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21 Apr 2008
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Correction: Puppy has a dermoid, not a pterygium in the eye. Toa Payoh VetsThis article was written in April 12, 2003. Pterygium in the images is incorrectly written. The eye condition is a dermoid. 

The Shih Tzu puppy has a dermoid

"Have you snipped off the Shih Tzu's hairs growing from the white tissue covering the left side of its cornea at 9 o'clock?" I asked the pet shop girl for the fifth time over several days. 

The thick white tissue was snow white and looked like a wing. Hence its medical term is  dermoid.  People like sun lovers do suffer from dermoid which is said to be caused by excessive exposure to ultraviolet light but this puppy was born with a dermoid.
Singapore 2-month-old Shih Tzu puppy with pterygium in the right eye
The dermoid had grown from the conjunctiva which is the tissue covering the sclera (eye white) and advanced to cover the left side of the cornea of the right eye.

When the pet shop girl wiped the eye discharge during one of my visits, I saw hairs growing from the dermoid which is unusual as a pterygium should not have hairs. (THE EYE CONDITION IS A DERMOID, NOT A PTERYGIUM - see e-mails below).

These hairs irritated the eye and cause inflammation and eye discharge overnight.

It was uncomfortable for this puppy and I could only pester the pet shop girl to snip off the hairs as veterinary surgery was not advised in such a young age.

"No," the pet shop girl apologised. "I have been busy with my work." She needed to be careful not to puncture the cornea and that might be the reason she had procrastinated. 

The pet shop girl loved animals and usually swiped off the sticky yellow eye discharge with a piece of tissue paper before showing me the puppy. I saw the hairs clump together and stand out vertically during one such visit.

The discharge was seen the next day when I visited the pet shop to vaccinate the other puppies. The puppy would feel uncomfortable and rub the eye. Soon, it would get infected sore eyes. 

This three-month-old Shih Tzu pup was amongst ten imported from Australia.

"Can the dermoid be removed by surgery?" the pet shop proprietor asked as I vaccinated the puppies.

He would not be able to sell it as fast as the other puppies. Who would want to buy a defective puppy for nine hundred and fifty dollars?

"It happens to other pet importers too," I said. "Some Australian pet exporters will throw in a healthy puppy with a defect occasionally and this means extra veterinary costs for treatment or a loss for you as nobody wants to buy the puppy." 

I examined this very cuddly  Shih Tzu. "The surgery will not remove this dermoid completely as there are chances of recurrence. There will be a scarred tissue over the cornea where the dermoid had been removed."

I elaborated: "A very young puppy is a high anaesthestic risk and it may die on the operation table."  This means a total loss to the pet shop proprietor.

"Furthermore, there will be a scarred cornea after removal of the dermoid and therefore the defect would still be obvious."

What the pet shop proprietor wanted was a clear cornea and if I could not give him what he wanted, I should not advise surgery as this would cost him money.  The anaesthesia and surgery would cost him at least two hundred dollars.

Singapore shop rentals are very high as demand is greater than supply and it is best to save him money if the cosmetic surgery would not guarantee a perfect clear cornea.

"It will be better to inform the prospective buyer of the eye defect, sell it much cheaper and let the new owner seek veterinary treatment." 

The pet shop proprietor decided to sell the puppy at a lower price but there were no buyers for the next two weeks. The older the puppy grows, the harder it will be to sell to most Singaporeans as they buy the youngest puppies available.

I remember this Shih Tzu very well as dermoids are rarely encountered by veterinarians.

Snipping off the hairs would help and it was best done by the pet shop girl.
I guessed there was too much harassment from me.  On the sixth phone call, the pet shop girl who was also a very experienced and fast dog groomer finally took up her scissors to trim the hairs. 

Singapore 2-month-old Shih Tzu puppy with pterygium in the right eye

"Are there any more eye discharge the next day?" I asked her.

"Much less," she said and continued with her work.

"Was there anybody interested in buying this puppy?" I asked as three weeks had passed.

"No," she replied. "The right owner had not presented himself yet." She believed in fate. Fate brings people and circumstances together. 

I doubt anybody will buy this Shih Tzu. What will happen to this Shih Tzu if there are no buyers? I don't really know.

When it grows older, surgical removal of the dermoid will be needed as it affects the vision. My concern was the inflammation of the eye as the dog may feel that it has a foreign body and keeps rubbing its eye, leading to blindness later in life.  

Many Singaporean pet owners tend to get advice from the pet shop girls who will usually suggest eye drops for eye problems in their pets to save on veterinary consultation costs.

Many will use the potent eye drops prescribed for members of their family. No amount of eye drops will dissolve a dermoid.  This Shih Tzu would need surgery when it is older to get the dermoid removed by the vet.


E-mail on April 11, 2008

Dear Judy
I am an eye surgeon in UK and by chance came across an article (see
link: 031803Shih_Tzu_pterygium_Singapore.htm
which I believed originated from your practice. I know it has been a while since it was written but I just wanted to inform the vet that treated the dog's eye that it is a dermoid and not a pterygium. It has hair as the lesion is a teratoma. It can be removed by superficicial keratectomy but it is much more difficult than removal of a pterygium and may be a patch graft (not sure if this is available for dogs?)
Hope this helps
b/w
Say Aun Quah

The article was written in April 2003. 5 years have passed. The eye condition of the puppy is a dermoid. 
 


E-mail reply on Apr 20, 2008

Hi

I am Dr Sing from Toa Payoh Vets. I am very grateful to you for taking the time to write to us. We could not find the article to correct the mistake earlier. 5 years have passed quickly. It is good that you have found the article in the internet. The puppy's eye condition is a dermoid, not a pterygium.

The puppy was sold and another practice had been consulted to remove the dermoid. I hope all are well with you.   

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