Crying Cat? Here's The Top 3 Reasons Why Your Kitten's Eye Won't Stop Tearing
Guest Post by Dr. Steven Hanes, Veterinary Ophthalmologist
Dear Readers,
The path to becoming a veterinarian is a long and challenging one. We spend over a decade in education and training, and at the end, we know far from everything. But because veterinarians are licensed to treat anything (and everything), it’s very important for a veterinarian to be aware of their limitations and to practice within their scope.
One area that general practitioners are classically undertrained in is ophthalmology. Though most vets can handle the basics, more often than not, eye problems are better off managed by an ophthalmologist. And for these cases, I’m thankful to have Dr. Hanes on speed dial.
My former college roommate and best friend of 12+ years, I’ve been fortunate to witness his entire professional journey from ramen-eating undergraduate to bleary-eyed resident, to accomplished veterinary eye specialist in New York City.
Today, he’s one of less than 500 boarded veterinary ophthalmologists in the entire United States (with other countries having far fewer). Due to the rarity of these highly-trained specialists, accessing a veterinary ophthalmologist isn’t possible for everyone. And because of this, I’m bringing him and his knowledge to you.
I hope you enjoy.
-Dr. Sami
Why is my kitten tearing constantly?
Picture this — you just brought home your new best friend, a tiny little kitten.
You spend a bunch of time and energy making sure that your living space is perfect for her. The two of you hang out constantly, but at some point between 4-10 months of age, you notice that one of her eyes is constantly tearing. She doesn’t seem very bothered by it, but it’s definitely a persistent issue.
Excessive tearing, called epiphora, is a common finding in young kittens.
There are three main categories of causes of chronic tearing in kittens:
irritation of the eye from abnormal eyelids, eyelashes, hairs, etc.
abnormalities of the tear drainage pathway, or
ocular surface viral disease
Though not an exhaustive list, and it’s definitely possible that your little friend’s epiphora has a separate cause entirely (for which they should be evaluated by a veterinarian), let’s discuss the major reasons epiphora occurs in kittens.
(1) Irritation from abnormal eyelids/eyelashes/hairs/etc.
There are many anatomical reasons for a cat to have chronic tearing.
Most of the time, these anatomic abnormalities also cause some degree of discomfort (this can look like: squinting or twitching of the eye, redness, etc.).
Some common anatomical sources of chronic tearing include:
o Entropion, or inward rolling of the eyelid margin. This allows the haired skin adjacent to the eyelid margin to rub against the cornea, causing tearing and discomfort.
o Distichia, or an eyelash that arises from an abnormal location within the eyelid, causing it to rub up against the cornea during blinking. An ectopic cilia is similar, but grows out of the conjunctiva rather than the eyelid margin.
o Trichiasis, or haired skin rubbing against the ocular surface. This tends to be more common in brachycephalic (“short-nosed”) cats and dogs with prominent facial folds that can touch the surface of the eye
If any of these are diagnosed in your pet, they typically require surgical intervention to treat appropriately.
(2) Abnormalities of the tear drainage pathway
The nasolacrimal duct is a tubing system that connects the inner eyelid margin to the nose — it’s the reason that our nose runs when we cry.
It’s also where a major percentage of tears evacuate the ocular surface normally. If there is a reason for the nasolacrimal duct to be obstructed (at any point throughout its length), a spillover of tears and epiphora can result. Nasolacrimal duct abnormalities can include:
Congenital (“from birth”) malformations
Foreign bodies
Cysts/masses/tumors
Trauma/injury
Etc…
In some of these cases, surgery to try to repair or re-route the duct can be considered, although the risk of permanent complications from this surgery is very high, so this is very rarely recommended.
More often, in these cases, we typically recommend tear management with regular cleaning and drying of the eyelids, instead of considering surgical treatment.
(3) Ocular surface viral disease
Your kitten’s tearing and conjunctival redness could also be indicative of an active Feline Herpes Virus 'flare up'.
Herpesvirus is the most common cause of conjunctivitis, corneal ulcers, and upper respiratory infections in cats. This infection is caused by a virus which is specific to cats — it is not contagious to other species (including humans).
Kittens are often exposed early in life. The symptoms then localize to the eyes with squinting, tearing and possible ulceration of the cornea. One or both eyes may be affected.
Herpesvirus can become dormant and remain within the nerves around the eyes with recurrence of symptoms.
Relapses of feline herpesvirus can be triggered by stressful episodes or any change in routine. Diagnosis of feline herpesvirus can be made with various tests. Since most cats carry the virus, testing a cat is not typically necessary.
Treatment for herpes virus involves the use of antiviral medications to control clinical signs and reduce the severity and frequency of flare ups.
Some cats require medical therapy only during flare ups, while some cats require medications long term. If a cat does not respond to topical medications, oral medications can be considered. Minimizing stress for cats at home is also vital to decreasing the frequency and severity of herpes viral 'flare-ups'.
Take Away Message:
There are a number of reasons why your kitten may have epiphora, and prompt evaluation by a veterinarian is helpful to address any significant pain/discomfort, as well as to make sure that vision is preserved long-term. Some of these causes are easily addressed with surgery or medications, while others require advanced diagnostics to be able to most definitively determine an underlying cause.
Steve Hanes, VMD, MS, DACVO
Dr. Hanes is originally from northern New Jersey and works as a veterinary ophthalmologist in New York City. He completed his undergraduate degree at Cornell University, and his veterinary degree at the University of Pennsylvania. Following school, Dr. Hanes completed a small animal medicine and surgery internship at the University of Florida, and a comparative ophthalmology residency at the Virginia-Maryland College of Veterinary Medicine at Virginia Tech.
While in training, Dr. Hanes was heavily involved in clinical research, with a primary focus on cataract surgery and glaucoma development in dogs. His main clinical interests include corneal and cataract surgery, as well as management of feline ocular diseases.
In his free time, you can find Dr. Hanes exploring the abundant restaurants & breweries in New York City, traveling, and hanging out with his two cats, Shrek & Bernard.
Do you have a question about your pet’s eye? Drop a comment and let us know which topic we should cover next!
Those residing in the greater NYC area can book an appointment with Dr. Hanes at the Veterinary Eye Center of New York City.
Amazing and informative post and pre-letter from the author <3
I'm not good at scientific names, so thanks for organizing this in a way that makes the process to diagnosis easier to understand.