Here’s Looking At You: Eyes Part One
Last week Oreo’s owner called up confused. She explained that Oreo, her sweet little black and white tuxedo was absolutely fine, but she had started winking at her the day before. Oreo was eating and drinking and running around like her crazy self, so she couldn’t be in pain, but still, there was that wink. Our staff scheduled a visit for Oreo and I saw her that day. Indeed Oreo was perfectly healthy except that she had scratched the surface of her eye- the cornea. We started her on medication right away, including pain medication. The wink disappeared and her eye healed within a few days.
Cats are much more stoic than we are. Most of the time, they show very few outward signs of pain, so as pet owners we need to be detectives. If you have ever had an eye injury or infection, you know how painful that is. Cats feel the same pain as we do, they just don’t show it.
Eye injuries require prompt veterinary evaluation and treatment. Treatment with the wrong medication can prolong disease and in some cases, make things worse, so you will want your cat examined by your veterinarian in person, not over the phone.
Here are some things to look for, starting with the basics. Each of these signs warrants evaluation by your veterinarian.
- Redness: if one eye, or part of the eye is red, that means inflammation. This is most commonly caused by trauma or infection and often comes with pain.
- Is one eye closed? This means pain, even if everything else seems fine.
- Is there swelling around one or both eyes? Swelling is due to trauma, infection or inflammation.
- Is your cat rubbing at one eye? That’s her way of saying “This eye is hurt. Please make it better before I make it worse.”
- Is the third eyelid showing? This can indicate infection, inflammation, trauma or other diseases. Please see my previous blog about third eyelids.
- Discharge. The eyes are constantly producing some watery and some mucousy material to coat and protect the eye. Excess of either signals underlying disease. Colored (green or brown) mucous discharge is usually caused by infection.
- Excess tearing is often caused by irritation. Irritation = pain.
- What about the eyelids? Some cats’ eyelids don’t sit flat on the eye and can roll in, causing the eyelashes to rub on the eye. This causes painful trauma to the eye surface (cornea). Ever get a grain of sand in your eye? Now think 30 grains of sand. You get the picture.
- Is there a growth or bump on the eyelid? If so, this is best addressed early. If surgery is needed, it is always best to do before a growth gets too large, especially in this delicate area. Many (but not all) eyelid growths are benign.
In most cases, your family veterinarian can evaluate and treat your cat. Sometimes evaluation and treatment by a board-certified veterinary ophthalmologist is necessary. See http://www.acvo.org/ for more information.
Stay tuned for Part Two- Weird Pupils.
Does Pancreatitis Mean the End?
I wrote last time about the choice my client Louis had to make to end the life of his beloved cat, Nadia. It is always a struggle for the owner and his/her veterinarian to make these decisions. Worse, of course, for the client because of the years of love and companionship that have transpired. The strongest desire of the cat owner facing the loss of a beloved companion is to do what is best for the kitty. Sometimes, the outcome that seems the least likely though, can mean a new reality for a cat and his owner. Let’s talk this time about Garfield.
Garfield, no surprise, is an orange tabby about 15 years old. He came in 6 months ago, just not feeling right. His bloodwork and urinalysis were not completely normal and it was obvious that he had severe pancreatitis. We started his treatment for that and he got somewhat better but just not quite back to normal. Perhaps we had not gotten to the bottom of the problem!
We did another ultrasound and, no surprise, his pancreas looked abnormal but everything was otherwise fine. A few days later and quite suddenly, Garfield took a turn for the worse. This time his bloodwork was far less normal; the white part of his eyes looked a tiny bit yellow; and, his ultrasound showed a large blocked gall bladder and a little fluid around his liver. The findings had changed a great deal in a very short time.
We contacted our favorite surgeon, one that I had been very happy with for many years. That afternoon, Garfield went to Dr. Griffin’s practice, 100 miles away. The next day, he had a complicated surgery to connect his gall bladder to his small intestine to allow his pancreas to heal and give his gall bladder a safe way to empty. A tube was placed in his esophagus to allow for adequate nutrition and administration of medicine. He came home with antibiotics, pain medication, liver supportive medication and more. We worked with the client to make sure he received adequate calories through the tube and got all of his medications.
As each day went by, Garfield got a little bit better. He began to gain weight and started to eat a little on his own. After three weeks, he was eating enough on his own that we removed the tube in his esophagus. We monitored him carefully for several months, both by examination and laboratory values. He is doing just fine.
The message of Garfield for me is that, even when things look complicated and very, very serious, good things can and do happen. We all need to stay optimistic and realistic, making sure not to allow for suffering or discomfort. If we maintain Quality of Life during a severe illness, we can be proud of our work together. The owner is the single most important member of the healthcare team. We are here to help make sure that is always true.
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