Part Five: The Diagnosis
The veterinary ophthalmologist’s name was Dr. Singh, and he drove forty minutes to the shelter two days later with portable equipment and the specific, focused manner of a specialist who has been told the situation is time-sensitive and has taken this information seriously.
The dog was brought to the examination room with Diane present — brought carefully, with the full protocol of an animal who had been designated risk, because Diane was a methodical person and methodology did not take breaks even when circumstances suggested they might not be needed. But the dog, in the examination room, was different. Not calm — he was not a calm dog, he had lived too long with too much fear for calm to be immediate or easy. But the aggression was muted, the defensive edge softened slightly, in the way of an animal who is still afraid but has been recently reminded that not everything is a threat.
Dr. Singh examined his eyes with the quiet efficiency of someone doing something they have done many times. He used the slit lamp, the indirect ophthalmoscope, the specific tools of a field that most people did not know existed. He was quiet throughout. He had the quality of silence that people in skilled work have when the work is speaking to them.
When he was finished, he sat back and looked at Diane.
“Progressive retinal atrophy,” he said. “Advanced stage. He probably has significant central vision loss — I’d estimate he’s down to perhaps twenty percent of normal vision function, and what remains is primarily peripheral and significantly impaired in lower light.” He paused. “This would have been developing for at least eighteen months, possibly longer, depending on when the genetic expression began.”
“He’s been here eleven months,” Diane said.
“Then he arrived already significantly impaired,” Dr. Singh said. “And has continued to deteriorate during his time here.”
She thought about the intake family, the notes that said sometimes unpredictable around strangers. She thought about the two years or more that this dog had been living in a world that was progressively going dark and trying to manage the fear that came with it, probably with a family that had not understood what was happening any more than she had.
“Is there treatment?”
“For PRA? No. It’s genetic. The deterioration isn’t reversible.” He looked at the dog, who was oriented toward the sound of their voices with the specific attentiveness of an animal for whom sound had become primary. “But understanding it changes everything about how you approach him. He’s not unpredictable — he’s responding to a completely logical assessment of his situation. He can’t see who’s coming. He can’t assess threat. His response to unexpected proximity is the response that made sense given what he was experiencing.”
“A child figured this out,” Diane said.
Dr. Singh looked at her. “Children often do,” he said. “They haven’t learned yet to separate the behavior from the animal having the behavior.”
