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6 yr old cat had right eye pupil not the same size as other…

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6 yr old cat...

6 yr old cat had right eye pupil not the same size as other n additional eyelid partially down (vet stated due to pain). This went on for 4 wks with antibiotics. Vet did further exam. Stated teeth needed to be extracted 4 on same side. Also clear drainage was present in the same eye. One day after extractions added sneezing; was on more antibiotics after surgery. Today is day 11...still sneezing a little, still swollen side of face, along with eye drainage, pupil different shape still not back to normal, eating so-so, eliminating fine. Vet stated prior to surgery no injury to her eye, should be teeth as the culprit. After surgery stated swelling should go down along with eye going back to normal, if not cancer though she did not find anything suspicious. Any thoughts? Most appreciated

Veterinarian's Assistant: I'll do all I can to help. What is the cat's name?

Ms Kitty

Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about the kitten?

No, she is 5-6 yrs of age We rescued from pound 4 yrs ago. Eats only dry food

Submitted: 6 months ago.Category: Cat Veterinary
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Answered in 24 minutes by:
12/29/2017
Cat Veterinarian: Scott Perry, Cat Veterinarian replied 6 months ago
Scott Perry
Scott Perry, Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 3,272
Experience: DVM
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Hello. My name is***** and I am a veterinarian that can answer your question. I understand Ms Kitty has a history of having a different sized pupil, clear discharge from one of the eyes, and facial swelling on the same side as the eye. Antibiotics did not resolve the issue. After 4 teeth were extracted then sneezing was observed. I am sorry to hear about this continuing problem you are experiencing. Can you please tell me if any diagnostic tests were performed such as blood work or x-rays of the skull or x-rays of the teeth in question?

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Customer reply replied 6 months ago
Only blood work presurgery. Originally took to vet due to clear discharge 3rd eyelid down. Was no swelling presurgery or sneezing eye had drops put in to relax eye for eye exam on first vet visit. Exam showed no damage or scratches to eye. Given antibiotic clavamox and eye med neomycin with Dex. No improvement. Took back to vet who stated 4 teeth need to be removed. Should clear the eye problem no suspicious tissue observed during surgery. Vet stated if this did not work she has cancer. Still on both meds day -11 with no improvement
Cat Veterinarian: Scott Perry, Cat Veterinarian replied 6 months ago

Thank you for taking me through that progression. Let's start at the beginning. Clear discharge in the eye and the third eyelid being exposed indicates some degree of inflammation in that eye. This can be caused by allergies, foreign material, scratched cornea, or an infection. Feline herpesvirus is a very big differential for eye inflammation. Steroid therapy (i.e. dexamethasone) can actually make this condition worse. However, the herpesvirus should not cause much swelling around the eye unless it is limited to the conjunctiva of the eye.

A swelling if present directly underneath the eye would indicate bone inflammation. The bone can be inflamed from a tooth abscess, but hopefully that would have been determined with dental x-rays at the time of the procedure. If no abscess was found then skull x-rays would evaluate the structure of the bone. The top differentials in this case would be cancer or a fungal infection (unlikely if she is an indoor cat). If the bone looks suspicious then a biopsy will give a diagnosis. The order of this can be flipped and the x-rays of the skull can be taken first, but they do not evaluate well for a tooth abscess.

If the swelling is NOT part of the bone and is part of the skin or connective tissue then an infection becomes a top differential. A cytology may be helpful in determining the bacteria in question, but this sometimes gives a false negative result if antibiotics have been given beforehand. It really sounds like information of what is causing the swelling is necessary. If it is the bone then cancer is a good differential as well as a fungal organism.

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