This column originally was published in the Tribune on April 30, 2001.
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When I looked into Sammy's eyes with my ophthalmoscope I knew something was wrong.
His owner had noticed that Sammy's pupils were both dilated wide open, making his eyes look sort of gray and glassy. And Sammy had been running into things sometimes, as if he couldn't see.
With an ophthalmoscope you can normally see the retina, a thin layer of light sensitive cells that lines the back of the inside of the eyeball. It should lie flat against the inside of the eyeball and the blood vessels should be clearly visible, adequate in number and nice and smooth.
A few weeks earlier I had looked in Smudge's eyes or, rather, tried to. Smudge has had a condition called "nystagmus" for some time now. Her eyes flick back and forth something like a quick little pendulum on a clock. It can be almost normal in cats and may not ever cause Smudge any real trouble but it sure makes it hard to examine the retina.
But I thought I could see a serious abnormality. In many places the fine red lines of normal blood vessels looked like they had been leaking. This can be caused by high blood pressure. Veterinarians have found that high blood pressure is more common in old dogs and cats than we used to think.
I sent Smudge to the Veterinary Teaching Hospital at Washington State University in hopes that the specialists up there could get a better look at her retinas. They didn't think the abnormalities were blown out blood vessels, and Smudge's blood pressure was normal. We will continue to check Smudge's eyes regularly, but it doesn't look like there is anything significantly wrong with her eyes.
But Sammy did have a serious problem in his eyes. His retinas had both been detached from the back of the eyeball and were billowing out toward the front of his eyes, like inside-out umbrellas in the wind.
A normal cat's blood pressure is around 120/80, not much different than ours. It is very difficult to measure the "diastolic" blood pressure - the lower number - in cats so we usually only measure the "systolic" pressure - the upper number. Sammy's systolic pressure was over 250.
Sammy's high blood pressure had not only blown out the fragile blood vessels in his retinas. The continual bleeding and high pressure had pushed the retinas away from the back of the eyeball. There is no practical treatment for this in cats, and Sammy will be blind the rest of his life.
There are several medications that may help Sammy's hypertension, but we have not yet been able to convince him to take them.
His owner found out a long time ago that giving Sammy pills was practically impossible. We first tried having a special paste compounded at a pharmacy so he could smear a dab of it in Sammy's ear once or twice a day. Sammy didn't go for that either. Cats usually won't eat food with medication in it but we are currently trying that.
Checking blood pressure on a cat is considerably more trouble than checking it on a human being but regular blood pressure checks can detect hypertension before it does serious damage. And most cats are considerably easier to give pills to than Sammy.
A patient like Sammy, who refuses to take his medicine, is one of the frustrations of veterinary medicine, but then, it's a frustration for doctors whose practice is limited to humans too.
There are a lot of old codgers out there with high blood pressure and other treatable - or preventable diseases - who also refuse to do what their doctor tells them.
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Roen is a retired Clarkston veterinarian whose columns were published weekly in the Lewiston Tribune for more than 30 years. He may be contacted at jazzvet@cableone.net.
