Cat battling eye problems. At my wits end...

thorax

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Please help.  Our cat occasionally itches around his eye until it bleeds.

Background:  The cat is 12 years old.  Around age 4 he was diagnosed with herpes.  When our regular vet couldn't seem to get them under control, he sent us to a eye specialist.  The specialist showed me the outbreaks he was having on both of his eyeballs.  We were eventually able to get those under control.  However, the itching (randomly) continued.  The eye specialist finally gave up and suggested that it must be a skin issue and suggested we go to a dermatologist.  

We took him to that specialist where they ran a series of parasite, worm, and mite tests.  All came back negative, but he wrote a script for Advantage Multi anyway, with the suggestion that the mites might not turn up in the tests even though they really are still there.  The script called for Advantage Multi once a week for four weeks (on all three of our cats) and then monthly after that.  That was a month and a half ago.  Today I found him with a bloody eye and back paw.

Also, we've tried various diets over the years, including a raw diet at one point for about a year, and none of that has helped either.

This is completely frustrating.  Thousands of dollars spent and he continues to suffer.  Please tell me that someone here can work some wonders that the medical community around me can't.
 

cinqchats

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He doesn't have ingrown eyelashes, does he?
 

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He doesn't have ingrown eyelashes, does he?
I would think/hope an ophthalmologist would have been able to diagnose this! (Not yelling at you, more like surprised if an eye specialist missed this.)

I know it can be iffy to do this with a herpes kitty, but has anyone every tried a low dose steroid? Anything else to combat a possible environmental allergy?

We have a at in our rescue that scratches her face (along with some other skin issues) and she definitely has environmental allergies. Did the dematologist do a allergy test using blood? This isn't a good test for detecting food allergies, but it can help with environmental allergies.

There are some medications other than steroids to try, including Atopica.
 
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thorax

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I would think/hope an ophthalmologist would have been able to diagnose this! (Not yelling at you, more like surprised if an eye specialist missed this.)

I know it can be iffy to do this with a herpes kitty, but has anyone every tried a low dose steroid? Anything else to combat a possible environmental allergy?

We have a at in our rescue that scratches her face (along with some other skin issues) and she definitely has environmental allergies. Did the dematologist do a allergy test using blood? This isn't a good test for detecting food allergies, but it can help with environmental allergies.

There are some medications other than steroids to try, including Atopica.
I *believe* one of the eye drops we were prescribed at one point was a steroid, for what its worth.  I do not believe the dermatologist did an allergy test, as he seemed positive it was a bug.

And I really think we can all but eliminate food allergies.  We recently lost a cat that blocked all the time, so they've all tried TONS of food and the problem has never gone away.

Thank you for the answers so far guys.  I really, really appreciate the help.
 

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Ok. I steroid eye drop is not the equivalent of treating dermatitis or other environmental skin allergy with an oral or injectable steroid. So, this would be something to consider. As is the use of Atopica (cyclosporine). There are also allergy injection that can be made specifically for the animal, though I am not sure how well these work.
 
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thorax

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Ok. I steroid eye drop is not the equivalent of treating dermatitis or other environmental skin allergy with an oral or injectable steroid. So, this would be something to consider. As is the use of Atopica (cyclosporine). There are also allergy injection that can be made specifically for the animal, though I am not sure how well these work.
Can you recommend a steroid that I could talk to my vet about?
 

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Depo Medrol is an injectable steroid. If it works, it typically provides 4-6 weeks of relief, but can work for up to 12 weeks. I consider this steroid a short-term solution (3 or so injections given no more than once every 12 weeks) as regular injections can lead to the development of diabetes.

Prednisolone (preferred over straight prednisone, which cats have a difficult time using appropriately). This is given orally (liquid or pill). There is often a "loading" dose, which is then tapered down to a maintaine dose. The goal is to try to get the cat down to one dose every 3 days, but there's more wiggle room with this.
This particular steroid carries the lowest risk of developing diabetes, especially when the maintainace dose is every 2-3 days.
 
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thorax

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I would think/hope an ophthalmologist would have been able to diagnose this! (Not yelling at you, more like surprised if an eye specialist missed this.)

I know it can be iffy to do this with a herpes kitty, but has anyone every tried a low dose steroid? Anything else to combat a possible environmental allergy?

We have a at in our rescue that scratches her face (along with some other skin issues) and she definitely has environmental allergies. Did the dematologist do a allergy test using blood? This isn't a good test for detecting food allergies, but it can help with environmental allergies.

There are some medications other than steroids to try, including Atopica.
So my vet prescribed some Atopica.  That stuff is pretty darn expensive, but if it works...

The problem is that its just making him throw up almost immediately.  Any suggestions on that?
 

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I had the same issue with vomiting/gagging/hyper salivating. My solution? Get size 3 or 4 gel capsules and divide the dose among 2 pills. I haven't had any issues since using the gel caps, so my guess is the taste is what causes such a severe reaction.
 
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thorax

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I had the same issue with vomiting/gagging/hyper salivating. My solution? Get size 3 or 4 gel capsules and divide the dose among 2 pills. I haven't had any issues since using the gel caps, so my guess is the taste is what causes such a severe reaction.
Since its liquid, do you just fill and then give quickly before they melt?  I can try that, but he was prescribed .5ml which is quite a bit for a gel cap.
 

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Yep, I just fill the capsule right before I administer. Harley gets the 12 lb dose (using the syringe that comes in the box), which I think is close to 0.5 mL. The amount fits just perfectly into 2 size 4 capsules.
 
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