Glaucoma

samiam1979

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Hi all! I'm new here and I just wanted to get some opinions on a situation I have with one of my cats (Templeton). Sorry - this is going to be a pretty long story

A few months ago, I noticed that his right pupil wasn't reacting to light normally. It didn't get nearly as small as his left eye. This was just after hiw yearly checkup and immunizations, so I wasn't particularly worried about it. I sort of watched it for awhile, but it didn't seem to be getting worse until about a month ago. Then I realized that it was getting worse. I made an appointment with the vet, who checked for a corneal ulcer (negative). All she said was that there seemed to be some inflammation and reddening of the iris and that his retinas looked weird (there was a cloudiness in the center that was preventing the retina from reflecting - she could only see a reflection on the outside edge of the retina all the way around). He does still have some vision, though. She prescribed an antibiotic that also had a steroid, mentioning that the steroid would be bad if he had an ulcer, but he didn't so it was okay. At the very end of the exam she noticed that his eye looked "bulgy" (her word, not mine) and to come back for a recheck in a week and she'd take pressures to check for glaucoma.
One week later: I came back and suddenly he had a horrendous corneal ulcer (exacerbated, I'm sure, by the steroid in the antibiotic). It's so bad all she did was walk in the room and say, "Oh, wow, that's a bad ulcer, I can see it from here." She decided not to do the pressure check because the ulcer was so bad. Then (this is where I was kind of mad) she said to keep giving him the antibiotic she prescribed the week before. So I asked about it, since she'd said it was bad for ulcers. She looked back in her notes and realized what she'd given him - then switched to an antibiotic ointment without a steroid 3x/day. (I'm thinking, don't you look over your notes when you are rechecking a patient?) She also put him on some eye drops 2x/day that are for glaucoma (Dipivefrin) that I had to get at a people pharmacy. She also said to come back in a week.
Two weeks from the first visit: I came back and she had to repeat the ulcer test because she couldn't see it with her naked eye anymore. It was still there but much much smaller.
She decided to go ahead and do the pressure testing this time. Poor poor Temp - he was NOT happy.
(He used to be good at the vet - after this, I doubt it). I won't go into details, but it didn't look like fun. The cutoff for normal eye pressure is 25. His right eye values were ranging from about 50-65. His left eye was even high at about 30-35, although she did say the instrument just normally reads a little high anyway, so it might have been just at the top of the normal range. She told me to cut the ointment back to 2x/day since the ulcer was getting better and that she'd write a prescription for some eye drops (this is where I get angrier). So I informed her that she had written the eye drop prescription the week before. (Once again, READ OVER YOUR NOTES, LADY!
) She looked confused for a second and then looked back, and sure enough, yep, there it was. So she says to up that to 3x/day and then prescribes a pill for glaucoma (Methazolamide 25 mg) 2x/day. Had to get that one at the people pharmacy too. She also scheduled a recheck for 2 weeks later (that is next Monday 1/24). She said that if I wanted, she could refer me to a veterinary ophthalmologist but that would get really expensive. I decided to wait until after this next recheck - but I'm thinking that if she makes one more dumb mistake, I'm going to go to the specialist no matter what. She admitted that she hasn't seen many cases - which is fine. From what I've read on the internet, glaucoma in cats is very rare. But for her not even glance over her previous notes before she starts telling me stuff? That is what is really bothering me. What if I didn't pay attention to or retain any of what she said? He'd still be on the steroid and probably ready to lose an eye. It's not that I expect her to just remember everything - but I would think looking over her previous notes for a recheck exam would be common sense. Am I crazy for thinking that?
Anyway - does anyone have any experience with a cat that has had glaucoma? From what I read on the internet, it's usually secondary to some other condition... But my vet hasn't really said much about that other than she thinks there is some sort of infection. I'm losing faith in her rapidly, though. There are 3 vets in the office that I go to and I've never had this particular one for anything but routine visits. Any suggestions?
 

kumbulu

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Hi Sam, welcome to TCS.


I would recommend that you take Templeton to see a veterinary opthalmologist. If you ask for the name from the vet, you can ring and ask how much they would usually charge. They may even let you do some sort of payment plan. My vet is a veterinary opthalmologist and doesn't charge more just because the visit is to do with eyes. It sounds like your vet is a bit 'lost' and if it were me, I would be seeing the specialist to make sure my cat didn't go completely blind, as you said the values were high normal in the other eye.
 
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samiam1979

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That is pretty much what I've been thinking I'll have to do... Since I have an appointment at the regular vet Monday, I'll wait until then and get the other vet's name.
Thanks for the welcomes
 

zanniesmom

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I am not at all sure that she has prescribed the best treatment. She is making some assumptions about his glaucoma and prescribing based on that. I would want to take him to the ophthalmologist sooner than Monday. If glaucoma isn't treated properly it can cause blindness and there are different types and the treatment for one is not the same as for others.
Becky
 
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