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 Post subject: Experience with Sequestrum
PostPosted: Sun Jan 29, 2012 4:06 am 
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I am a first time pet owner and am totally in love with my Persian cat, Oscar! He turns one next month, but I have a concern.

He has a sequstrum in his eye. I took him to the specialist--three weeks ago they said they didn't think he needed the surgery, to wait three weeks and see if it falls off.

The sequstrum didn't fall off, and now the vet is suggesting the surgery. The surgery costs 2200-2500 dollars. I am by no means wealthy, but I could afford the surgery; however, I am afraid to do it. His eye does not appear to be bothering him at all. She said we could wait another month, but it makes her nervous that it hasn't fallen off yet. The issue for me is quality of life for Oscar. I was wondering what experiences people on this forum have had with the surgery, and what experiences you may have had with sequstrums.


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 Post subject: Re: Experience with Sequestrum
PostPosted: Sun Jan 29, 2012 4:40 am 
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I adopted a one eyed 4 year old cat who weeks later developed a sequestrum in her only eye- it was a large brown spot they called a nigrum.
Specialist said wait and see- but he was sure it would need surgery.
The sequestrum/nigrum didn't bother her or seem to cause pain. But I assume that was the reason she had lost her other eye in the past
3 weeks later saw the eye specialists practive partner (basically a second opinion) He said it was deep and she needed surgery and it was done that day. It was a corneo-conjunctival graft.
The result was brilliant- a bit of a long recovery as the graft went cloudy for weeks- which I was told was normal.
The surgery was worth every cent as it saved her sight- and the graft was hardly visible after a year.
Just my experience.
Also a firm beliver in second opinions for things like this.
Good luck with whatever you decide
Eye problems are stressful- and your kitty is very young

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 Post subject: Re: Experience with Sequestrum
PostPosted: Sun Jan 29, 2012 4:44 am 
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Hi and welcome!

I've never had experience with eye surgery involving sequestrums, but I do have a cat, Miss Maggie Moo, who had two grafts on her one eye. (She only has one eye -- the other was removed.) Small sequestrums do fall off, but the larger ones often need surgery since if they fall off the eye may rupture, which, believe, is not something you want to experience. If the sequestrum is deep, they probably will graft the area to strengthen the cornea and prevent rupture. There is a 90% success rate for grafts (Maggie was in the 10% the first time :( ). The success rate depends a lot on the quality of the surgeon doing the operation. Make sure the vet is a Diplomate of the American College of Veterinary Ophthalmologists.

Assuming they have to do a graft, the aftercare with a graft is tedious but effective. You will be giving eye drops 4-8 times a day, 2-3 kinds, for several weeks as the graft grows in place. Then the drops are slowly phased out and after about 2 months, you are down to 1 drop a day. You and Oscar will get used to the eye drops in a few days -- he will hate them, but a treat afterwards will help him not hate them so much.

Now, with Maggie's graft, the tissue came from her eyelid, so it never will be clear. Presumeably if Oscar needs a graft, it will come from the eyeball itself and once healed, it will be clear and totally functional. Even with a cloudy graft in the middle of her only eye and scar tissue from previous infections, Maggie can motor around with no problems.

I wish you and Oscar the best in all this.

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 Post subject: Re: Experience with Sequestrum
PostPosted: Sun Jan 29, 2012 6:29 am 
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This was Vinnie's eye about 2-3 years after her surgery
Hard to see the scar
Image
Linda- I was surprised at how little aftercare her specialist recommended
No cone, no drops- just eye cleaning with gauze moistened with hot water- but then he was not concerned about infection.
He said the sequestrum will never re-occur where she had the graft- and Vinnie's eye was perfect until she died of something very different 4 years later.

Edited to add a picture of Vinnie's sequestrum pre-surgery- it was the dark spot on her eye.
she was looking directly at me when I took the photo.
Image

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 Post subject: Re: Experience with Sequestrum
PostPosted: Sun Jan 29, 2012 3:57 pm 
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My Sparky has a sequestrum that has been there for almost two years. She has herpes and got an ulcer that developed into the Sequestrum. In the beginning the Eye specialist opted to treat it conservatively with artificial tear ointment (preservative free ) antibiotics because of infection, oral antiviral Famcyclovir and antiviral drops. She was off and on the antivirals for a year. I watch it closely and take her in annually to have it checked, or whenever there are concerns. It remains stable and in fact she is doing well most of the time. I continue to wipe her eyes 2x day with a warm rag and put artificial tears gel in. At times the herpes acts up bothers her and I realize that surgery may still be needed at some point in time. Did you see a veterinary opthomologist , maybe a second opinion ? My cat is stable, I don't know your cat's situation and I am not a vet so I can't advise, I just know from experience that not all need surgery and can remain for a long time. There are many things that determine if surgery is needed. If it is deep there is more concern as Linda said. As Linda pointed out make sure that the vet is a DAVCO certified eye specialist, that is of major importance.

This is Sparky, I was unable to find a picture that shows the sequestrum, she has some scar tissue on both eyes but as you can see her eyes look good.

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 Post subject: Re: Experience with Sequestrum
PostPosted: Sun Jan 29, 2012 5:20 pm 
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Catherine P wrote:
Linda- I was surprised at how little aftercare her specialist recommended
No cone, no drops- just eye cleaning with gauze moistened with hot water- but then he was not concerned about infection.

I suppose a lot has to do with the health of the cat (Maggie was 4lbs and sick), the source of the graft (inner eyelid not corneal tissue), and the fact this was #2 for Maggie. I remember with the first graft (by Dr. Ammanda), it was cone and 4-6 eye drops a day, but since it failed in a weird way (veins were growing but a hole developed in the graphed tissue -- Dr. Sarah had never seen this before), I'm sure she went to the max on trying to assure success.

I would take a photo of Maggie's eye now, but it doesn't look great. To control her sniffles and prevent an eye infection, I took her off the neo-poly-dex, so the graft is re-vascularizing and getting cloudy. Once she's over the cold she has now, it'll be back to re-clearing the graft. To Oliver's person: what I go thru with Maggie is NOT normal with grafts.

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 Post subject: Re: Experience with Sequestrum
PostPosted: Thu Apr 12, 2012 5:29 am 
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So his sequestrum seems to be bothering him more and more. I will probably end up opting for the expensive surgery. He has an appointment on Saturday. If the specialist recommends surgery, I will go ahead and do it.


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 Post subject: Re: Experience with Sequestrum
PostPosted: Thu Apr 12, 2012 1:00 pm 
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If it is bothering him that is the best option. It is painful and there is always the chance of it becoming worse which could result in the loss of the eye. Good luck

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 Post subject: Re: Experience with Sequestrum
PostPosted: Thu Apr 12, 2012 1:16 pm 
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OK...I'm late to the game again but I am going to chim in anyway. I have had my fair share of eye issues and some are easy to solve and others take FOREVER! Sassy had a sequestrum that took exactly 6 months to fall off. And honestly my vet ended up removing it in the office on our last check up...numb the eye, and pull the lifted "scab"...vala done. Now my situation was not the norm. Sassy's was HUGE...so big that I didn't see it until I noticed her squinting. It was the size of her pupil so it went easily unnoticed. Below is a picture that I took of the sequestrum after it was removed at the vet's office.

Image

I will tell you that I FIRMLY believe in using Vit E during an eye issue. Use it at least 30 minutes AFTER putting the medication from your vet in the eye. This is not to replace anything your vet has suggested you do but to only assist. Vit E has healing properties to it plus it keeps the eye more moist than the medications you may be using. But the medications have a purpose. Buy the Vit E gel caps and snip the end off with sissors and put 1/2 the cap in the effected eye...it will seem you are putting more in than needed but that is ok. Do this EVERYTIME you give meds...as I said tho, wait 30 minutes after regular medications before putting the Vit E in because you want the medication to have time to do its job too. You should also being doing meds at least 4 times a day. I know your vet will tell you 2-3...but you really should do 3-5....at least 4.

I have cleared some cats up in a matter of 6-8 weeks and others like Sassy with a more serious eye issue like a sequestrum can take up to 6 months or even more to have the sequestrum sluff off. They eye will scar -- surgery wont change that. I can see the scar on Dianne's Sparky...but it doesn't change her quality of life...she can still see clearly.

I have a feeling that if you try the Vit E you might see a huge change and avoid surgery.
Good luck!

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