Page 1194 - Problem-Based Feline Medicine

1186 PART 15 CAT WITH EYE PROBLEMS

idiopathic in origin, but may be associated with dia- Diagnosis
betes mellitus or hereditary hyperchylomicronemia.
Diagnosis is based initially on the clinical signs of
Post-prandial lipidemia may be seen in normal cats,
a severely anemic cat with poor pupillary light reflexes
especially after a high-fat diet, and obese cats. It can
and multiple small retinal hemorrhages.
occur after administration of corticosteroids.
Diagnosis is confirmed on hematology, and ruling out
Diagnosis coagulopathy as a cause of retinal hemorrhage.
Anemia must be profound for this syndrome to occur,
The clinical signs of large retinal blood vessels that i.e. usually the PCV is less than 10% or hemoglobin
have a yellow to orange hue should alert the clinician to less than 5 g/dl.
lipidemia. Blood cholesterol and triglyceride levels
The cause of the anemia should be identified. Common
should be checked.
causes of profound anemia are chronic and include
Diagnosis is based on clinical signs and increased FeLV-associated anemia or Mycoplasma hemofelis
plasma triglycerides. (Hemobartonella felis) infection. FeLV-associated ane-
mia may also be accompanied by thrombocytopenia,
Blood glucose levels should be checked for diabetes
which may contribute to the retinal hemorrhages.
mellitus.
There may be a history of corticosteroid use, particu- HYPERVISCOSITY SYNDROME
larly megesterol acetate.
Classical signs

● Blindness and loss of pupil reflexes.
ANEMIC RETINOPATHY ● Dilated tortuous retinal vessels, retinal
hemorrhages, retinal detachment.
Classical signs ● Monoclonal globulin spike on plasma
electrophoresis.
● Blind, weak cat with profound anaemia
(PCV < 10% or hemaglobin < 5 g/dl).
● Retinal hemorrhages and attenuated, pale Clinical signs
retinal vessels.
Severe plasma hyperviscosity causes blindness and
● Partial to complete loss of pupillary light
loss of pupillary reflexes.
reflex.
Markedly increased plasma proteins cause increased
viscosity of blood. This results in sluggish blood flow
to the retina and retinal hypoxia.
Clinical signs
On fundoscopy, there are extremely dilated, tortuous
Typically the cat presents as blind and weak, with
retinal vessels, retinal hemorrhages, retinal detach-
profound anemia (PCV < 10%). The severe anemia is
ment, perivascular effusion and optic disc edema may
thought to cause a hypoxic retinopathy.
be evident.
On fundoscopy there are focal retinal hemorrhages
A variety of other clinical signs may be present asso-
associated with anoxia of the retinal blood vessel cell
ciated with the primary disease causing the hyperpro-
wall. The vessels appear pale and are attenuated
teinemia, including lethargy, pale mucous membranes,
(thinned).
neurologic signs and lameness.
Partial to complete loss of the pupillary light reflex
is present as a result of retinal hypoxia. Diagnosis
Other signs of severe anemia are present including pale Diagnosis is initially based on the suspicious signs seen
mucous membranes, increased respiratory rate, on fundoscopy, especially the presence of bizarre
lethargy and weakness. dilated, tortuous retinal vessels.