Page 1310 - Problem-Based Feline Medicine

1302 PART 15 CAT WITH EYE PROBLEMS

Treatment Clinical signs

Antifungal medications. Drug chosen should be based Signs of anterior uveitis, e.g. miosis, injected iris sur-
on results of fungal culture and sensitivity where possi- face, anterior chamber flare, fibrin.
ble. Treatment may need to be prolonged, depending on
Discrete iris or ciliary body masses causing iris
response.
swelling, which is associated with lymphosarcoma.
● Itraconazole 100 mg PO daily with food.
● Fluconazole 50 mg PO q 8 hours.
● Amphotericin B. See page 26 (The Cat With Signs Diagnosis
of Chronic Nasal Disease) for description of admin-
Diagnosis is based on the clinical signs of uveitis or
istration in a subcutaneous infusion of glucose and
lymphosarcoma in a FIV-positive cat, and failure to
sodium chloride to reduce the renal toxicity.
identify any other possible cause.
Avoid use of systemic corticosteroids in systemic fun-
gal disease.
LYMPHOCYTIC-PLASMACYTIC UVEITIS*
Topical steroids or non-steroidals may be used to
control the anterior uveitis. Classical signs

Supportive therapy is important until anti-fungal ● Gray to tan nodules on the anterior surface
medication is effective. of the iris.
● Keratic precipitates.
Enucleation of the eye is recommended if endoph-
thalmitis and/or secondary glaucoma develop.
PATHOGENESIS
Prognosis
Lymphocytic-plasmocytic uveitis stems from an
Guarded to grave in most cases where there is systemic immune-mediated process, which results in the
involvement. formation of numerous lymphoid nodules within the
anterior uveal tract. It is probably a response to
FELINE IMMUNODEFICIENCY VIRUS (FIV) endogenous antigens, and in some cats, Toxoplasma is
INFECTION** regarded as a possible cause.

Classical signs
Clinical signs
● Signs of uveitis.
● Bilateral iris swelling associated with Typically there are gray to tan nodules on the ante-
neoplasia. rior surface of the iris.
Opacities occur on the endothelial surface of the
See main references on page 330 for details (The Thin, cornea (keratic precipitates)
Inappetent Cat) and page 399 (The Cat With Enlarged
Lymph Nodes). Aqueous flare (cloudiness of the anterior chamber due
to suspended proteins and cells)
Pathogenesis Pre-iridal fibrovascular membranes occur in the

Ocular disease including uveitis, glaucoma, infiltration chronic stages.
of inflammatory cells in the posterior chamber (pars Secondary glaucoma, lens luxation and globe enlarge-
planitis), focal retinal chorioretinitis and retinal hemor- ment occur in the chronic stages.
rhages have been reported associated with FIV infection.

Neoplasia including lymphoma (often extra-nodal) Diagnosis
have been associated with the terminal stage of the dis-
ease, although the exact role of FIV in the neoplastic Diagnosis is based principally on the appearance of
process is unclear. the iris.