Page 1225 - Problem-Based Feline Medicine

59 – THE CAT WITH OCULAR DISCHARGE OR CHANGED CONJUNCTIVAL APPEARANCE 1217

Hemorrhage.
Classical signs—Cont’d
● There may be diffuse or focal areas of redness, usu-
ally with little hyperemia or inflammation. ● Red and ulcered lesion with dry crusty
● There will be very little discharge associated with surface (later).
the hemorrhage. ● Deep erosions may develop at medial
canthus.
● Eyelid and conjunctiva eroded away
Treatment
(advanced lesion).
Topical tetracycline ointment applied four times daily.
(may no longer be available) See the main reference on pages 1321, 1334, 1069,
1089 for details (The Cat With Abnormal Eyelid Appe-
Topical fluoroquinolone (particularly oflaxacin) seems
arance or The Cat With an Abnormal Third Eyelid, The
to have very good results in this author’s experience
Cat With Skin Lumps and Bumps and The Cat With
using tid/qid.
Non-healing Wounds).
Oral tetracycline, for example, doxycycline 5 mg/kg
PO q 12 h for 3–4 weeks. Clinical signs
Oral Azithromycin (Zithromax, Pfizer) 5 mg/kg q 24 h
Squamous cell carcinoma usually secondarily
PO for 14 days as an alternative treatment to tetracycline.
involves the conjunctiva from a primary eyelid lesion.
Some chronic cases may require long-term systemic
Redness and mild swelling of the eyelid is seen in the
therapy.
pre-cancerous stage. The affected area may be small
initially, but later spreads to include the entire eyelid
Prognosis margin. It is more common on the medial part of the
lower eyelid. The adjacent conjunctiva is inflamed.
Generally prognosis is very favorable with few damag-
ing sequelae. In advanced cases, the epithelial surface erodes to
form an ulcer that may have a dry crusty surface.
Recurrent infections and latent carrier state are
The adjacent conjunctiva may become ulcerated and
believed to occur.
red, and can have a crusty mucopurulent discharge.
Transmission The entire lid margin including conjunctiva, can be
eroded away in advanced cases.
Transmission is thought to occur by direct contact of
Deep erosions may develop in the medial canthus.
susceptible cats with ocular and nasal secretions from
When lesions occur at the medial canthus, the normal
affected cats. A chronic latent carrier state probably
canthal contour is missing. In advanced cases, it is
occurs.
common for secondary bone involvement of orbital
and nasal bones.
Prevention
Usually seen in cats with non-pigmented eyelids, and
Vaccination has produced conflicting results and is not
is usually on the lower lid, as this is more exposed to
widely used.
sunlight and ultraviolet light damage.
SQUAMOUS CELL CARCINOMA OF THE Diagnosis
EYELID AND CONJUNCTIVA***
The lesion is fairly typical, and consists of an ulcer-
Classical signs ated area, usually involving the lower eyelid and con-
junctiva, on a poorly pigmented eyelid.
● Red, slightly swollen eyelid margin with
inflamed adjacent conjunctiva (early lesion). Cytology is very useful, as samples can easily be taken
with a little local anesthetic. The surface of the lesion