Is this a sequestrum in this cat's eye?

RE: Is this a sequestrum in this cat's eye?

Robert Lowe — Sat, 05 Dec 2015 19:57:33 GMT

Perhaps hold off the prednisolone in the face of active infection and absence of definitive diagnosis of eosinophilic keratitis. EK tends to affect the dorsolateral cornea (but I have seen it much more rarely in this location).

I would also check behind the third eyelid thoroughly for a retained foreign body.

RE: Is this a sequestrum in this cat's eye?

Emma Middleton — Sat, 05 Dec 2015 19:11:14 GMT

Thank you all for your help and sorry for the delay in responding. Cytology showed degenerate neutrophils and phagocytosed cocci so I've started it on ofloxacin. However I stupidly debrided with a cotton bud before then deciding I actually needed a sample for cyto (and thrown away said cotton bud) so I'm not sure I can rule out eosinophilic keratitis as there were not that many total cells on the slide! So I'm also giving it prednisolone to cover that possibility also.

RE: Is this a sequestrum in this cat's eye?

Richard Carter — Sat, 05 Dec 2015 12:03:24 GMT

cotton bud rolled across the eye is sufficient for a smear sample to check if eosinophils, neuts or plasma cells. DDs for keratitis/ corneal ulcers still remain viral, mycoplasmas/chlamydias (less likely), inflammatory, auto-immune, traumatic etc so lots of options out there but at least you have started making a plan for diagnosis.

RE: Is this a sequestrum in this cat's eye?

Anthony Dennison — Fri, 04 Dec 2015 18:02:44 GMT

[quote user="grumpyoldman"]

Sequestrums are often darker and firmly adherent to the underlying corneal stroma. That could be a plaque of eosinophilic keratitis . Cytology may help decide what to do.

[/quote]

I'd go with this. I had a cat with something similar, plaque ended up becoming very wide and across the bottom of the eye, quite white. Non responsive to antibiotics, but responded very well to optimmune. I didn't do cytology/culture, but I should have.

RE: Is this a sequestrum in this cat's eye?

Kate Richardson — Fri, 04 Dec 2015 17:42:50 GMT

Doesn't look like a sequestrum per se, but am worried is heading that way. Cytology not a bad idea but I would do under sedation as may be very fragile, one thing I would say NOT to do though is ANY kind of keratotomy or you will get a sequestrum. If you have the option of a referral to an ophthalmologist then that's what I would advise (but I am lucky enough to have one working with us)

RE: Is this a sequestrum in this cat's eye?

grumpyoldman — Fri, 04 Dec 2015 16:27:23 GMT

Sequestrums are often darker and firmly adherent to the underlying corneal stroma. That could be a plaque of eosinophilic keratitis . Cytology may help decide what to do.

RE: Is this a sequestrum in this cat's eye?

Emma Middleton — Fri, 04 Dec 2015 15:46:50 GMT

Orange not "organe"!

And forgot to say there is purulent discharge