriate option are not preventable. Conditions such as glaucoma are strongly linked to genetic conditions such as luxating lens or poor drainage angles from the eye. Breeds most commonly at risk include terriers, Basset Hounds, and American cocker spaniels.

Owners of these breeds should be vigilant for the earliest signs of discomfort in their dog to get the eyes checked. Early medical treatment stands a better chance of success than much later intervention. 

Other problems such as eyes popping out of sockets are linked to face shape. Flat-faced breeds such as pugs and pekes are at greatest risk. To avoid problems, the owner should avoid scruffing their dog (which pulls back the eyelids) and use a harness rather than a neck collar. 

Owners should be vigilant for signs of eye discomfort, such as blinking and squinting, closing the eye, rubbing, or an ocular discharge, and seek veterinary attention. Prompt treatment of ulcers on the cornea (surface of the eye) can stop them from perforating which could result in the loss of an eye. 

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Enucleation Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Ask a Vet

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Chi spaniel

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One Year

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Unknown severity

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1 found helpful

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Has Symptoms

Non Functional Eye

I‘m fostering a cocker mix. He’s about 1yo. He had cherry eye surgery, but it didn’t take because his eye is abnormally small and non-functional, according to to the ophthalmologist. They recommended removing the eye to prevent intermittent infections throughout his life. I scheduled his surgery for this week, but wondering if I should move forward with it right now. He doesn’t seem to be in pain and doesn’t have discharge. He might have dry eye but doesn’t rub at it. I guess I’m looking for reassurance that removing the eye now is the right move even though it doesn’t seem to be causing pain.

July 27, 2020

Owner

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Dr. Ellen M. DVM

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0 Recommendations

Hello, thank you for your question. I am sorry to hear that your foster dog has been having eye issues and I can certainly understand your concern. I would absolutely follow the ophthalmologist's recommendation of going forward and removing the eye. Veterinary ophthalmologists are extremely knowledgeable, and absolutely want what is best for the dog! If he is having dry eye, that will definitely cause discomfort and eye issues down the road, even if it isn't right now. It would be better to remove the eye now before it is painful, then to wait until he's having lots of issues and in pain. Dogs tend to recover very quickly from this surgery, and since he can't see out fo that eye anyway, he won't know any different! He will still be his normal, happy self!

July 27, 2020

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Silky Terrier

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Eleven Years

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Unknown severity

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Unknown severity

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Grey/Cloudiness

My dog developed cataracts and I opted to do the cataract surgery about a year ago. One eye never healed properly and I had to have it removed. The other eye is starting to show signs of the same thing and she has been squinting like it bothers her. I am taking her back to Cincinnati Animal Eye Institute today to have them look at it... My question is, will she be ok if they have to remove it and will she live ok without her eyes. I'm super sad about this because before the cataract surgery she could see and nothing has been the same since the surgery except I'm deeper in debt.

July 22, 2020

Owner

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Dr. Michele K. DVM

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0 Recommendations

Thank you for your question. I'm sorry that that has happened to your dog. The good news, is that dogs actually do quite well if they cannot see. As long as she leads a protected life, where she is not outside wandering alone, and you are careful not to move furniture or disrupt her environment too much, a lot of time people do not even notice that their dogs cannot see. They have so many other heightened Senses at that point. I hope that all goes well with your appointment, and that they are potentially able to save that I. If they are not, however, I think she will be okay.

July 22, 2020

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Christie

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Miniature Schnauzer

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13 Years

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Fair severity

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Fair severity

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Discharge In Eye

Hi, Christie is a 13 years old miniature Schnauzer, she lost her eye 2 weeks ago because of a weird fight with another dog. The vet removed the stitches 6 days ago and everything seem fine except that she has like a brown crust in the corner of the eye (where the eye used to be). Is this normal?

Aug. 7, 2018

Christie's Owner

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3320 Recommendations

A brown crust may form for a few reasons including drainage, wound not fully healed among others; I would keep an eye on the area for now and remove the crust with a warm damp cloth when it forms. If it is still forming by the end of the week return to your Veterinarian. Regards Dr Callum Turner DVM

Aug. 7, 2018

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Bogey

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Shihpoo

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9 Years

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Moderate severity

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2 found helpful

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Moderate severity

Has Symptoms

Blind

Our 9.5 year old dog had his eye removed two weeks ago due to glaucoma. His other eye was cloudy but he could still see to go outside, eat treats,etc. Now it is apparent that he has gone blind in the other eye. He is running into things and seems confused. Could a complication of the surgery have caused this or is it more than likely just weird timing?

July 16, 2018

Bogey's Owner

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3320 Recommendations

Dogs which develop glaucoma in one eye will develop glaucoma in the other eye within twelve months in the majority of cases, the intraocular pressure of the remaining eye should be monitored regularly and treated as appropriate. You should visit your Veterinarian to check the remaining eye as soon as possible. Regards Dr Callum Turner DVM

July 16, 2018

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phoenix

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Chihuahua

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8 Years

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Fair severity

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1 found helpful

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Has Symptoms

Scabbing
Pus Like Discharge

My dog had an enucleation done last week, now she has some black scab looking substance around a few of the stitchings, there is some discharge but its a very light green (kind of like a booger). She doesn't seem to be in pain and we have finished with all of her antibiotics, her stitches are due to be removed 4 days from now.

July 4, 2018

phoenix's Owner

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Dr. Michele K. DVM

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1611 Recommendations

If the discharge that you are seeing looks like it may be pus, Phoenix should probably have a recheck sooner than the 4 days. She may need further antibiotics, or it may be normal discharge. Since I can't see her, it would be best to have it looked at just to make sure.

July 5, 2018

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Rosie

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American Bulldog

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1 Year

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Serious severity

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Pain
Glaucoma
Eye Pressure
Blind

My dog 1.5 year old Rosie was born with primary glaucoma. She has been on eye drop medication since she was 8 months old to control the pressure in her eye. Recently the meds have stopped working as effectively and her ophthalmologist feels it is time she has it removed. The ophthalmologist was going to charge us $2,000 for the surgery... obviously we are not thrilled with that price. We found another vet that will do it for $900. After reading through some of these posts, I still feel like that seems rather high. But I'm also concerned with the fact that the ophthalmologist was going to use a nerve blocker during the procedure and said that is better than just anesthesia... but none of the other vets we have talked to say they do that. So my questions are: 1.) How important is this nerve blocker? I definitely want the best for my dog and want her to have no pain or complications whatsoever and am willing to pay for the best experience.. so is it worth the money to do the nerve blocker or are we ok going with a regular vet who does not do so? 2.) Even going with a normal vet it is $900... after reading some of these comments and the prices they listed, I feel like we are being way over charged... is that the case? I'm just not sure how the same procedure can be priced at $250 - $500 for some people and then the cheapest we have been able to find was the $900?! I'm just at a loss as to what to do and who to trust... I want my dog to be the taken care of in the best possible way and that is my first priority... but I also really want to find the most affordable option I can. and 3.) Is there a difference between a silicon eye and a prosthetic eye? I told the ophthalmologist we would not be interested in a prosthetic because we don't care about how she looks we just want it to be the most simple and effective procedure with as little chance for complications as possible... I just want her to be comfortable and never feel it for the rest of her life. He agreed but then still mentioned later putting a silicon ball in her eye...is that done to hold the shape of her face or was he still talking about the prosthetic? I'm just confused because I guess I thought there would be nothing in her eye and it would just be sown shut? Please help me figure out what to do. Thank you!

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Jayla

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Chihuahua

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2 Years

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Fair severity

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Fair severity

Has Symptoms

Not Eating Much
Sleeping A Lot
Whimpering Very Low At Times

Hi, My foster pup Jayla, a Chihuahua, had to have her eye removed which was done on Thurs 9/19/19. She seems to be eating very little since then and normally she eats her whole bowl of food. She does go outside when she needs to, but other than that she lays in her bed and has been sleeping a lot. How long does it normally take for a dog to return to normal activity after an eye enucleation? I am concerned about her not eating much and I do have to hide her antibiotic and her pain pill in food in order to give it to her.

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Texas

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Rat Terrier

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16 Years

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Serious severity

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0 found helpful

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Serious severity

Has Symptoms

Squinting
Not Thirsty
Sleeping
Pawing
Not Hungry
Inadequate Tears

Corneal Ulcer, ruptured eye My Rat Terrier, Texas, is nearing 16 and experienced a corneal ulcer a month ago. I did not catch it in time, and the eye ruptured. He can no longer see and Ophthamologist is recommending enuleation of this eye. I am so scared for him.

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Dixon

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Chihuahua

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2 Years

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Moderate severity

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1 found helpful

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Moderate severity

Has Symptoms

Eye Itching
Eye Clouding

My chihuahua got a scratch on his eye and the vet said it’s very deep and wants him to have Enucleation to have his eye removed. I’m very worried and scared for him. He goes Friday for the follow up and to schedule surgery.

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Max

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Boxer

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10 Years

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Mild severity

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2 found helpful

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Mild severity

Has Symptoms

Wax Build Up
Wax Build Up Enuc
Enucleation

Our dog max had his eye removed about year and half ago. Since he has had a lot of black wax built up in that ear. I’m not sure if that is normal just yet and he has recently began to drink a lot of water.

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