Creature Comforts: There’s more than meets the eye
There’s more than meets the eye
Max is a young, handsome, neutered, orange tabby cat. Max darts outdoors regularly, despite his owners’ best efforts to keep him in, and is an avid hunter, occasionally seen consuming his prey. He lives in a densely wooded area, sharing his domain with many wild creatures. Max is a free spirit. Max has a strong, confident personality. He has an obnoxious habit of pouncing on people in the middle of the night and delivering “love bites” to get attention. His people describe him as “a jerk.” They like him, anyway.
One day, Max wasn’t right — less lively, not his normal, naughty self. By that evening, though, he was back to annoying his owner for a taste of her food. She tried to shoo him away, to no avail, and finally relented and let him have a taste. It was a spicy jalapeno chip. She figured he’d see the error of his ways soon enough. But her plan went horribly wrong.
The minute Max tasted the spicy snack, he let out a blood-curdling scream and ran off to hide. His owner felt terrible. She tried to comfort him and offer something to soothe his injured ego and burning tongue — those chips, she admitted, were pretty hot. Max continued to hide for hours, causing his owner to feel supremely guilty. Jerk or not, she loved Max, and hadn’t expected such an extreme reaction. She gave him his space, but the next morning, he was still laying low. “Great,” she thought, “I’ve killed my cat with a jalapeno chip.”
When Max came in to see us that day, he was kind-of grumpy. His physical examination was unremarkable, aside from a very slight swelling on one side of his face, but no visible wounds. It was presumed he had tangled with a not-so-friendly animal, with a possible abscess just beginning to form. He was given a long-acting antibiotic injection, anti-inflammatory and pain medications and a broad-spectrum dewormer for good measure.
He went home, and though quieter than normal, resumed his customary activities, acting more affectionate than usual — actually being snuggly and sweet, which pleased his family greatly. But as each day passed, he still seemed “off.” His people became increasingly concerned. He began eating and drinking less and less, looking at his food as if he was hungry, but then walking away. He seemed to resent having to take his medications with each subsequent dose, to the point of screaming, running and hiding. He seemed suddenly afraid of food and his people.
Max came back in to see us. This time, it was clear that Max was experiencing severe pain in his mouth. His rabies vaccine was current and he was able to swallow, which was good to know — rabies is a serious concern with cases like this, but we had other suspicions. Because he was so painful, we had to anesthetize him to do a proper examination of his head and mouth. It was time to bring in the big guns to find out what was ailing Max.
We performed a CT scan of his skull. Unlike traditional radiographs, which use one x-ray picture at a time, a CT scan takes hundreds (in some cases, thousands) of x-ray pictures in a 360-degree swath around a patient, and compiles these images into a 3-D rendering. This allows the clinician to filter forward and back, up and down and at any conceivable angle through the area of interest to search for anatomical anomalies and clues to what ails the patient.
Because of Max’s aversion to eating and apparent mouth pain, we were curious to see if there were any tooth root or other dental problems that would explain his symptoms. His teeth were perfect. But, thanks to the CT images, we did find the cause of the trouble: A retrobulbar abscess. Max had a pocket of pus and inflamed tissue BEHIND HIS RIGHT EYEBALL! We were able to appreciate a slight proptosis (his eye was protruding very subtly from its socket) on the images, and sure enough, when we palpated both eyes (while he was anesthetized and not feeling pain) there was a firm swelling behind the right eye — likely to be caused by a puncture wound near the eye or inside his mouth from a tussle with another animal, and definitely not a jalapeno chip.
“AHA!” moments are the best. Once we were able to zero in on the source of Max’s problem, the solution became much more straightforward. After lancing and draining the abscess (from a delicate area inside the roof of his mouth) Max’s eye settled right back to its normal position, and Max is back to being naughty AND nice.
— Daverio is a veterinarian at Williamsport West Veterinary Hospital. Her column is published every other Sunday in Lifestyle. She can be reached at firstname.lastname@example.org.