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Non-ulcerative keratitas

CandiBender

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Hey guys, I could really use some help. DaMinci has just turned a year old and we've been fighting a losing battle for 6 months. My vets ( we've been to three), all believe DaMinci has herpes that is causing non-ulcerative keratitas in both eyes. His eyes are cloudy and one Has blood vessels spreading out from one corner. He has been on terramycin, tobramycin, steroid drops, clavamox, famciclovir, and currently cidofovir. Nothing is working. I am terrified that my baby is going to lose his eyes sight. He squints constantly and has been on lysine since I've had him. Any help, cause I'm at a loss, my vets seem ignorant and I'm so so scared. Please share any experience or advice. Thanks y'all.
 

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celsei

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Do you have a vet university nearby or an eye specialist? Does he have any other symptoms of herpes?
 

CandiBender

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Yes, it was the eye specialist that put him on famciclovir and cidofovir. No, he doesn't have any other symptoms. Only his eyes. He's been on 500mg of lysine for months and I can't tell it does anything at all. He's been stained and no ulcers and his tearducts are normal.
 

celsei

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Do you have a good close up picture of his eyes? Have his eyelids/lashes been checked? Entropion is common in sphynxes where the eyelid or eyelashes are irritating the eye and corrective surgery is needed. It's hard to spot and often missed by vets who aren't experienced with it/the breed. Constant squinting and inability to open eyes fully is common with it.

"The most common complications of a herpetic infection are scarring of the eye, non-healing corneal ulcers, corneal sequestration (brown degeneration of cornea, usually require surgery for healing), chronic tearing from the eye, eosinophilic keratitis or conjunctivitis, and inward rolling of the eyelids ("entropion"). Eosinophilic keratitis and conjunctivitis are conditions where there is infiltration of ocular tissues with the eosinophil, which is a type of inflammatory cell."

The inward rolling (entropion) is also common with a herpes infection. I think he needs the corrective surgery to stop the eyelids from creating a cycle where his eye can't heal because the rolled in eyelids are constantly causing friction against the eye/ irritating it.
 

celsei

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From the pictures I see his eyelids seem to be covering his eye way too much, I had this for one of my boys and surgery fixed it immediately. Vets were hesitant to diagnose it and tried different antibiotics for weeks with no progress but took up on it once I suggested it.
 

celsei

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As for Herpes management recent studies show Lactoferrin is the superiror antiviral/herpes management supplement, Lysine has been shown to be ineffective against herpes in studies but it won't hurt.

URI & Herpes Management (on lactoferrin)

I use this one Jarrow Formulas, Lactoferrin, 250 mg, 60 Capsules twice a day sprinked/mixed in wet food. The taste shouldn't bother them. There are also ones with colostrum but the milk association can give sensitive tummy/very lactose intolerant cats diarrhea so the plain lactoferrin is more likely to be tolerated by your cat. If there's still diarrhea or any issues stop and introduce it very slowly by giving 1/8th of the capsule or so and increase every few days. The article also mentions a few other supplements.
 

CandiBender

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Actually, I thought it was entropian when I first went to the vet. Three vets later and they all said it was not entropian. All they keep going back to is herpes. One even had the gall to suggest that maybe it's normal and how they breed them in Russia! This intelligent comment came from a so called cat specialist!
 

CandiBender

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As for Herpes management recent studies show Lactoferrin is the superiror antiviral/herpes management supplement, Lysine has been shown to be ineffective against herpes in studies but it won't hurt.

URI & Herpes Management (on lactoferrin)

I use this one Jarrow Formulas, Lactoferrin, 250 mg, 60 Capsules twice a day sprinked/mixed in wet food. The taste shouldn't bother them. There are also ones with colostrum but the milk association can give sensitive tummy/very lactose intolerant cats diarrhea so the plain lactoferrin is more likely to be tolerated by your cat. If there's still diarrhea or any issues stop and introduce it very slowly by giving 1/8th of the capsule or so and increase every few days. The article also mentions a few other supplements.
Thank you so much. I will look it up right now!
 

celsei

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Actually, I thought it was entropian when I first went to the vet. Three vets later and they all said it was not entropian. All they keep going back to is herpes. One even had the gall to suggest that maybe it's normal and how they breed them in Russia! This intelligent comment came from a so called cat specialist!

Seriously >> Do any of them have sphynx experience or is there a vet that does? He's a Donskoy, yeah? I think Donskoys are extra prone to this, they have naturally sort of squinty eyes and fat eyelids but there's clearly a line where it bothers the cat. Have they even confirmed with tests that it is in fact herpes/ruled out other viruses/infections? It seems strange for that to be the only symptom and whether it is caused by herpes or not the question is are the eyelids currently touching the eye in a way that they shouldn't be (and given how closed his eyes are it's kind of impossible for them to not be) and is this responsive to medicine. It doesn't even have to be an entire eyelid just a lash/lashline touching the eye is enough to cause a constant state of irritation/swelling. If they are and it's not responsive to medicine it's a simple surgery with very few risks other than general anesthesia. Clearly this has not responded to their herpes protocol at all. I had to see every single vet in my town before I found one that I felt was knowledgeable enough and listened to me and found solutions rather than prescribing the same thing over and over again when it's not working. Pet parent instincts do matter and are often right, you're with this cat all the time you can see if a lid is bothering him. It's especially easy to see the difference if you have another healthy Donskoy next to them.
 
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Sheldon13

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I don't know whether it's entropian or not, but I can tell you my first thought. My first thought is that if it's not responding to treatment it's because it's a different problem. The diagnosis is likely wrong. It would be exceedingly rare for an illness not to respond to the treatment that it normally does. Does that make sense?


Sent from my iPhone using Tapatalk
 

CandiBender

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Yes, he is a donskoy. None of the vets have seen a Don before though they all claimed to have treated Canadians. It started out with a diagnosis of URI, which I thought was accurate since he had flown in from Russia but of course, it wasn't. The eye specialist was convinced the famciclovir would work but it literally did nothing. That medicine had to be compounded and he hated it but for a solid month i forced it down his throat twice a day for nothing. Now he's on cidofovir eye drops and I don't hold out much hope that they'll work. I know I'm heading back to the specialist but this has gotten very discouraging.
 

celsei

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Sadly my pictures are phone quality to hard to see but

the pink hoodie one is my chubbylids before surgery


you can see there's an excessive amount of wrinkle/fold particularly for his lower eyelids compared to the normal eyed boys, pinkie here has good eyes
Instagram post by Ethel Pruss • May 22, 2017 at 2:46pm UTC black boy's eyes are kind of borderline where if his lids were any chubbier they would be hurting his eyes and he needs more eye cleanings/squints more than the pink boy but it's not enough to be a medical issue.
 

CandiBender

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Sorry about the slow update. The ophthalmologists put him on another round of the same meds with the exact same result. Nothing at all. I tried to convince her that Minci has entropion to no avail. She told me repeatedly that he did not. I was then told, there's nothing else to be done and he'll suffer with this for the rest of his life! I am beyond heartbroken and still convinced that all these vets and specialist are ignorant as hell when it comes to a naked cat. I don't know what else to do!
 

celsei

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I mean, that's just not true. This is not how nonulcerative keratitis is treated - it's not throwing a bunch of random antibiotics which actually have no reason to work for any of these causes and then say there's nothing else to be done. Did they culture test the fluid in the eye? Infectious issues generally come with ulcers, there's no reason to think this is bacterial or would respond to antibiotics. Are there any pigment spots or fluid build-up in the cornea? Any dead/diseased tissue? If yes to either it needs to be removed via radiation, cryotherapy or surgery. It doesn't matter if it's caused by herpes or anything else. Where do you live, do you have other vets available? Veterinary hospitals/universities are often best.

"
Treatment


Your cat will only need to be hospitalized if it does not respond adequately to medical therapy. Outpatient care is generally sufficient. Radiation therapy may be prescribed for long-term superficial inflammation of the cornea. Radiation therapy and cryotherapy (a freezing technique that is used for removal of diseased tissue) may also be prescribed for inflammation characterized by the presence of pigment that is deposited in the cornea.



If the diagnosis is inflammation of the cornea characterized by the presence of a type of white-blood cell called an eosinophil, surgical removal of the surface of the cornea may be done for diagnostic purposes. This is usually unnecessary as it only temporarily resolves clinical signs; medical treatment is preferred.



If the condition takes the form in which part of the cornea tissue is dying, leaving a pigmented lesion and fluid build-up, surgical removal of the surface of the cornea may be curative, but recurrence is possible; eye discomfort is the primary indication for surgery."
 

celsei

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"
  • Herpesvirus – the nonulcerative keratitis is believed to be an immune-mediated reaction to the herpes virus antigen rather than an actual effect of the viral infection" If it is herpes as they believe - it's not a direct effect of the virus so the herpes drugs they gave you would have no reason to work either. Since it's an immune related inflammatory response steroids would work for that - you should see about Prednisone - this is used for similar problems in other parts of the body and should bring down inflammation
 

CandiBender

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He has cloudy spots and blood vessels in both eyes. The ophthalmologists said it doesn't affect his vision which is bull crap because all he does is squint which tells a person with half a brain that it hurts him. The ophthalmologists was in a group of veterinary specialists that's suppose to be the best in the upstate. She sucks. No dead tissue according to her expertise
 

CandiBender

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He's been on two different types of steroids. Prednisone made his eyes immediately worse and the other had no affect at all
 

celsei

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I'd be worried about cataracts and glaucoma with cloudy spots and blood vessels - did they measure the fluid pressure in his eyes? Cataracts/cloudy spots generally need to be surgically removed and with the blood vessels it sounds like pressure in the eye might be too high - this might also develop at any point from a chronic condition so would be good to recheck even if they did check it a while ago
 

Yoda mom

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@CandiBender ,((hugs))) to you and gentle healing head smooches to DaMinci

I am so sorry to read all the difficulties with the specialist
I have a kitty now I am dealing with a small eye sequestrum and
I get so many different opinions and suggestions from vets and eye specialist -
Not sure what to believe - and then it's like the sky is the limit for all the very expemsive options along with being told well it can come back -

What was the latest actual diagnosis from the "specialist "
And did they say why it is not entropion ?
Is it possible Mimci has two things going on?

What is the latest medications prescribed?

I feel for you and sweet Minci ((hugs)))

Is there a university you can call and consult with ?
whAt state do you live in ?
Have you posted a looking for in the vet recommendation section?
Recommended Sphynx Vets

A lair full of positve vibes sent for Minci
Please please keep us updated
 

CandiBender

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Thank you from the bottom of my heart for your sweet words. The latest was another round of famciclovir and steroid drops and cidofovir drops. With same results as before. She also said if this doesn't work we can try restasis! Which is for dry eyes that Minci doesn't have. His tear production was normal, so I don't understand that at all. I live in South Carolina and the specialist in Greenville was recommended by every vet I've seen in North and South Carolina . I've literally taken him to a vet outta state with experience with sphynx. I'm at a loss. I cannot stand seeing him like this. Not to mention that we're living in the poor house cause the price of vets and meds! This just stinks!
 

Yoda mom

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(((Hugs)))
I feel for you and sweet Minci
i really do ..
My vet was kind enough to offer on her own knowing meds are expemsive to
Google goodrx.com for the meds she was going to prescribe
And called in to the local ome with the best price .
All I need to do was call the pharmacy and give thr numbers and codes off thr goodrx.com
Associated coupon .. No print outs !

I also learned and bought an annual family prescription card at Walgreems -
They told me it covers pet meds! It cost me &35 a year amd already saved over 100 dollars on first pet prescription!
Your local pharmacys may have the sa,ex to inquire about - before I bought the meds I asked the, for the cash precor for the specific med with the "family card"
And it was a no brainier for my pets meds
I also learned to compare check with good RX and my Walgreems family plan for the best price
I ended up getting doxcycline cheaper through thr family plan and the oflaxacin with a better price the goodrx

It's worth the juggle for me to try to save especially with a tight month
Just wanted to pass it on because going through thr sa,e right now and totally get it .

I also got a carecredit card
Charges over &200 have a 6 mos promo but absolutely has to be paid in full within 6 mos or get walked compounding interest at 29% or so- if you are financial responsible keeping on top of it it can be a great tool to use for pet care .
*Know thst the minimum care credit payment will not pay off thr promo in full- that's where they get you !
So I divide the total charge by 6 amd make thst as the monthly pay,eat and add a fee dollars as a buffer

I even learned thst when my bill is like $189 I add a bottle of Hylyt shampoo or product to the bill to make it over $300 amd get thr 6 mos promo thst way :)

My vet for a $500 bill actually gave me a 18 mos promo so worth asking around

I swear I spend ,ore om pet stuff this month than my own food!
It will get better - keep being persistent to you get answers for Minci

It is obvious how much you love amd care for Minci !

Please please know we are here for you
eith a lair full of hugs m healing vibes thst you get amswers amd relief for Minci

I swear we have to be their advocate when we hit the wall of frustration amd keep on going ..
Go with your gut amd never give up
 

Yoda mom

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@CandiBender , here is an example of price differences .
Prices and Coupons for Famciclovir

I ask the vet to call in to pharmacy with best deal
Sometimes it is not always my walgreens family card as you can see in this example

Hope this helps

Recemtly I got charged by a vet $36 for erythromycin
With good RX the next one I got was $11 thru cvs!
Every little bit helps in ho to put towards the next prescription amd care
 
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