All the Better to See You With

D. E. Larsen, DVM

RC was a big orange tabby cat. I had first treated RC for a severe fracture of a hind leg when he fell from a tree. Repair of that fracture required a pin and many wires, plus four weeks of cage rest. He was a friendly cat but displayed utter self-confidence when he was in the clinic.

He sat upon the exam table, watching for me to come through the door when I entered the room. 

“My, what an ugly eye,” I said. RC’s right eyeball was swollen and bulging out from under his eyelids.

“I noticed this a little bit yesterday, and then this morning it was like this,” Nancy said. “It is painful if I try to touch it, but he seems to tolerate it well when he is left alone.”

“This is an advanced case of glaucoma,” I said. “It is a little unusual to see this occur with no prior warning.”

“Do we have any treatment options?” Nancy asked.

“We have a couple of options with an eye like this,” I said. “We can go to Corvallis to see the veterinary ophthalmologist, or we can remove the eye.”

“What is the ophthalmologist going to do,” Nancy asked.

“There are a couple of surgeries that can be done to save the eyeball, and maybe its vision,” I said. “However, with an eye that looks like this, the vision is probably already lost. She can also offer evisceration and implantation of a silicone prosthesis instead of removal of the eyeball. Some people think that gives a better cosmetic appearance. A blank, nonfunctional eyeball remains.”

“And what do we have when you remove the eye?” Nancy asked. “He will still have one eye, so I guess it won’t change his vision much.”

“I remove the eye and all the associated structures, including the eyelid margins,” I said. “When things are healed, we have a blank slate. If I do it right, that side of the face is smooth. If there is not enough dense tissue to close over the eye socket, there may be a little caved in appearance over the socket. Most cats get along fine with one eye.”

“I think that we will just have you take the eye out here,” Nancy said.

With that decided, we removed RC’s right eye. Dr. Maxwell had recommended that I submit that eye for a pathologist to look at. She thought it was unusual for such a sudden onset of advanced glaucoma.

I had the results from the pathologist when Nancy returned with RC for suture removal.

“He is absolutely normal,” Nancy said. “He does everything he did with two eyes. He still climbs his tree and everything.”

“I am not sure that he has always climbed that tree too well,” I said with a chuckle. “The pathology report says he had an autoimmune problem in his eye. They say there is a possibility that he may develop the same problem in his left eye.”

“I guess we will cross that bridge when it happens,” Nancy said.

In the following years, RC seemed to have more issues than I would expect to see in a middle-aged cat. But everything was manageable, and he was not bothered by the loss of his right eye.

It was almost 3 years to the day that Nancy rushed RC through the door. His remaining left eye had literally exploded overnight.

“He seemed fine last night,” Nancy said as she caught her breath. “Then I looked at him early this morning, and I could see that his eye was getting big like his other eye. A few hours later, I look, and this is what we have.”

“It looks like we have crossed that bridge you mentioned years ago,” I said. “This eye is going have to come out, there is no saving it now.”

“Oh my! How will he get along, being totally blind?” Nancy asked.

“To be honest with you, I haven’t had too many patients who were totally blind,” I said. “I did have a client with a calf that was born blind. It had no functional eyes. It did just fine. It knew the pastures, knew where the feed rack was and where the water was. It could go in and out of the barn as long as it was with another animal or two. That calf grew up and had several calves, all born with normal vision.”

“RC is so active, it will break his heart if he can’t go out in the yard and climb his tree,” Nancy said.

“I was at a veterinary conference several years ago,” I said. “One of the speakers was a veterinary ophthalmologist. He told the story of his cat, who, it turned out, was totally blind. He said they had dinner guests at the house one night, and the guy noticed that the cat was blind. The doctor had no clue. That cat had lived in the house for several years, and the ophthalmologist had not noticed that it was blind.”

“Okay, let’s get it done,” Nancy said.

The surgery was done, and RC went home with a blank slate for a face. It was a little eerie when he came back for suture removal. Sitting up on the exam table like he always did, he followed my every move with his ‘blank slate.’ Just like he was watching me.

“He is outside playing in the yard, just like he has always done,” Nancy said. “Yesterday, he was even climbing his tree. We are so pleased that we didn’t make the decision to put him to sleep.”

RC lived an almost normal life. As he aged, like many cats, he had his share of problems. Whenever RC was on the exam table, he ‘watched’ every movement I made. When he was in the clinic for hospital treatment, he would sit in his kennel and ‘watch’ everyone in the room.

RC lived to a couple of months short of his 18th birthday and died of chronic kidney disease. Chronic kidney disease is the number one killer of cats over 14 years of age. In those years, a male cat, neutered or not, was most unusual living to the age of 18.

Photo by EVG Culture from Pexels