Medical management of deep ulcerative keratitis in cats

13 cases

Michelle G. Martin de Bustamante, Kathryn G Koehler, Brian C Leonard, Steven R Hollingsworth, Sydney G. Edwards, Kelly E. Knickelbein, Ann E. Cooper, Sara M Thomasy, David J Maggs

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Case series summary: Described are 13 cats diagnosed with deep ulcerative keratitis and successfully managed medically without grafting procedures. Typical treatment involved frequent topical application of serum and antibiotics (usually a fluoroquinolone and a cephalosporin). Seven cats also received systemic antibiotics. Analgesia was achieved using various combinations of topical atropine and systemic buprenorphine, robenacoxib or corticosteroids. Six cats were hospitalized for a median (range) period of 2.5 (1–8) days, typically because of frequent medication administration. Median (range) follow-up time was 41.5 (9–103) days. Median (range) number of recheck examinations was 4 (2–6). Median (range) time to corneal re-epithelialization was 21 (9–103) days. Median (range) topical antibiotic course was 29.5 (16–103) days. Median (range) duration of Elizabethan collar use was 28 (13–73) days. At the time of writing, no further recheck examinations were recommended for 10 cats; median (range) time between initial to final examinations in these cats was 35 (20–103) days. All cats retained the affected globes and were apparently comfortable and visual at the latest recheck examination. Relevance and novel information: These cases reveal that aggressive medical management is highly successful in select cats with deep ulcerative keratitis, and can result in a cosmetically acceptable, apparently comfortable and visual globe. However, therapy is intensive with frequent administration of multiple topical and sometimes systemic medications, and requires multiple veterinary visits over many weeks. Referral to a veterinary ophthalmologist for consideration of surgical stabilization is recommended, as not all cases may be amenable to the medical therapy described here.

Original languageEnglish (US)
JournalJournal of Feline Medicine and Surgery
DOIs
StateAccepted/In press - May 1 2018

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Corneal Ulcer
keratitis
Cats
cats
antibiotics
Anti-Bacterial Agents
drug therapy
Re-Epithelialization
buprenorphine
Topical Administration
Buprenorphine
cephalosporins
therapeutics
fluoroquinolones
Fluoroquinolones
atropine
topical application
adrenal cortex hormones
Cephalosporins
collars

ASJC Scopus subject areas

  • Small Animals

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Medical management of deep ulcerative keratitis in cats : 13 cases. / Martin de Bustamante, Michelle G.; Koehler, Kathryn G; Leonard, Brian C; Hollingsworth, Steven R; Edwards, Sydney G.; Knickelbein, Kelly E.; Cooper, Ann E.; Thomasy, Sara M; Maggs, David J.

In: Journal of Feline Medicine and Surgery, 01.05.2018.

Research output: Contribution to journalArticle

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abstract = "Case series summary: Described are 13 cats diagnosed with deep ulcerative keratitis and successfully managed medically without grafting procedures. Typical treatment involved frequent topical application of serum and antibiotics (usually a fluoroquinolone and a cephalosporin). Seven cats also received systemic antibiotics. Analgesia was achieved using various combinations of topical atropine and systemic buprenorphine, robenacoxib or corticosteroids. Six cats were hospitalized for a median (range) period of 2.5 (1–8) days, typically because of frequent medication administration. Median (range) follow-up time was 41.5 (9–103) days. Median (range) number of recheck examinations was 4 (2–6). Median (range) time to corneal re-epithelialization was 21 (9–103) days. Median (range) topical antibiotic course was 29.5 (16–103) days. Median (range) duration of Elizabethan collar use was 28 (13–73) days. At the time of writing, no further recheck examinations were recommended for 10 cats; median (range) time between initial to final examinations in these cats was 35 (20–103) days. All cats retained the affected globes and were apparently comfortable and visual at the latest recheck examination. Relevance and novel information: These cases reveal that aggressive medical management is highly successful in select cats with deep ulcerative keratitis, and can result in a cosmetically acceptable, apparently comfortable and visual globe. However, therapy is intensive with frequent administration of multiple topical and sometimes systemic medications, and requires multiple veterinary visits over many weeks. Referral to a veterinary ophthalmologist for consideration of surgical stabilization is recommended, as not all cases may be amenable to the medical therapy described here.",
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