This cat came to the vet for a routine appointment but had an intraocular haemorrhage while sitting in a dog-filled waiting room. What do you see in the retina and how might explain the haemorrhage? What diagnostic and therapeutic steps might you take?
Stress had raised the poor cat’s already supranormal blood pressure through the roof resulting in the bleed. By the time I got to see the cat (a 15 year old polydypsic individual)the iris haemorrhage had all but resolved, but given time the numerous bullous retinal detachments (for that’s what the small circles in the retina are) would develop to complete detachment with blindness. Amlodipine treatment will lower the blood pressure and prevent this, so we can prevent loss of vision. Interestingly while chronic renal failure is almost certainly the root cause of the problem, the blood urea and creatinine were not markely raised in this animal, probably because the cat was drinking so much it was excreting those waste products quite satisfactorily.