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I have a 14 year old cat, Max, who has CKD. We found out he…

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I have a 14 year...
I have a 14 year old cat, Max, who has CKD. We found out he had CKD because he got very stressed out one day. His blood pressure spiked and pressure built up in his eye. The eye turned extremely red. We took him to the vet who diagnosed the high blood pressure secondary to CKD. Unfortunately he permanently lost vision in his left eye. The vet started him on Amlodipine. This was a year and a half ago. His original dose was .25 ml am and pm. This was bumped up to .5 in the am and .25 in the pm. The last time his blood pressure was measured was about three weeks ago. It was 140.
Yesterday, I noticed that something seemed "off" about Max. He seemed reticent in walking around the house and he bumped into a few things. We're in the process of moving, so there are boxes around and many more objects than normally on the floor. He didn't have a full on collision with anything, but there were a couple of close calls. His good eye isn't red at all. It appears normal. It seems as though he's lost all vision in both eyes, or he's become very near-sighted in his remaining eye. If he has lost vision in his other eye, it happened suddenly. A couple of days ago he was moving around the house (and around objects) easily. What could have caused this? His blood pressure appears to be well controlled. Is it possible his vision has been gradually declining and has now come to a head?
Submitted: 3 years ago.Category: Pet
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Answered in 14 minutes by:
11/19/2014
Pet Specialist: Dr. B., Veterinarian replied 3 years ago
Dr. B.
Dr. B., Veterinarian
Category: Pet
Satisfied Customers: 22,830
Experience: I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

Now based on his current signs, we have 2 concerns. The first is that his current sight deterioration could be due to the progressive old age change of the lens known as lenticular sclerosis. This is a normal old age change where the lens becomes clouded and over time leads to reduced sight clarity and then reduced vision over time.

That said, our other concern (and the top suspect given the sudden change in his coping with the altered layout in the house) is the potential for partial or total retinal detachment in the good eye. This can be related to spikes in blood pressure as well. And while last time he either had an ocular bleed or increased intraocular pressure that caused that redness, this isn't always necessarily seen. So, it is quite possible for the retina to detach from the back of the eye without appreciable visible changes for you to see.

Therefore, in this case, I'd be most concerned that the sudden appearance of sight deterioration is due to the retina becoming partially or completely detached. Therefore, in this case even though he was recently seen, it would be best to revisit his vet urgently. They can double check that the blood pressure hasn't spiked again and examine the eye to make sure there are no other issues (ie changes to the retinal blood vessels, inflammation, intra ocular disease, tumors, etc). If we act quickly, we can help regain sight in some cases. That said, if the retina has been fully detached for an extended period, we often cannot regain sight even if we treat the underlying issue.

Overall, I suspect he hasn't had any severe collisions because he is using his whiskers, his knowledge of the current floor lay out, and caution to avoid doing so. But even though he isn't totally lost, his signs are highly suspect for detachment of his retina. Therefore, it would be best to have his eyes checked urgently here. If the lens are just becoming hazy, his vets can confirm that. Otherwise, they can perform an ocular examination to tell you if the retina is damaged or detached and whether there is anything else in the eye causing this.

I hope this information is helpful.

If you need any additional information, do not hesitate to ask!

All the best,

Dr. B.

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