Continuing Eye Issues

[sonnyvincent]

My almost 14 year old cat Sonny has been having a problem with his right eye for just over a month now. It started as red, swollen with a discharge, then was fine for a day, then his eye started to grey over. It was the weekend so we saw a vet on March 16. He was diagnosed with uveitis and put on steroid eye drops (Neomycin and Polymyxin B Sulfates & Dexamethasone) three times a day. Within a couple days his eye was looking better and at the follow up the readings were normal.

Since then he's had a couple setbacks every time I try to taper the eye drops. The first time I called and the vet said to go back up to three then start tapering again. I've been doing that and as of yesterday his eye looks bad again. Redness and swollen with discharge, and his reaction to the drops now seems as if it's painful whereas before it seemed like just a nuisance. I'm calling tomorrow about getting him back in but I don't get paid until next Friday so I'm hoping they'll work with me.

Has anyone had eye issues with their cat? They did put refills on the drops which makes me think they believed it would take awhile before he was off them, and we seem to be getting to the end of the bottle... But I'm just worried I can't seem to taper at all without the problem coming right back...

 

[mrsgreenjeens]

Bumping this thread up since you've not had any responses.

Definitely talk to your Vet again about this, as sometimes uveitis itself is a symptom of something else and that something else has to be treated too in order for the uveitis to heal up completely. 

 

[puck]

Seconded, uveitis is a secondary symptom to a primary cause. He needs diagnostics to find why his intraocular pressure is lower than normal.

Also, flurbiprofen is a better treatment for uveitis, opthalmic NSAID that helps with the long-term inflammation and pain associated with low pressures, better tolerated than dex when used for many weeks or months consecutively. It actually helps increase intra-ocular pressure too, thus it's not good for critters with glaucoma or high pressures.

Ask if he can have that called in to a pharmacy of your choice, preferably comparing cost and go for the least expensive, as opthalmic drops are pricey. $15-20 per small 2-2.5mL bottle is typical fee with online veterinary pharmacies I've called the Rx in to previously. Hospitals tend to charge 50-100% more than that per bottle.

Staining the corneas is important to ensure he doesn't have abrasions or ulcers, common in uveitis and glaucoma patients as they rub and paw at their face more, inuring their own cornea. If he does have a corneal abrasion, the opthalmic meds with steroid/NSAID will have to be temporarily suspended while the cornea is healing, as steroids/NSAIDs inhibit corneal cell replication.

Many systemic viruses and bacterial infections cause uveitis in cats. Some do just have idiopathic primary uveitis, with no other associated disease or primary cause, but blood tests for infectious viruses and bacteria should be performed before assuming primary uveitis. Then, if a treatable infection, the cause for the uveitis will be identified and treated. For example, FIP, FIV, FeLV, Bartonella (thanks fleas!), Toxoplasma, and herpes can all cause uveitis.

For now, adding L-lysine, an essential amino acid, to his regimen to limit viral replication can't harm, and could help him. Testing for bacteria first is best, prior to antibiotics, so a culture can distinguish what is infecting him, if anything, and the appropriate effective antibiotic can be chosen for the right duration to kill the bacteria. Bartonella and Toxo needs many weeks of antibiotics to be eradicated, but weeks of unnecessary abx, without properly diagnosing via the labwork, could be detrimental to your cat.

Hope Sonny is comfy again soon, kicking back and reading the funnies again before you know it!