Civvie question: Eye surgery for symblepharon and/or enucleation?

We have two new kitties that came in to rescue with essentially untreated eye infections, who became foster fails. FYI: We knew all of what you see below when we adopted them and agreed to adopt them now and take on all future care and expenses, none of it was unknown to us.

We are fortunate to have a dedicated animal ophthalmologist in town, who confirmed that all four of their eyeballs had ruptured in the past - one actually happened while we were fostering her, which is one of the most nauseating things I have ever seen, while the other 3 eyeballs happened at some point in their past. The rescue paid for this consult, and when we decided to adopt them after that visit since we then knew the scope of what was going on. The specialist confirmed that they are both totally blind in their right eyes, and depending on whether they give them trouble, they can either be left alone or removed - it remains to be seen. Right now their right eyeballs are just getting smaller and smaller, as they warned us would probably happen. Lily's as sunken in, it always has some discharge and you can barely see her right eyeball any more, so we might have hers removed. Chester's looks somewhat normal, but is also starting to shrink, so we will see. Both kitties have been fully treated with antibiotics and anti-inflammatories for multiple courses. Right now they are getting no medications.

But I'm here asking about their left eyeballs. They do have some level of vision in them, but it would look to you like their inner lids are "stuck" to their eyeballs. I thought originally that the lid just hadn't receded because of lingering infection, but apparently they truly are STUCK to the eyeballs. In all of the feline health issues we've dealt with, eyes haven't been one of them. This is called symblepharon, per VIN: "Symblepharon is the permanent adhesion of conjunctival surfaces following inflammation and ulceration in cat flu of young cats. It may occur in feral or poorly cared-for kittens and also in pedigree breeding households. Palpebral and bulbar conjunctiva, nictitating membrane and cornea may be involved in various combinations. Because the active inflammation has often subsided by the time the animal is homed the changes may be misinterpreted as congenital. The degree of the problem may vary from insignificant through to effective blindness and may also be very asymmetrical between the eyes. Correction is surgical but this is not straightforward. Each case requires individual assessment. Many cases are not suffering more than a cosmetic problem and should be left alone."

Their cases are not cosmetic, particularly the inner corner of their left eyes but also coming down from the top, the adhered conjunctiva is physically interfering with their sight. The specialist recommended surgery at 6-8 months to peel that conjunctiva off of their left eyeballs, because to do it now it could re-grow/re-adhere and require a second surgery later, which we certainly don't want.

Unless you knew that they were at least 50% blind, you would NEVER KNOW. They are both phenomenal, they get around fine with a bump on the noggin only every now and then when running at 135mph through the house, and they can't see things that are really close to their faces. We now have 5 oranges in the house (and our first ever orange girl). We fell in love with them while fostering, and once we knew we would likely be fostering them for many more months until their surgery, my husband (Sorry ladies - he's a keeper! ) is the one that actually suggested that we "pull the trigger" to adopt them after the visit with the specialist laid out the care plan, because we really wouldn't be able to let them go after many many months.

I'm just wondering if any of you have dealt with surgery for symblepharon before? If so, at what age did you have it done? What was the recovery like? Or does your cat have it and you decided not to proceed with surgery? And if you have dealt with eye enucleations, I assume that is a pretty straight forward recovery, but let me know if you have experience with that as well. Did you consider leaving the eye instead? We know that it is totally blind. Fortunately, the one thing that we do not have to worry about is that this specialist is top notch. Our own vet said that they are second to none and she refers all of her eye cases there. It isn't that I don't trust what they are saying, I am just looking for feedback from a parents' perspective. It sucks that we still can't go in to veterinarian's office with our babies, we are still under COVID curbside rules or I would have likely probed more of this with the specialist. I am hoping that by the time we go back for a visit before their surgery that we'll be able to go in to the office with them. I got to talk to the specialist by phone, but it just isn't the same...

Thanks for sharing any eye experiences that you have, and of course here is the picture of the brother and sister, Chester Cheetah is the mackerel tabby on the left, and Lily Pepper is the classic tabby with white on the right, looking like they had some sort of slow speed front-end collision on the sofa Picture of Lily's eyes included as a thumbnail since it looks a little icky to some.

 

Check out the Thor videos on this channel. Double enucleation. Recovery. And eventually adopted.
This video is post-surgery.

 

Thanks! Cats are just so resilient and amazing. Our Lily carries around a toy that is exactly like the one that Thor is carrying around

 

Sending love and healing vines... sigh

 

I have never had to deal with the eye conditions your cats have but if they have to have the eyes removed, they should be fine. A friend of mine runs a rescue and recently adopted out two older kittens born without eyes. The adopters posted a video of the two playing and you would never suspect they are blind. They are running around and jumping on things just as kittens and cats normally do. Your babies sound like they are adjusting well and would likely continue to do so if they lost all sight. Bless you for giving them a loving safe home.

 

Oh Sandi they are so precious.
Thank you for giving them such a loving home.
Your husband is a keeper for sure. Bless him too
Those poor kitties, it breaks my heart.
But like everyone has said they adapt.
Best of luck with them and please keep us posted

 

Sandi, you are such a sweetheart and these are 2 luck kittens.

 

Hi Sandi,

It's wonderful that you and your hubby are giving these little kittens a forever home. They are blessed to have you both. Your hubby is a star!

I can only offer some suggestions on recovery from enucleation:

- During the recovery period, watch for any puffiness or swelling around the eyelids/eye socket area and ask the vet about a course of antibiotics if you observe any such signs.

- Make sure that any antibiotics prescribed are given for long enough.

- While the eye area is healing, it is extremely difficult to give medications in pill form, e.g. antibiotics following surgery. (I really wish I'd had advanced warning of this, so I hope this might help you.) I managed to get liquid versions of Saoirse's meds (would have been screwed without these). If your little ones are prescribed any human meds your local pharmacy may be able to help with this. If amoxycillin is prescribed it can be given as an injectable. For the version my vet uses, each injected dose provides cover for 3 days - much, much more comfortable for the kitty than trying administer orally when its poor little face is sore.

- It can be uncomfortable to eat during the recovery period. Adding water to make the food a soupy consistency can help with this, and also helps to keep your little ones hydrated. Watch out for any possible inflammation of the roof of the mouth.

- If supervising feeding, it can help to put food on a saucer or plate. I used a spatula to keep the food in one spot as Saoirse was eating so as to avoid her getting food onto the surgery site.

- When kitties need to eat unsupervised, an elevated bowl like the one below is easier for a kitty to negotiate if it is wearing a Cone of Shame:





- Watch out for any constipation issues because, in addition to the inherent discomfort, they can make a kitty not want to eat (and anti-nausea treatments don't tend to work until the constipation is addressed). If you do have any issues in that department, ask your vet about treating for a couple of days with metoclopramide (Reglan). It helps restore normal gut motility. Adding a smidgen of pure pumpkin or psyllium husk to food can help keep a kitty regular thereafter. If that's not adequate, a stool softener may help. More info at felineconstipation.org. Get your vet to check your little ones first before starting any preventative measures (to make sure there's no obstruction in the gut).

- While the eye area is healing you may want to restrict the movement of your little ones, particularly when you don't need the Cone of Shame all the time but it's not yet quite safe for them to move around the house freely. If you have the space I can't recommend a kitty hotel highly enough (see below). No sharp prongs or rough edges to catch the eye area on.






You can find the kitty hotels at reasonable prices on eBay or Amazon, and they come in different sizes.

As you can see from the picture, I put the elevated ceramic bowl into the stand for Saoirse's regular bowls to keep it upright just in case the edge of her Cone of Shame pushed against it.

Another helpful addition to the kitty hotel is a flat sissal mat to provide a nice surface for scratching:




I hope some of the above is helpful to you, and I wish your new furbabies a long and happy life with the two of you.




Mogs
.

 

My Badger had his left eye enucleated 13 days ago. here is photo when he came home after surgery.

His eye was removed since it was permanently blind due to glaucoma and there were freckles in the iris of both eyes indicating possible melanoma. He is 13 and I only had a cone on hime over the first night. He never scratched it so no reason to the cone. The first couple of days were rough but he has recovered nicely but his BGs are still high. The biopsy showed diffuse iris melanoma and I have appointment with oncologist tomorrow for how to proceed.

 

Fingers and paws crossed for tomorrow, Larry.

(((Badger)))


Mogs
.

 

@Critter Mom : Thank you very much for all the suggestions -- yes I had not considered that giving pills would be difficult, but you are right, the mechanics of it could prove difficult! Noted. We have that exact cat playpen in our Hurricane Evacuation kit, but had not even thought about using it during their recovery - excellent suggestion. We already use elevated bowls for everyone due to having elderly cats, and all wet food is already given at 50/50 food/water for everyone so fortunately they are used to that and that should help if any pain medication, or anything else, causes constipation. As always, your experiences are very valuable, and glad that you are able to be around more recently to share with others even though I know you have health issues of your own

@Larry and Kitties : Thank you, we will definitely be prepared for a rough couple of days. It is information exactly like this that I was looking for, and information that you don't always get from a vet, even if you can go in with your cat and ask questions more easily. These little tikes bounced out of their spay/neuter with nary a hiccup and didn't need cones at all, so I am hoping that bodes well for their recovery from their eye surgeries as well. Your experience certainly makes me think more, though, about whether we should just push for enucleation for both kitties. I expect that melanoma of the eye is not common, but if they are totally blind in those eyes anyway... I wonder if we should just take their right eyes out. You can't have a problem without that eye. Cost is not a deciding factor -- they quoted us a cost is per patient, not per eye, so the cost will be the same with symblepharon surgery on the left eye with or without enucleation on the right eye.

Thanks for the well wishes everyone, we feel very lucky to have these two. Little Lily is SO sweet, and Chester is just a little character. They've fit in perfectly with our ever growing clowder that numbers 9 now I'll let everyone know later this year how they are getting on after their surgery. As long as they are having no immediate issues with their eyes, we are probably going to try to get it done closer to the end of the year to guarantee that we only have to have the symblepharon surgery done once.

Be well everyone!

 

Love to hear how happy they are. you and hubby truly blessed When I come back as a kitty can I live with you???

 

My newest little babies (I call them the "tangerines" because they are our smallest oranges ) are now 6.5 months, and little Lily just started having a lot of crusty discharge from her right eye 2 weeks ago, so they both had a re-check appointment with the ophthalmologist today to set a plan.

Two months ago we thought it was inevitable that both kittens would have their right eyes removed and sewn shut, and symblepharon surgery to remove the adhered conjunctival tissue from their left eyes. And Lily is, she is now scheduled for exactly that on November 11th.

But the Doctor said that Chester's had progressed differently from hers after his rupture, which we could mostly tell just based on appearance. You can't even see her actual right eyeball at all, he confirmed that it shrunk and the tissues just folded in onto her eye so that pink tissue is basically all that you see, and on her left it looks like a semi-translucent film is now over her entire eye. You can see Chester's right eyeball just fine even though he is blind in it, it is just smaller size than normal and has the same film on most of it (and he has no sight in that eye). But on Chester's left eye, it is only about 20% covered with that film on mostly the inner corner. So the doctor recommended to wait and see with Chester. If his blind right eye stays stable and doesn't need to be removed, then he also didn't feel that the minimal increase in vision on his left was worth it.

But for Lily it should be night-and-day improvement in the vision in her left eye, and she should be far more comfortable with the right eye removed too. We are prepared to to set up her little Princess Playpen in our bedroom as Mogs suggested to keep anyone from rough-housing with her during her recovery, and we are actually excited to move forward with it to get her feeling and seeing better.

I'll update this post again after surgery on the 11th. Thanks all for your advice thus far!

 

Lil darlins

 

Sandi,
Your kitty's are having so many problems, I am so sorry. I have not been on the board for a while because of a lot of health issues here at home. How is Whisper doing. My kitty Kit Kat quit peeing and I was scared to death, he was at the vet several times and we found out he hurt his back and was afraid to get in position to pee because it hurt his back. The vet is giving him steroid injection's to make him feel better.
Hope things are going better with your kitty's and Whisper's steroid injections are still helping.