Spontaneous Superficial Ulcerative Keratitis in Client-Owned Cats: Risk Factors for Delayed Healing, Corneal Sequestration, or Corneal Stromal Vascularization.

PURPOSE: To investigate risk factors for delayed healing, corneal sequestration, or corneal stromal vascularization in cases of spontaneous superficial feline ulcerative keratitis. METHODS: A retrospective review was performed of 71 corneal ulcers in 68 cats. Patient factors, medications, treatments and time until first recheck were each assessed to determine relationships with delayed ulcer healing (> 1 SD above mean healing time), corneal sequestration, or corneal stromal vascularization after ulcer healing. RESULTS: Delayed healing (8/71; 11.3%), corneal sequestration (20/71; 28.2%) and corneal stromal vascularization after ulcer healing (9/71; 12.7%) occurred commonly. Corneal ulcers were significantly more likely to experience delayed healing if chemosis was initially present (p = 0.04), or if therapy included oral lysine (p = 0.04), topical nonsteroidal anti-inflammatory drugs (NSAIDS; p = 0.03) or topical ethylenediaminetetraacetic acid (EDTA; p = 0.04). Ulcerated corneas were significantly more likely to undergo sequestration following cotton-tipped applicator (CTA) debridement (OR = 4.1, p = 0.03), or if faint corneal brunescence was initially present (OR = 5.0, p = 0.01). Corneal stromal vascularization after ulcer healing was significantly more likely in Persian cats (OR = 7.3, p = 0.02) or if corneal vascularization was initially present (OR = 8.6, p = 0.01). CONCLUSIONS: Delayed healing, corneal sequestration, and corneal stromal vascularization appear to be common sequelae of feline ulcerative keratitis. Clinicians should use caution when treating feline ulcers using oral lysine, topical NSAIDs, topical EDTA, or CTA debridement.