Third eyelid 'syndrome' and diarrhoea

Re: Third eyelid 'syndrome' and diarrhoea

bob lehner — Sat, 12 Nov 2011 13:29:48 GMT

[quote user="James Allsop"] Again was under the impression that this was torovirus[/quote]

Just noticed a colleague at work spelt it 'tauro' virus today. probably appropriate as by all accounts the theory about it is a load of bull...

Re: Third eyelid 'syndrome' and diarrhoea

Julian Earl — Fri, 11 Nov 2011 18:26:22 GMT

[quote user="Bob Russell"]

[quote user="Julian Earl"]

This thread's making me smile... so far we have worms, toxins, Giardia, coronavirus, torovirus, dysautonomia, post-viral stress, pancreatitis, pain, and now botulism thrown in for good measure.

Personally, I think it's an idiopathic idiopathy.

[/quote]

Hence it is called a 'syndrome' rather than a specific diagnosis.

[/quote]

I think you might find my post is called "light-hearted" rather than a criticism.

Re: Third eyelid 'syndrome' and diarrhoea

Bob Russell — Fri, 11 Nov 2011 15:49:00 GMT

[quote user="Julian Earl"]

This thread's making me smile... so far we have worms, toxins, Giardia, coronavirus, torovirus, dysautonomia, post-viral stress, pancreatitis, pain, and now botulism thrown in for good measure.

Personally, I think it's an idiopathic idiopathy.

[/quote]

Hence it is called a 'syndrome' rather than a specific diagnosis.

Re: Third eyelid 'syndrome' and diarrhoea

Julian Earl — Fri, 11 Nov 2011 15:24:07 GMT

This thread's making me smile... so far we have worms, toxins, Giardia, coronavirus, torovirus, dysautonomia, post-viral stress, pancreatitis, pain, and now botulism thrown in for good measure.

Personally, I think it's an idiopathic idiopathy.

Re: Third eyelid 'syndrome' and diarrhoea

Martin Atkinson — Fri, 11 Nov 2011 09:26:01 GMT

[quote user="J G Wray"]

[quote user="Holly Dale"]I've been following this post avidly as I've recently seen something resembling this syndrome in one of my clients.[/quote]

Eh?

[/quote]

Obviously (probably) a Freudian slip but maybe not so daft as some have made a comparison of prolapsed 3rd eyelids in cats with Bell's palsy in humans - inflammation of whatever cranial nerve (neurology is not my strong point)!

Re: Third eyelid 'syndrome' and diarrhoea

Mark Hedberg — Fri, 11 Nov 2011 07:40:35 GMT

[quote user="Kate Richardson"]

[quote user="Mark Hedberg"]Occasionally, i get a nonspecific gi case, and I will often give a 7 day course of fenbendazole at 50mg/kg to rule out giardia. Sometimes it works impressively well, especially with outdoor cats.[/quote]

I don't disagree with your thinking, but how do you know they haven't just better all on their own?

[/quote]

Good question! I usually reserve it for chronic diarrheas that have been in a few times, before i go to a sensitivity diet.

Re: Third eyelid 'syndrome' and diarrhoea

James Allsop — Thu, 10 Nov 2011 18:08:22 GMT

I've seen several of these over the years, normally younger cats. most have responded without treatment within 7-10days but a couple have continued with diarrhoea and/or 3rd eyelid protrusion for upto 21days at which point I have treated the diarrhoea symptomatically. Again was under the impression that this was torovirus

Re: Third eyelid 'syndrome' and diarrhoea

Kate Richardson — Thu, 10 Nov 2011 17:02:53 GMT

I don't disagree with your thinking, but how do you know they haven't just better all on their own?

Re: Third eyelid 'syndrome' and diarrhoea

J G Wray — Thu, 10 Nov 2011 15:27:18 GMT

[quote user="Holly Dale"]I've been following this post avidly as I've recently seen something resembling this syndrome in one of my clients.[/quote]

Eh?

Re: Third eyelid 'syndrome' and diarrhoea

Mark Hedberg — Thu, 10 Nov 2011 15:17:28 GMT

Occasionally, i get a nonspecific gi case, and I will often give a 7 day course of fenbendazole at 50mg/kg to rule out giardia. Sometimes it works impressively well, especially with outdoor cats.

Re: Third eyelid 'syndrome' and diarrhoea

Bob Russell — Thu, 10 Nov 2011 13:07:31 GMT

Definitely worth getting the owner to keep the cat in for a day or two so the litter tray can be closely inspected! Cats are very private in their habits and lots of things can be missed by owners! Vomiting/diarrhoea/thirst being key things the owner often does not judge effectively!

Re: Third eyelid 'syndrome' and diarrhoea

Kate Richardson — Thu, 10 Nov 2011 12:55:02 GMT

As the cat is quieter than normal, I would definitely put pain at the top of my list initially, and trial treatment with some pain relief to see if cat becomes brighter. If it is an outdoor cat, I always consider it MAY have vomiting or diarrhoea or be polydipsic still, just cos the owners don't see this. doesn't mean it isn't happening. (Also Owners don't think an animal has diarrhoea unless it is squirting it out through the eye of a needle, they often don't appreciate that any softening of faeces is still diarrhoea.)

Re: Third eyelid 'syndrome' and diarrhoea

Holly Norman — Thu, 10 Nov 2011 12:19:59 GMT

I've been following this post avidly as I've recently seen something resembling this syndrome in one of my clients.Bilateral third eyelid protrusion, no abdo pain, bloods wnl, currently eating but O reports quieter than usual.Not dehydrated. 2.5yo neutered tom cat. O hasn't noticed any diarrhoea.

I've noticed that some of you have seen some of these and treated them- could I please ask what you all used and if you ahev any other ideas about this case?

Thank you

Re: Third eyelid 'syndrome' and diarrhoea

Bob Russell — Mon, 08 Aug 2011 13:57:07 GMT

As expected the cat is pretty much back to normal except for the third eyelids. I confidently expect these to return to 'normal' over the next weeks but I have warned the owners it can take several months.

Full investigation only if necessary!

Re: Third eyelid 'syndrome' and diarrhoea

Richard Carter — Sun, 07 Aug 2011 13:29:34 GMT

with Gi irritation/ aborbed toxins also causing vagal stimulation/ feedback which upsets the autonomic nerves. Similar signs seen constipation, IBD etc (which of course is root of dysautonomia as mentioned above)

Re: Third eyelid 'syndrome' and diarrhoea

Bill Manton — Sat, 06 Aug 2011 17:14:50 GMT

Well my understanding is that this is not a syndrome as such but just a symptom. Protrusion of the third eyelids is probably rarely related to dehydration as most of these cases are very normal on full clinical examination and routine blood work. IMO the protrusion is due to reduced sympathetic tone in a cat which is or has recently been mildly unwell for whatever reason (parasitism, poor nutrition, viral infection etc). Since post viral fatigue syndrome is a very well recognised phenomenon in Homo sapiens it would perhaps not be surprising that a mild acute feline viral infection could come and go and then leave a legacy of mild non specific symptoms such as third eyelid protrusion lasting for weeks or months before spontaneously recovering.

Re: Third eyelid 'syndrome' and diarrhoea

Claire Edgington — Sat, 06 Aug 2011 08:56:15 GMT

I saw a suspected Key-Gaskell syndrome kitten a few weeks ago! Has now sadly been PTS.

Re: Third eyelid 'syndrome' and diarrhoea

Stephen Courtney — Sat, 06 Aug 2011 00:02:49 GMT

We saw our last Key-Gaskells about 4 years ago - and 6 months prior to that the owner's other cat had it too. She brought he second one in saying 'here's another one'. She was right.

I personally believe the third eyelid protrusion is usually caused by a temporary, mild neuropathy secondary to an unkown something. they always get better, but it can take a few weeks to a few months.

Re: Third eyelid 'syndrome' and diarrhoea

Eamon McAllister — Wed, 03 Aug 2011 14:22:46 GMT

I used to see lots of these and they would all recover eventually. Typically my wife's siamese took about 4 months before it's 3rd eyelids returned to normal and I took a bit of stick about that - " call yourself a vet ? " etc... I also thought that it was due to a torovirus causing a GI disturbance. The protrusion seemed to persist long after GI signs had cleared up and I never saw the same cat get it twice so I concluded that some sort of immunity had been conferred.

Re: Third eyelid 'syndrome' and diarrhoea

Gina Dungworth — Wed, 03 Aug 2011 13:51:01 GMT

I lost a cat to probable K-GS about six years ago. Semi-feral even though she'd moved around the country with me since a kitten and not a chance of getting pills down her every day. Hasn't botulism been implicated in the aetiology more recently? It would certainly tie in with me ex-cat's habits.

Re: Third eyelid 'syndrome' and diarrhoea

Martin Atkinson — Wed, 03 Aug 2011 13:24:00 GMT

[[quote user="Kate Richardson"]

Rare now I believe, but Key-Gaskells can also cause NM protrusion.

[/quote]

Indeed, very common for a short time when I was in my first flush as a neo-practice owner. They also tended to be inappetant, vomiting/regurgitating and lost weight due to megoesophagus - an X-ray would help diagnosis there. Does it still occur? - I've not seen one in 25 years. Purina dry food was implicated. I adopted a cat with K-GS after it was abandoned by its owner at the clinic and it lived for 12 year which was a record I believe until the children's nanny ran it over!!

Re: Third eyelid 'syndrome' and diarrhoea

Kate Richardson — Wed, 03 Aug 2011 11:17:21 GMT

Pain will also cause 3rd eyelid protrusion.

I had a cat recently with very non specific signs other than being mildly inappetant and 3rd eyelids across. Examination unremarkable other than mild pyrexia. Bloods incl FPLI were unremarkable other than mild elevation in urea due to dehydration (although cat wasn't clinically dehydrated); no vom/diarrhoea. Cat was on long term pred for IMHA. No better with fluids/git protectants in case of git ulceration/antibiotics. Injected vetergesic- within 1/2 an hour completely different cat. No detectable physical pain, but just goes to show how cats don't show pain like dogs. Suspected pancreatitis despite normal PLI, or viral infection with reduced immune response due to chronic pred therapy.

But not sure that pain explains the prolonged 3rd eyelid protrusion seen in some cases, when the cat is otherwise completely clinically normal, and eating etc. unless some cats have low grade discomfort, but their instinct to eat over rides this?

Rare now I believe, but Key-Gaskells can also cause NM protrusion.

Re: Third eyelid 'syndrome' and diarrhoea

Martin Atkinson — Wed, 03 Aug 2011 10:48:13 GMT

[quote user="amanda nicholls"]

Pancreatitis is an interesting thought which I had not considered.

[/quote]

It is an interesting thought. I'm pretty sure that a lot of cats that present with non-specific GI signs have pancreatitis, given the number that apparently show at post mortem, having died from an unrelated problem, with evidence of past pancreatitis. Unless some pancreatic change is a normal ageing process in cats - another inteesting thought.? Because it is difficult to diagnose and even fPL is not reliable I'm sure we miss a lot. No matter probably in the short term as treatment is largely symptomatic but I wonder if more long term dietary control would benefit them if we did know.

Re: Third eyelid 'syndrome' and diarrhoea

Simon Neuhoff — Tue, 02 Aug 2011 22:07:06 GMT

I agree pancreatitis (or other GIT issues) can cause third eyelid protrusion as a result of dehydration - but the cats I'm referring to are usually eating and bright, no abdo pain, mild diarrhoea only - not really consistent with pancreatitis. What's more the third eyelids keep protruding long after the other sympotms disappear.

This is probably NOT what's going on in Bob's case - where pancreatitis is a possibility I think.

Re: Third eyelid 'syndrome' and diarrhoea

Amanda Nicholls — Tue, 02 Aug 2011 22:01:50 GMT

[quote user="Martin Atkinson"]

Pancreatitis? A horribly large number of cats have undiagnosed chronic/acute pancreatitis I wonder if there's a link. Years ago I was lead to believe that the third eyelid/diarrhoea syndrome could be tapeworms or coronovirus but whatever, symptomatic treatment seems to work.

[/quote]

I see quite a few young cats with 'haws' sometimes they have GI signs (often owners are unaware of diarrhoea), most of these cats spend a lot of time outside and are hunters which lead me to believe GIT infection / parasites would be the likely cause. They get better with symptomatic treatment and deworming. I have worked up a few that have had 3rd eyelids up for over a month and not reached a diagnosis and they eventually got better.

Pancreatitis is an interesting thought which I had not considered.