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

Avoid oral lysine, topical NSAIDs, topical EDTA, and CTA debridement in feline corneal ulcer management to minimize complications.

This retrospective study evaluated risk factors for delayed healing, corneal sequestration, and corneal stromal vascularization in 71 spontaneous superficial corneal ulcers across 68 client-owned cats. Delayed healing occurred in 11.3% of cases, corneal sequestration in 28.2%, and post-healing stromal vascularization in 12.7%, highlighting that these are common sequelae of feline ulcerative keratitis. Delayed healing was significantly associated with initial chemosis, and with treatment involving oral lysine, topical NSAIDs, or topical EDTA. Corneal sequestration was significantly more likely following cotton-tipped applicator (CTA) debridement (OR=4.1) and when faint corneal brunescence was present at initial examination (OR=5.0). Post-healing corneal stromal vascularization was significantly more common in Persian cats (OR=7.3) and when corneal vascularization was already present at the initial visit (OR=8.6). These findings suggest that certain commonly used treatments—including oral lysine supplementation, topical NSAIDs, topical EDTA, and CTA debridement—may be associated with worse outcomes in feline corneal ulcer management. Persian breed predisposition for stromal vascularization should be considered when counseling owners. The study underscores the importance of reassessing therapeutic defaults in feline ophthalmology, particularly the use of adjunctive treatments that may not provide benefit and could contribute to complications.

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