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Enucleation in Cats
Written By hannah hollinger
Published: 01/05/2017Updated: 11/19/2021
Veterinary reviewed by Dr. Linda Simon, MVB MRCVS
What is Enucleation?
Enucleation is the surgical removal of the eye. Enucleation surgery is an irreversible and permanent solution for various eye disorders. Enucleation in cats is performed when all other medical options have proven ineffective in order to alleviate pain and give the feline a better quality of life. Enucleation surgery is performed by a veterinary ophthalmologist.
The veterinary ophthalmologist can approach enucleation surgery in two ways; transconjunctival or transpalpebral. The transconjunctival approach to enucleation has the advantage of reducing orbital tissue loss, subsequent orbital sinking, less hemorrhaging and a faster procedure time overall. In a transconjunctival surgery, the veterinarian ophthalmologist will only remove a portion of the eye’s orbit. With the transpalpebral approach, the entire eye globe is removed including the elements within the conjunctival sac (nictitating membrane, conjunctiva, eyelids). The veterinary eye specialist may choose to take the transpalpebral approach if the eye is unsalvageable.
Enucleation Procedure in Cats
The patient’s vital signs are taken before pre-anesthetic drugs are administered. General anesthesia is started after sedation is achieved through injectable tablet induction. The fur surrounding the affected eye is shaved to the midline. The upper eyelashes are trimmed with fine scissors and douched with ointment to prevent lashes from falling into the eye’s orbit. Tape is applied directly to the skin to remove fine hairs.
- The periocular skin, corneal surface and the conjunctival fornix is prepared with a 1:50 povidone-iodine solution.
- The patient’s head is placed in lateral or semi dorsal recumbency with the palpebral fissures aligned parallel to the floor.
- The endotracheal tube is reinforced to avoid anesthetic complications.
- The eyelids may be sutured shut if the globe is infected. Any suture material may be used, as the sutures begin from one corner of the eyelid to the other, close to the meibomian glands.
- A No. 5 scalpel blade is used to cut around the eye. 5 mm thick elliptical incisions will be made away from the eyelid margins, joining the incisions at the lateral and medial canthus.
- An Allis tissue forceps or towel clamp will be used to grasp the incised eyelid margins.
- Blunt dissections will be made using a Metzenbaum scissor, alternating from side to side until approaching the sclera.
- Using a No.15 scalpel blade, the medial and lateral canthal ligaments are transected.
- Hemorrhaging is controlled and the orbital rim is identified.
- The posterior ciliary arteries and optic nerve are clamped, or ligated. These structures are severed through use of a curved Metzenbaum scissor.
- A plane of dissection is made using Metzenbaum scissors to release the globe from the orbital tissues that remain in the orbital rim.
- The dissected globe is removed and handed off to a veterinary technician to prepare for histological laboratory submission. (Important for detecting life-threatening disease).
- The veterinary ophthalmologist will return to the orbital opening, dissecting the periocular tissue from the sclera.
- The eye socket will be packed with gauze, applying light pressure for 5+ minutes to encourage a clot to form. Excessive bleeding may be ligated and synthetic hemostasis products may be applied to halt unsourced bleeding.
- A sterile silicone orbital prosthesis will be placed in the orbit. The veterinarian will trim the prosthetic to size. (only used in non-neoplastic or infectious conditions)
- Using 3-0 or 4-0 monofilament polyglyconate synthetic, absorbent sutures, the orbit will be closed with a minimum of three layers. The last layers of sutures will be using a 3-0 absorbable braided or monofilament type.
Efficacy of Enucleation in Cats
Enucleation surgery is a permanent solution for unresponsive eye conditions. Removing the painful, infected, necrotic, damaged, or cancerous eye completely will ideally eliminate the problem, as well as preventing the condition from spreading.
Enucleation Recovery in Cats
The surgical site will be protected following surgery, as the feline will be sent home with an Elizabethan collar to wear at home until healing is complete. Mild swelling, inflammation and bruising around the suture site are to be expected. Blood may drip from the nose occasionally as the tear ducts are connected to the inner nostrils. Any epistaxis (bloody nose) will diminish approximately two to four days post-op. Careful monitoring is essential following surgery, as trauma to the suture site can cause adverse effects. Sutures are typically removed about seven to 10 days post-op, however, the feline’s whiskers will not regrow for six to eight weeks. Cats without whiskers are prone to becoming imbalanced and must be monitored to stay protected.
Cost of Enucleation in Cats
An enucleation surgery for a feline can cost approximately $600 to $1,000. Preoperative and postoperative care should be taken into consideration for the total price.
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Cat Enucleation Considerations
Removal of one eye can be a concern to cat owners, as partial vision will be lost. The majority of felines respond very well to partial blindness and resume regular activities quickly.
Enucleation Prevention in Cats
Enucleation surgery is often used for feline eye conditions that have unknown causes and prevention is not always possible. Preventing eye trauma is important and seeking veterinary attention immediately when a problem is noted will be a step in the right direction.
Enucleation Questions and Advice from Veterinary Professionals
Calico
Kate
14 Years
1 found this helpful
1 found this helpful
My pet has the following symptoms:
Vomiting
Sneezing
Fatigue
Hi, I have a 14 year old cat who underwent a single enucleation (due to a tumour) 5 days ago. She was kept at the vet for one day afterward and was sent home with three days of a NSAID for post op care (her last dose was yesterday morning). The wound and sutures seem to be fine and though she has been a bit more calm and aloof, she has still been cuddling and enjoys being brushed. Since the operation she has been eating and drinking, but is being more picky about her food. She’s been sneezing a little bit and also vomitted a small amount late last night but hasn’t (as far as I know) since. Should I be worried?
May 20, 2018
Answered by Dr. Michele K. DVM
1 Recommendations
It sounds like everything is going well for her recovery so far, and you seem to be taking good care of her. From your description, I don't think that you need to worry a lot, but I do think it would be a good idea to continue to monitor her eating and energy levels. She may still have some discomfort from that surgery, or she may be fighting off a viral infection. If her appetite isn't back to normal and the sneezing resolved over the next few days, it would be a good idea to call your veterinarian and let them know what is going on, and they can decide if she needs to be seen or not. I hope that she recovers well.
May 20, 2018
That’s great, thank you for your advice. I was getting too worried and appreciate you helping to relieve some of my anxiety.
May 20, 2018
Kate's Owner
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British Shorthair
Beau
10 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Eye Infection
Conjunctivitis
Herpes
My cat has a herpes induced eye infection which is ulcerating the cornea. The infection is now secondary (staph) and proving impossible to treat as we’re on a third range of broad spectrum antibiotics with no marked signs of improvement. The vet opthamologist has suggested that removal of the eye may be required as the quality of the cat’s eye sight is going to be compromises.
May 19, 2018
0 Recommendations
There are two possible options here: one is to have a culture and sensitivity test done to identify a specific antibiotic which the infection is susceptible to or if the Ophthalmologist believes in their opinion that it isn’t possible to save the eye then enucleation would be recommended. Personally, I would follow the lead from your Ophthalmologist and put trust in their opinion. Regards Dr Callum Turner DVM
May 20, 2018
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domestic short hair
Thor
2 Months
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Swollen Eye
Bloody Eye
I found a kitten with an eye closed, I started putting terramycin eye ointment I read helped a lot of problems, and it seemed to work but I had to travel for the weekendand my parents didn't continue the care, when I got back his eye was swollen again and now its eye bleeds and the eye gel didn't work anymore, now there's discharge and blood and it seems like a little ball popped up, its dried and he can't close his eye. I'm on disability so I don't have a lot of money but don't want to dump him at the shelter, does he needs his eye taken out?
May 14, 2018
Answered by Dr. Michele K. DVM
0 Recommendations
I'm sorry that that is happening to Thor. Sadly, without seeing him or his eye, I'm not sure what might be going on with him, and he needs to see a veterinarian. Many clinics do offer a 'free first exam', or there may be a low cost clinic in your area that would be able to see him. He may need different medication, and the eye may be able to be saved. I hope that he is okay.
May 14, 2018
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dsh
Lucky
Four Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
See Above
Our cat is four years old, I found him as a kitten and he had no eye balls. He has gotten along great until recently when one eye developed a small pea like bulb which sticks out of the corner of the eye. It doesn't seem to bother him but I talked to our vet about it and he suggested the enucleation of that eye. My problem is that since he was neutered and was at the vet clinic to have that done, he is terrified of people other than my husband and I. My vet said I could give him some valium to help calm him to get him to his office which is 45 minutes away. I am dreading taking him, the surgery, and the cone he will have to wear afterwards. Do you think this surgery is necessary at this time?
April 25, 2018
Answered by Dr. Michele K. DVM
0 Recommendations
Without seeing Lucky or knowing what the mass might be, it isn't possible for me to comment on whether he needs the surgery, but you seem to have a veterinarian who is trying to work with you, and him, to make the procedure as comfortable as possible. They think that the procedure is necessary, and it would probably be best to trust that opinion. It should help to know that it is only a day out of his life, and once he is back home he will be happier. There are also soft cones that you can look into buying for him so that he is more comfortable. I hope that everything goes well for him.
April 25, 2018
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Domestic longhair
Puffy
13 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Bloody Nose Sneezing
My cat had his eye removed last Wednesday (4 days ago). He has developed sneezing fits which resulted in a relatively severe nose bleed this afternoon. Almost like he was choking. Is this normal? He may also have allergies.
April 23, 2018
0 Recommendations
This isn’t normal to see after enucleation surgery, however the surgery may be causing some sneezing; if it is getting bad you should visit your Veterinarian for a check to make sure that everything is alright especially if Puffy’s nose is bleeding. Regards Dr Callum Turner DVM
April 23, 2018
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Domestic long hair
astro
9 Weeks
1 found this helpful
1 found this helpful
My pet has the following symptoms:
Diarrhea
Wheezing
About 3 days ago my 9 week old Kitten's eye was removed due to a severe infection, this evening I noticed that she still has bloody discharge from the eye incision and her nose, her appetite seems to be a little off and her breathing sounds a bit wheezy, she is currently on antibiotics as well as pain medicine. She also has been having diarrhea. She has a reevaluation scheduled in a couple of days but I'm just really worried about her. Is this normal?
