Feline Ocular Manifestations of Systemic Disease

Question 1

ocular manifestations of systemic disease are more common in felines than canines… True or False

Answer 1

FALSE – they are less common in felines

Question 2

What is griseofulvin?

Answer 2

Causes birth defects in kittens when the queen ingests this ANTI-FUNGAL during the first half of gestation.

Question 3

Types of PeriOrbital and Sinus Neoplasia

Answer 3

1. sinus adenocarcinoma
2. sinus and/or orbital SCC
3. orbital LSA
4. bacterial sinusitis
5. cryptococcal sinusitis
6. work up may include plain rads, nasal endoscopy, nasal swabs for cytology/ C&S, FNA, CT/MRI

Question 4

Feline Eyelid Disease

Answer 4

1. Demodex rarely causes issues with cats
2. Scabies and dermatophytosis Alopecia, erythema, scaly pruritis (rare as well)
3. Pemphigus - ulcerations at mucocutaneous junctions
4. Horner’s - intrathoracic lesions, middle ear, tympanic bullae, orbital dz —- Phenylephrine test to localize – Post-ganglionic most common but Cats have more PRE-ganglionic than dogs
5. Eyelid neoplasia rare in cats – if you see them BAD, get rid of them now!

Question 5

Eyelid neoplasia

Answer 5

1. SCC - most common, cut it off or laser or hyperthermia or cryosurgery
2. basal cell carcinoma - same as SCC but RARE
3. fibrosarcoma - FIRM, DEEP masses; difficult to excise, RARE also
4. MCT - deep or superficial, ULCERATED and PRURITIC, unlike in dog, these ones are usually BENIGN, don’t need as wide margins as dog. can use intralesional steroids or saline.
5. Swollen, firm eyelids – cutaneous LSA – RARE, responds to chemo somewhat
6. palpebral conjunctival melanomas are MALIGNANT

Question 6

Conjunctival diseases

Answer 6

1. chlamydophila
2. mycoplasmal KC
3. Calici virus
4. Herpes – Root of all Evil

Question 7

Sequellae of Herpes FHV-1

Answer 7

1. neonatal ophthalmia
2. acute infection - bilateral serous ocular nasal discharge
3. recrudescent FHV-1 - episodic blepharospasm, epiphora, conjunctival hyperemia
4. CORNEAL SEQUESTRA - highly associated
5. Eosinophilic KC -
6. very RARE to be a cause of anterior uveitis
7. KCS* - chronic herpes cats or symblepharon
8. bartonellosis - tx with Azithromycin or doxycycline (especially in california)

Question 8

DX Herpes in cat

Answer 8

1. PCR BEST test
2. cytology showing intraNuclear inclusions in epithelial cells
3. IFA Testing of conjunctival scrapings - false neg high

Question 9

TX Herpes

Answer 9

Acute - Topical and systemic antibiotics; cleaning exudates

DO NOT USE TOPICAL CORTICOSTEROIDS in RECRUDESCENT CASES — leads to SEQUESTRUM formation

Cidofovir antiviral good; systemic antivirals good too; Lysine good;

Question 10

What do you treat a cat in California with for infectious conjunctivval disease?

Answer 10

THey do not have Chlamydia — treat with Azithromycin or Doxycycline for Bartonella henselae

Question 11

Uveal neoplasia in kitty

Answer 11

1. FeLV induced LSA
2. Met to the eye - uncommon in cat, (usually iris, choroid or ciliary body)
3. Diffuse iris melanoma - localized to stroma, met is rare; however if in filtration angle or into sclera met more likely YEARS later to get in liver, spleen, lungs so TAKE it OUT

Question 12

Is metastatic neoplasia in the uveu common in kitties?

Answer 12

no, usually the iris, choroid or ciliary body

Question 13

feline spastic pupil syndrome

Answer 13

pupil randomly dilates and constricts all of a sudden

associated with FeLV

Question 14

lipemic aqueous humor

Answer 14

OLD and FAT cats — indicates systemic LIPEMIA

TX is symptomatic - topcial steroids, NSAIDs, and/or mydriatics to control inflammation

Look for cause of lipemia

Question 15

Hyphema and posterior segment hemorrhage in kitties

Answer 15

hyphema:
blunt trauma to the eye
coagulopathies
platelet disorders
neoplasia/masses
ant. uveitis
toxins

posterior:
high blood pressure – not hyphema

Hyphema TX: topical steroids and mydriatics

Question 16

Posterior segment diseases: retinal dysplasia

Answer 16

peripheral “folds” and scars on neuroretina.

associated with neonatal infection with panleukopenia virus (before 8 weeks of age while retina is still developing)

Question 17

Posterior segment diseases: taurine deficiency

Answer 17

induced cardiomyopathy and retinal degeneration

bilaterally symmetrical areas of retinal degeneration of the AREA CENTRALIS that will progress across the fundus in a horizontal band and eventually lead to total retinal degeneration and blindness and congestive heart failure

TX dietary management

PX once degenerated, won’t come back; changing diet will stop progression though

Question 18

Posterior segment diseases: retinal hemorrhages

Answer 18

BAYTRIL Retinal Toxicity -- BRONZING of the eye
high blood pressure
anemia
hyperviscosity
optic neuritis
blunt trauma to the eye
coagulopathies
platelet disorders
neoplasia/masses
ant. uveitis
toxins

Question 19

Baytril retinal toxicity

Answer 19

initial hyperpigmentation results in BRONZING of the eye
Baytril think bronzing

will see Non-Tapetal Zone DEPIGMENTATION, so there will be light spots on the dark area

IV can cause toxicity no matter what; lowered normal dose to 5mg/lb/day