Feline Ocular Diseases: Common Conditions and Treatment
Veterinarians examining cats with ocular signs must differentiate between primary eye diseases and manifestations of systemic infections. Feline conjunctivitis, keratitis, glaucoma, and uveitis each require distinct diagnostic approaches and management strategies. This article reviews clinical presentation, diagnostic tests including Schirmer tear test, fluorescein staining, and tonometry, and medical or surgical treatment options for common feline eye disorders. The goal is to provide a practical framework for diagnosis, treatment, and escalation to specialist care.
At a Glance: Key Features of Common Feline Ocular Diseases
| Condition | Typical Presentation | Key Diagnostic Test | Common Etiology |
|---|---|---|---|
| Conjunctivitis | Ocular discharge, conjunctival hyperemia, chemosis | Conjunctival cytology, PCR for feline herpesvirus | Feline herpesvirus type 1 (FHV-1), Chlamydia felis, Mycoplasma spp. |
| Keratitis | Corneal edema, vascularization, ulceration | Fluorescein staining, slit-lamp examination | FHV-1, corneal trauma, eosinophilic keratitis |
| Glaucoma | Buphthalmos, mydriasis, corneal edema, vision loss | Tonometry (intraocular pressure >25 mmHg) | Primary (rare in cats), secondary to uveitis or neoplasia |
| Uveitis | Miosis, aqueous flare, hyphema, hypotony | Ophthalmic examination, systemic workup | Feline infectious peritonitis (FIP), toxoplasmosis, feline leukemia virus (FeLV), trauma |
Conjunctivitis in Cats
Clinical Presentation and Etiology
Feline conjunctivitis presents with ocular discharge that may be serous, mucoid, or purulent, along with conjunctival hyperemia and chemosis. The condition is frequently bilateral but can be unilateral. Feline herpesvirus type 1 is the most common infectious cause, followed by Chlamydia felis and Mycoplasma species. The Ocular manifestations of feline viral diseases review notes that FHV-1 is a primary pathogen in feline conjunctivitis and keratitis. The Feline herpesvirus infection ABCD guidelines on prevention and management provide recommendations for diagnosis and control of this infection.
Diagnostic Approach
Conjunctival cytology can help identify intracytoplasmic inclusions suggestive of Chlamydia felis or neutrophilic inflammation. Polymerase chain reaction (PCR) testing on conjunctival swabs is the most sensitive method for detecting FHV-1, C. felis, and Mycoplasma species. The Merck Veterinary Manual provides general guidance on feline eye disorders and diagnostic approaches.
Treatment Considerations
Topical antiviral therapy with cidofovir or famciclovir is used for FHV-1 conjunctivitis. Topical tetracycline antibiotics (oxytetracycline) are effective against C. felis. Supportive care includes lubricating eye drops and cleaning ocular discharge. Systemic antibiotics may be indicated for severe or refractory cases. The ABCD guidelines on prevention and management of feline herpesvirus infection emphasize that stress reduction and management of concurrent disease are important for controlling recurrences.
When to Escalate to a Specialist
Referral to a veterinary ophthalmologist is indicated when conjunctivitis does not respond to initial therapy within 7 to 14 days, when corneal involvement is suspected, or when the cat shows signs of pain such as blepharospasm or photophobia.
Keratitis in Cats
Types and Clinical Signs
Feline keratitis includes ulcerative keratitis, eosinophilic keratitis, and stromal keratitis. Ulcerative keratitis presents with corneal epithelial defects that stain positive with fluorescein. Eosinophilic keratitis is characterized by raised, white to pink corneal plaques with vascularization. The Feline ocular emergencies review provides context on acute corneal conditions requiring urgent attention.
Diagnostic Tests
Fluorescein staining is essential to identify corneal ulcers and assess their depth. Slit-lamp examination allows evaluation of corneal layers. Corneal cytology can differentiate eosinophilic keratitis from other forms. Schirmer tear test should be performed to rule out keratoconjunctivitis sicca.
Medical Management
Ulcerative keratitis requires topical broad-spectrum antibiotics to prevent secondary bacterial infection. Eosinophilic keratitis responds to topical corticosteroids or cyclosporine, but corticosteroids are contraindicated in the presence of corneal ulceration. Topical antiviral therapy is indicated when FHV-1 is suspected as the underlying cause.
Surgical Options
Deep or perforating corneal ulcers may require conjunctival grafts or corneal sutures. Indolent ulcers that fail to heal with medical therapy may benefit from grid keratotomy or superficial keratectomy.
Monitoring and Follow-up
Recheck examinations should occur every 3 to 7 days for ulcerative keratitis until the cornea is healed. Eosinophilic keratitis often requires long-term topical therapy and periodic rechecks to assess disease activity.
Glaucoma in Cats
Pathophysiology and Classification
Feline glaucoma is most commonly secondary to uveitis, intraocular neoplasia, or lens luxation. Primary glaucoma is rare in cats. Increased intraocular pressure (IOP) leads to optic nerve damage and vision loss. The Merck Veterinary Manual provides information on glaucoma diagnosis and management.
Clinical Signs
Cats with glaucoma may show buphthalmos, mydriasis, corneal edema, and vision loss. Acute glaucoma can cause pain manifested as blepharospasm, epiphora, and behavioral changes. Chronic glaucoma may be less painful but results in irreversible vision loss.
Diagnostic Confirmation
Tonometry is essential for diagnosis. Normal IOP in cats ranges from 10 to 25 mmHg. Values above 25 mmHg are suspicious for glaucoma. Gonioscopy can assess the iridocorneal angle. Ocular ultrasound may be needed if the cornea is edematous.
Medical Therapy
Topical carbonic anhydrase inhibitors (dorzolamide, brinzolamide) and beta-blockers (timolol) are first-line therapies. Prostaglandin analogs (latanoprost) are less effective in cats than in dogs. Systemic carbonic anhydrase inhibitors may be used but require monitoring for side effects.
Surgical Interventions
When medical therapy fails to control IOP, surgical options include cyclophotocoagulation, gonioimplants, or enucleation for blind, painful eyes. The goal of treatment is to preserve vision and maintain comfort.
Prognosis
Vision loss from glaucoma is often irreversible. Early detection and aggressive management improve the chances of preserving vision. Cats with secondary glaucoma require treatment of the underlying cause.
Uveitis in Cats
Etiology and Systemic Associations
Feline uveitis is frequently associated with systemic infections. Feline infectious peritonitis (FIP) is a common cause, as noted in the Feline Infectious Peritonitis: European Advisory Board on Cat Diseases Guidelines. Toxoplasmosis is another important infectious cause, as described in the Toxoplasmosis review. Other causes include FeLV, feline immunodeficiency virus (FIV), and fungal infections. The LeishVet update and recommendations on feline leishmaniosis notes that leishmaniosis can also cause ocular inflammation.
Clinical Presentation
Anterior uveitis presents with miosis, aqueous flare, hyphema, and hypotony. Posterior uveitis may cause chorioretinitis, retinal detachment, and vision loss. Cats with uveitis often show blepharospasm, photophobia, and epiphora.
Diagnostic Workup
A complete ophthalmic examination is essential. Systemic workup includes complete blood count, serum chemistry, and testing for FIV, FeLV, FIP, and toxoplasmosis. The Medical management of an anterior chamber fibrinous mass accompanied by uveitis in 3 cats report describes management of severe uveitis with fibrinous exudate.
Medical Management
Topical corticosteroids (prednisolone acetate) are the mainstay of therapy for non-infectious uveitis. Topical atropine is used to relieve ciliary spasm and prevent synechiae. Systemic therapy targets the underlying infectious cause when identified. Non-steroidal anti-inflammatory drugs are used cautiously due to potential renal and gastrointestinal side effects.
Complications
Chronic uveitis can lead to glaucoma, cataracts, lens luxation, and retinal detachment. These complications may require surgical intervention. Regular monitoring is essential to detect and manage complications early.
Prognosis
The prognosis depends on the underlying cause and the severity of inflammation. Infectious uveitis may resolve with appropriate systemic therapy, but chronic inflammation can cause permanent ocular damage.
Diagnostic Tests for Feline Ocular Diseases
Schirmer Tear Test
The Schirmer tear test measures tear production. Normal values in cats range from 10 to 25 mm per minute. Low values indicate keratoconjunctivitis sicca, which can predispose to corneal disease. The test is performed by placing a standardized strip in the lower conjunctival fornix for one minute.
Fluorescein Staining
Fluorescein staining identifies corneal epithelial defects. The dye is applied to the cornea and then flushed with saline. Areas of epithelial loss retain the dye and appear green under cobalt blue light. The test also assesses nasolacrimal duct patency.
Tonometry
Tonometry measures intraocular pressure. Rebound tonometry (Tonovet) is commonly used in cats and does not require topical anesthesia. Applanation tonometry (Tono-Pen) is also used. Normal IOP is 10 to 25 mmHg. Elevated IOP suggests glaucoma, while low IOP may indicate uveitis.
Conjunctival Cytology
Conjunctival cytology involves collecting cells from the conjunctival surface using a sterile brush or spatula. Samples are stained with Diff-Quik or Gram stain. Intracytoplasmic inclusions suggest Chlamydia felis. Neutrophilic inflammation is common in bacterial conjunctivitis.
PCR Testing
PCR testing on conjunctival swabs detects DNA from FHV-1, C. felis, and Mycoplasma species. This test is highly sensitive and specific. Results guide antiviral or antibiotic therapy.
Ocular Ultrasound
Ocular ultrasound is used when the cornea is opaque or when intraocular structures cannot be visualized. It can detect lens luxation, retinal detachment, intraocular masses, and posterior segment disease.
Treatment Protocols and Considerations
Topical Medications
Topical medications are the mainstay of therapy for most feline ocular diseases. Frequency of administration depends on the severity of the condition. Acute conditions may require hourly application, while chronic conditions may be managed with twice-daily therapy. Proper technique for administering eye drops is important to ensure compliance and efficacy.
Systemic Medications
Systemic antibiotics, antivirals, or anti-inflammatory drugs are indicated when topical therapy is insufficient or when the underlying cause is systemic. Doxycycline is effective for Chlamydia felis and Mycoplasma species. Famciclovir is used for FHV-1 infections. Corticosteroids are used for non-infectious uveitis.
Surgical Interventions
Surgical options include conjunctival grafts for deep corneal ulcers, cyclophotocoagulation for glaucoma, and enucleation for blind, painful eyes. The decision to pursue surgery depends on the condition, the cat's overall health, and the owner's preferences.
Monitoring and Recheck Schedule
Recheck examinations are essential to assess response to therapy and detect complications. Acute conditions may require rechecks every 3 to 7 days. Chronic conditions may be rechecked every 1 to 3 months. Owners should be instructed to monitor for signs of pain, discharge, or vision loss.
Common Failure Patterns in Feline Ocular Disease Management
Incomplete Diagnostic Workup
Failure to identify the underlying cause of ocular disease can lead to ineffective treatment. For example, treating uveitis with topical corticosteroids without addressing systemic FIP will not resolve the inflammation. A thorough diagnostic workup is essential for successful management.
Poor Owner Compliance
Administering eye drops multiple times daily can be challenging for owners. Cats may resist treatment, and owners may miss doses. Providing clear instructions and demonstrating proper technique can improve compliance. Using combination products or reducing frequency when possible may also help.
Inadequate Duration of Therapy
Some ocular conditions require prolonged therapy. Stopping treatment too early can lead to recurrence. For example, eosinophilic keratitis often requires long-term topical cyclosporine. Owners should be informed about the expected duration of therapy.
Failure to Address Underlying Systemic Disease
Ocular disease may be a manifestation of systemic illness. Treating the eye without addressing the underlying cause will not resolve the condition. For example, uveitis caused by toxoplasmosis requires systemic clindamycin or other appropriate therapy.
Delayed Referral
Some conditions require specialist care. Delaying referral can lead to irreversible vision loss or complications. Veterinarians should have a low threshold for referring cases that are not responding to therapy or that require advanced diagnostic or surgical procedures.
Records and Measurements
Essential Records for Feline Ocular Cases
- Signalment and history including onset and progression of signs
- Ophthalmic examination findings including Schirmer tear test, fluorescein staining, and tonometry results
- Diagnostic test results including cytology, PCR, and serology
- Treatment plan including medications, doses, and frequency
- Recheck schedule and response to therapy
- Owner communication and compliance assessment
Monitoring Parameters
- Intraocular pressure at each visit for glaucoma cases
- Corneal healing assessed by fluorescein staining for ulcerative keratitis
- Aqueous flare and cell count for uveitis
- Vision assessment using menace response and maze testing
- Pain assessment using behavioral indicators
Welfare and Safety Context
Pain Management
Ocular diseases can cause significant pain in cats. Signs of ocular pain include blepharospasm, epiphora, photophobia, and behavioral changes such as hiding or decreased appetite. Pain management should be part of the treatment plan. Topical atropine can relieve ciliary spasm in uveitis. Systemic analgesics may be needed for severe pain.
Zoonotic Considerations
Some causes of feline ocular disease have zoonotic potential. Chlamydia felis can cause conjunctivitis in humans, particularly immunocompromised individuals. Toxoplasmosis is zoonotic and can cause serious disease in pregnant women and immunocompromised individuals. Owners should be informed about appropriate hygiene measures.
Environmental Management
Stress reduction is important for cats with FHV-1 infection. Stress can trigger viral reactivation and recurrence of ocular signs. Environmental enrichment, pheromone therapy, and minimizing changes in routine can help reduce stress.
Public Health
The World Organisation for Animal Health (WOAH) provides guidelines on animal health and welfare that apply to veterinary practice. Veterinarians should follow standard infection control practices when examining cats with suspected infectious ocular diseases.
Professional Escalation Criteria
Urgent Referral to Veterinary Ophthalmologist
- Acute glaucoma with IOP >40 mmHg not responding to initial therapy
- Deep or perforating corneal ulcers
- Lens luxation
- Intraocular neoplasia
- Uveitis with hyphema or fibrinous exudate not responding to therapy
- Vision loss of unknown cause
Routine Referral
- Chronic conjunctivitis not responding to therapy after 14 days
- Eosinophilic keratitis requiring long-term management
- Glaucoma requiring surgical intervention
- Cataracts causing vision impairment
- Ocular manifestations of systemic disease requiring specialist input
When to Hospitalize
- Cats with acute glaucoma requiring frequent IOP monitoring
- Cats with deep corneal ulcers at risk of perforation
- Cats with severe uveitis requiring intensive topical therapy
- Cats with systemic illness causing ocular signs
Practical Decision Framework for Managing Feline Ocular Emergencies and Chronic Cases
Veterinarians managing feline ocular diseases must make rapid decisions about triage, diagnostic prioritization, and treatment initiation. A structured decision framework helps ensure consistent care, reduces the risk of irreversible vision loss, and guides appropriate escalation to specialist care. This section provides a practical decision framework for common feline ocular presentations, a record system for tracking cases, and troubleshooting methods for treatment failures.
Triage Decision Matrix for Feline Ocular Presentations
The initial triage of a cat with ocular signs determines the urgency of intervention and the diagnostic pathway. The following decision matrix categorizes presentations by urgency and guides initial actions.
Emergency Presentations (Immediate Intervention Required)
Acute glaucoma with intraocular pressure above 40 mmHg requires immediate medical therapy to reduce IOP and preserve vision. The Merck Veterinary Manual notes that glaucoma in cats is most commonly secondary to uveitis, intraocular neoplasia, or lens luxation. Initial therapy includes topical carbonic anhydrase inhibitors (dorzolamide or brinzolamide) and beta-blockers (timolol). Systemic carbonic anhydrase inhibitors may be used but require monitoring for side effects. Referral to a veterinary ophthalmologist is indicated if IOP does not decrease within 30 to 60 minutes of initial therapy.
Deep or perforating corneal ulcers require immediate surgical intervention. Fluorescein staining will identify the ulcer and assess its depth. A positive Seidel test (dilute fluorescein streaming from the cornea under cobalt blue light) indicates corneal perforation. The Feline ocular emergencies review provides context on acute corneal conditions requiring urgent attention. Initial management includes topical broad-spectrum antibiotics and referral for conjunctival graft or corneal suturing.
Lens luxation presents with a displaced lens visible in the anterior chamber or vitreous. This condition can cause secondary glaucoma and requires surgical removal of the lens. Ocular ultrasound may be needed if the cornea is edematous.
Intraocular neoplasia may present with a visible mass, hyphema, or secondary glaucoma. Ocular ultrasound helps characterize the mass. Referral to a veterinary ophthalmologist is indicated for surgical removal or enucleation.
Urgent Presentations (Intervention Within 24 Hours Required)
Acute uveitis with hyphema or fibrinous exudate requires prompt medical therapy to control inflammation and prevent complications. The Medical management of an anterior chamber fibrinous mass accompanied by uveitis in 3 cats report describes management of severe uveitis with fibrinous exudate. Topical corticosteroids (prednisolone acetate) are the mainstay of therapy for non-infectious uveitis. Topical atropine relieves ciliary spasm and prevents synechiae. Systemic workup for underlying causes should be initiated.
Corneal ulcers that are not deep but show progressive stromal loss require aggressive medical therapy and close monitoring. Topical broad-spectrum antibiotics should be applied every 2 to 4 hours. Recheck examination with fluorescein staining should occur every 24 to 48 hours.
Acute onset of vision loss requires immediate ophthalmic examination and diagnostic workup. Causes include retinal detachment, optic neuritis, and sudden acquired retinal degeneration. Ocular ultrasound and electroretinography may be needed.
Non-Urgent Presentations (Intervention Within 1 to 7 Days)
Chronic conjunctivitis without corneal involvement can be managed with diagnostic testing and medical therapy. Conjunctival cytology and PCR testing for FHV-1, Chlamydia felis, and Mycoplasma species guide treatment. The Feline herpesvirus infection ABCD guidelines on prevention and management provide recommendations for diagnosis and control of this infection.
Eosinophilic keratitis presents with raised corneal plaques and vascularization. Corneal cytology confirms the diagnosis. Topical corticosteroids or cyclosporine are effective, but corticosteroids are contraindicated in the presence of corneal ulceration.
Chronic glaucoma with IOP between 25 and 35 mmHg requires medical therapy and monitoring. Topical carbonic anhydrase inhibitors and beta-blockers are first-line therapies. Recheck IOP within 7 days to assess response.
Diagnostic Prioritization Framework
When multiple diagnostic tests are indicated, prioritization based on clinical presentation ensures efficient use of time and resources.
Presentation: Ocular Discharge with Conjunctival Hyperemia
- Schirmer tear test to rule out keratoconjunctivitis sicca
- Fluorescein staining to identify corneal ulcers
- Conjunctival cytology to identify inflammatory cells and inclusions
- PCR testing for FHV-1, Chlamydia felis, and Mycoplasma species
Presentation: Corneal Opacity or Ulceration
- Fluorescein staining to identify and assess corneal ulcers
- Schirmer tear test to rule out dry eye
- Corneal cytology to differentiate eosinophilic keratitis from other forms
- Slit-lamp examination to evaluate corneal layers
Presentation: Red Eye with Miosis or Mydriasis
- Tonometry to measure intraocular pressure
- Ophthalmic examination to assess aqueous flare, cell count, and anterior chamber depth
- Gonioscopy to evaluate the iridocorneal angle if glaucoma is suspected
- Systemic workup including complete blood count, serum chemistry, and testing for FIV, FeLV, FIP, and toxoplasmosis
Presentation: Vision Loss
- Menace response and maze testing to assess vision
- Ophthalmic examination to evaluate the anterior and posterior segments
- Tonometry to rule out glaucoma
- Ocular ultrasound if the cornea is opaque or intraocular structures cannot be visualized
- Electroretinography if retinal function needs assessment
Record System for Feline Ocular Cases
A standardized record system ensures complete documentation and facilitates monitoring of disease progression and treatment response. The following template can be adapted for practice use.
Initial Examination Record
Patient Information
- Signalment: species, breed, age, sex, neuter status
- Presenting complaint: onset, duration, progression
- Previous ocular history: prior diagnoses, treatments, surgeries
- Systemic history: vaccination status, FIV/FeLV status, concurrent diseases, medications
Ophthalmic Examination Findings
- Vision assessment: menace response, maze testing, pupillary light reflexes
- Schirmer tear test: right eye ___ mm/min, left eye ___ mm/min (normal 10-25 mm/min)
- Fluorescein staining: positive/negative, location and depth of ulcer if present
- Tonometry: right eye ___ mmHg, left eye ___ mmHg (normal 10-25 mmHg)
- Slit-lamp examination: conjunctiva, cornea, anterior chamber, iris, lens
- Fundic examination: optic nerve, retina, blood vessels
Diagnostic Tests Performed
- Conjunctival cytology: findings
- PCR testing: results
- Serology: FIV, FeLV, FIP, toxoplasmosis
- Ocular ultrasound: findings
Diagnosis
- Primary diagnosis
- Secondary diagnoses or complications
Treatment Plan
- Topical medications: drug, concentration, frequency, duration
- Systemic medications: drug, dose, frequency, duration
- Surgical interventions: type, timing
- Recheck schedule: date and time
Follow-up Record
Date and Time of Recheck
Owner Report
- Compliance with medication administration
- Observed changes in clinical signs
- Adverse effects or concerns
Ophthalmic Examination Findings
- Vision assessment
- Schirmer tear test
- Fluorescein staining
- Tonometry
- Slit-lamp examination
- Fundic examination
Assessment of Treatment Response
- Improved, stable, or worsened
- Complications or new findings
Modified Treatment Plan
- Changes to medications, doses, or frequency
- Additional diagnostic tests needed
- Referral to specialist if indicated
Outcome Record
Final Outcome
- Resolved, controlled, or progressive
- Vision status: normal, impaired, or blind
- Complications: glaucoma, cataracts, lens luxation, retinal detachment
Duration of Treatment
- Total days of medical therapy
- Number of recheck visits
- Surgical interventions performed
Owner Satisfaction
- Compliance assessment
- Quality of life assessment
- Recommendations for future monitoring
Troubleshooting Method for Treatment Failures
When a feline ocular condition does not respond to initial therapy, a systematic troubleshooting approach helps identify the cause and guide adjustments.
Step 1: Confirm the Diagnosis
Re-evaluate the clinical presentation and diagnostic test results. Consider alternative diagnoses that may mimic the initial condition. For example, eosinophilic keratitis can be mistaken for ulcerative keratitis, and treatment with corticosteroids for eosinophilic keratitis would be contraindicated if a corneal ulcer is present. The Ocular manifestations of feline viral diseases review notes that FHV-1 can cause both conjunctivitis and keratitis, and antiviral therapy may be needed.
Step 2: Assess Owner Compliance
Ask the owner about medication administration. Common issues include difficulty administering eye drops, missed doses, and improper storage of medications. Provide clear instructions and demonstrate proper technique. Consider using combination products or reducing frequency when possible.
Step 3: Evaluate Medication Selection and Dosing
Review the medications being used. Are they appropriate for the diagnosis? Are they being administered at the correct frequency and dose? For example, topical antibiotics for corneal ulcers should be applied every 2 to 4 hours initially. Topical corticosteroids for uveitis should be applied every 4 to 6 hours for acute inflammation.
Step 4: Consider Drug Resistance or Ineffectiveness
Some pathogens may be resistant to the chosen antibiotic. For example, Chlamydia felis is susceptible to tetracyclines but may be resistant to other antibiotics. PCR testing can confirm the presence of specific pathogens and guide antibiotic selection. The Feline herpesvirus infection ABCD guidelines on prevention and management note that antiviral therapy with famciclovir may be needed for FHV-1 infections that do not respond to topical therapy.
Step 5: Investigate Underlying Systemic Disease
Ocular disease may be a manifestation of systemic illness. If the ocular condition is not responding to topical therapy, consider systemic causes. For example, uveitis caused by FIP or toxoplasmosis requires systemic therapy. The Feline Infectious Peritonitis: European Advisory Board on Cat Diseases Guidelines provide recommendations for diagnosis and management of FIP. The Toxoplasmosis review describes treatment with clindamycin or other appropriate therapy.
Step 6: Recheck Diagnostic Tests
Repeat diagnostic tests to confirm the diagnosis or identify new findings. For example, repeat conjunctival cytology may show changes in inflammatory cell types. Repeat PCR testing may detect pathogens that were not present initially.
Step 7: Consider Complications
Chronic ocular inflammation can lead to complications that require additional treatment. For example, chronic uveitis can cause glaucoma, cataracts, lens luxation, and retinal detachment. These complications may require surgical intervention. Regular monitoring is essential to detect and manage complications early.
Step 8: Escalate to Specialist Care
If the condition does not respond to therapy after 7 to 14 days, or if complications develop, refer to a veterinary ophthalmologist. The specialist can perform advanced diagnostic tests and surgical procedures that may be needed.
Common Failure Patterns and Solutions
Failure Pattern 1: Conjunctivitis Not Responding to Topical Antibiotics
Possible Causes
- Viral etiology (FHV-1) not covered by antibiotics
- Chlamydia felis resistance to chosen antibiotic
- Poor owner compliance
- Concurrent keratitis or dry eye
Solutions
- Perform PCR testing for FHV-1, Chlamydia felis, and Mycoplasma species
- Switch to topical tetracycline (oxytetracycline) for Chlamydia felis
- Add topical antiviral therapy (cidofovir or famciclovir) for FHV-1
- Perform Schirmer tear test to rule out keratoconjunctivitis sicca
- Recheck in 7 days
Failure Pattern 2: Corneal Ulcer Not Healing
Possible Causes
- Indolent ulcer (epithelial basement membrane disease)
- Secondary bacterial infection
- Dry eye (keratoconjunctivitis sicca)
- Eosinophilic keratitis misdiagnosed as ulcerative keratitis
- FHV-1 infection
Solutions
- Perform grid keratotomy or superficial keratectomy for indolent ulcers
- Culture and sensitivity for bacterial infection
- Perform Schirmer tear test and treat dry eye if present
- Perform corneal cytology to differentiate eosinophilic keratitis
- Add topical antiviral therapy for FHV-1
- Recheck every 3 to 7 days
Failure Pattern 3: Glaucoma Not Responding to Medical Therapy
Possible Causes
- Secondary glaucoma from uveitis or neoplasia not addressed
- Inadequate dosing or frequency of topical medications
- Poor owner compliance
- Advanced disease with irreversible damage
Solutions
- Treat underlying cause (uveitis, neoplasia, lens luxation)
- Increase frequency of topical medications
- Add systemic carbonic anhydrase inhibitors
- Consider surgical intervention (cyclophotocoagulation, gonioimplants, enucleation)
- Refer to veterinary ophthalmologist
Failure Pattern 4: Uveitis Not Responding to Topical Corticosteroids
Possible Causes
- Infectious etiology (FIP, toxoplasmosis, fungal) not addressed
- Systemic disease requiring systemic therapy
- Secondary glaucoma or other complications
- Poor owner compliance
Solutions
- Perform systemic workup for infectious causes
- Add systemic therapy for identified cause (e.g., clindamycin for toxoplasmosis)
- Measure IOP to rule out secondary glaucoma
- Add topical atropine to relieve ciliary spasm and prevent synechiae
- Refer to veterinary ophthalmologist
Welfare and Safety Considerations in Decision Making
Pain Assessment and Management
Ocular pain is a significant welfare concern. Signs of ocular pain in cats include blepharospasm, epiphora, photophobia, and behavioral changes such as hiding, decreased appetite, and aggression. Pain management should be part of the treatment plan for all ocular conditions. Topical atropine relieves ciliary spasm in uveitis. Systemic analgesics such as buprenorphine or non-steroidal anti-inflammatory drugs may be needed for severe pain. The World Organisation for Animal Health (WOAH) provides guidelines on animal health and welfare that apply to veterinary practice.
Zoonotic Risk Assessment
Some causes of feline ocular disease have zoonotic potential. Chlamydia felis can cause conjunctivitis in humans, particularly immunocompromised individuals. Toxoplasmosis is zoonotic and can cause serious disease in pregnant women and immunocompromised individuals. Owners should be informed about appropriate hygiene measures, including hand washing after handling the cat and avoiding contact with ocular discharge. The Toxoplasmosis review provides information on zoonotic transmission.
Environmental Management for FHV-1
Stress reduction is important for cats with FHV-1 infection. Stress can trigger viral reactivation and recurrence of ocular signs. Environmental enrichment, pheromone therapy, and minimizing changes in routine can help reduce stress. The Feline herpesvirus infection ABCD guidelines on prevention and management emphasize that stress reduction and management of concurrent disease are important for controlling recurrences.
Professional Escalation Criteria
Immediate Referral to Veterinary Ophthalmologist
- Acute glaucoma with IOP above 40 mmHg not responding to initial therapy within 30 to 60 minutes
- Deep or perforating corneal ulcers requiring surgical intervention
- Lens luxation
- Intraocular neoplasia
- Uveitis with hyphema or fibrinous exudate not responding to therapy within 24 to 48 hours
- Vision loss of unknown cause
Routine Referral
- Chronic conjunctivitis not responding to therapy after 14 days
- Eosinophilic keratitis requiring long-term management
- Glaucoma requiring surgical intervention
- Cataracts causing vision impairment
- Ocular manifestations of systemic disease requiring specialist input
When to Hospitalize
- Cats with acute glaucoma requiring frequent IOP monitoring
- Cats with deep corneal ulcers at risk of perforation
- Cats with severe uveitis requiring intensive topical therapy
- Cats with systemic illness causing ocular signs
Implementation Steps for Practice
Develop a triage protocol for feline ocular presentations based on the decision matrix provided. Train all veterinary staff on the protocol.
Create standardized record templates for initial examination, follow-up, and outcome records. Ensure all team members use the templates consistently.
Establish a troubleshooting checklist for treatment failures. Review the checklist with the team during case discussions.
Schedule regular recheck appointments for ocular cases. Acute conditions require rechecks every 3 to 7 days. Chronic conditions require rechecks every 1 to 3 months.
Maintain a referral list of veterinary ophthalmologists and emergency clinics. Provide owners with contact information for specialist care.
Educate owners on medication administration, monitoring for signs of worsening disease, and the importance of compliance. Provide written instructions and demonstrate proper technique.
Document all decisions and communications in the medical record. Include the rationale for diagnostic and treatment choices, owner discussions, and referral recommendations.
Practical Decision Framework for Managing Feline Ocular Emergencies and Chronic Cases
Veterinarians managing feline ocular diseases must make rapid decisions about triage, diagnostic prioritization, and treatment initiation. A structured decision framework helps ensure consistent care, reduces the risk of irreversible vision loss, and guides appropriate escalation to specialist care. This section provides a practical decision framework for common feline ocular presentations, a record system for tracking cases, and troubleshooting methods for treatment failures.
Triage Decision Matrix for Feline Ocular Presentations
The initial triage of a cat with ocular signs determines the urgency of intervention and the diagnostic pathway. The following decision matrix categorizes presentations by urgency and guides initial actions.
Emergency Presentations (Immediate Intervention Required)
Acute glaucoma with intraocular pressure above 40 mmHg requires immediate medical therapy to reduce IOP and preserve vision. The Merck Veterinary Manual notes that glaucoma in cats is most commonly secondary to uveitis, intraocular neoplasia, or lens luxation. Initial therapy includes topical carbonic anhydrase inhibitors (dorzolamide or brinzolamide) and beta-blockers (timolol). Systemic carbonic anhydrase inhibitors may be used but require monitoring for side effects. Referral to a veterinary ophthalmologist is indicated if IOP does not decrease within 30 to 60 minutes of initial therapy.
Deep or perforating corneal ulcers require immediate surgical intervention. Fluorescein staining will identify the ulcer and assess its depth. A positive Seidel test (dilute fluorescein streaming from the cornea under cobalt blue light) indicates corneal perforation. The Feline ocular emergencies review provides context on acute corneal conditions requiring urgent attention. Initial management includes topical broad-spectrum antibiotics and referral for conjunctival graft or corneal suturing.
Lens luxation presents with a displaced lens visible in the anterior chamber or vitreous. This condition can cause secondary glaucoma and requires surgical removal of the lens. Ocular ultrasound may be needed if the cornea is edematous.
Intraocular neoplasia may present with a visible mass, hyphema, or secondary glaucoma. Ocular ultrasound helps characterize the mass. Referral to a veterinary ophthalmologist is indicated for surgical removal or enucleation.
Urgent Presentations (Intervention Within 24 Hours Required)
Acute uveitis with hyphema or fibrinous exudate requires prompt medical therapy to control inflammation and prevent complications. The Medical management of an anterior chamber fibrinous mass accompanied by uveitis in 3 cats report describes management of severe uveitis with fibrinous exudate. Topical corticosteroids (prednisolone acetate) are the mainstay of therapy for non-infectious uveitis. Topical atropine relieves ciliary spasm and prevents synechiae. Systemic workup for underlying causes should be initiated.
Corneal ulcers that are not deep but show progressive stromal loss require aggressive medical therapy and close monitoring. Topical broad-spectrum antibiotics should be applied every 2 to 4 hours. Recheck examination with fluorescein staining should occur every 24 to 48 hours.
Acute onset of vision loss requires immediate ophthalmic examination and diagnostic workup. Causes include retinal detachment, optic neuritis, and sudden acquired retinal degeneration. Ocular ultrasound and electroretinography may be needed.
Non-Urgent Presentations (Intervention Within 1 to 7 Days)
Chronic conjunctivitis without corneal involvement can be managed with diagnostic testing and medical therapy. Conjunctival cytology and PCR testing for FHV-1, Chlamydia felis, and Mycoplasma species guide treatment. The Feline herpesvirus infection ABCD guidelines on prevention and management provide recommendations for diagnosis and control of this infection.
Eosinophilic keratitis presents with raised corneal plaques and vascularization. Corneal cytology confirms the diagnosis. Topical corticosteroids or cyclosporine are effective, but corticosteroids are contraindicated in the presence of corneal ulceration.
Chronic glaucoma with IOP between 25 and 35 mmHg requires medical therapy and monitoring. Topical carbonic anhydrase inhibitors and beta-blockers are first-line therapies. Recheck IOP within 7 days to assess response.
Diagnostic Prioritization Framework
When multiple diagnostic tests are indicated, prioritization based on clinical presentation ensures efficient use of time and resources.
Presentation: Ocular Discharge with Conjunctival Hyperemia
- Schirmer tear test to rule out keratoconjunctivitis sicca
- Fluorescein staining to identify corneal ulcers
- Conjunctival cytology to identify inflammatory cells and inclusions
- PCR testing for FHV-1, Chlamydia felis, and Mycoplasma species
Presentation: Corneal Opacity or Ulceration
- Fluorescein staining to identify and assess corneal ulcers
- Schirmer tear test to rule out dry eye
- Corneal cytology to differentiate eosinophilic keratitis from other forms
- Slit-lamp examination to evaluate corneal layers
Presentation: Red Eye with Miosis or Mydriasis
- Tonometry to measure intraocular pressure
- Ophthalmic examination to assess aqueous flare, cell count, and anterior chamber depth
- Gonioscopy to evaluate the iridocorneal angle if glaucoma is suspected
- Systemic workup including complete blood count, serum chemistry, and testing for FIV, FeLV, FIP, and toxoplasmosis
Presentation: Vision Loss
- Menace response and maze testing to assess vision
- Ophthalmic examination to evaluate the anterior and posterior segments
- Tonometry to rule out glaucoma
- Ocular ultrasound if the cornea is opaque or intraocular structures cannot be visualized
- Electroretinography if retinal function needs assessment
Record System for Feline Ocular Cases
A standardized record system ensures complete documentation and facilitates monitoring of disease progression and treatment response. The following template can be adapted for practice use.
Initial Examination Record
Patient Information
- Signalment: species, breed, age, sex, neuter status
- Presenting complaint: onset, duration, progression
- Previous ocular history: prior diagnoses, treatments, surgeries
- Systemic history: vaccination status, FIV/FeLV status, concurrent diseases, medications
Ophthalmic Examination Findings
- Vision assessment: menace response, maze testing, pupillary light reflexes
- Schirmer tear test: right eye ___ mm/min, left eye ___ mm/min (normal 10-25 mm/min)
- Fluorescein staining: positive/negative, location and depth of ulcer if present
- Tonometry: right eye ___ mmHg, left eye ___ mmHg (normal 10-25 mmHg)
- Slit-lamp examination: conjunctiva, cornea, anterior chamber, iris, lens
- Fundic examination: optic nerve, retina, blood vessels
Diagnostic Tests Performed
- Conjunctival cytology: findings
- PCR testing: results
- Serology: FIV, FeLV, FIP, toxoplasmosis
- Ocular ultrasound: findings
Diagnosis
- Primary diagnosis
- Secondary diagnoses or complications
Treatment Plan
- Topical medications: drug, concentration, frequency, duration
- Systemic medications: drug, dose, frequency, duration
- Surgical interventions: type, timing
- Recheck schedule: date and time
Follow-up Record
Date and Time of Recheck
Owner Report
- Compliance with medication administration
- Observed changes in clinical signs
- Adverse effects or concerns
Ophthalmic Examination Findings
- Vision assessment
- Schirmer tear test
- Fluorescein staining
- Tonometry
- Slit-lamp examination
- Fundic examination
Assessment of Treatment Response
- Improved, stable, or worsened
- Complications or new findings
Modified Treatment Plan
- Changes to medications, doses, or frequency
- Additional diagnostic tests needed
- Referral to specialist if indicated
Outcome Record
Final Outcome
- Resolved, controlled, or progressive
- Vision status: normal, impaired, or blind
- Complications: glaucoma, cataracts, lens luxation, retinal detachment
Duration of Treatment
- Total days of medical therapy
- Number of recheck visits
- Surgical interventions performed
Owner Satisfaction
- Compliance assessment
- Quality of life assessment
- Recommendations for future monitoring
Troubleshooting Method for Treatment Failures
When a feline ocular condition does not respond to initial therapy, a systematic troubleshooting approach helps identify the cause and guide adjustments.
Step 1: Confirm the Diagnosis
Re-evaluate the clinical presentation and diagnostic test results. Consider alternative diagnoses that may mimic the initial condition. For example, eosinophilic keratitis can be mistaken for ulcerative keratitis, and treatment with corticosteroids for eosinophilic keratitis would be contraindicated if a corneal ulcer is present. The Ocular manifestations of feline viral diseases review notes that FHV-1 can cause both conjunctivitis and keratitis, and antiviral therapy may be needed.
Step 2: Assess Owner Compliance
Ask the owner about medication administration. Common issues include difficulty administering eye drops, missed doses, and improper storage of medications. Provide clear instructions and demonstrate proper technique. Consider using combination products or reducing frequency when possible.
Step 3: Evaluate Medication Selection and Dosing
Review the medications being used. Are they appropriate for the diagnosis? Are they being administered at the correct frequency and dose? For example, topical antibiotics for corneal ulcers should be applied every 2 to 4 hours initially. Topical corticosteroids for uveitis should be applied every 4 to 6 hours for acute inflammation.
Step 4: Consider Drug Resistance or Ineffectiveness
Some pathogens may be resistant to the chosen antibiotic. For example, Chlamydia felis is susceptible to tetracyclines but may be resistant to other antibiotics. PCR testing can confirm the presence of specific pathogens and guide antibiotic selection. The Feline herpesvirus infection ABCD guidelines on prevention and management note that antiviral therapy with famciclovir may be needed for FHV-1 infections that do not respond to topical therapy.
Step 5: Investigate Underlying Systemic Disease
Ocular disease may be a manifestation of systemic illness. If the ocular condition is not responding to topical therapy, consider systemic causes. For example, uveitis caused by FIP or toxoplasmosis requires systemic therapy. The Feline Infectious Peritonitis: European Advisory Board on Cat Diseases Guidelines provide recommendations for diagnosis and management of FIP. The Toxoplasmosis review describes treatment with clindamycin or other appropriate therapy.
Step 6: Recheck Diagnostic Tests
Repeat diagnostic tests to confirm the diagnosis or identify new findings. For example, repeat conjunctival cytology may show changes in inflammatory cell types. Repeat PCR testing may detect pathogens that were not present initially.
Step 7: Consider Complications
Chronic ocular inflammation can lead to complications that require additional treatment. For example, chronic uveitis can cause glaucoma, cataracts, lens luxation, and retinal detachment. These complications may require surgical intervention. Regular monitoring is essential to detect and manage complications early.
Step 8: Escalate to Specialist Care
If the condition does not respond to therapy after 7 to 14 days, or if complications develop, refer to a veterinary ophthalmologist. The specialist can perform advanced diagnostic tests and surgical procedures that may be needed.
Common Failure Patterns and Solutions
Failure Pattern 1: Conjunctivitis Not Responding to Topical Antibiotics
Possible Causes
- Viral etiology (FHV-1) not covered by antibiotics
- Chlamydia felis resistance to chosen antibiotic
- Poor owner compliance
- Concurrent keratitis or dry eye
Solutions
- Perform PCR testing for FHV-1, Chlamydia felis, and Mycoplasma species
- Switch to topical tetracycline (oxytetracycline) for Chlamydia felis
- Add topical antiviral therapy (cidofovir or famciclovir) for FHV-1
- Perform Schirmer tear test to rule out keratoconjunctivitis sicca
- Recheck in 7 days
Failure Pattern 2: Corneal Ulcer Not Healing
Possible Causes
- Indolent ulcer (epithelial basement membrane disease)
- Secondary bacterial infection
- Dry eye (keratoconjunctivitis sicca)
- Eosinophilic keratitis misdiagnosed as ulcerative keratitis
- FHV-1 infection
Solutions
- Perform grid keratotomy or superficial keratectomy for indolent ulcers
- Culture and sensitivity for bacterial infection
- Perform Schirmer tear test and treat dry eye if present
- Perform corneal cytology to differentiate eosinophilic keratitis
- Add topical antiviral therapy for FHV-1
- Recheck every 3 to 7 days
Failure Pattern 3: Glaucoma Not Responding to Medical Therapy
Possible Causes
- Secondary glaucoma from uveitis or neoplasia not addressed
- Inadequate dosing or frequency of topical medications
- Poor owner compliance
- Advanced disease with irreversible damage
Solutions
- Treat underlying cause (uveitis, neoplasia, lens luxation)
- Increase frequency of topical medications
- Add systemic carbonic anhydrase inhibitors
- Consider surgical intervention (cyclophotocoagulation, gonioimplants, enucleation)
- Refer to veterinary ophthalmologist
Failure Pattern 4: Uveitis Not Responding to Topical Corticosteroids
Possible Causes
- Infectious etiology (FIP, toxoplasmosis, fungal) not addressed
- Systemic disease requiring systemic therapy
- Secondary glaucoma or other complications
- Poor owner compliance
Solutions
- Perform systemic workup for infectious causes
- Add systemic therapy for identified cause (e.g., clindamycin for toxoplasmosis)
- Measure IOP to rule out secondary glaucoma
- Add topical atropine to relieve ciliary spasm and prevent synechiae
- Refer to veterinary ophthalmologist
Welfare and Safety Considerations in Decision Making
Pain Assessment and Management
Ocular pain is a significant welfare concern. Signs of ocular pain in cats include blepharospasm, epiphora, photophobia, and behavioral changes such as hiding, decreased appetite, and aggression. Pain management should be part of the treatment plan for all ocular conditions. Topical atropine relieves ciliary spasm in uveitis. Systemic analgesics such as buprenorphine or non-steroidal anti-inflammatory drugs may be needed for severe pain. The World Organisation for Animal Health (WOAH) provides guidelines on animal health and welfare that apply to veterinary practice.
Zoonotic Risk Assessment
Some causes of feline ocular disease have zoonotic potential. Chlamydia felis can cause conjunctivitis in humans, particularly immunocompromised individuals. Toxoplasmosis is zoonotic and can cause serious disease in pregnant women and immunocompromised individuals. Owners should be informed about appropriate hygiene measures, including hand washing after handling the cat and avoiding contact with ocular discharge. The Toxoplasmosis review provides information on zoonotic transmission.
Environmental Management for FHV-1
Stress reduction is important for cats with FHV-1 infection. Stress can trigger viral reactivation and recurrence of ocular signs. Environmental enrichment, pheromone therapy, and minimizing changes in routine can help reduce stress. The Feline herpesvirus infection ABCD guidelines on prevention and management emphasize that stress reduction and management of concurrent disease are important for controlling recurrences.
Professional Escalation Criteria
Immediate Referral to Veterinary Ophthalmologist
- Acute glaucoma with IOP above 40 mmHg not responding to initial therapy within 30 to 60 minutes
- Deep or perforating corneal ulcers requiring surgical intervention
- Lens luxation
- Intraocular neoplasia
- Uveitis with hyphema or fibrinous exudate not responding to therapy within 24 to 48 hours
- Vision loss of unknown cause
Routine Referral
- Chronic conjunctivitis not responding to therapy after 14 days
- Eosinophilic keratitis requiring long-term management
- Glaucoma requiring surgical intervention
- Cataracts causing vision impairment
- Ocular manifestations of systemic disease requiring specialist input
When to Hospitalize
- Cats with acute glaucoma requiring frequent IOP monitoring
- Cats with deep corneal ulcers at risk of perforation
- Cats with severe uveitis requiring intensive topical therapy
- Cats with systemic illness causing ocular signs
Implementation Steps for Practice
Develop a triage protocol for feline ocular presentations based on the decision matrix provided. Train all veterinary staff on the protocol.
Create standardized record templates for initial examination, follow-up, and outcome records. Ensure all team members use the templates consistently.
Establish a troubleshooting checklist for treatment failures. Review the checklist with the team during case discussions.
Schedule regular recheck appointments for ocular cases. Acute conditions require rechecks every 3 to 7 days. Chronic conditions require rechecks every 1 to 3 months.
Maintain a referral list of veterinary ophthalmologists and emergency clinics. Provide owners with contact information for specialist care.
Educate owners on medication administration, monitoring for signs of worsening disease, and the importance of compliance. Provide written instructions and demonstrate proper technique.
Document all decisions and communications in the medical record. Include the rationale for diagnostic and treatment choices, owner discussions, and referral recommendations.
Frequently Asked Questions
What is the most common cause of conjunctivitis in cats?
Feline herpesvirus type 1 is the most common infectious cause of conjunctivitis in cats. The Feline herpesvirus infection ABCD guidelines on prevention and management provide recommendations for diagnosis and control of this infection. Other causes include Chlamydia felis and Mycoplasma species.
How is feline glaucoma diagnosed?
Glaucoma is diagnosed by measuring intraocular pressure using tonometry. Normal IOP in cats ranges from 10 to 25 mmHg. Values above 25 mmHg are suspicious for glaucoma. Gonioscopy and ocular ultrasound may also be used to assess the iridocorneal angle and intraocular structures.
What systemic diseases cause uveitis in cats?
Feline infectious peritonitis (FIP) is a common cause of uveitis in cats, as noted in the Feline Infectious Peritonitis: European Advisory Board on Cat Diseases Guidelines. Toxoplasmosis is another important infectious cause. Other causes include FeLV, FIV, and fungal infections. The LeishVet update and recommendations on feline leishmaniosis notes that leishmaniosis can also cause ocular inflammation.
Can feline ocular diseases be treated at home?
Many feline ocular diseases can be managed with topical medications administered at home. However, proper diagnosis and treatment planning require veterinary examination. Owners should be instructed on proper medication administration and monitoring for signs of worsening disease.
What is the prognosis for cats with glaucoma?
The prognosis for cats with glaucoma depends on the underlying cause and the stage at diagnosis. Vision loss from glaucoma is often irreversible. Early detection and aggressive management improve the chances of preserving vision. Cats with secondary glaucoma require treatment of the underlying cause.
How is eosinophilic keratitis treated?
Eosinophilic keratitis is treated with topical corticosteroids or cyclosporine. Corticosteroids are contraindicated in the presence of corneal ulceration. Long-term therapy is often required to control the condition. Recheck examinations are needed to assess disease activity.
What diagnostic tests are used for feline ocular diseases?
Common diagnostic tests include Schirmer tear test, fluorescein staining, tonometry, conjunctival cytology, PCR testing, and ocular ultrasound. The choice of tests depends on the clinical presentation and suspected underlying cause.
When should a cat with ocular disease be referred to a specialist?
Referral to a veterinary ophthalmologist is indicated when the condition does not respond to initial therapy, when advanced diagnostic or surgical procedures are needed, or when vision is threatened. Acute glaucoma, deep corneal ulcers, and intraocular neoplasia are examples of conditions requiring specialist care.
Related Veterinary Guides
- Cat
- Chronic Kidney Disease In Cats
- Symptoms Of Kidney Disease In My Cat
- Symptoms Of Kidney Disease In Old Cats
- Symptoms Of Kidney Disease In Senior Cats
References and Further Reading
- www.merckvetmanual.com
- catvets.com
- www.acvim.org
- Merck Veterinary Manual. Merck Veterinary Manual.
- Animal Health and Welfare. World Organisation for Animal Health.
- Feline Infectious Peritonitis: European Advisory Board on Cat Diseases Guidelines.. Viruses, 2023.
- Periodontal disease.. Topics in companion animal medicine, 2008.
- Feline ocular emergencies.. Clinical techniques in small animal practice, 2005.
- Ocular manifestations of feline viral diseases.. Veterinary journal (London, England : 1997), 2014.
- Feline herpesvirus infection. ABCD guidelines on prevention and management.. Journal of feline medicine and surgery, 2009.
- Toxoplasmosis.. The Veterinary clinics of North America. Small animal practice, 2000.
- Medical management of an anterior chamber fibrinous mass accompanied by uveitis in 3 cats. Journal of Veterinary Clinics, 2020.
- LeishVet update and recommendations on feline leishmaniosis. Parasites and Vectors, 2015.
This article is educational and is not a substitute for veterinary diagnosis or treatment. Contact a veterinarian for advice about an individual animal.