C10010108 / invoice 10000

Seen at MEV recently but want a second opinion from JN. Cm

**Problem?**
R eye had small amount of discharge (more of a normal discharge- brown in colour, not watery like previously) and mild squinting last
couple of days of doxy and then more so in the last few days.
No sneezing. He is not off food.
Both eyes are not inflamed.
Fluoro stain negative.
No squinting in consult.

**How Long?**
months/years

**Which eye?**
both

**Medication?**
Gabapentin 100mg - trying on 1/2 capsule as per RV hx
Vibravet (doxycycline) paste  - Give one notch orally twice daily. Give with food. **4
week course required**
Gabapentin (Neurontin) 100mg capsules - Give 1 capsule the night before then 1 capsule 2 hours before vet appointment. May cause sedation.

Hx attached. Cm


MEV Hx 13/1/26

Assessments
Both eyes: Normal eye examination today. We suspect that the previous episodes are due to conjunctivitis. There is some very mild medial entropion and rolling of the hairs on the inner eyelids, which at this stage is not causing any concerns.
In cats this is commonly caused by Chlamydia and Feline Herpes virus. We have discussed treating with a longer course of the
doxycycline to treat for Chlamydia.
Health Status
Weight(kg): 5.50
Master Problems
NO NSAID
Stage 2 CKD

Physical Exam
AG / CJ - very agitated for examination. Brief episode open-mouth breathing. Vocalising and very wriggly. Requires pre-visit anxiolytic in future
Schirmer Tear Test: Right eye: 23 mm/min Left eye: mm/min
Tonometry: Not measured as no indication and very stressed
Gonioscopy: not performed
Fluorescein dye uptake: no uptake in either eye
Comfort: normal both eyes
Discharge: none
Vision: Right eye normal, Left eye normal
Menace: Right eye normal, Left eye normal
Dazzle: Right eye normal, Left eye normal
Pupillary Light Reflex: Right eye normal, Left eye normal
Indirect PLR Right eye normal, Left eye normal
Neurophthalmic Exam: Right eye normal, Left eye normal
Orbit: Right eye normal, Left eye normal
Globe size and position: Right eye normal, Left eye normal
Eyelids: Right eye normal, Left eye normal
Third Eyelid: Right eye normal, Left eye normal
Nasolacrimal duct Right eye normal, Left eye normal

Conjunctiva Right eye normal, Left eye normal
Cornea: Right eye normal, Left eye normal
Anterior chamber: Right eye normal, Left eye normal
Iris: Right eye normal, Left eye normal
Lens: Right eye normal, Left eye normal
Vitreous: Right eye normal, Left eye normal
Retina: Right eye normal, Left eye normal
Optic Nerve Right eye normal, Left eye normal

gets very watery discharge and squinting only in the right eye, no symptoms at all in the left eye.
Have used doxycycline previously for full 2 week course and problem resolves very quickly within days. Signs tend to recur after a few
months but in between episodes is completely normal.
Last flare-up was treated with steroids (injectable dex and 1mg pred orally) which also helped within a few days though did have one day where had sciharge again - essentially steroids and doxy were equally effective.

Not on any medication currently
Was seen one week ago and no treatment started. Signs have improved as of today (7 days later) which is a longer duration for
resolution compared with times that medications were used
No eye problems before onset of first symptoms in April 2025

General health
Arthritis - on solensia as needed
Stage 2 kidney disease