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Ziggy had anisocoria (unequal pupil dilation)

Chris Elliott

Savannah Super Cat
#1
We had a big scare last night, but it seems to be resolving. I'd be very interested if anyone has a similar experience or any advice.

We had a big day yesterday that included:
- A vet visit for vaccines and checkup, including nail trim and ear cleaning
- Short crated introductions to Oni and Jax
- Longest walk yet on leash in the back yard
- And Ziggy jumped to the top of a bookcase from the coffee table for the first time

Carolyn went to bed, and around midnight I went to see Ziggy. Almost immediately, I noticed that his left pupil was just a slit and his right was almost fully dilated. He seemed fine otherwise, and did not seem to notice, except possibly for a reluctance to look at the bright ceiling light. He also seemed to be able to at least see motion in both eyes.

I immediately called a cat health line. They advised taking him in to an emergency clinic immediately, which we did.

Ziggy's pupils by this time were almost back to the same size, but not quite.

They examined him and the vet came and talked to us for a long time. They had not identified any abnormalities at all, including any neurological symptoms. They just manually checked that the eye pressures seemed the same and in the range expected.

We were going over the possibilities, including a possible fall while trying to jump to the top of the book case, when the vet noticed that his ears were cleaned. She said that this can sometimes trigger anisocoria by triggering or disturbing an ear infection.

This morning the pupils were still just a bit different. I called our vet who suggested we keep monitoring him and talk to them again on Monday.

Now I am not sure I can see a difference.

Does this tentative diagnosis of anisocoria being triggered by an ear cleaning seem reasonable?

If so, should we assume the possible infection has resolved itself as it seems the anisocoria has?

Thanks!
Chris.
 

Patti

Admin
Staff member
#2
I suppose an inner ear infection could be aggravated by ear cleaning causing some swelling which could cause pressure on the brain and the cranial nerve that controls eye constriction, not sure how plausible that is though. I had a cat that had an inner ear tumor that was growing into his brain - I noticed more balance problems than pupil or visual disturbances though. In any case, if Ziggy's anisocoria was caused by an infection then the it is still there - infection doesn't go away overnight, especially if not treated. If it was just swelling from an inflammatory response to the ear cleaning then yes, once the inflammation and swelling goes back down the symptoms would disappear.
 

Chris Elliott

Savannah Super Cat
#3
I believe the emergency vet mentioned an inflammatory response at the same time she talked about an infection. I conflated the two, sorry!

So far, so good. The only effect I see right now is that I think I lost some trust for taking him to the vet two times in less than 14 hours. It took him quite a while after we got back to settle down. When he did, he settled right next to me on the couch and slept. But he's still moving around in a cautious way today.
 

Patti

Admin
Staff member
#4
Poor Ziggy, he's been through so much, it's not surprising he might have been anxious with all the traveling and new people, not to mention the poking and prodding. Sleeping next to you is a good sign, I think he'll be back to his usual trusting self soon.
 

Chris Elliott

Savannah Super Cat
#6
Yes. The contrast was so dramatic that I immediately envisioned neurological issues or a stroke.
Inflammation from an ear cleaning was not on my list!
 

Brigitte Cowell

Moderator
Staff member
#8
I hope it was some sort of weird inflammatory response to the ear cleaning. Like Patti, I might be concerned that there was an underlying infection that if not treated would be a problem...when they cleaned his ears were they particularly dirty and did they look at some of the dirt under the microscope to check for yeast or mites?

I can imagine how scary it was to find Ziggy like that... I am so glad his eyes are gone back to normal!

His moving around cautiously might well have something to do with whatever was going on too... it might take a little for everything to equalize and settle down?
 

Chris Elliott

Savannah Super Cat
#9
They said there was a lot of wax, but no mites. I can ask Monday if they used a microscope to determine this.

His moving around cautiously was reminiscent of how he was when he first got here. In any case, he's gaining energy and playing this evening, so I'm happy.