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Cat Eye Ulcer

This question is for Aleda. I was told you are very helpful and compassionate when it comes to people and their pets. I have a 5 year old male orange tabby that is an outdoor cat and there are two other cats in the household. He has developed a milky grey ulcer on his left cornea. It has been there some time now. The colour of the iris has also changed to a darker orange colour than the other one and the pupil is oddly shaped. He began to squint it shut and looked as if he was in pain so I took him to the vet in December. She prescribed fusidic eye gel and I used it as directed. Since then he does not squint it anymore and doesn't appear to be in any pain at all. He still purrs all the time and his vision doesn't appear to have diminished at all (although I don't think he can see from this eye).

I have been speaking with other cat owners on Medhelp and they think it could be feline herpes that caused the ulcer. I found Lysine, an aminoacid that is taken orally to help suppress the virus. I do not know for sure if he has the herpes virus but was wondering if that is the most likely case since the fusidic gel did not fully clear up the ulcer. I know with a bad ulcer the eye will never go back to normal. If he is not squinting it or if there is no discharge could it just be scaring from the ulcer?

I am a student and can't afford many trips to the vet or expensive surgeries so I am trying my best to help him with over the counter remedies and online help. I feel very helpless. I would be willing to remove the eye but that too is a very expensive surgery.

I guess my questions are; is there a way to tell that it's the herpes virus without going to a vet? And if there is not what test do I have done to find out and is it very expensive? Also, does this Lysine drug have much effect if it is herpes? Lastly, if it's not herpes and it is just an ulcer, what will happen to the eye if just treated with the antibiotic drops?

Many thanks,
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234713 tn?1283530259
Thank you for your kind words.  

It does sound as if your cat is infected with Herpes or another common upper respiratory virus such as calicivirus.  

I have answered your questions as follows:  

1.  Is there a way to tell that it is the herpes virus without going to a vet?   No.  If Lysine and an anti-viral eye drop are effective in controlling the eye infection, it is possible that it is a herpes viral infection, but other viral infections do respond to anti-viral eye drops.  Definitive diagnosis is only achieved by having your vet collect a sample from the infected eye and submit the sample for a PCR test, and culture and sensitivity.  

2.  The tests can run to approximately $200.00.  The more important test is the PCR.

3.   The Lysine is very helpful for Herpes virus.  The dose of Lysine is 1000mg twice daily, if given with food or 500mg twice daily, if given on an empty stomach (empty stomach is more effective).

4.   If it is not herpes and it is just an ulcer, what will happen to the eye if just treated with the antibiotic drops?   There are other ways that a cat can develop corneal ulcers, such as trauma to the eye, but from your description, I believe that the ulcer is due to Herpes or other viral infection with a secondary bacterial infection.  Antibiotic eye drops will not be sufficient to completely treat the condition due to the degree of damage, and the requirement for additional therapies.  The ulcer could worsen to a complete thickness ulcer and could perforate.  The infection could spread to deeper tissues.

Seeking the help of a veterinary ophthalmologist would really be the best option for your cat.  Due to the degree of damage, it sounds as if your cat may require surgery to save the eye and vision.  The fact that your cat’s eye has changed color may mean that he also has iritis and uveitis.  Common surgeries include a conjunctival graft for deep corneal ulcer; for more superficial ulcers,  a bandage is placed over the corneal defect using the third eyelid, or by partially suturing the upper and lower eyelids together .   There are even soft contact lenses for cats that can be used as a corneal bandage.  These procedures are usually only performed by veterinary ophthalmologists.

Fusidic is an antibiotic, which is fine for the secondary bacterial eye infection.  Your cat also requires an antiviral eye drop such as idoxuridine, trifluridine (Viroptic), or vidarabine (Vira-A).

Since you are low on funds, try the following:  Continue using Fusidic, and, request a prescription from your vet for an anti-viral eye drop (which I have listed above), and, continue with the Lysine at the higher dose.  If there is no improvement soon, please consider seeking veterinary ophthalmologist assistance.
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