History
An 8-year-old spayed female domestic longhair cat was presented with a 2-month history of ulceration of the right lower eyelid. The patient had been examined by the primary care veterinarian several times for the same issue, and a presumptive diagnosis of blepharitis was made. Prior to presentation, multiple medications were prescribed, including topical polymyxin B / bacitracin / neomycin ointment (Tricin) applied 4 times daily, oral doxycycline (50 mg once daily), and oral meloxicam (0.05 mg/kg once daily) for 7 days. Improvement was noted during treatment; however, clinical signs recurred immediately after discontinuation. One month later, the patient was treated with topical dexamethasone 0.1% ophthalmic drops (Maxidex) twice daily, ofloxacin 0.3% ophthalmic drops (Ocuflox) 4 times daily, and an additional course of doxycycline for 10 days. There was minimal response to this therapy.
Clinical and Gross Findings
Ocular examination revealed a severe ulcerative lesion involving the medial half of the lower right eyelid (Figure 1). The margin was completely eroded with exposure of the palpebral conjunctiva. There was a moderate amount of blood-tinged, seromucoid discharge adhered to the medial canthus and eyelids. The lateral eyelid margin and upper eyelid were normal. There was mild conjunctival hyperemia. The remainder of the ophthalmic examination was unremarkable, including the left eye. Topical proxymetacaine hydrochloride 0.5% ophthalmic solution (Alcaine) was applied to facilitate an incisional biopsy of the ulcerated tissue, which was submitted for histopathology.
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