What is Corneal Sequestrum?
Persian, Himalayan, and Burmese breeds have a higher chance of developing this condition. However, male and female cats of all breeds and ages can develop corneal sequestration.
A corneal sequestrum is a piece of dead corneal tissue, which appears as a dark brown or black spot in the eye. The spot forms as a result of the deterioration of the stroma, the primary supportive layer of the cornea. Corneal sequestra may vary in size and shape, and may also cause ulcers. Chances of total vision loss – or, in severe cases, loss of the eye – are increased if the sequestrum is large and extends deep within corneal tissue.
Symptoms of Corneal Sequestrum in Cats
Corneal sequestra should be treated as a veterinary emergency, as they can cause pain and loss of vision. Seek immediate veterinary attention if you notice any of the following symptoms:
- Dark scab-like tissue in the eye
- Rubbing at the eyes
- Excess tear production
- Signs of pain
- The appearance of ulcers
- Signs of impaired vision
- Behavioral changes
Causes of Corneal Sequestrum in Cats
The causes of corneal sequestrum in cats, while not fully understood, typically involve chronic corneal irritation. This may be attributed to trauma or dry eye syndrome. Corneal sequestrum may also be caused by the feline herpesvirus.
Genetics may play a role in the development of the condition. Brachycephalic breeds – characterized by their broad skull shapes – have a higher chance of developing corneal sequestrum due to congenital factors such as decreased tear production and corneal sensation.
Diagnosis of Corneal Sequestrum in Cats
Your vet will make a tentative diagnosis based on a thorough physical examination, a complete medical history, and presentation of symptoms. Be sure to inform your vet of the extent and duration of your cat’s symptoms, as well as any previous eye conditions or traumatic injuries that you know of. Your vet can normally make a tentative diagnosis based on presentation of symptoms, particularly the presence of the dark spot on the cornea.
Treatment of Corneal Sequestrum in Cats
In some mild cases, the eye may try to eject the sequestrum on its own, and drug therapy may be prescribed to assist in this process. However, corneal sequestrum treated solely with drug therapy has a higher chance of recurring, and will cause more pain and a prolonged recovery period for your cat.
While certain medications may help manage corneal sequestrum, surgery is usually favored as the most effective course of treatment. The surgical procedure is known as a keratectomy. Your cat will be placed under general anesthesia and the sequestrum removed using an operating microscope. Depending on the depth of the sequestrum, a graft of conjunctival tissue may also be applied over the surgery site to provide additional protection and assist healing. Corneal transplant may be recommended as an alternative to grafting.
Following surgery, your cat will be given an Elizabethan collar to prevent it from irritating the surgery site. Your vet will also prescribe an antibiotic ointment for up to ten days following surgery. If your cat has a decreased tear production, artificial tear supplements may be prescribed long-term. Pain management medications and oral antibiotics may also be prescribed. Your vet will be able to advise you on a treatment and recovery plan based on your cat’s specific needs.
Recovery of Corneal Sequestrum in Cats
Recovery and prognosis will depend on the severity of the condition and the effectiveness of treatment. In most straightforward cases of corneal sequestrum in cats, keratectomy has a high success rate. Most cats make a full recovery within six months of treatment. The placement of a graft may slightly reduce your cat’s vision, but the vision of the affected eye typically remains functional. In fact, vision should improve following surgery.
Always follow your vet’s post-operative instructions carefully. It is imperative that you administer antibiotic medications for the entire recommended duration of treatment even if the condition starts to improve. Failure to do so could result in aggressive recurrence or loss of sight. Never use any eye drops or artificial tear supplements made exclusively for human use unless specifically instructed by your vet.
Ensure your cat has a warm, safe place to rest upon returning home. Your cat will be sore after the surgery, and may keep the affected eye partially or fully closed for a few days. This is normal. Keep the Elizabethan collar secured until the surgery site has completely healed. Your vet may recommend that you carefully clean the affected eye up to twice a day with a wet cotton ball.
Your vet may schedule follow-up appointments as needed to monitor your cat’s progress. If you have any questions regarding aftercare, ask your vet. If the sequestrum recurs, or if your cat sustains a new eye injury following treatment, contact your vet immediately.
Corneal Sequestrum Questions and Advice from Veterinary Professionals
My cat has had the graft and also an entropian was repaired. It's two days after surgery and he has a loot of reddish brown discharge under his eye. I am assuming this is normal? He is hard to handle so I don't think I am able to give him any compresses or wipe his eye. I can barley give him the drops, which sends him into a howl.
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My cat was operated for a corneal sequestrum on 16th of July. The surgeon just looked at the pictures and decided to operate on it. On the day of the surgery, she just looked at the eye under some light and a couple of hours later took him for sedation. The surgery lasted 1.5-2 hours and we were told the infection was very deep. A graft was placed, a collar was put and medications prescribed.
However, he was unconscious for 2 hours after the surgery making it a total of 4 hours of unconsciousness.
Post the surgery his trauma started as he wouldn't eat well right from the next day, started vomiting the day after, used to cry at night, the collar was visibly uncomfortable and he gradually left his food and continued vomiting.
After 10 days of not eating properly and vomiting constantly, his blood tests were done which showed a high creatinine and BUN indicating kidney damage. Post which he was given saline daily and we were asked to force feed him renal food. Nothing seemed to help him really and finally on 6th of August, he passed away.
The questions that are plaguing my mind are:
1- Was surgery really needed or some other line of treatment could have been tried first?
2- Was this much anesthesia required that he remained unconscious for such a long time?
3- What was the co-relation of the surgery with his kidneys getting affected considering that prior to surgery all his blood tests were normal?
4- Was giving saline the only option once Creatinine levels were high. We were asked to stop feeding him anything. Was that prudent?
5 - What could be the possible cause of his death?
Please answer these to the best of your abilities. It would give us some closure.
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Our cat has a history of feline heroes virus in his eye passed down from his mother. He has had issues in past with his eyes so he was on a antiviral medication for a while but recently his eye has inflamed and the vet said he requires surgery to remove the sequestering. The quote we got from our vet on corneal sequesterum removal and hospitalization for our kitten is over $2400. Is this normal or can we find a better price ?
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I found that my Persian boy has some brown pigmentation on his right eye few days ago and my local vet said it may be corneal sequestrum. His eye does not appeal to be inflamed. Unlike most cases where there would be dark to black pigmentation on the center of the cornea, my cat only has light brown on the corner of the cornea. So, I am not too sure if that is corneal sequestrum. If my cat has early stage corneal sequestrum, what are the treatment option? can we use medication to treat it or is surgery necessary?
I am shocked to hear how traumatic your surgery has been for you and your beloved cat. I feel so deeply for you and fully understand how stressed both you and your cat must be feeling and I just wanted to say that my cat this this procedure 2 days ago and he is already on the road to recovery. He came home the same day / he only has one ointment to be used twice a day and oral pain relief in necessary. I might add that he had this op 2 years ago on the other eye and it was also ABC so all I can say is whoever your surgeon was I can tell you he surely sounds like a quack and definitely should not be doing this procedure as his inexperience is shining thru. If u still in any kind of trouble with your cat feel free to contact me as I would do anything to try and help. Diane
My cat just had corneal sequestrum surgery, with a graft placed in order for best results, and I have to say if I had known what I was subjecting him to, I would have had him put down. I have never seen an animal in this much distress. He is supposed to receive 6 different Meds, both in the eye and orally, 4 times a day. It is a near,y impossible feat, even with 2 people. He frantically whips his head around and gets loose even when tightly encased in a towel. He is wearing a cone, which initially had him running through the house, falling down the stairs, banging into walls, now he either sits all hunched up or periodically frantically tries to get the cone off. He is not eating or drinking. I have just started bringing him to the vet daily, so that two, sometimes 3, of the tech's can get his Meds in at least once per day. He may have to have subcutaneous hydration if he doesn't start drinking. Very long story short, this is a nightmare I had no idea the scope of when deciding to go this route. I would NEVER do it again. My animal is suffering terribly, and I am sick myself having to witness his misery. His condition is unbearable , for both of us. I can only pray to God that this cone comes off after the 2 weeks and he lives through it. Please don't do this to your own cat, it is absolutely hideous and gut wrenching.
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