Veterinary Medicine - June 2008 - (Page 310)

PEER-REVIEWED A challenging case: Conjunctival lymphoma in a cat The owner’s schedule and ﬁnancial constraints made the cause of this cat’s protruding nictitating membrane a challenge to diagnose and treat. Juliet R. Gionfriddo, DVM, MS; Fiona Tancredi-Ballugera, DVM; David Gardiner, DVM; and E.J. Ehrhart, DVM, PhD A Vital Stats Signalment • A 10-year-old 12-lb (5.5-kg) female spayed domestic shorthaired cat 10-year-old 12-lb (5.5-kg) female spayed domestic shorthaired cat was presented to Colorado State University’s Veterinary Medical Center for evaluation of a protruding nictitating membrane of the right eye. The cat’s eye had not improved with topical gentamicin ophthalmic drops (1 drop b.i.d.) prescribed two weeks earlier by the referring veterinarian. The right eye had been blind and the cornea had been cloudy since birth. The cat had no history of other medical problems, and its vaccination status was current. evaluate the eye. The owner failed to take the cat to the imaging appointment the next day. SECOND PRESENTATION The owner returned with the cat two months later. The right eye was extremely exophthalmic (Figure 1), the conjunctiva had severe chemosis and hyperemia, the eyelids were markedly swollen, and lagophthalmos was present. The conjunctiva was so swollen it covered most of the cornea and precluded corneal evaluation. The cat appeared to be in pain and resisted eyelid manipulation. FIRST PRESENTATION Differential diagnoses Physical and ophthalmic examinations The results of a Schirmer tear test and tonometry were normal in both eyes, and there was no corneal staining with uorescein dye in either eye. The right eye had scarring and edema of the entire cornea, so the internal ocular structures could not be evaluated. The bulbar and nictitating membrane conjunctiva were moderately hyperemic, and the nictitating membrane protruded and covered about half the cornea. Retropulsion of the right globe was severely limited compared with the left eye. The cat appeared to be in pain. The remainder of the physical examination ndings were normal, and no enlarged lymph nodes were detected on palpation. Presenting complaint • Protruding nictitating membrane of the right eye that had not improved with topical gentamicin drops Our two differential diagnoses were an extensive retrobulbar mass that was causing venous stasis in the eyelids and conjunctiva leading to swelling or a primary eyelid or conjunctival in ammatory or cellular in ltrate. Cytologic evaluation of a ne-needle Ocular examination ﬁndings • Scarring and edema of the entire cornea of the right eye • Moderately hyperemic bulbar and nictitating membrane conjunctiva • Limited retropulsion of the right globe Juliet R. Gionfriddo, DVM, MS Fiona Tancredi-Ballugera, DVM Department of Clinical Sciences College of Veterinary Medicine & Biomedical Sciences Colorado State University Fort Collins, CO 80538 David Gardiner, DVM E.J. Ehrhart, DVM, PhD Department of Microbiology Immunology and Pathology College of Veterinary Medicine & Biomedical Sciences Colorado State University Fort Collins, CO 80538 Presumptive diagnosis • Retrobulbar mass Presumptive diagnosis We suspected that a right retrobulbar mass was present and recommended ophthalmic ultrasonography to further 310 June 2008 VETERINARY MEDICINE Getty Images

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Veterinary Medicine - June 2008 Contents Leading Off Clinical Exposures Idea Exchange A Challenging Case: Conjunctival Lymphoma in a Cat Updates on Canine Hypoadrenocorticism Product Preview CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller Clinical Edge - June 2008 Table of Contents Managing Diabetes Mellitus in Cats: What Makes it Work? Porcine Insulin Zinc Suspension in the Management of Feline Diabetes Mellitus Monitoring Diabetes Mellitus in Diabetic Cats Feline Diabetes Mellitus: Important Client Communication Points

Veterinary Medicine - June 2008

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