Entropion in Peke-face Persian cats. INFOGRAPHIC.

Entropion is an inherited eye condition and a logical consequence of the cat fancy’s Peke-face Persian’s breed standard, which aims to produce the extremely flat face. The infographic outlines the causes, symptoms, and treatments. Long-term prevention would be fairly straightforward: reduce the extreme selective breeding over a long time to produce cats with more normal facial features, as seen in the Doll-face Persian. This traditional breed is the progenitor of the flat-faced Persian, developed over decades of selective breeding. Click this link to see more infographics on Peke-face Persian health.

Entropion in Peke-face Persian cats by Michael Broad

The surgery to correct entropion in Peke-face Persian cats is usually a type of blepharoplasty, a procedure aimed at reshaping the eyelids to prevent them from rolling inward and causing irritation. This is the most effective and long-term solution for cats with inherited entropion. Below is a more detailed look at the surgical process, techniques, and considerations.

Pre-Surgical Evaluation

Before the surgery, the veterinarian will conduct a thorough examination of the cat’s eyes to assess the severity of the entropion and any complications (e.g., corneal ulcers or infections). They may use:

Fluorescein staining to check for corneal damage.
Schirmer tear test to evaluate tear production, as some cats may have dry eye (keratoconjunctivitis sicca) along with entropion.

The surgeon will also evaluate whether the entropion affects the upper eyelids, lower eyelids, or both, as this will influence the surgical approach.

Surgical Techniques to Correct Entropion

Eyelid Reshaping (Hotz-Celsus Procedure):
This is the most common procedure to correct entropion. The goal is to reshape the eyelid so that it no longer rolls inward. Here’s how it works:

Incision along the eyelid: The surgeon makes a crescent-shaped incision just below the affected eyelid.
Removal of a small section of skin: A portion of the skin and sometimes a small amount of muscle are removed. This is done in such a way that, when the edges of the skin are sutured together, the eyelid is pulled outward into a normal position.
Suturing: Tiny sutures are used to close the incision and hold the eyelid in the correct position. These sutures may be absorbable, depending on the case, or they may need to be removed a few weeks after surgery.

Wedge Resection (for Severe or Complex Cases):
In more severe cases, especially if the entropion affects a larger part of the eyelid, a wedge of tissue may need to be removed from the eyelid. This is typically done when a longer section of the eyelid is involved, and it is similar to the Hotz-Celsus method but with a larger area of skin excision.
Eyelid Tacking (Temporary Fix for Kittens):
If the cat is very young or if the entropion is mild and expected to improve with growth, eyelid tacking sutures may be placed temporarily. These sutures are used to pull the eyelid away from the eye without removing any skin, giving the eyelids a chance to grow into a more normal shape. However, this is not a permanent solution and is often used as a stopgap until the cat matures.
Canthoplasty (Corner of Eye Surgery):
In some cases, particularly when the entropion affects the corner of the eye (medial canthus), a canthoplasty may be performed. This involves surgically adjusting the position of the eyelid at the inner or outer corner of the eye to tighten or lift it.

Anesthesia and Recovery

Anesthesia: Cats are placed under general anesthesia for the procedure. Due to the delicate nature of the surgery and the proximity to the eye, the cat needs to be completely still.
Surgical time: The surgery itself is typically short, lasting around 30 minutes to an hour, depending on the complexity of the case.
Recovery: Postoperative care is crucial for a good outcome. The cat will need to wear an Elizabethan collar (cone) to prevent rubbing or scratching the eyes during the healing process. Sutures are usually left in place for 10-14 days, and the vet may prescribe:
Antibiotic eye drops or ointments to prevent infection.
Anti-inflammatory medication to reduce swelling and pain.
Pain relievers, if needed.

Post-Surgical Care and Monitoring

After surgery, follow-up appointments are essential to monitor healing and ensure the eyelids remain in the correct position. Common post-surgical steps include:

Suture removal (if non-absorbable sutures were used) after 10-14 days.
Monitoring for complications: In some cases, if the eyelids are over-corrected or under-corrected, a second surgery may be necessary. Complications, though rare, include infection, scarring, or incomplete correction.
Continued monitoring of eye health: Since Peke-face Persians are prone to other eye conditions due to their flat faces (e.g., tear duct issues, corneal ulcers), regular eye check-ups are advisable.

Prognosis

The prognosis after surgical correction is generally very positive. Most cats experience a significant improvement in comfort, and the risk of further damage to the eyes is greatly reduced. In most cases, the surgery is successful on the first attempt, but in some instances, if the entropion recurs, an additional procedure may be needed.

Considerations for Peke-face Persians

Recurrence of Entropion: Due to the inherited facial structure of Peke-face Persians, entropion can sometimes recur, especially if the initial correction is mild or if the cat’s facial features continue to change as they age.
Ongoing Eye Care: Even after surgical correction, these cats may require lifelong eye care, such as regular cleaning around the eyes and monitoring for other eye-related issues common in brachycephalic breeds.

In summary, surgical correction for entropion in Peke-face Persians is highly effective and essential for relieving pain and preventing eye damage. It is a relatively safe procedure, but due to the breed’s predisposition, ongoing eye care and regular vet check-ups are recommended to maintain good eye health.

Routine?

Yes, corrective surgery for entropion in domestic cats is considered fairly routine and commonly performed by veterinary ophthalmologists or experienced general veterinarians. While the condition itself can be serious if left untreated, the surgical techniques used to correct it are well-established, straightforward, and typically have a high success rate.

Key Reasons Why Entropion Surgery Is Considered Routine:

Familiarity with the Procedure:
Entropion is a well-recognized condition in many domestic cats, particularly brachycephalic breeds like Peke-face Persians. As a result, the surgical techniques (e.g., the Hotz-Celsus procedure) are commonly performed and well-practiced in veterinary settings.
Straightforward Surgical Technique:
The surgery usually involves removing a small section of skin and sometimes muscle from the eyelid to tighten it and prevent it from rolling inward. This type of blepharoplasty is relatively simple compared to more complex eye surgeries.
High Success Rate:
When performed correctly, entropion surgery has a high success rate. Most cats experience significant relief from symptoms and the procedure rarely leads to complications. For most veterinarians, it is a manageable condition with predictable outcomes.
Short Surgical Time:
The surgery itself is relatively quick, often taking about 30 minutes to 1 hour depending on the complexity of the case. This reduces the time the cat needs to be under anesthesia, which helps minimize risks.
Post-Surgical Care is Manageable:
Recovery from entropion surgery usually involves basic post-surgical care, such as using an Elizabethan collar to prevent scratching, applying prescribed eye drops or ointments, and a follow-up visit to remove sutures. Complications are rare if post-operative care is followed properly.

Complications and Considerations:

While the procedure is routine, there are still some factors to consider:

Recurrence: In some cases, particularly with breeds predisposed to brachycephalic conditions (like Peke-face Persians), entropion may recur and require additional surgery.
Experience Matters: While the surgery is considered routine, the outcome often depends on the skill and experience of the veterinarian, especially if more complex issues are involved (like severe facial conformation problems).
Additional Eye Problems: Cats with entropion may also have other eye conditions (e.g., dry eye or corneal ulcers) that could complicate recovery, but these are usually manageable with proper care.

In summary, corrective surgery for entropion in cats is indeed routine, with predictable outcomes and a high success rate when performed by an experienced veterinarian. It’s a reliable treatment that significantly improves the cat’s quality of life.

Source for this section is ChatGPT. It was checked and verified.