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Ophthalmology > Feline Ocular Disorders > Flashcards

Feline Ocular Disorders Flashcards

1
Q

Feline conjunctivitis - most common primary causes

A
  • Infectious

- Herpesvirus and Chlamydia

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2
Q

Feline conjunctivitis - most common secondary causes

A
  • Traumatic injury with scratch or bite, foreign body
  • Dental disease
  • Hypersensitivity, allergy, eosinophilic
  • Neoplasia
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3
Q

Dfdx for respiratory and eye infection

A
  • Herpesvirus of Calicivirus
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4
Q

Dfdx for just an eye infection

A
  • Not calicivirus

- Could still be herpesvirus

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5
Q

Clinical signs of conjunctivitisi

A
  • Hyperemia, chemosis, exudate, pain
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6
Q

Steroids in cats with conjunctivitis

A
  • Don’t do it, even if you don’t see an ulcer
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7
Q

Chlamydia bacteria type

A
  • Chlamydophila felis
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8
Q

How contagious is chlamydia?

A
  • Highly
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9
Q

Signs with chlamydia***

A
  • Mild to severe conjunctivitis
  • Often begins unilateral and spreads to the fellow eye
  • No corneal involvement (DOES NOT CAUSE AN ULCER)**
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10
Q

Cytology of Chlamydia

A
  • Epithelial cell, intracytoplasmic inclusion bodies may be seen on conjunctival cytology
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11
Q

Treatment for Chlamydia

A
  • Topical terramycin or erythromycin and systemic doxycycline
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12
Q

What is the only definitive way to diagnose Herpesvirus or know that it’s present?

A
  • Presence of a corneal ulcer
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13
Q

Bartonella appearance

A
  • May be associated with conjunctivitis +/or uveitis
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14
Q

Diagnosis of Bartonella

A
  • Serology
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15
Q

Treatment for Bartonella

A
  • Doxycycline

- May not be eliminated

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16
Q

Calicivirus clinical signs

A
  • Conjunctivitis occurs with CONCURRENT URI and often ulcers on the tongue
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17
Q

Dfdx for concurrent URI and conjunctivitis

A
  • Herpesvirus
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18
Q

Does calicivirus cause corneal ulcers?

A
  • NO IT DOES NOT
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19
Q

Treatment for calicivirus

A
  • Symptomatic therapy for respiratory disease and topical terramycin or erythromycin for conjunctivitis for secondary bacterial infection
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20
Q

Mycoplasma - what type of bacteria?

A
  • Normal bacterial inhabitant of conjunctiva
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21
Q

Mycoplasma and conjunctivitis

A
  • Possible cause of conjunctivitis
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22
Q

Treatment for Mycoplasma

A
  • Topical terramycin
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23
Q

Who gets Mycoplasma?

A
  • Goats and cattle

- Sometimes cats

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24
Q

Most common cause of conjunctivitis in cats

A
  • FHV1 AKA Rhinotracheitis
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25
Q

How contagious is Herp?

A
  • Highly
  • > 90% cats are carriers
  • Ubiquitous
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26
Q

Herpes outbreaks

A
  • Initially URI

- Subsequent outbreaks are ocular

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27
Q

Clinical signs of Herpes outbreaks

A
  • Brown waxy exudate
  • SErous discharge to purulent
  • Conjunctivitis can be mild to severe
  • Chronic or recurring
  • Unilateral or bilateral
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28
Q

Where is FHV1 latent?

A
  • trigeminal ganglion
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29
Q

How is FHV1 induced to recrudesce?

A
  • Stress
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30
Q

Injectable vaccine to prevent ocular disease FHV1

A
  • Does NOT prevent

- Intranasal vacine is much better

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31
Q

Where are the ulcers for FHV1?

A
  • Central cornea

- If it’s peripheral, maybe think something else

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32
Q

Consequences of neonatal herpes infection

A
  • Symblepharon (adhesion of conjunctiva or eyelids)
  • Ophthalmia neonatorum
  • ulcerations
  • Perforations
  • Pthisis bulbi
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33
Q

Treatment for neonatal herpes infection

A
  • Depends on the issue, but she would vaccinate them for sure
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34
Q

Herpes diagnosis

A
  • Often based on clinical signs (and it being a cat)

- Inconsistent data on diagnostic value of PCR, virus isolation, fluorescent antibody

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35
Q

Herpes conjunctivitis treatment

A
  • Lysine
  • Topical antibiotic
  • Oral doxycycline
  • Avoid stress
  • Intranasal vaccine
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36
Q

Lysine - how does it work?

A
  • Interferes with viral replication as an arginine antagonist
  • Reduces shedding
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37
Q

Which topical antibiotics for herpesvirus?

A
  • Terramycin or erythromycin ointment or tobramycin solution
  • Secondary bacterial infection
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38
Q

Why oral doxy for herpes?

A
  • Coinfection with chlamydophila
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39
Q

What is pathognomonic for feline herpes keratitis?

A
  • Dendritic or punctate ulcers
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40
Q

How can you see dendritic or punctate ulcers?

A
  • Fluorescein, cobalt filter, and magnification

- DARKENED ROOM

41
Q

Progression of dendritic or punctate ulcers

A
  • May progress to geographic ulcers

- Deep stromal ulcers may be perforated

42
Q

Loose epithelial edge of corneal ulcer - how to treat for herpes keratitis?

A
  • Debride

- DO NOT GRID

43
Q

What is associated with eosinophilic keratitis?

A
  • FHV-1
44
Q

How do you diagnose eosinophilic keratitis?

A
  • Raised white plaques and cytology with at least 1 eosinophil
45
Q

How easy is it to treat eosinophilic keratitis?

A
  • No easy
46
Q

Treatments for eosinophilic keratitis

A
  • Antivirals, vaccination, cyclosporine, mast cell blockers

- Steroids may clear BUT (!) may lead to herpes corneal ulcers

47
Q

Treatment of herpes keratitis

A
  • Lysine
  • Terramycin or erythromycin
  • Doxycycline
  • Topical antiviral
  • Oral antiviral
  • Intranasal FVRC vaccine
48
Q

Topical antivirals for herpes keratitis

A
  • Idoxuridine (5x a day, compounded)
  • Trifluridine (5x a day and expensive)
  • Cidofiovir (compounded, $$$, twice a day)
49
Q

Which oral antiviral for herpes keratitis?

A
  • Oral famcyclovir
  • Expensive
  • Takes about 6 weeks
  • Acyclovir is TOXIC to cats and not effective
50
Q

Acyclovir for cat

A
  • TOXIC

- Not effective

51
Q

Why don’t you grid keratotomy a cat?

A
  • It can lead to a sequestrum
52
Q

Corneal sequestrum appearance

A
  • Brown discoloration of the cornea
  • It’s a dead area of the cornea
  • Ca be a black or dark brown seed-like appearance
  • Not pigment
  • Chronic irritation
  • Don’t blink well
  • Poor tear film
53
Q

What is a corneal sequestrum a sequela to?

A
  • Herpes keratitis
  • Chronic ulcer or irritant
  • Foreign body
  • Grid keratotomy
54
Q

Primary treatment for corneal sequestrum

A
  • Can’t treat with medical therapy (long-term, painful, anti-virals)
  • Keratectomy and Graft are ideal
55
Q

Breeds predisposed for corneal sequestrum

A
  • Persian cats
56
Q

Are corneal sequestrums painful?

A
  • YES
57
Q

Stain uptake with corneal sequestrum

A
  • All around the edge
58
Q

Causes of feline uveitis

A
  • Infectious disease (herpes)
  • Trauma
  • Neoplasia
  • Lens induced
  • Immune mediated lymphocytic-plasmacytic
59
Q

What are the most common causes of feline uveitis in the cat?

A
  • Infectious disease (herpes)

- Lymphoma

60
Q

Appearance of feline uveitis

A
  • Flare and some hypopyon
61
Q

Do you usually see rapid onset cataracts causing LIU in cats?

A
  • Not as much

- More that chronic uveitis leads to cataracts leading to LIU

62
Q

What are the infectious causes of uveitis in cats AKA the “F diseases”

A
  • FeLV
  • FIV
  • FIP
  • FHV1

-

63
Q

Other infectious diseases that cause uveitis in cats

A

Toxoplasmosis

  • Bartonella
  • Systemic mycosis
64
Q

Diagnostics for feline uveitis

A
  • Complete physical and ocular exam
  • CBC/Chem/UA
  • Serology (FeLV/FIV/FIP)
  • Toxo Titers IgG and IgM
  • She will aspirate aqueous and do cytology (I don’t think we should do this)
  • Bartonella
  • Fungal screen if suspicious
65
Q

What is it if feline uveitis diagnostics are negative?

A
  • IMmun mediated lymphocytic-plasmacytic uveitis

- But could be Herpes or Bartonella

66
Q

Granuloma in the choroid - what should you think?

A
  • FIP
67
Q

Feline fungal diseases

A
  • Histoplasmosis
  • Blastomycosis
  • Coccidioides
  • Cryptococcus
  • Aspergillus
68
Q

Treatment for diffuse iris melanoma

A
  • Enucleation
69
Q

Oral causes of uveitis

A
  • Dental disease

- Neoplasia

70
Q

LSA and uveitis

A
  • You can see it in the eye sometimes
  • It hides in the eye sometimes
  • Nodules on the iris
71
Q

What do you worry about with perforated lens?

A
  • LIU and secondary glaucoma
  • They are also at risk for post-traumatic sarcoma
  • Very high chance
72
Q

With lens perforation, what is the usual recommendation in a cat?

A
  • Removing the eye right away

- Don’t want the post-traumatic sarcoma

73
Q

Uveitis and cataracts

A
  • Kind of a chicken and the egg situation

- Uveitis may be lens induced or cataract may be secondary to uveitis

74
Q

Treatment of feline uveitis

A
  1. Directed toward primary agent if possible
  2. Topical anti-inflammatory
  3. Systemic nati-inflammatory
  4. Mydriatic/cycloplegic
  5. Systemic antibiotic if indicated
75
Q

Topical anti-inflammatory for uveitis

A
  • Diclofenac (NSAID) - ideal
  • Prednisone acetate if no ulcer (but expect to develop one)
  • Be careful with diclofenac still because it can affect kidney function
76
Q

Systemic anti-inflammatory for cats

A
  • NSAID (not labeled long term)

- Prednisolone used with caution (many side effects)

77
Q

Bartonella tx for uveitis

A
  • Doxycycline/azithromycin
78
Q

Toxoplasma tx for uveitis

A
  • Clindamycin
79
Q

Septicemia tx for uveitis

A
  • Clavamox or based on C&S
80
Q

Herpes tx for uveitis

A

Lysine

Famcyclovir (vaccine)

81
Q

Mycosis cause of uveitis tx for uveitis

A
  • Anti-fungal

- Fluconazole, etc.

82
Q

Sequelae of chronic feline uveitis

A
  • Cataract
  • Lens luxation
  • Glaucoma
83
Q

How does uveitis lead to glaucoma?

A
  • Obstruction of the drainage angle or synechia
84
Q

Review the treatment for feline glaucoma

A
  • Dorzolamide/timolol BID best choice for cats with glaucoma or enucleation if blind, tumor, or unable to manage pain
85
Q

Normal feline fundus

  • Is the optic nerve myelinated or not?
  • Where are vessels?
  • Where is the optic nerve relative to the tapetum?
A
  • Non-myelinated optic nerve
  • Vessels extend from the periphery of the optic nerve
  • optic nerve is in the tapetum
  • Large tapetal area
86
Q

Enrofloxacin and cat retinas

A
  • IT IS TOXIC

- Avoid or do not exceed 5 mg/kg/day

87
Q

Causes of feline retinal degeneration

A
  • Enrofloxacin
  • Other toxicities
  • Taurine deficiency
  • Hereditary
  • Traumatic
88
Q

Taurine deficiency in cats

A
  • can cause retinal degeneration
  • Not very common now
  • May need to supplement Bengals
89
Q

Hereditary causes of retinal degeneration in cats

A
  • Abyssinian cats
90
Q

Trauma that leads to retinal degeneration - what should you consider in cats?

A
  • Development of sarcomas
91
Q

What should you consider with a cat that has absent PLRs and dilated pupils?

A
  • hypertension

- Check blood pressure

92
Q

What can cause hypertension in cats?

A
  • Hyperthyroidism
  • Renal disease
  • Primary
93
Q

Around what value does hypertension become a concern?

A
  • Around 230 mmHg
94
Q

What will the fundus look like with hypertensive retinopathy?

A
  • Retinal hemorrhages

- Serous detachment

95
Q

Prognosis for hypertensive retinopathy and retinal detachment

A
  • It will reattach as blood pressure lowers

- Best prognosis for vision if it attaches under 2 weeks, but may get some vision up to 6 weeks

96
Q

Treatment for feline hypertension

A
  • Amlodipine

- Start at a lower dose and give to effect

97
Q

How should you handle an extremely hypertensive cat?

A
  • Do not stress them out

- They are at risk for cerebral hemorrhage and death

98
Q

Pulmonary hypertension appearance on retinal exam

A
  • Tortuous, thickened vessels
99
Q

Haw’s syndrome

A
  • Elevation of 3rd eyelids
  • No underlying ocular disease
  • GI disease (diarrhea) often present
  • No treatment indicated for the eyes

Ophthalmology (8 decks)

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