Management of Haws Syndrome in Cats With Gastrointestinal Diet: A Case Series.

Gastrointestinal diet may resolve HS ocular signs in cats by addressing dysbiosis.

Haws syndrome (HS) in cats presents with bilateral third eyelid protrusion and ptosis, frequently accompanied by gastrointestinal symptoms including diarrhea. This case series of five cats explores the role of gut-brain axis dysfunction and microbiota dysbiosis in HS pathogenesis. All cats underwent comprehensive ophthalmic and physical examinations, fecal Giardia testing, and phenylephrine pharmacological testing. Management consisted of a prebiotic-enriched gastrointestinal diet (Hill's Gastrointestinal Biome) for three months. Phenylephrine responsiveness indicated underlying sympathetic neuropathy. Initial Giardia positivity was documented in 4/5 cats, with 3/5 clearing on recheck. Gastrointestinal symptoms resolved within 4-14 days in 2/3 symptomatic cats, with partial improvement in one. Notably, ocular signs completely resolved in all five cats within 11-39 days without recurrence during 327-438 day follow-up periods. These findings suggest dietary management targeting microbiota dysbiosis may benefit cats with HS, though additional research is needed to establish efficacy in refractory cases and when gastrointestinal symptoms persist.

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