A challenging case: Uveitis and secondary glaucoma in a cat - Veterinary Medicine
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A challenging case: Uveitis and secondary glaucoma in a cat
This cat's acute onset of hyphema and uveitis was initially attributed to trauma, but the ocular problems progressed despite treatment. These clinicians narrowed a long list of differential diagnoses to identify the cause.


VETERINARY MEDICINE


Treating toxoplasmosis

Azithromycin was chosen in case this cat had bartonellosis or toxoplasmosis. Systemic drugs used to treat toxoplasmosis are protozoal-static and only influence the tachyzoite phase; thus, they will not kill tissue cysts and will not prevent recurrent infection. Clindamycin may also be used to treat T. gondii infection.22

PROGNOSIS

The prognosis for toxoplasmosis varies depending on the tissues affected and the age at which the cat is infected. Adults that ingest bradyzoites may develop self-limiting diarrhea or be asymptomatic. However, T. gondii infection can be rapidly progressive and fatal in cats that have respiratory and central nervous system signs.

CONCLUSION

Consider T. gondii infection in an outdoor cat with uveitis even if it has no other clinical signs, as uveitis and chorioretinitis may occur without other systemic signs.9

Lyndsey Larson, VMD
Wheat Ridge Animal Hospital
3695 Kipling St.
Wheat Ridge, CO 80033

Todd Hammond, DVM, MS, DACVO
The Veterinary Eye Clinic
7630 W. 39th Ave.
Wheat Ridge, CO 80033

ACKNOWLEDGMENTS

A special thanks to Lori Wise, DVM, MS, DACVIM; Elisa Mazzaferro, DVM, PhD, DACVECC; Brad Graham, DVM, MS, DACVO; and Gary Loeffler.

REFERENCES

1. Glaze MB, Gelatt KN. Feline ophthalmology. In: Gelatt KN, ed. Veterinary ophthalmology. 3rd ed. Philadelphia, Pa: Lippincott Williams and Wilkins, 1999;997-1052.

2. Powell CC, Lappin MR. Causes of feline uveitis. Compend Contin Educ Pract Vet 2001;23(3):128-140.

3. Severin G. Anterior chamber and anterior uvea. Severin's veterinary ophthalmology notes. 3rd ed. Fort Collins, Colo: Veterinary Ophthalmology Notes, 1995;351-378.

4. August JR. Infectious causes of uveitis. In: Consultations in feline internal medicine, volume 5. Philadelphia, Pa: WB Saunders Co, 2006;21-27.

5. Powell CC, Lappin MR. Diagnosis and treatment of feline uveitis. Compend Contin Educ Pract Vet 2001;23(3):258–266.

6. Ketring KL, Zuckerman EE, Hardy WD Jr. Bartonella: a new etiological agent of feline ocular disease. J Am Anim Hosp Assoc 2004;40(1):6-12.

7. Lappin MR. Feline infectious uveitis. J Feline Med Surg 2000;2(3):159-163.

8. English R. Immune responses and the eye. In: Gelatt KN, ed. Veterinary ophthalmology. 3rd ed. Philadelphia, Pa: Lippincott Williams and Wilkins, 1999;239-258.

9. Greene CE. Toxoplasmosis and neosporosis. In: Infectious diseases of the dog and cat. 3rd ed. St Louis, Mo: WB Saunders Co, 2006;754-774.

10. Gelatt K, Gelatt J. Surgical procedures of the anterior chamter and anterior uvea. In: Small animal ophthalmic surgery. Philadelphia, Pa: Butterworth Heinemann, 2003;232-235.

11. Plumb D .Veterinary drug handbook. 5th ed. Boston, Mass: Blackwell Publishing, 2005;116-118.

12. Holmberg BJ, Maggs DJ. The use of corticosteroids to treat ocular inflammation. Vet Clin North Am Small Anim Pract 2004;34(3):693–705.

13. Brooks DE, Ollivier FJ. Matrix metalloproteinase inhibition in corneal ulceration. Vet Clin North Am Small Anim Pract 2004;34(3):611-622.


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