Chronic conjunctivitis

Hi everyone,

I have a four year old female cat that has had chronic conjunctivitis and inflammation on her left eye for most of her life. I talked to the vet about it when it first started giving her problems because she wasn't responding well to the neomycin eye ointment I had been using so they gave me a steroid based eye ointment for her. It helped but she would still get occasional flareups so whenever it would act up I would start treating it twice daily with the steroid ointment and usually after a few days it would show a dramatic improvement. But, no matter how long I continued the treatment I could never completely send it into remission....there was always a slight pinkness around her eyelids and a small amount of eye watering. Usually after I stopped the ointment treatment she would go three to four weeks at a time before another flareup occurred. A few times it flared up quickly and became so badly inflamed her eyeball wasn't even visible until after I started treating it again. Its been this way for over three years now and I've asked the vet different times about it and usually got the same response: its caused by the herpes virus and will likely affect her for the rest of her life. After a recent flareup I asked them about it again and they said something about an antiviral treatment they could try that works on some cats, but I would have to bring her in to have her examined first. I was busy with work and couldn't make it in right away. This past week it flared up badly again so I made an appointment for Saturday morning. The vet used a Q-tip with some kind of solution and pulled up her third eyelid. He was concerned about some roughness on the tissue which he said was most likely caused by tumor growth and said it was most likely malignant. At the time of the exam she still had some inflammation left from the flareup. He showed me another spot on her eyeball which he was concerned looked abnormal. Her eye is cloudy looking, it has been for years which I attributed to scarring from the persistent conjunctivitis. He recommended a biopsy and I scheduled it for this morning.

Over the weekend I was a nervous wreck and spent hours researching herpes in cats and cancer of the eyelids. She is a gray and white cat with white around the affected eye which makes them more susceptible to cancer from exposure to sunlight. She was an inside/outside kitty for about two years but this eye has been giving her problems since even before she ever started going outside. She's been an indoor cat for over a year now. With the inflammation mostly gone now I examined her myself but found no visible masses, lumps, scaling, darkened areas or anything abnormal looking other than a slight swelling of her conjunctiva. The vet has ruled out irritation caused by hair follicles. After over three years of having recurring conjunctivitis, I have a difficult time believing this is being caused by something malignant. Wouldn't it have grown or spread after this long? Could the roughness he was concerned about just be scar tissue and inflammation? From what I've researched about the most common form of this eyelid cancer, squamous cell carcinoma, it doesn't look or sound like what she has. She's perfectly healthy, happy and active otherwise. Another thing I found is that steroid ointment can actually suppress the immune system and make it more difficult for them to fight off the virus that's causing the inflammation....something the vet clinic never told me and I was completely unaware of until I started researching. Once I found that out I stopped using the steroid ointment immediately and switched back to the regular neomycin stuff. Its not as effective at controlling the inflammation but its better than nothing at all. So, this morning I cancelled the biopsy appointment. I just don't feel comfortable putting her through that stress and pain unless its absolutely necessary and I'm having serious doubts about the vet's diagnosis after I gave him her full history. I don't know what to do and I'd like more opinions on what to do next. I've searched online for veterinary opthamologists but the closest one I can find is over two hours away. Do I need to be seriously freaking out over this or does it sound like herpes related conjunctivitis? Are there any other treatments that might work? I've read a lot of promising things about Willard water for treating herpes conjunctivitis and I ordered a bottle on Amazon but I won't have it until Wednesday. I wouldn't be so seriously stressed out right now if he hadn't brought up the possibility of it being malignant. Should I try the Willard water for a week or so and see if there is any improvement?

I would wait for the biopsy to come back before trying anything. Depending on the cause, she could have a corneal abrasion--this will cause excessive tearing and a cloudly look to the eye.

Many, many cats have herpes ---in their eyes. Much like humans, if your mom has cold sores, you will have them as that's a virus (not genital herpes--herpes is cold sores, but they have two types for humans 1 and 2).  My mom's persian had it bad---likely because she was white you could see it more. We had eye drops and it cleared it right up (from the vet). My two kitties have it, but it only crops up under severe stress. Well, I should say my cat because my other beautiful baby was put down last week But, as he got sicker, his eye was runniner. 

I hope you get answers for your kitty!

darkhorse321 said:

 
I would wait for the biopsy to come back before trying anything. Depending on the cause, she could have a corneal abrasion--this will cause excessive tearing and a cloudly look to the eye.

Many, many cats have herpes ---in their eyes. Much like humans, if your mom has cold sores, you will have them as that's a virus (not genital herpes--herpes is cold sores, but they have two types for humans 1 and 2).  My mom's persian had it bad---likely because she was white you could see it more. We had eye drops and it cleared it right up (from the vet). My two kitties have it, but it only crops up under severe stress. Well, I should say my cat because my other beautiful baby was put down last week But, as he got sicker, his eye was runniner. 

I hope you get answers for your kitty!

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I cancelled the biopsy until I had more time to research and get more opinions. Based on her history and the length of time this has been going on I had serious doubts about his diagnosis and I didn't want to put her through the pain and stress of the biopsy. They would have to put her under to do it.

I'm glad you did that and very surprised they want to biopsy. There is an easy test to run to see if the cornea is scratched, and drops to put her on if they suspect an infection.  I'm shocked they want to run such invasive tests without going through the proper channels first of the simpiler issues.

When you wipe away the gunk in her eye, does it have a bloody appearance? That usually is indicitive of herpes, but your vet should know that and start on eye drops to see if it clears up--not order a biopsy!! Is there even a lump there???

The discharge is clear and watery, no signs of any blood in it. It mainly affects her left eye but the past few days both eyes have been watering some. I stopped using the steroid ointment after finding out it can suppress the immune system. I did a lot of research on treating and preventing herpes outbreaks and read about lysine so I've started giving her that twice a day to see if she shows any sign of improvement but its not going well. She's such a picky eater she won't touch anything I try putting it in so I've had to basically hold her and feed her like a baby. I've tried mixing it in with moist treats, fresh tuna, raw hamburger, cheese, sour cream...but she turns her nose up at everything and will only eat her dry kibble. I've only given her three treatments so its obviously too soon to see any results but I'm about ready to give up because of how difficult she's being. Her eye had been much better the past three days but last night when I got home from work it was inflamed again so I had to start using ointment. UPS messed up with the shipping so my Willard water won't arrive until at least Friday, possibly Monday now. I took a picture of her this morning. Its kind of hard to see because she blinked from the flash, but you can see how her eyelid is inflamed. There aren't any lumps visible but it does become more puffy and swollen when its acting up. I put ointment on it half an hour ago and its starting to look better already.

There is an eye drop that many herpes owners use with their cats, idoxuride, that has been very helpful.  I have used Gentimycin or Tobramycin drops, too with good results, but idoxuride drops are the ones many herpes owners swear by.  (My herpes kitty doesn't have eye issues, just upper respiratory issues.)  Also, some other things you can try is adding lysine to her diet, 500mg twice a day.  I use the powdered kind and mix it into canned food with a little water added. You can crush pills between two spoons or you can look for capsules and open the contents on food.  Additionally, if you don't already feed a grain free diet, I would recommend transitioning to one. Sometimes the grains in food can cause herpes to flare, so eliminating them might help. It's just something to try. 

Thanks. I've been grain free for a long time with my cats so I don't think its food related. I only recently found out about Lysine...something my vet never even told me about. I couldn't find capsules so I've been giving her crushed 500mg tablets twice daily. Its too soon to tell if it will help her or not and I'm having a great deal of difficulty getting her to eat anything I put it in. I'm strongly considering trying to get an appointment for Saturday with a different vet to get a second opinion and put my mind at ease.