Uveitis?

[Tina B and crew]

He's resting now. Looks slightly clearer. I can make out the outline of his pupil where I couldn't before. Yes, my phone and pics will be with ne. I'll update you tomorrow.

[Tina B and crew]

At the vet, waiting on blood work. She doesn't think it's anterior uveitis. I'm wondering if it's lipid flare/aqueous due to Hyperlipidemia. Curious to see what blood work shows.

[Tina B and crew]

Yep...everything (bloodwork, eye exam) points to possible lipid flare/lipid aquaeous due to Hyperlipidemia. Going to try the low fat diet and omega-3s and recheck in a month.

Amazingly his eye is nearly clear now! Last night it was totally opaque. Clearer this morning but still cloudy.

When we arrived at the vet's office (you can see he isn't happy!)




I took this one just about 10 minutes ago. It's even clearer than this morning. Still slightly hazed but not nearly as bad. When I look at him from about 4 feet away I can't even tell.

[Traci]

Ok, so this is a condition I never would have thought of. He sure is a special little case, isn't he!

So, did the vet rule out common underlying conditions like diabetes, HYPOthyroidism, pancreatitis? Did Doc ever have any noticeable symptoms? (skin lesions or little bumps, anorexia, unusual weight gain or loss?)

What diet did she recommend? (may I ask what you were feeding previously?)

Regardless if this is secondary to another condition, or primary, you will have to keep this monitored indefinitely - hopefully the dietary change is all that is needed, but please don't deviate from it in any way (probably no treats, unless your vet approves them for fat content/protein source).

[Tina B and crew]

Everything looked good. Blood sugar was normal. Liver enzymes were normal. Kidney function good. His WBC was slightly elevated but not out of normal range and she mentioned something about the bands indicating inflammation or infection. I forgot to get a copy of the lab work. She did put him on doxycycline because of this. She's going to get back to me later because she wanted to further look into all this since, as you say, he's a special little case! I'll ask her about the possibility of pancreatitis, but he has exhibited none of the observable symptoms. That would be one of the possible causes of hyperlipidemia, correct?

No weight loss (he's down a little over a pound from last year, which was actually good as he was a bit too plump. He's at 15.3 lbs now down from 16/17), no lethargy, no vomiting or diarrhea, no skin lesions or bumps - although he at times does get some scabby spots but he has none now, coat is shiny, eyes are clear (other than the haze), gums pink.


She put him on the Purina OM, canned.

[Traci]

Yes, the 3 most common underlying problems could be diabetes, hypothyroidism, or pancreatitis. Those would be underlying and secondary conditions - otherwise, this could be genetic (inherited) or simply idiopathic.

I'm assuming she didn't test the T4, and may be no need for that, since no significant weight loss, increased or decreased appetite, etc, and his young age.

If amylase and lipase were elevated, would want to test fPLI specifically, but without symptoms, most likely not pancreatitis (symptoms would be vomiting/diarrhea, inappetance, painful abdomen, low OR high temperature, general lethargy) - the dietary change could actually help prevent pancreatitis - but it would be good to always keep an eye out for those symptoms.

If glucose normal, probably not necessary for a urinalysis at this point.

Anemia is one of the signs you want to treat this aggresively (that is, trying to avoid medications other than dietary modification). You caught this early on, so let's hope the diet change works.

As far as I know, this is not a particularly painful condition, either abdominally or ocular - however, regardless IF there is yet an underlying cause, you still have to monitor this indefinitely since he may be susceptible to any of the three primary conditions mentioned above. As long as he remains healthy, chances are good this can be managed effectively with little intervention beyond strict diet. There isn't a whole lot of established research in cats for the medications typically used for humans or dogs, and none of them are without side effects and needing to be used with caution. Let's keep good thoughts this is idiopathic with nothing underlying and will be managed with diet alone

[Tina B and crew]

Knowing my cats it is probably idiopathic. Chunk had idiopathic hypercalcemia.

And yes, I'll be attentive about the diet etc. Trying to find a way to make sure Doc only eats his diet while the others get theirs. Why can't my cats eat all their food at once? Lucy certainly doesn't need low-fat and Chunk has to avoid carbs. If I have to isolate him I will. I won't be easy, given the small space we have but I'd like to see if the eye resolves completely with a change in diet and I don't want him sneaking the other's food.

So Doc came home from the vet and did go to the food bowls and ate. Since I posted that last image his eye has become cloudier. I'm wondering if this is a case of postprandial lipemia? He wasn't fasting this morning when blood was drawn. I am going to start a diary and take note of the changes/times.

[Tina B and crew]

He showed very little interest in the food tonight but he's had a stressful day so I'm not sweating it at this point.

[Traci]

Yes, it very well could be postprandial, thus one good reason to fast before testing.

It may be time to consider scheduled feeding. With all that's going on with things, it might be the best plan of action for all the cats. When you're home of course, you can sneak in an additional small meal when you can supervise but you don't want to rock the boat with any of them.

[Tina B and crew]

I don't really free feed in the literal sense. They get a morning meal and an evening meal. Most days they empty the bowls within an hour or so, but when they are eating the same food I never gave a second thought about them roaming from bowl to bowl - which they do. But that's a no-no now, unless I can find a food that's low/no carb AND low fat.

So give me some advice on scheduled feeding and actually getting them to eat what I put down for them. What time limit do you suggest?