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Trouble with Toodles

By: Louisa Shepard Date: Nov 10, 2016

In what may be the first procedure of its kind, New Bolton Center ophthalmologists have performed cataract surgery on both eyes of a goat, and implanted artificial lenses, making it possible for her to see.

Such a procedure is common for dogs, and increasingly for horses. A goat? Well, that is something new.  

Toodles with Dr. Catherine Nunnery“I wouldn’t have thought of putting artificial lenses in a goat, but her owners wanted her to have the best vision possible,” said Dr. Catherine Nunnery, New Bolton Center’s board-certified ophthalmologist. “We pushed the envelope.”

Nunnery ordered the custom-made lenses from Germany. Dog, cat, and horse lenses are available premade. “There are no goat lenses ready on the shelf,” she said. “As far as I know, no one has done this for a goat.”

A Natural Mower

Donald Nissley and his wife, Martha, got a few goats to keep the grass trimmed around a retention pond on their property in Ephrata, PA, where their rental storage unit business is located.

A farmer kept them at his place over the winter, and the two females became pregnant and each had two kids. When the goats returned, the Nissleys were concerned. The two kids of mom Spot, Toodles and Sissy, were not doing well.

“Toodles didn’t look right from the get-go,” Nissley said. “She was walking into things. Her mother pushed her away when she tried to nurse.”

Nissley started bottle-feeding Toodles two weeks after birth, every six hours around the clock. Toodles improved, and when she was three months old, her primary veterinarian referred her to New Bolton Center for an examination of her eyes, which were cloudy.

Cataract Surgery

The initial consult in July confirmed that Toodles had bilateral congenital cataracts that inhibited her vision. The Nissleys decided to pursue surgery, but first Toodles had to be tested to determine that vision was possible.

Toodles is positioned under the microscope before surgery.In August, Toodles returned and clinicians conducted ultrasounds of the eyeballs, examining behind the lenses to make sure the structures were normal, and the retina was in place. Additionally, they did electroretinograms, or ERG (like the EKG for the heart), to make the sure electrical pulses of the retina were normal.

“The retina was working normally and there were no abnormal structures behind the lens,” Nunnery said. “These tests confirmed that, if we did the cataract surgery, the eye should be able to see light and send the message to the brain.

“But since Toodles had never been able to see before, the question was whether the brain would be able to process the information correctly to make vision possible,” she continued. “All species learn how to see things, and process it as part of our brain development.”

Nunnery explained the situation to the Nissleys, saying that clinicians were hopeful she would do well because there were no other congenital abnormalities. But then there was the question of the quality of sight.

“Simply removing the cataract improves light getting to the retina and improves vision, but it’s fuzzy, farsighted, unfocused vision,” which would be good enough for a goat to navigate safely, Nunnery said.

The Nissleys opted for the artificial lenses so their pet Toodles, white with long black ears, could see as well as possible. “She’s a special goat and we have fallen in love with her,” he said, adding that his wife came up with her name. "It was such a sweet-sounding name for such a precious animal that depended upon my wife and me for her survival."

Dr. Braidee Foote and Dr. Catherine Nunnery place new lenses into Toodles' eyes.On October 11, Toodles had cataract surgery in both eyes. Dr. Braidee Foote, Ophthalmology Fellow, and Dr. Simone Iwabe, Ophthalmology Resident, assisted in the surgery. To avoid making a longer incision, Nunnery injected the lenses into both eyes.

The actual surgery on the eyes took about an hour, but the entire procedure four hours. A good portion of the time was spent positioning the goat’s horns to get the head perfectly parallel to the ground and eye level.

“I’ve put artificial lenses in horses and dogs, but never a goat,” said Nunnery, who searched in veterinary literature but saw no other case like this one. “It went really well, considering all of the unknowns.”

A Complicated Recovery

Toodles had a system of tiny tubes placed to allow medication to be administered easily several times a day. But she rubbed her left eye and caused an abrasion on the cornea, and had to remain hospitalized until that healed. She steadily improved and was discharged on November 3.

Before and after surgery- the image on the right shows one of Toodles' new lenses.“She sees and navigates in her environment very well,” Nunnery said, adding that Toodles’ lenses should last a lifetime. “Before, we had to coax her everywhere. Now, she comes along with us. She’s not bumping into things. She goes through doorways easily.”

Toodles also has the “menace response,” flinching when something comes toward her eye, which is a learned behavior, Nunnery said.

Nissley said he could tell the difference in Toodles immediately. “There is no doubt in my mind she can see,” he said. “When we first got her home we put her in her pasture and she ran and jumped like a new little kid. Before she was running into things.”

They sent the other goats to the farmer for the winter, but they are keeping Toodles and her mother with them.

Nissley said Toodles and her mother are getting along much better. “It’s a whole different thing,” he said, adding that they now share food without tension. “Her mother rejected her when she was little, but now they are really pals. She’s a happy little goat.”

They are pleased that they decided to go through with the surgery, he said, adding that he appreciated the detailed explanation Nunnery and the New Bolton Center staff provided.

“We would have done anything to see if her eyesight could improve,” Nissley said. “We are going to give her the best life we can.”

From left, Dr. Catherine Nunnery, Dr. Braidee Foote, Toodles, and the Nissleys 

About Penn Vet

Ranked among the top ten veterinary schools worldwide, the University of Pennsylvania School of Veterinary Medicine (Penn Vet) is a global leader in veterinary education, research, and clinical care. Founded in 1884, Penn Vet is the first veterinary school developed in association with a medical school. The school is a proud member of the One Health initiative, linking human, animal, and environmental health.

Penn Vet serves a diverse population of animals at its two campuses, which include extensive diagnostic and research laboratories. Ryan Hospital in Philadelphia provides care for dogs, cats, and other domestic/companion animals, handling more than 34,600 patient visits a year. New Bolton Center, Penn Vet’s large-animal hospital on nearly 700 acres in rural Kennett Square, PA, cares for horses and livestock/farm animals. The hospital handles more than 6,200 patient visits a year, while our Field Services have gone out on more than 5,500 farm service calls, treating some 18,700 patients at local farms. In addition, New Bolton Center’s campus includes a swine center, working dairy, and poultry unit that provide valuable research for the agriculture industry.