Help! Severe eye infection

NYCatMom

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Hello.. New to the forum and hoping someone can offer helpful suggestions..

Tuesday of last week, we noticed that our 10.5 year old sweetie Zora had a bit of her third eyelid inflamed on her left eye. She had been unusually lethargic and had diarrhea over the prior weekend. The next day, more of her third eyelid was inflamed and protruding from her eye. Her usual vet wasn't available so we took her to another highly rated vet for an evaluation. That vet performed a number of tests (Schirmer Tear Test, Corneal stain) and those tests came out fine. She pushed both eyes and did not detect any mass behind her eyes. She gave a diagnosis of severe conjunctivitis and prescribed antibiotic drops. She also told us to follow up with our normal vet (or her office) within one week and to schedule an appointment with an ophthalmologist, though she did not say there was an emergency. The doctor also put her in an e-cone. The earliest ophthalmology appointment we were able to get was for April 11th..

Our cat struggled mightily against the application of the drops but we applied them that Wednesday, Thursday and Friday with no noticeable improvement. In fact, her condition worsened and more of the third eyelid became inflamed and continued to sort of bubble out of her eye. So we took her to her normal vet on Saturday. The vet repeated the same exams and reported that he did find it harder to push her left eye back compared to her right eye so he's worried there might be a mass. He also suggested administered a shot of Convenia and prescribed Terramycin ointment to be applied to the eyeball twice per day for a week. He told us to stop using the other drops (which were ofloxacin) and he suggested taking her out of the e-cone.

It's only been one day of course but we noticed that her eye has not improved at all since yesterday. In fact, her third eyelid is even more swollen than it was last week. I'm attaching photos showing the progression from last Tuesday through today. Her left eye is now almost completely covered by her swollen third eyelid, she's totally miserable and in obvious pain. She's still eating (though less than normal) and using her litter box. But she's not really playing and spends most of the day sleeping. We also found her hiding a few times, which is alarming for us.

Zora has never had an eye infection before and we've never seen anything like this, so I'm freaking out at this point and anxious about her losing her eyesight. The original eyedrops didn't work, though we only used them for two and a half days. The ointment seems to be a better approach because it's easier to apply -- but it hasn't made any improvement at all in the last day. Has anyone ever seen an eye condition like this before? I'm considering whether I should rush her back to the vet or an emergency animal hospital.. or give the ointment and convenia shot more time. How do we know if we're dealing with an eye emergency? And what do we do if we can't get an opthamology appointment anytime soon? We want to take her somewhere reputable and we're terrified of having to bring her to a 24/7 vet hospital in our neighborhood because almost all of them we can find have awful and alarming reviews.

Any suggestions would be deeply appreciated..
 

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LTS3

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Convenia is an antibiotic that has an effect that lasts at least 2 weeks and lasts in the body for at least 2 months. A vet would not give another injection just a week later.

I'd call the regular vet tomorrow for additional suggestions on what to do. Your vet can request a consult from a veterinary school or a vet hospital that has an ophthalmologist for more help until your appointment with the ophthalmologist on April 11.
 

fionasmom

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Since there is no improvement with two reliable eye medications, you might want to see if this might be considered enough of an emergency to bump up your appointment with the specialist. In most cases, a visible third eyelid does not mean something this extreme.

I am just going to put this out there so that you might feel a little better. Hopefully, Zora will not lose her eye; if it is necessary though, cats adjust extremely well to using one eye.

I agree that you try to contact the regular vet as well. Update him with her declining appetite and pain issue....back to my comment that maybe this is an emergency. If you need an ER for any reason, go. But an ER vet is more adept at doing just that and Zora's situation requires a lot more diagnosis.
 
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NYCatMom

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Convenia is an antibiotic that has an effect that lasts at least 2 weeks and lasts in the body for at least 2 months. A vet would not give another injection just a week later.

I'd call the regular vet tomorrow for additional suggestions on what to do. Your vet can request a consult from a veterinary school or a vet hospital that has an ophthalmologist for more help until your appointment with the ophthalmologist on April 11.
Thank you so much for your suggestions.. We'll update her regular vet tomorrow and send him the photo of her eye, which is already worse now (more protruding conjunctiva) than this morning. The good news is that I found another eye specialist that might be able to see her tomorrow.. I don't feel comfortable waiting until April 11th.
 
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NYCatMom

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Since there is no improvement with two reliable eye medications, you might want to see if this might be considered enough of an emergency to bump up your appointment with the specialist. In most cases, a visible third eyelid does not mean something this extreme.

I am just going to put this out there so that you might feel a little better. Hopefully, Zora will not lose her eye; if it is necessary though, cats adjust extremely well to using one eye.

I agree that you try to contact the regular vet as well. Update him with her declining appetite and pain issue....back to my comment that maybe this is an emergency. If you need an ER for any reason, go. But an ER vet is more adept at doing just that and Zora's situation requires a lot more diagnosis.
Thank you for this perspective.. I guess I'm worried that she'll either go blind or that the condition is something more sinister, like a cancerous mass behind the eye. But at this point we don't have a diagnosis or any certainty about what's going on so I'm assuming the worse. And you're right -- we hope truly she doesn't lose her eye but it's true that even if that case, she could adjust. I agree with you that this may be an emergency so I'm moving things around to see another eye specialist who might have an opening tomorrow. Waiting another two weeks for the original ophthalmologist appointment just doesn't feel tenable..
 
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NYCatMom

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Convenia is an antibiotic that has an effect that lasts at least 2 weeks and lasts in the body for at least 2 months. A vet would not give another injection just a week later.

I'd call the regular vet tomorrow for additional suggestions on what to do. Your vet can request a consult from a veterinary school or a vet hospital that has an ophthalmologist for more help until your appointment with the ophthalmologist on April 11.
Oh! And just to be clear - I wasn't suggesting that she go back to the vet for another shot of convenia.. I was trying to say that I wondered if we just need to give the antibiotics she's already taking more time to take effect. But the bottom line is that I think she has to see a specialist sooner rather than later.
 
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NYCatMom

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Please let us know what happens!
Here's our update.. we took her to an eye specialist yesterday. The ophthalmologist diagnosed her with chemosis but we still don't know the origin. She is treating it with more aggressive oral antibiotics as well as a low dose steroid. One of the big problems with Zora right now is that she cannot close her left eye at all due to the inflamed conjunctiva, so we were instructed to keep the part of her eye that's still visible covered with artificial tears or with Terramycin. The doctor also instructed us to increase her Terramycin from twice a day to 4-7 times per day. We have a follow up appointment with the eye specialist on Friday. Fingers crossed. We are desperately hoping that the swelling begins to go down and that we can save her left eye..
 
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NYCatMom

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Oh! She also now has an ulcer (because she can't close her eyelid) ...
 

fionasmom

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Try to remind yourself that you have been completely proactive for Zora and that you can only continue medications and doctor visits while you hope for the best. This certainly may heal, so try to remain optimistic. Definitely keep the eye moist as you have been instructed.

How is Zora taking all this handling of her eye? Did the doctor have any idea what might have prompted this in a cat who is well cared for and probably did not encounter some of the causes of this condition? You had mentioned that she felt poorly when this started.
 
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