Blindness Due To High Blood Pressure

[Jem]

Hi everyone! OK, so this will probably be a long post so forgive me!

A little backstory:

Toby, our almost 20 yo male, has end stage kidney disease/failure. He is palliative, but we are keeping him comfortable until we feel it's time. I won't go into details but he's happy and content for the time being.

Almost 2 weeks ago, we brought him into the vet to see if our latest course of treatment was helping him. And unfortunately, that visit did not go well and he was very stressed. So the vet did not bother trying to test him further and simply told us to bring him home, keep him comfortable and really start thinking of his end of life care. (this is the short version, our vet is wonderful and we've been both working very hard and trying everything possible for our Toby)
So Toby had been going blind already, but we knew he could still see shapes and movement from far and more details up close. When I brought him home from the vet, and I took him out of his carrier, I could tell he went completely blind. I figure it was due to high blood pressure that was exacerbated by the stressful vet visit. (CKD cats are prone to high blood pressure and the retinas can detach due to high blood pressure causing blindness) I have read that if you can get and keep the blood pressure under control quickly, vision can be restored. What I seem to be missing from the information I'm trying to find is, does that mean the retinas will heal / re-attache on their own / vision come back by itself?? or does that just mean the vet will be able to do a procedure, and it will be successful??

The reason I ask, is as soon as we came home although he was disoriented for the first day (walking into walls, tripping, did not use litter box....) he managed to find his way and adapt to the blindness. But now almost two weeks later, I swear he can see!!!! He follows small movements with his eyes, his pupils are no longer totally dilated and he will follow our movements as we move about the room. He does not "sniff" his way about as much and has, for the first time this morning, found his way into his little "comfy cave", which he has avoided these past two weeks, even though it was his favorite spot to sleep. I'm overjoyed that he seems much more comfortable and engaged and it gives me hope that his quality of life is THAT much better.

So, are the things I'm noticing for real? Do the retinas re-attache by themselves? If anyone has had experience with this, I would greatly appreciate it.

 

[Furballsmom]

are the things I'm noticing for real?

In my humble opinion, yes.
I know you were asking for someone with experience, and I don't fit that but I am one of those people who steadfastly and absolutely thinks that the body, human, feline or otherwise, is an amazing creation, --incredibly resilient and adaptive, and has truly awesome recuperative powers when given the chance.

 

[fionasmom]

I rescued a wonderful abandoned cat several years ago....about 3 years old. He was the most desperate-to-be rescued cat that I have ever had and I always wondered if he knew something was wrong. Fast forward to a huge seizure and a dx of lymphoma and cryptococcus, followed by sudden blindness. He failed from there and I had to let him go; however, to answer your question, I was told that in an early detatchment of retina due to high blood pressure, it might be able to heal itself. One of the high blood pressure meds supposedly can be a help with this. In Pangur Ban's case, nothing was going to save him, but I do believe that your cat has possibly experienced a reattachment of the retina and has regained some vision.

 

[white shadow]

When I brought him home from the vet....I could tell he went completely blind. I figure it was due to high blood pressure...I have read that if you can get and keep the blood pressure under control quickly, vision can be restored....does that mean the retinas will heal / re-attache on their own / vision come back by itself??....Do the retinas re-attache by themselves?

'Tanya's' CKD site has a lot to say about this. I'll pull some snippets and their links for you.

But....IF Toby has high blood pressure, whatever about his vision loss, there are other life-and-death reasons to get the hypertension under control. Those are covered at the bottom here.

Blindness, Particularly Sudden Blindness (Retinal Detachment)
Unfortunately this is a relatively common occurrence in cats with untreated hypertension. The hypertension causes the retinas to detach, so the cat becomes blind.......

Even if your cat's retinas detach because of high blood pressure, if treatment is started quickly enough, there is a chance of the retinas re-attaching and your cat regaining some sight.......
LINK: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - All About Hypertension

Why Amlodipine is the Preferred Treatment

• it is a safe treatment with very few side effects
• it is very effective at controlling hypertension in cats
• it works for most cats
• most importantly, it...may reverse blindness in cats who have suffered retinal detachment caused by the hypertension.
• it takes effect quickly (usually within a week).
• it is reasonably priced.

LINK: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - All About Hypertension​

Amlodipine and Blindness
If your cat is blind because of hypertension, there is an approximately 50:50 chance of the retinas re-attaching and your cat regaining some sight if treatment with amlodipine is started quickly enough (usually within three days of detachment).....
LINK: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - All About Hypertension​

It's been two weeks since that Vet visit, and you said he had already been losing his sight.

It may be that your 'window of opportunity' for the retinas to re-attach has passed.

HOWEVER...IF it's high blood pressure that's caused his blindness, there are other reasons to get it under control:

Why Monitoring Blood Pressure is So Important
Untreated hypertension can cause permanent damage to the heart, eyes, brain and kidneys (with the latter making the CKD progress faster), so it is very important to treat hypertension if it is present.........
LINK: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - All About Hypertension
​

Just below (click here) look for "Veterinary Links Recommending Amlodipine" and share that section with your Vet.

Then, there's this final bit:

If Your Vet Refuses to Treat Your Cat for Hypertension
I often hear about vets who refuse to treat hypertension. This may be because they do not have the necessary equipment to measure blood pressure (which frankly is inexcusable these days); or because they think it is impossible to take accurate readings in cats; or because they believe treatment will do more harm than good.

Let me spell this out loud and clear: if your cat has untreated hypertension, it could kill him or her. So if you have checked your cat's blood pressure and it is at a level where it needs to be controlled, insist upon treatment. If your vet refuses, find another vet.
LINK: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - All About Hypertension (my emphasis)​

The sooner, the better if there's to be any chance for Toby to regain vision.

Hope that helps.
.

 

[Jem]

The sooner, the better if there's to be any chance for Toby to regain vision.

That's the thing, he has regained his vision. I'm just elated that he can see again. I've been testing him all day!!!
When I first posted, I just wanted confirmation that if the blood pressure went down quickly (home and comfy, no stress) That they could have re-attached on their own, or if surgical intervention or whatever SHOULD have be needed.
His blindness that he had previously was slow growing, due to age, then with the stressful visit, I took him out of his carrier and "poof" all vision gone. Before the vet visit he could see and after, not. But now it's back!!!

When I first brought him home from the vet, I did not act on trying to regain his vision, even though I thought it due to blood pressure, because at the time, not only did I not want to bring him back in because he was so stressed after that visit, I was bringing him home to discuss with my husband our end of life options. We have already done all we can regarding his CKD and CHF, and I honestly think it was a short bout of high blood pressure from stress that put him over the edge.

Thank you for all the information.

 

[Furballsmom]

 

[sperry01]

I am so glad he is able to see again!! Not that it matters, but I would guess that his retinas probably did not detach, and just that the pressure in his eyes was just so extreme that it caused temporary blindness, which can happen with hypertension and glaucoma. At least with humans, in cases of retinal detachment, once you completely lose your vision (which is very quickly after onset), it's highly unlikely you'd get your vision back, even with surgical intervention. Maybe cat's eyes are better than ours, but I'd find that surprising if that was what happened with Toby. Either way -- he is clearly a fighter and hearing how well he has recovered from that episode at 20 is great. It gives me hope that maybe my dreams of my babies living another 11 years (roughly 20yo) is not so crazy after all!

Warmest of wishes to you and Toby, keep us updated!

 

[Furballsmom]

It gives me hope that maybe my dreams of my babies living another 11 years (roughly 20yo) is not so crazy after all!

Me too