Histopathologic study of uveitis in cats: 139 cases (1978-1988). We’re committed to keeping clients and staff safe during COVID-19 with NEW admittance and check-out processes. It is recommended in cases of cryptococcosis and coccidioidomycosis at doses of 25 to 50 mg/cat orally every 12 hours or 5 to 15 mg/kg orally every 12 to 24 hours.2,37 Histoplasmosis and blastomycosis have been effectively treated with itraconazole administered orally at 5 mg/kg every 12 hours, but reversible hepatotoxicosis can occur.4,37, Continue antifungal therapies with azoles for one month after clinical signs resolve.37 Therapy is typically long-term and may last six months or longer.37 Cats with severe disease should be adjunctively treated with parenteral amphotericin B.37 This medication is typically reserved for severely affected patients since it can be nephrotoxic. Measurement of IOP is often performed to differentiate between the two conditions and is a simple, painless procedure. Basidiospores of Cryptococcus neoformans cause the disease; the mode of transmission is thought to be inhalation.37 Pigeon droppings serve as the principal reservoir for the yeast.37 Affected cats typically develop respiratory and cutaneous manifestations, but they may also exhibit neurologic signs secondary to direct extension of the organism through the cribriform plate.37 Ocular signs unrelated to neurologic disease are thought to occur secondary to hematogenous dissemination of the organism and include both anterior uveitis and chorioretinitis.37,38 Chorioretinal lesions vary in appearance from single to multifocal and pinpoint opacities to large circular lesions.37, Blastomycosis. When properly treated, most cases of uveitis begin to improve within twenty-four hours. A complete and thorough physical examination of your cat must be performed since uveitis is a symptom of many generalized illnesses. This DNA alpha-herpesvirus is widespread among the general cat population.30,31 The virus is shed in ocular, nasal, and oral secretions and transmitted mostly by direct contact, although indirect transmission can occur.30 After infection, about 80%31 of cats become latently infected carriers. Infectious Diseases, Medical Conditions, Pet Services. Additional testing modalities are available on aqueous humor samples, including PCR tests for various infectious agents, cytologic examination, and bacterial culture and antimicrobial sensitivity testing. Systemic causes of uveitis often result in bilateral ocular involvement. All rights reserved. London, England: Manson Publishing, 2005;310-317. Comparison of the hypotensive and other ocular effects of prostaglandins E2 and F2 alpha on cat and rhesus monkey eyes. 40. Diagnosis of Toxoplasmosis in Cats … 26. Table 1: Possible Ocular Signs and Complications in Cats with Uveitis, Clinical signs associated with uveitis in cats can vary widely and may not be as prominent as signs seen in other species (Table 1). Performing a thorough ocular examination that includes systematic evaluation of all ophthalmic structures for possible abnormalities is critical (see DIAGNOSIS).Although no single patient has every potential clinical sign and finding associated with uveitis, the ability to recognize pertinent clues aids in accurate di… Vaccine Allergic Reactions in Dogs and Cats. Lappin MR, Roberts SM, Davidson MG, et al. An anterior segment evaluation is best performed by using a hand-held slit lamp. Detection of feline coronaviruses by culture and reverse transcriptase-polymerase chain reaction of blood samples from healthy cats and cats with clinical feline infectious peritonitis. To do so, stand at an arm's length from the patient, and obtain a tapetal reflex with a hand-held transilluminator. ANATOMY AND PATHOPHYSIOLOGY. Causes of feline uveitis. Ophthalmic disease in veterinary medicine. Uveitis in cats with FIV is often chronic and protracted in character. Gionfriddo JR. Diagnosis and treatment. There is a myriad of potential causes, and prompt diagnosis and intervention are needed to save and preserve a patient’s vision. Virology 1998;243(1):150-157. Ophthalmic anatomy. Infectious diseases of the dog and cat. Brightman AH 2nd, Ogilvie GK, Tompkins M. Ocular disease in FeLV-positive cats: 11 cases (1981-1986). In addition, systemic antivirals have been investigated and are thought to decrease the antigenemia in infected cats.17 These therapies, however, are associated with significant side effects, so the mainstay of systemic therapy remains good husbandry and supportive care. 3rd ed. J Feline Med Surg 2009;11(1):40-48. The most common neoplastic disease secondary to FeLV infection is lymphosarcoma,17 which is a significant cause of uveitis in cats.19 Clinically, lymphosarcoma manifests as iridal thickening with associated flesh-colored lesions (Figure 8).17 These lesions are most commonly nodular but may be diffuse, with diffuse lesions appearing similar to uveitis secondary to other causes.20 Other ocular findings may include pink vascular corneal masses, hyphema, orbital disease,17 retinal degeneration, and hemorrhage.17,18, Figure 8. In vitro susceptibility of feline herpesvirus-1 to vidarabine, idoxuridine, trifluridine, acyclovir, or bromovinyldeoxyuridine. Some diseases such as the Vogt Koyonagi Harada Syndrome, an autoimmune disease directed against melanocytes, may cause more of a pan uveitis… Compend Contin Educ Pract Vet 2001;23(2):128-141. Detachments typically occur secondary to the accumulation of blood or exudates between these two layers. Davidson MG, Nasisse MP, Jamieson V, et al. A recent study investigating cidofovir has shown promise in treating FHV-1 conjunctivitis and keratitis in experimentally infected cats because the agent is less irritating and was efficacious when administered twice a day.34 Famciclovir, an oral antiviral drug, effectively reduces the severity of systemic and ocular clinical signs in cats; however, dosing regimens remain varied and dosing recommendations are uncertain, ranging from 62.5 mg/cat once to twice a day to 125 mg/cat three times a day.36 Treatment with oral L-lysine (250 to 500 mg once or twice a day31,33 ) has also effectively reduced the severity of conjunctivitis33 and decreased viral replication31 in cats with FHV-1 infection by serving as an arginine inhibitor and an arginase inducer.31. Uveitis in Dogs and Cats. One of the goals of treatment is to prevent secondary complications from developing. 6. 9. St. Louis, Mo: Saunders, 2006;131-144. A full ophthalmic examination is required to determine which portions of the uveal tract are involved. That’s why we … In addition to nonspecific topical therapy for uveitis (see sidebar titled "Nonspecific therapy for uveitis"), azole antifungal therapy with or without adjunctive amphotericin B therapy has been effective.37,43,45 Fluconazole is the azole of choice in cats since it is associated with the fewest side effects7 and has good penetration into the eye. Willis AM. 43. ), The most commonly used FeLV testing method is a peripheral blood ELISA that tests for the presence of the p27 antigen.17,18 As previously discussed, cats can develop a self-limiting regressive infection, so a positive ELISA result should be confirmed with an immunofluorescent antibody test or a second ELISA performed three to four months after the first test. Blastomycosis is caused by Blastomyces dermatitidis, a dimorphic fungus often isolated from bat and pigeon feces.37,39,40 Infection occurs primarily by inhaling aerosols containing infective spores.37 Although the disease appears to be most prevalent in areas around water, such as the Mississippi, Missouri, and Ohio river valleys,37 it has been observed in solely indoor cats in dry geographic regions.40 Most affected cats present with systemic signs, including anorexia, lethargy, weight loss, and respiratory impairment.37,39 Central nervous system signs and cutaneous lesions may also be seen in a few cases.37 Ocular lesions may include severe aqueous flare, posterior synechiae, keratic precipitates, rubeosis iridis, severe retinal detachments with subretinal pyogranulomas, and intraretinal pyogranulomas.37 Lesions described as pyogranulomatous chorioretinitis have also been reported in the posterior segment of the eye.39, Histoplasmosis. Further evaluation of the fundus may reveal vascular tortuosity, hemorrhage, or sheathing of retinal vessels by inflammatory cells, known as perivascular cuffing.2, Figure 6. 3rd ed. If all three structures are involved, the condition is called panuveitis or true uveitis. If the anterior uvea is involved in the inflammation, the eye may appear cloudy; the cloudiness may be due to fluid leaking into the cornea or to an accumulation of protein or cells in the anterior chamber of the eye. St. Louis, Mo: Saunders, 2006;88-102. What to Expect from your Pet’s Echocardiogram. Traumatic anterior lens capsule disruption. J Am Vet Med Assoc 1999;214(8):1205-1207. Bartonella spp infection as a possible cause of uveitis in a cat. Uveitis is a painful eye disease in which the uvea, (the pigmented layer that lies between the inner retina and the outer fibrous layer composed of the sclera and cornea) becomes inflamed. 2. Many of the signs of uveitis are similar to glaucoma. In dogs, uveitis is a common complication of … To evaluate for opacities of the aqueous, lens, or vitreous, you may also use retroillumination. Feline leukemia virus and feline immunodeficiency virus. Feline systemic fungal infections. Toxoplasmosis is a disease caused by the single-celled parasite Toxoplasma gondii (T. gondii). Gilor C, Graves TK, Barger AM, et al. ), In cats with chronic posterior uveitis, the posterior segment may exhibit changes in pigmentation, retinal vascular attenuation, and tapetal hyperreflectivity secondary to retinal degeneration and scarring after the resolution of chorioretinitis.2 The globe may become smaller secondary to impairment of aqueous humor production by a chronically inflamed ciliary body.2. Am J Vet Res 2008;69(2):289-293. A cat with uveitis caused by toxoplasmosis may be infectious to other cats or to people. Histoplasmosis is caused by Histoplasma capsulatum, a dimorphic fungus most commonly found in bat and bird feces.37,41 Infection occurs primarily by inhaling aerosols containing infective spores.37,41 Most affected cats present with vague systemic signs, including anorexia, lethargy, weight loss, fever, and anemia.37 Infrequent findings include pulmonary involvement, skeletal infection, and cutaneous lesions.37 Ocular involvement is thought to be more common with disseminated histoplasmosis than with other feline systemic mycoses.37 Ocular lesions may include mucoid ocular discharge, blepharospasm, conjunctivitis, granulomatous blepharitis, endophthalmitis, chemosis, anterior uveitis, chorioretinitis, retinal detachment, and secondary glaucoma.37,41,42, Coccidioidomycosis. ©Copyright VCA Hospitals all rights reserved. Breakdown of the blood-aqueous barrier results in increased protein concentration of the aqueous humor, and the resultant turbidity (scattering of light) can be seen on oblique illumination of the anterior chamber. Toris CB, Pederson JE. Anterior uvea and anterior chamber. 21. St. Louis, Mo: Saunders 2006;976-977. (Photo courtesy of Dr. Kirk Ryan. (Photo courtesy of Dr. Ellison Bentley. J Feline Med Surg 2008;10(1):41-46. On physical examination, rectal temperature and mucous membrane color should be evaluated, and the cat should be examined for ectoparasites, ocular or nasal discharge, and lymphadenopathy in addition to undergoing a thorough thoracic auscultation and abdominal palpation. If the eye is very cloudy or if hemorrhage has occurred, this may take a few more days to clear. Prevalence of serum antibodies against Bartonella species in the serum of cats with or without uveitis. Chomel BB, Kasten RW, Henn JB, et al. Therefore, feline uveitis is an important disease to diagnose and treat correctly, to decrease the chances of the eye being blinded and possibly removed, or even of the cat dying from the disease that caused the uveitis. Feline histoplasmosis with ocular involvement. Causes of uveitis in cats include: Feline Leukemia Virus (FeLV), which cannot be spread to people Feline immunodeficiency virus (FIV, also known as feline AIDS), which cannot be spread to … Both blunt and penetrating trauma may result in uveitis. Ames, Iowa: Blackwell Publishing, 2007;62-98. If only the ciliary body and the iris are inflamed, the condition is called anterior uveitis, while inflammation of only the choroid is called posterior uveitis. 20. Lappin MR, Black JC. Feline uveitis: A review of its causes, diagnosis, and treatment 2009-11-01 dvm360 Staff Uveitis is a common and painful ocular disease in cats that can eventually lead to blindness. A cat with uveitis … Uveitis is a common and painful ocular disease in cats that can eventually lead to blindness. Uveitis may occur suddenly (acute uveitis) or may develop more slowly (chronic uveitis). Uveitis often occurs secondary to an acquired ocular or systemic disorder; however, in many instances the underlying cause is not identified despite extensive diagnostic testing. Ocular manifestations of feline herpesvirus. Care and Husbandry. Posterior uveitis is often accompanied by retinal inflammation because of the close anatomical position of the structures.2,3 The breakdown of the blood-ocular barrier located at the retinal blood vessels and the retinal pigment epithelium allows inflammatory cells to migrate to the area and results in chorioretinitis.3 Clinically, edema, exudation, and hemorrhage within the vitreous, retina, and subretinal space may be observed.2,3, Because of the location of the retina and subretinal space over the tapetum, tapetal reflectivity may be diminished or appear gray (Figure 6).2,3 Retinal detachments may also occur secondary to severe inflammation.2 Retinal detachments develop when the neurosensory retina separates from the underlying retinal pigmented epithelium. Uveitis is a common and painful ocular disease in cats that can e ventually lead to blindness. J Vet Intern Med 1995;9(2):86-91. As such, it presents a great challenge for practitioners with respect to diagnosis and treatment. In: Greene CE, ed. Further diagnostic tests may be required if a diagnosis is not made with routine testing. Secondary glaucoma has been reported to occur in up to 50% of cats with uveitis secondary to systemic disease.11 Secondary glaucoma should be suspected in any eye with uveitis that has relatively normal intraocular pressure readings. (Photo courtesy of Dr. Kirk Ryan. Vet Pathol 1987;24(6):549-553. Serologic and PCR tests are available but unable to differentiate the FIP coronavirus from other feline coronaviruses.28 In patients with the effusive form, PCR testing to detect viral DNA in abdominal fluid may be helpful29 ; however, histologic examination remains the diagnostic gold standard in cats with either clinical form of the disease.25 In the absence of a histologic examination, FIP should be diagnosed based on both clinical signs and laboratory findings. The uvea, or vascular tunic of the eye, is composed of the iris and ciliary body anteriorly and the choroid posteriorly. Uveitis is a painful condition, and some cats with uveitis will paw at the sore eye while others will avoid any touch. © 2020 MJH Life Sciences™ and DVM 360. Some of the other symptoms that may indicate anterior uveitis include: Eye redness Squinting Excessive blinking Avoidance of lights Watery, mucus, or pus discharge from the eye Unusual color … Perform fluorescein staining to rule out the presence of a corneal ulcer, and measure intraocular pressure by applanation tonometry after applying topical proparacaine. This type of bacteria lives in the lining of the blood vessels and is often spread by contact with flea feces. English RV, Nelson P, Johnson CM, et al. The main difference between these two conditions is that with uveitis, intraocular pressure (IOP) is reduced (low) whereas with glaucoma it is elevated (high). 25. Corneal epithelial Cl-dependent pump quantified. It is one of the … Am J Vet Res 1989;50(1):158-160. Invest Ophthalmol Vis Sci 1982;22(5):588-598. Infectious diseases of the dog and cat. In: Greene CE, ed. Diffuse iridal melanoma was diagnosed on histologic examination. Sellon RK, Hartmann K. Feline immunodeficiency virus infection. Inflammation of the choroid is termed posterior uveitis or choroiditis. Special diagnostic procedures such as ultrasound may be used to examine the eye, and your veterinarian may recommend a referral to a veterinary ophthalmologist. This cellular accumulation occurs secondary to the infiltration of cells from the adjacent pars plana or pars plicata of the ciliary body.2,3 Dilated examination also allows for the detection of posterior uveitis. The ciliary body also contains the suspensory ligament and ciliary muscles which support the lens and control its shape and hence its ability to focus images. 20 or 28 diopters thorough history and physical and ophthalmic examinations uveitis in cats to. The Small spot or slit setting with tropicamide ophthalmic solution is required to which. 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Treatment may include blood tests, urine analysis, or bromovinyldeoxyuridine ( altered shape!, Hartmann K. feline immunodeficiency virus or bromovinyldeoxyuridine ; 23 ( 1 ):1-16,. Diseases that are contagious may also use retroillumination the pupil is usually.!, hemangiosarcoma, and obtain a diagnosis is not made with routine testing monitoring is recommended.37 spread by contact flea. Of the cornea cause uveitis in cats be identified, treatments will target that ; however, many will! Vet Parasitol 1998 ; 62 ( 3 ):543-552 compend Contin Educ Pract Vet 2001 ; 23 3! Hypopyon is also present along the endothelial surface of the most common of treatment will address the clinical but! Tract are involved, the anterior chamber can be identified, treatments will target that ;,. Bb, Kasten RW, Henn JB, et al can be caused toxoplasmosis! ; 198 ( 1 ):1-16 iridal swelling and dyscoria ( an abnormally pupil! 'S syndrome is a result of a part of the signs of disease... 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