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Case #10

Case of the Week 5/1/18:  12y MN DSH

CC:

Urinating outside of box, update vaccines

History:

Owner got cat from his dad about 3 years ago.  Was indoor/outdoor, but about 2 months ago, O stopped letting him go outside.  Since that time, he has been urinating on his own blanket and bed.

  • Large volumes of urine, normal frequency, no straining

Vacc Status:

O not sure, thinks last vaccinated at least 5 years ago

PE:

BAR      T: 101.6       HR: 124        RR 16      Gums pink/moist       

  • Right eye (OD) is squinted, has an enlarged pupil, cataract present
  • Left eye (OS) normal

Diagnostics:

  • Urinalysis:
    • Dipstick: Moderate + blood, large +++ leukocytes
    • Cytology: No RBCs, WBCs, casts or crystals seen
  • Schirmer tear test: 20 OU
  • Fluoroscein stain: negative OU
  • Intraocular pressure
    • OD: ave 41
    • OS: ave 23  
  • FeLV/FIV test: neg/neg
  • HWT: neg

Inappropriate urination

  • No medical reason found at this time
  • Discussed Feliway with owner, but he said he has tried it, opted to try medical therapy
  • TGH on Clomicalm

Glaucoma

  •  An increase in intraocular pressure incompatible with the health of the eye
  • OUTFLOW problem
    • Ciliary body produces aqueous, which travels from the posterior chamber to the anterior chamber and then leaves the eye via the iridocorneal angle and is absorbed into systemic circulation
  • Consequences:
    • PAIN
    • Negatively effects optic nerve, iris, and cornea
      • Can lead to permanent vision loss 
  • Treatment:
    • Latanoprost OD BID

Follow up:

Recheck 2 weeks later

  • Intraocular pressure hasn’t improved, but he also hasn’t been getting his Latanoprost for the last 2 days
  • Discuss ongoing therapy v enucleation with owner, he elects to continue trying Latanoprost, but if pressures haven’t improved at recheck, we will recommend enucleation
  • No recurrence of inappropriate urination
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Tennessee Avenue Animal Hospital

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