Corneal ulcer--Keratectomy surgery?

[cardinale]

Hi:

My 6-year old DSH (formerly feral, a Burmese or Siamese cross) developed conjunctivitis/squinting in one eye, about 2 weeks ago. Local vet found that he had a corneal ulcer. After 10 days of no improvement being treated with topical antibiotic ointment, I figured it was probably FLV-related and needed antiviral therapy, so took him to a specialist at a VCA Eye Clinic (local vet was uncomfortable using antivirals). The specialist confirmed the ulcer and prescribed antibiotic (Ofloxacin) and antiviral (Idoxuridine) eyedrops, plus Optixcare gel lubricant. I have a recheck in 6 days.

The specialist advised that if medication doesn't work, the cat will need a keratectomy with conjunctival graft.

What are your experiences with the surgery? With medication-only treatment and long term management? I read through existing threads on this site dealing with FLV eye problems and it appears quite a few people manage their cats with medication. The surgery is $3,500-$4,000 and if the cat has subsequent flareups, what happens--can the eye get just as bad again? Does the surgery work well most of the time?

Also, this is VCA = corporate owned / traded on Wall Street / profit center for the Mars family = I'm suspicious of them pushing an expensive procedure.

Thank you

 

[white shadow]

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Hi cardinale !

You've mentioned this a couple of times in there....."FLV".

What do you understand that to be?
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[cardinale]

I just came back to fix the post after I realized I put FIV instead of FLV. It's FLV. I don't know how to edit the post.

 

[cardinale]

I meant FHV (eyeroll at myself).

 

[white shadow]

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OK - I suspected it was feline herpesvirus, FHV, causing the conjunctivitis.

I'd be very uncomfortable using a Vet who's reluctant to use a 'simple' antiviral eye med - you might consider looking around for a cat-only Vet.

Understand, too, that such ulcers are notoriously stubborn healers, and, while there should be some sign of improvement by recheck time, I wouldn't expect full recovery by then. Stick with the meds like clockwork, and continue with the plain lubricant until it's resolved.

However, you also need to stop the herpes outbreak. For years, it's been established and well-known that L-lysine acts to prevent FHV from accessing another amino acid (argenine) that FHV requires for replicating. Without argenine, no new FHV is created and the flareup quells.

If/when I get a flare here, I'll give 2x1000mg on day one, 500x2 daily until visible symptoms disappear and then 250x2 for a few days after that. There are folks with kitties that are severely impacted by the virus who will give lysine in a small quantity, possibly 250 daily, as they feel this keeps flares at bay. Others will "pulse" dosing periodically and find that this works for them. Your Vet and certainly this specialist should be aware of similar protocols.

There's an excellent and reliable coverage of herpesvirus eye conditions here: https://www.mspca.org/angell_services/feline-herpesvirus-therapeutic-review/

L-lysine is tasteless. I find it's easiest given by mixing the powder from a capsule into a small quantity of irresistible wet food - this confirms when/that it has been consumed. I use this product: https://www.nowfoods.com/supplements/l-lysine-500-mg-capsules.

And, personally, I wouldn't go rushing into surgery anytime soon in light of my own experience with stubborn, slow healing ulcers. But, I would continue with the meds, the lubricant and lysine.

Hope that helps.



[btw, "editing" of posts becomes enabled after a set number of posts have been made]
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[posiepurrs]

Not sure if it is appropriate for your cat but ask the vet about Eye Serum (Or Remend) The eye serum is used regularly with horses and dogs with eye ulcers. My vet treated one of my kittens with it and her eye healed with no scarring. We had been treating it traditionally with the antibiotics with very little improvement. A breeder friend suggested Eye Serum and I thought it sounded like witch doctor medicine but when I asked my vet he was willing to try it. He had used it with dogs and horses but never a cat. They take blood from the animal and put it in a centrifuge to make it. I applied it as often as I could 6-7 times a day, in conjunction with the antibiotics. It is not expensive either (a plus now days!).