Cataract surgery

We finally found out what was going on with Aoibhe's eyes. During a vet check, our vet could not see the Aoibhe's retina and we started treating her for uveitis with steroid eye drops as well as Clindamycin to eliminate any possibility of toxoplasmosis (which can cause uveitis). No improvement so we were sent to a ophthalmologist. We saw him today and he diagnosed cataracts. It is most likely congenital because Aoibhe's so young (5 months).

And because she is so young, he thinks she is a good candidate for surgery. It could restore 80-90% of her eye sight. There are other tests she needs to have and pass before she can be considered for the surgery. Mainly to see if she can take the anesthesia and if her eye developed enough to support sight.

But this is not simple surgery. It is expensive, but that is not a factor in our decision. It does mean intensive post-surgery care. 4-6 weeks of keeping her from jumping and grooming her face, administering eye drops 3-4 times a day. So she would most likely have to be kept in a large kennel crate away from Kiefer. Either he would body slam her or groom her.

A decision doesn't have to be made right away. She needs to get a little older to make sure her liver is developed enough and we would continue steroid drops to reduce as much inflammation of the eye.

I am so torn. I would like to give her a chance at a higher quality of life, but also know there are a lot of cats who adapt to being blind. And then I'm ambivalent at separating her from Kiefer. I feel like their bond (which we love so much) will be broken. I will then have 4 cats who tolerate one another and don't interact. There is always the risk of complications in and after the surgery too.

Does anyone have any advice on making this decision?

Oh man, that's tough... When you said cataract, I thought - yeah, that's no big deal... Then I thought again... sure, in a human, that can follow instructions! But Wow, in a kitten... wow... Hard decision to make that one....
Is her other eye completely normal? Or are there chances that she is going to develop cataracts on it as well? Does the vet think this has a genetic factor, considering she is so young?
My point is, if this is the only eye that is most likely going to be affected in her life, then I would probably not do it... Just because I think it would be really really hard to confine her for 4-6 weeks away from he brother, and without playing, jumping, etc. With cataract, you really need to restrict her space for no jumping, so the crate is probably going to be small - Not like otto's Eva Castle... That I think will be that hardest part... Unless you can crate both of them together for a little while everyday... But I don't know...
Now, if there is a chance she is going to develop this on the other eye, then the story changes pictures for me... Then I would do whatever it takes to save the eye, to preserve her eyesight. I would not want to rob her from seeing. 4-6 weeks might be bad, but I do not think worse than a lifetime of not seeing...
I would arrange a way to make sure they both spend time together, and don't lose their relationship, but by all means, I would save that eye if she has a genetic predisposition and is likely to have the same issue on the other eye as well...
Just my 2 cents for what is worth....

Are we talking 1 eye or both? If it's 1 eye I wouldn't do it, if it's both I would be a lot more likely to do it since this is a young cat.

Most young blind animals are blind due to issues that can't be cured. Abby, my Old English Sheepdog went blind at 5 years old due to retinal degeneration(irreversible, no treatment, no cure.) She was starting to show cataracts about year before she crossed the bridge(they started being visible at 10, she crossed at 11 1/2) but they were very obviously a total non-issue- she was already blind. She was blind longer than she was sighted. At her age, if she had had full sight I wouldn't have put her through surgery, she was old and her body didn't need that kind of stress(not to mention 10-12 years is average life span for OES, she she was at the very end of her life anyways, the risk would have outweighed the benefit.) Now if the retinal degeneration was surgically curable at age 5 I think I would have done it, she was still young and had a life ahead of her. Now age plays into it, this is a young kitten, if both eyes are effected then it needs to be done. If it's only eye is effected then I wouldn't do it(unless it was highly likely that the other eye would eventually lose sight) but that's just me. Health also plays into it, Attitude would have gone blind because there was no way I would have it done on her and Nuts would be a very hard decision.

Taryn

It is both eyes. The doctor didn't seem to think that she needed to be confined to a small place as long as she didn't have things to jump on. DH and I are considering clearing out a spare room for her so she would have space.

But definitely she would have to be sequestered away from Kiefer for at least a couple of weeks because the first thing he would probably do is groom her eyes which is why she would be required to wear a cone.

Originally Posted by katachtig

It is both eyes.

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Yeah... I would do it then...

Tough decision - unfortunately their is no "right" or "wrong" answer. How risky is the surgery? Could she end up blind anyways?

On the other hand, having had Damita who was pretty much blind, she adapted very well. In fact, IMO w/ her being blind it made the bond between her & Dory (no relation) even stronger.

That is the dilemma. She could have post-surgery problems with glaucoma or detached retinas which would result in the same thing. And her relationship with Kiefer would suffer.

Right now she is very smart at adapting to her environment. The doctor noticed that. She wouldn't jump off the table until the nurse put her one the floor. Once that happened then she was jumping up and down off the table with ease. Kind of like she noticed the drop when the nurse moved her.

We have an appt with our regular vet on Saturday to discuss the results. Fortunately, this doesn't have to be done right away.

Honestly, like I said before, with such a young cat I would do it just because it will make her life easier, and safer. She knows the layout because she has it memorized, it will have to stay that way for the rest of her life(once she is blind) or she will be tripping or running into anything that is moved. When my son was 4 months old he had 80 lbs worth of blind dog step on his head(he was fine, he just had a small scratch on his forehead from one of her nails) because she didn't know he was there and I wasn't fast enough picking him up(he was literally right in front of me, she could move fast her arthritis wasn't that bad yet) when she decided to follow my dad into the kitchen in hopes he'd let her lick what was left from his bowl of ice cream. Obviously a 10 lb cat stepping on someone is no big deal but you get the point that anything out of place will get stepped on or tripped over. If I pulled a chair back from the table and forgot to push it back in she would run into it. Abby was large enough that running into a chair was more of an annoyance to us(she was stubborn and wouldn't always listen when we told her to stop or turn) than it was a danger to her, but I could see a cat getting hurt bumping into a chair, especially if she was running(and yes blind animals can and do run at top speed especially once they learn the layout of their environment.) Literally anything moved out of place will get run into, bumped into, stepped on, tripped over. Abby ran into the coffee table so much my parents eventually put it up, once again, an annoyance to an 80 lbs dog but could really hurt a lb cat. Stairs aren't a problem as long as she knows they are there since they don't move. Abby had no problem with the stairs at my dad's townhouse(she knew the layout of my parent's house and the townhouse my dad lived in when he was working in Indiana(he commuted to where we lived on his days off, about a 4 hr drive) when she went to visit my dad.

Sorry just had to put in 2 cents more on this. I thought it was important to point out that she will be fine as long as her environment never changes once she totally loses her vision.

Taryn

Originally Posted by Taryn

Sorry just had to put in 2 cents more on this. I thought it was important to point out that she will be fine as long as her environment never changes once she totally loses her vision.

Taryn

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Don't apologize. I'm welcoming all input. She still has enough site right now to make out objects but you're right, she will go speeding through the house chasing after Kiefer. There have been a few collisions with the older cats, much to their dismay.

We leaning toward the surgery. I now need to figure out how to minimize the disruption to the household and get more details on what her post-surgery regimen will mean.

I wonder if she could still have limited supervised time with Kiefer. If that was the case, if they could have some contact that would be the best of both worlds.

Originally Posted by kluchetta

I wonder if she could still have limited supervised time with Kiefer. If that was the case, if they could have some contact that would be the best of both worlds.

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I was wondering that, too. Maybe if she were in a large crate for an hour or so a day they could have contact without him licking her or enticing her to jump.

Maybe as long as you're there watching them closely, you could still let her and Kiefer spend some time together.

Originally Posted by katachtig

That is the dilemma. She could have post-surgery problems with glaucoma or detached retinas which would result in the same thing. And her relationship with Kiefer would suffer. <snip>

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Do they know the probability of this happening? Did the specialist provide any info on how likely this is - or isn't?

As there are other tests and steps that need to be taken to get to the point of the decision to have the surgery, it seems to me it's worth starting the process.

If you do decide in favor of the surgery, it seems to me there have got to be ways for Aoibhe and Kiefer to spend some time together during the time she'll need to recover.

Originally Posted by LDG

Do they know the probability of this happening? Did the specialist provide any info on how likely this is - or isn't?

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He feels that the surgery will be 90% effective and while these are possibilities he doesn't expect any problems. What is hard about it is that feline cataracts are rare. As he's seen only 6-8 cases in his 15 years of practice, he can't tell me confidently from his experience.. Most of the patients are dogs. He does say that felines are more tolerant of the surgery than dogs so that reduces the risk.

I'm finding the surgery is less of a fear than the post-surgical stress. The ophthalmologist is 30 minutes away. She will need to see him at least the 3 days after the which is an hour in the carrier. She hates the carrier so I will need to get her used to it over the next couple of months. We need to find out how soon Kiefer can make visits without jeopardizing her recovery. The doctors says they could be crated together, but I think that would drive Kiefer nuts. And keep Aoibhe occupied so she doesn't get bored or depressed.

I am saving most of my vacation so I can take 3 weeks off when she has the surgery so I can spend time with her.

And I want to look for the more friendly soft collars instead of the cone. Does anyone have any suggestions? It would be important that she can't scratch her eye area.

Anything else I might be missing?

I've got one of these foam cat collars instead of a cone. For some reason the one in the picture here doesn't look as wide as what I've got, but that's where I ordered it. There are also inflatable collars that close with velcro, but they don't hold up very well and aren't as wide.

Have you considered harness training Aoibhe and Kiefer? They're young enough it shouldn't be difficult. Then you could put them on leashes for playtime during her recovery and keep both more under control. The H-shaped (small dog) harnesses can't be slipped as easily as the figure-8 cat harnesses.

What I discovered with Squishy's ear ablation, is:

1)the "gauze wrap necklace" was what he kept scratching at when he was wearing it
2) nail caps helped on all 4 paws
3) hard cones make him spray

The vet was so matter of fact - get her used to a cone and she'll be fine. I still remember Lucy's experience with it. The little Houdini could escape one in less than a minute. I had to harness her into it.




Tricia, that is a good idea about the harnesses. They probably should be trained any way.

I agree - harness training is definitely worth a go! Also, while you can try to get her used to a cone - you may find she doesn't need it. Flowerbelle didn't mess with her eye AT ALL, and she had numerous procedures done on it, each one requiring stitches. The vet was sure we'd need a cone, and she just didn't.

So while it's definitely best to (try to) get her used to wearing one, in the end she may not need it.

Edited to add: When Tuxedo needed two back-back surgeries, one at a specialist and then the blood transfusion at our vet, the specialist sent him home with us with a "port" taped into his front leg. We could NOT risk him popping it, or it would have been blood city over here. He FREAKED with the cone - and I mean FREAKED. So instead of keeping the cone on him, Gary and I just did shifts of "Tuxedo watching" and sleeping. Of course, it was only for a little over a day, not three weeks. But if you're going to be on vacation, just thought I'd toss that out there.... she should, at least, be able to get some breaks from the thing.

We had a visit with our usual vets. One of them is trying to get a hold of the ophthalmologist to get some details, but they recommended a wait-and-see for the surgery. They believe (and we agree) that Aoibhe has a decent amount of sight to get around. In fact this morning, I was having to untangle her from the blinds. For a cat with little or no sight, she can get into things.

Waiting is not going to hurt her chances with the surgery. In fact, she needs to mature more because this is serious surgery. The ophthalmologist will use an inject-able anesthetic which means that Aoibhe will need mechanical breathing. There are a lot of things that could go wrong in the post-surgery period.

So our biggest question now is the one our vet is following up with. What happens if we don't do the surgery (besides the worsening blindness). We will keep up the steroid eye drops so she doesn't have problems with inflammation which hurts her sight in addition to the cataract.

Thanks everyone for your feedback. The support through this decision has been fantastic.