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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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Jingles

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Papillon

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12 Years

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Serious severity

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1 found helpful

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Serious severity

Has Symptoms

High Pressure In Eye

My almost 13 yr old Papillon had lens luxation surgery in December of 2016. Brought her to vet ophthalmologist today and pressure was very high. They are suggesting either injection or Intrascleral Prosthesis. I asked about removal of the eye completely. They are also quoting $1,200 for injection, $2,400 for removal and $2600 for Intrascleral Prosthesis. Worried cause of her age and the cost is so expensive.

June 29, 2018

Jingles' Owner


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1 Recommendations

Enucleation is a nice cure all for issues relating to the eye; the cost is high due to being quoted by an Ophthalmologist, however there are low cost clinics which may carry out the removal of the eye for a lower cost (see link below). You should decide which course of action is best for Jingles. Regards Dr Callum Turner DVM www.helpinghandsvetva.com/procedures-pricing/

June 29, 2018

More worried about the surgery because of her age. Her pressure was 30 in her eye. Do you think with meds it can be controlled?

July 2, 2018

Jingles's Owner

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Pongo

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Shih Tzu & Toy Poodle mix

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10 Years

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Moderate severity

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1 found helpful

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Moderate severity

Has Symptoms

Eye Itching

my dog was attacked by another dog last year, slowly his eye seems like it’s shrinking, and his eyelid is rolling back. i have to clean his eye about once a week because it gets super gross and crusty and slimy very quickly. he itches the eye a lot and won’t let me go near it. should i consider enucleation as an option or should i not be too worried

June 14, 2018

Pongo's Owner

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1 Recommendations

You should have your Veterinarian examine Pongo regardless just to see what is happening before deciding on any drastic action like enucleation; without examining him myself I cannot weigh in and say whether the eye should be removed or not. Regards Dr Callum Turner DVM

June 14, 2018

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Rexx

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Labrador

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10 Years

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Serious severity

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4 found helpful

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Serious severity

Has Symptoms

Eye Itching
Eye Clouding
Eye Redness

What are the pros and cons of getting the prosthesis eye rather than just stitching the eye closed after Enucleation? Our vet just recommended getting the surgery after they did another review of his eye yesterday. He had a partially detached retina from birth and it has now fully detached. He was first diagnosed two years ago and we have been using a steroid drop to help with the inflammation and it has worked great until a few months ago. They recommended removal because the eye is going to continue to build pressure (I believe) and could be causing him pain and discomfort.

May 31, 2018

Rexx's Owner

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4 Recommendations

A prosthetic eye is purely for owner satisfaction, a dog is not going to be able to see with a prosthetic eye so it is not going to add any value to their life but will make them a little more visually appealing to humans; I know it isn’t pleasant to say. I would just go with a standard enucleation as it is more simple, cost effective and carries minimal complications; I would only recommend a prosthetic eye if a show dog or similar. Regards Dr Callum Turner DVM

June 1, 2018

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Diesel

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Great Dane

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9 Weeks

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Moderate severity

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1 found helpful

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Moderate severity

Has Symptoms

Blind
Corneal Scarring

We have a puppy, 9 weeks old, that has experienced a corneal perforation where the iris has adhered to the cornea. He is blind in his right eye as a result. He has a scar that has formed over his cornea. Will he be in pain, and should we consider enucleation or leave the bad eye alone?

Jan. 18, 2018

Diesel's Owner


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Dr. Michele K. DVM

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1 Recommendations

Thank you for your email. I'm sorry that happened to Diesel. Since every eye injury is different as far as pain or the potential for ongoing disease, it would be best to ask your veterinarian that question, as they can see the eye and know the degree to which it is affecting him. With an adherence of the iris, there is always the potential for for that eye to develop glaucoma, which may be a factor in deciding which route to take, but your veterinarian will be able to assess if that is a risk.

Jan. 18, 2018

Hi, my yorkie's eye popped out of his socket over a month ago. We took him to the vet and they told us it was because of infection in his mouth. He needed the eye and all his back teeth removed. Well we couldn't afford that whole surgery so we just got him on antibiotics for 10 days which got rid of the infection in his teeth. He's back to normal if not a better version of himself than before. He's very happy and does not seem in pain. But now I'm not sure what to do about his eye. Will it fall off or close up on its own eventually?? It's completely blind now for sure. He seems to have adjusted to that pretty easy. It's shriveled up now. But when I move it I can see behind it that it is not closed up. If anything surgery may be the only option but till then I'd like to just know if what the eye will do on its own?

March 16, 2018

Jessica

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Bailey

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pit mix

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10 Years

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Moderate severity

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4 found helpful

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Moderate severity

Has Symptoms

Pain

My dog has advanced glaucoma in her right eye (not sure if primary) & I’m leaning towards this eye removal surgery. She’s 10 years old pit mix. She’s been taking meds & eye drops for about 2 months now. Her ophthalmologist is charging 1900 for eye removal surgery. Can you recommend a good ophthalmologist in Los Angeles area that is more reasonably priced? I’m in north Hollywood. Thank you !!!

Dec. 28, 2017

Bailey's Owner


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Dr. Michele K. DVM

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4 Recommendations

Thank you for your question. If Bailey is suffering from glaucoma, and your veterinaian is recommending enucleation, that is probably whata she needs, as that can be a very painful condition. I am not local to your area, and cannot recommend a specialist, but perhaps your veterinarian can recomend an alternative surgeon. I hope that everything goes well.

Dec. 29, 2017

Our chihuahua just had his eye out. He had glaucoma for a couple years, he's only 3 years old. His headaches were bad!! We didn't realize how bad until after his eye was removed. He was like a new puppy! Running and playing! We regretted not doing it sooner because it was the right decision. It cost us $1800, a lot of money but it was worth it to see his quality of life now!!

Jan. 9, 2018

Lisa S.

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Chippy

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cockapoo

dog-age-icon

9 Years

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Moderate severity

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0 found helpful

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Moderate severity

Has Symptoms

Glaucoma

I recently adopted a 9.5yr old Cockapoo. He is blind due to lack of care. He has Glaucoma in the one eye. Our vet and the doggy eye specialist are speaking of eye removal within the year. My only concern is coming from a home he loved for 9 yrs, to a rescue, to the foster, back to the rescue and then to me- im afraid it will traumatize him more. Im not super informed on dogs and how the process these things. Will it effect him greatly? Also I read that eventually both eyes will have glaucoma. Should both be removed at the same time? Or will they only remove the other if it has glaucoma? Both eyes have zero vision! Thanks!

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