Mind Over Miller: The eyes have it

As every practitioner knows, men are more likely to faint or get sick to their stomachs watching some of our more gory procedures than are women. I guess cleaning up after infants and tending to their wounds desensitizes a lot of women.

Have you noticed how often when a couple brings in a pet to have an abscess drained, an eye infection treated, or a nasty wound cleaned up or for some other odorous or nasty-looking procedure, the woman looks on with great interest while the man retreats and looks elsewhere or sits down suddenly and gets quiet?

But more than seeing blood, more than glimpsing viscera, more than watching a purulent mass being incised, nothing staggers the laity like seeing an injured eye. A Pekingese with a prolapsed eyeball is a classic example. That really gets to people.

Back when my practice was 50% beef cattle and the white-faced Hereford breed completely dominated the ranches in my area, we saw an enormous amount of squamous cell carcinoma of the eyeball. These tumors were one of the negative aspects of California sunshine, along with similar concerns involving the ears in white cats, collie nose in certain breeds, and cancer of unpigmented and hairless areas of the body in Paint and Appaloosa horses.

I tried to train my cattle clients to watch for the earliest signs of neoplasia. If I could get to those "cancer eye" cows before the lesions were larger than a pea, I had great success in cauterizing them with a hyfrecator.

In order to do this, with the cow standing in a squeeze chute, I administered regional anesthesia with a Peterson block and then prolapsed the eyeball from its socket. This technique immobilized the globe and allowed me to treat it before popping it back in place.

Somewhere between levering the eyeball out of the socket, using the handle of an operating scissor, and popping the eyeball back in once I was done is when some cowboys would collapse. Some would just keel over and pass out. Others would stagger away, sit down, turn pale, and say something like, "I must have ate something bad."

Some cowboys would reel and vomit, most in a direction away from my patient. But one I remember vomited all over the cow's neck. I remember thinking, "Hmm! Projectile vomiting!"

Of course it was never the eye that caused the reaction. Of course not. It was that morning's breakfast or the previous evening's supper.

Over the course of a decade, on one purebred polled Hereford ranch with a couple of hundred head of cattle, I treated every eye in the herd at least once. The rancher always managed to be busy elsewhere when I was ready to prolapse an eye.

I never had a complaint about my fee either.

Robert M. Miller, DVM, is an author and a cartoonist, speaker, and Veterinary Medicine Practitioner Advisory Board member from Thousand Oaks, Calif. His thoughts in "Mind Over Miller" are drawn from 32 years as a mixed-animal practitioner. Visit his Web site at www.robertmmiller.com.