Anyone heard of nictating lids not retracting in diabetic cat?

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Martha and Lolly (GA)

Martha and Lolly (GA)

Member Since 2015
Hi,

Three days ago, Lolly, my diet regulated diabetic, started showing her nictating membranes in her eyes. They just don't retract all the way, some of the time. She'll look up at me, and there they are, covering 1/4 of her eyes.

She has had occasional slightly gunky discharge from one eye, and she squints a little from that eye, but the vet ruled out any infection. Everything is white or healthy pink in both eyes. I've put systane eye drops (saline only, no preservatives) in.

Any ideas why this would start, except for infection?

Thanks
 
Bandit is cross-eyed (if you can't tell from his picture), and I've noticed when his BG is higher (above 300), his eyes cross a little more than usual and his membranes will come out a bit in the corners of his eyes. This is normal for him, and usually it will last a few hours and then his eyes will go back to normal, and start up again when his BG peaks. I don't know if this is unusual for a cat, and Bandit was already cross-eyed to begin with so his eyes already aren't 100% normal, but that has been my experience.

Also, his eyes would do it on occasion when he was in remission, but not nearly as much as when his BG is high. Maybe I'd notice it once a week or so instead of every day. He's always had mildly gunky eyes, too.
 
Oh, and FVR can also cause those sorts of symptons, and it is SUPER common in cats. If they weren't vaccinated for it it's something they can get as kittens and it lies dormant and can flare up any time in their lives due to stress. http://pets.webmd.com/cats/feline-herpes-symptoms-treatment. My other cat that I just adopted from the SPCA had it and it went away after about a month. It caused the same thing--gunky eyes and nose, and slight showing of the membranes at times. And lots of sneezing.
 
I'm afraid the inner eyelids drooping is a non-specific thing in a cat that says, "I'm not well. Something is wrong.". Right after I euthanized Mr. Bill, Mr. Sluggo's buddy due to a large cell lymphoma of his liver (I'd mised a 1.5 lb weight loss in Bill... he was building up ascites), the first thing I did was buy a pediatric scale and weigh both my remaining kitties. Two weeks later, I weighed them again & Mr. Sluggo (in the picture) had dropped 3/4 lb. I took him to the vet right away. She checked him out, did an abdominal flat plate and full set of labs (because I insisted) and said she could find nothing wrong. She suggested I just keep an eye on him. Two weeks later, he had dropped another 1/2 lb and at that point his inner lids came down. I took him back to the local vet & she said, "something's clearly wrong, but I don't know what...". She then referred me to the cat specialist 250 miles away. He did an abdominal ultrasound showing a thickened small bowel and took him in for an exploratory laparotomy that very day. Pathology came back suspicious for small cell lymphoma of the bowel, but clonality of B and T-cells was negative. Long story short, he got chemo, which didn't help him at all (got worse) and he got better on a small dose of flagyl, ate well and put on weight for the first time. At that point, his ultrasound showed the bowel thickening to be worse, so the cat specialist offered a cut-rate on a second exp. lap which I jumped at. It showed only very mild inflammation (possibly within normal limits) and moderate fibrosis (which was probably the bowel wall thickening at that point). He's alive today & doing well. I suspect his dx was actually severe ibd (can be hard to tell from lymphoma sometimes). My new smarter local vet took one look at him 16 months after diagnosis (he's quite overweight and out of remission on his diabetes) and said, "he doesn't have lymphoma".

Long story. But sluggo is a diabetic kitty also, though he was in remission from his diabetes at the time this was all going on. Your cat is sick. I'm not saying it is or isn't lymphoma or ibd or anything else. It could really be just about anything. I would not make the mistake of automatically ascribing it to the diabetes. It could well be something else. Get your cat to a good vet asap if you love him/her.

Good luck.
 
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Oh no-- how do I find a better vet? The vet was totally unconcerned about the eyes, as long as discharge was clear.

I should mention that at the same time, Lolly was dxd for hard stools with liquid coming out around them. She also had impacted anal glands. The vet expressed the glands, and luckily she passed the stool, The vet prescribed flagyl for a week, an advised pumpkin or miralax. She detects the miralax and won't eat it. I'm going to try the pumpkin. If that doesn't work, should I syringe feed it to her? She's had two doses of flagyl and has developed bad gas. Can I wait to see if the flagella clears up the eyes/inflamed bowel- or is this an emergency? I just spent $900 on her brother, a teeth cleaning/extraction and ultrasound because he was losing weight. He is scheduled for another ultrasound because they found a small kidney stone (nothing else thank god). I'm already doing this on credit. Can I wait on Mickey's ultrasound or Lolly?
 
Martha and Lolly said:
Oh no-- how do I find a better vet? The vet was totally unconcerned about the eyes, as long as discharge was clear.

I should mention that at the same time, Lolly was dxd for hard stools with liquid coming out around them. She also had impacted anal glands. The vet expressed the glands, and luckily she passed the stool, The vet prescribed flagyl for a week, an advised pumpkin or miralax. She detects the miralax and won't eat it. I'm going to try the pumpkin. If that doesn't work, should I syringe feed it to her? She's had two doses of flagyl and has developed bad gas. Can I wait to see if the flagella clears up the eyes/inflamed bowel- or is this an emergency? I just spent $900 on her brother, a teeth cleaning/extraction and ultrasound because he was losing weight. He is scheduled for another ultrasound because they found a small kidney stone (nothing else thank god). I'm already doing this on credit. Can I wait on Mickey's ultrasound or Lolly?
Click to expand...

I'm sorry. I'm not a vet. I don't even play one on tv. I am a human doctor (board certified anesthesiologist). And as I said, the lid going down like that is non-specific. About all I can say for certain is that your cat is sick. In my case, that was the finding that convinced my not particularly skilled vet who at least wasn't a fool (recognized her limitations) that I needed to go to somebody with better skills. Vets are very non-uniform in their skill sets. The worst are the unskilled ones who don't know it. Then you find the ones that are unskilled and know it. A few are very, very good. Your best shot would be getting your cat to a cat specialist. I'm lucky in that about a 4 hour drive from here, I have the guy who writes the texts other vets use. And he is, indeed, very very good.

Gary Norsworthy Bio

It doesn't cost any more to go see him, but it takes time to get there, stay there, etc. Your cat needs a diagnostic work-up. Whether it needs to happen immediately or not, I really can't say. I'm sorry. I can say with certainty your cat is sick, it's dangerous to ascribe it to the diabetes, and if she's in remission, it's unlikely that's the problem. I really can't tell you more.
 
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Check my signature link Vet Interview Topics if you need to go searching.
Eye infections, respiratory infections, etc. may cause the inner eyelid to not close completely. Your current vet has you on watchful waiting, so documenting what you observe each day may be helpful in the next vet visit. Monitor redness, degree of closure, discharge amount and color. Note any other respiratory symptoms - sneezing, coughing, wheezing, respiration rate, evenness, and depth.
 
Well, I spoke to another vet over the phone- this vet successfully treated one of my cats for weight loss and kidney stones. He has taken a conservative diet based approach with regular ultrasound monitoring that is working. He does not seem to think the membranes showing are a problem, he is suggesting I try zyrtec in case it is a pollen allergy. I will say the pollen count has been horrendous this year, but its never been a problem before, and I live in the Delaware Valley, a high allergy area. I don't think that's the problem. I could also take her to the University of Pennsylvania vet hospital, a two hour drive (and $$$). Even then, I may get a grad student. Feeling very indecisive and worried right now.

Lolly seems fine otherwise; but Sat makes one week since I noticed it, and I think its a little bit worse.
 
Forgot to add - I see no redness. A very little clear discharge which I've been wiping away. She does squint out of the right eye sometimes, not always.
 
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