On July 3rd we noticed that Pika's eye was looking pretty bad. The vet clinic had closed early due to the July 4th holiday and would not reopen until the 5th when we already had an appointment, so we decided to wait until then instead of taking him to the emergency clinic. We increased the frequency of ophthalmic ointment and artificial tears to try and keep him as comfortable as possible until the appointment.
The vet placed a dye in Pika's eye to make it easier to visualize the extent of the problem, he had a 10mm x 4 mm corneal ulceration. To treat the ulceration, the eye was anesthetized with drops and the ulceration was debrided using betadine soaked swabs. Then small holes were poked in the ulceration with a hypodermic needle to encourage neovascularization which will hopefully encourage healing of the ulceration. I believe this prcedure is called Anterior Stromal Puncture. The final piece of the treatment was to withdraw a blood sample, spin it down to remove cells and puts drops of the resulting serum in the eye 6 times per day for 5 days. This was the difficult part since we both work during the day and it would be difficult for one of us to be at home during the day, but we (mostly Betty) managed to do it, Betty had to go back the next week to get more blood drawn to replenish our supply of serum. I had to go out of town for a week during this time which put a pretty big strain of Betty but she did a great job with Pika's treatments.
While we were at the vet clinic I brought up a few things I had found during my research that might be useful as treatments for this disease. The first is Vitamin D therapy, which we have not tried yet since it is a fat soluble vitamin which can have some serious toxicity if too much is given. The second item, which I was more excited about, is a proteolytic enzyme called serrapeptase. This enzyme, first isolated from the digestive tracts of silk worms, digests the fibrin that is a major constituent of scar tissue. It's used to help reduce internal scar tissue from surgery or sports injury and is not regulated as a drug. The vet seemed to think this may be of value in treating Pika, so I ordered some serrapeptase from Amazon but then found that I could also get some from The Vitamin Shoppe located within walking distance of home. I picked some up from The Vitamin Shoppe the night before I had to go to Kentucky for a week, rather than start Pika on the enzyme and then skip town I opted to wait until I got back. While in Kentucky I started taking the serrapaptase myself at various dosages to see if there would be any side effects that might be a problem for the cat. I didn't notice any problems so I started Pika on a high dose of serrapeptase within an hour of returning to Chicago on Saturday the 14th. The capsules contain 40,000 activity units (AU) and the human dosages go from 1 capsule at the low end to 3 capsules (120,000 AU) at the high end twice a day. I calculated the high dose for Pika based on his body weight divided by mine (6/100) multiplied by high dose of 120,000 AU. That resulted in a dose of 7200 AU, but using the average human weight of 70kg the dose comes out to 10285 AU so I decided on a dose 8000 AU to simplify things. This means I can get 5 doses out of one capsule. I do this by dumping the contents of 1 capsule in a shot glass and adding 5 ml water. I use a syringe to suspend the powder in the water and draw 1 ml for a dose. My biggest concern now is how much of the enzyme makes it through the stomach intact and enters the bloodstream since it is no longer contained in a capsule. I may look for a low-dose capsule of serrapeptase that we can give to him intact if I can't find any information on the use of the enzyme without an enteric coated capsule.
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