Wierd cat eyes

Re: Wierd cat eyes

Charlotte Marshall — Fri, 04 Jul 2014 21:31:09 GMT

Hurrah I've been trying to find a picture of keratic precipitates for ages so now I know what it means! It definately does not look like eosinophillic keratitis as there are no lesions on the surface of the cornea -I've seen that before. Useful tip about thinning of the cornea thanks.

Re: Wierd cat eyes

Robert Lowe — Wed, 02 Jul 2014 15:14:16 GMT

Hi Charlotte

The corneal opacities certainly look like keratic precipitates to me and this would be consistent with a low grade anterior uveitis. This would explain why it got better on the Depo-med. Eosinophilic keratitis would be superficial, mainly dorsal or lateral with neovascularisation and white plaques on the surface.

As already mentioned a basic screen for the FeLV/FIV and toxo would be sensible but the list is as long as your arm for things it could be. Topical steroid assuming it is fluorescein negative is the way forward but chronic use can cause thinning of the corneas over time so maybe switch to a topical NSAID such as ketorolac once the eyes have improved.

The retinal haemorrhage is unusual with anterior uveitis and it might be worth getting a systemic blood pressure as well.

Rob

Re: Wierd cat eyes

Gareth C. — Mon, 30 Jun 2014 19:48:27 GMT

It certainly looks like a chronic uveitis and the bilateral presentation would point to something systemic. To say much more than that needs some testing all the usual things as you mention plus lymphoma (but less likely if chronic and well). Pred. Eye drops probably will clear it up a bit.

Re: Wierd cat eyes

Linda Filshie — Mon, 30 Jun 2014 19:47:24 GMT

Eosinophilic keratitis would be top of my list.

Notes I took from a session on feline ophthalmology at NAVC on EK:

Dx on appearance, conjunctival corneal cytology (eosinophils, mast cells - presence of eosinophils (even one) is diagnostic for EK). CBC may or may not show eosinophilia.

Tx - topical steroids 0.1% dex or 1% pred. Dep on severity 3-4 times a day to 1-2 times a week - topical cyclosporine 1.5% - clinical response in 88% of cases (Spiess et al 2009) (Commerically available is 0.2% so need to use compounding pharmacy) - megaoestrol acetate - but NB serious SEs Tx is LONG TERM Role of FHV-1 in EK is controversial : 76% of the cornea from EK is FHV-1 +ve (may rep the FhV-1 DNA in 80% of cats). Steroids may reactivate the virus, Topical antivirals TRIFLURIDINE, Idoxuridine, cidofovir - pencicolvir. FAMCICLOVIR L lysine - antagonises argine, decreases severity of conjunctivitis and reduces ocular shedding.

edited to add that I should have read your post more carefully, as I now see you mention the iris being affected. I'll leave the EK bit up in case it's helpful to anyone though.