Haws syndrome in cat secondary to giardiasis enteritis
DOI:
https://doi.org/10.31533/pubvet.v19n04e1756Keywords:
Autosomal sympathetic innervation, nictitating membrane, protrusionAbstract
The Haw's syndrome is an ocular condition that can occur in cats, characterized by the acute and symmetric bilateral protrusion of the third eyelid; however, the exact pathophysiology of the disease remains unknown. This case report describes Haw's syndrome in two cohabiting cats, secondary to giardiasis-induced enteritis, and discusses its pathophysiology, differential diagnosis, and management. The syndrome is generally associated with dysfunctions in the autonomic control of the third eyelid musculature, and parasitic infections, such as giardiasis, may affect the autonomic nervous system, leading to protrusion of the nictitating membrane. Clinical investigation includes ophthalmic exams, a phenylephrine test, laboratory tests for the detection of Giardia spp., and differential diagnosis with other neurological and systemic conditions. Treatment of the underlying cause, such as giardiasis, is crucial for the resolution of clinical signs. This article emphasizes the importance of early diagnosis and targeted therapeutic approach for the complete recovery of patients affected by Haw's syndrome.
References
Andrade, A. L. (2008). Semiologia do sistema visual dos animais domésticos. Semiologia Veterinária.
Antunes, M. I. P. P., & Borges, A. S. (2011). Síndrome de Horner em cães e gatos. Veterinária e Zootecnia, 18(3), 339–346.
Bruning, J., Chapp, A., Kaurala, G. A., Wang, R., Techtmann, S., & Chen, Q. H. (2020). Gut microbiota and short chain fatty acids: Influence on the autonomic nervous system. Neuroscience Bulletin, 36(1), 91–95. https://doi.org/10.1007/s12264-019-00410-8.
Calabrò, S., Kankowski, S., Cescon, M., Gambarotta, G., Raimondo, S., Haastert-Talini, K., & Ronchi, G. (2023). Impact of gut microbiota on the peripheral nervous system in physiological, regenerative and pathological conditionsg. International Journal of Molecular Sciences, 24(9), 8061. https://doi.org/10.3390/ijms24098061.
Corrêa, L. F. D., Santalucia, S., Oliveira, M. T., Souza, F. W., Pohl, V. H., Feranti, J. P. S., & Brun, M. V. (2014). Síndrome de Haw em gatos. Acta Scientiae Veterinariae, 42.
DeLahunta, A., Glass, E., & Kent, M. (2009). Lower motor neuron: General somatic efferent, cranial nerve. In Veterinary Neuroanatomy and Clinical Neurology.
Fruchter, B., & Kuzi, S. (2024). Clinicopathological findings in cats with haws syndrome. Veterinary Record.
Gelatt, K. N., Gelatt, J. P., & Plummer, C. E. (2022). Surgical procedures for the conjunctiva and the nictitating membrane. In Veterinary Ophthalmic Surgery. https://doi.org/10.1016/b978-0-7020-8163-7.00008-1.
Herrera, D. (2008). Oftalmologia no gato. In Herrera. D (Ed.), Oftalmologia clínica em animais de companhia (pp. 237–263). MedVet Livros.
Lim, C. C., & Maggs, D. J. (2015). Oftalmologia. In S. E. Little (Ed.), O gato: Medicina interna (pp. 1150–1189). Roca.
Mani, S., Somu, Y., & Vererselvam, M. (2024). Understanding haw’s syndrome in a domestic cat (pp. 1–2).
Martins, A. J. A., Dower, N. M. B., Monzem, S., Viccini, F., Gomes, L. G., Spiller, P. R., Dall’Acqua, P. C., & Martini, A. C. (2020). Síndrome de Haw em felino: Relato de caso. Brazilian Journal of Development, 6(11), 91684–91692. https://doi.org/10.34117/bjdv6n11-542.
Mendonça, A. P., Silva, T. F., Moraes, R. S., Amaral, A. V. C., & Ramos, D. G. S. (2022). Haw’s syndrome aassociated with giardiasis in a cat. Acta Scientiae Veterinariae, 50. https://doi.org/10.22456/1679-9216.118829.
Morgan, R. V., & Zanotti, S. W. (1989). Horner’s syndrome in dogs and cats: 49 cases (1980-1986). Journal of the American Veterinary Medical Association, 194(8), 1096–1099.
Muller, P. A., Schneeberger, M., Matheis, F., Wang, P., Kerner, Z., Ilanges, A., Pellegrino, K., del Mármol, J., Castro, T. B. R., Furuichi, M., Perkins, M., Han, W., Rao, A., Picard, A. J., Cross, J. R., Honda, K., Araújo, I., & Mucida, D. (2020). Microbiota modulate sympathetic neurons via a gut–brain circuit. Nature, 583(7816), 441–446. https://doi.org/10.1038/s41586-020-2474-7.
Nuyttens, J. J., & Simoens, P. J. M. (1995). Morphologic study of the musculature of the third eyelid in the cat (Felis catus). Laboratory Animal Science, 45(5), 561–563.
Oria, A. P., & Laus, J. L. (2009). Síndrome de Haw. In J. L. Laus (Ed.), Oftalmologia clínica e cirurgia em cães e gatos (p. 197). Roca.
Penderis, J. (2015). Disorders of eyes and vision. In S. R. Plats & N. J. Olby (Eds.), BSAVA Manual of canine and feline neurology (3ed., p. 153). British Smal Animal Veterinary Association.
Rocha, K. S. (2106). Disautonomia felina - Revisão bibliográfica. Universidade Federal do Rio Grande do Sul.
Samuelson, D. A. (2013). Ophthalmic anatomy. In K. N. Gellat, B. C. Gilger, & T. J. Kern (Eds.), Veterinary ophthalmology (pp. 39–158). John Wiley & Sons.
Sebbag, L., Fruchter, B., & Kuzi, S. (2024). Haws syndrome: A gut affair? Annual Scientific Meeting of the Eoropean College of Veterinary Ophthalmologists.
Slatter, D. (2005). Neurooftalmologia. In D. Slatter (Ed.), Fundamentos de oftalmologia veterinária (p. 513). Roca.
Souza, S. L. P. (2014). Giardíase. In M. M. Jericó, J. P. Andrade Neto, & M. M. Kogika (Eds.), Tratado de medicina interna de cães e gatos (pp. 2121–2133). Guanabara Koogan Ltda.
Suchodolski, J. S., Foster, M. L., Sohail, M. U., Leutenegger, C., Queen, E. V., Steiner, J. M., & Marks, S. L. (2015). The fecal microbiome in cats with diarrhea. PLoS ONE, 10(5), e012378. https://doi.org/10.1371/journal.pone.0127378.
Taylor, M. A., Coop, R. L., & Wall, R. L. (2017). Protozoologia veterinária. In Parasitologia veterinária (pp. 546–548). Guanabara Koogan Ltda.
Whitley, R. D. (1993). Diseases of the orbit, globe, eyelids, and lacrimal system in the cat. Veterinary Medicine, 88(12), 1150–1162.
Zhang, W., Li, Y., Sun, T., Li, Z., Manyande, A., Xu, W., Feng, M., & Xiang, H. (2022). Superior cervical ganglionectomy alters gut microbiota in rats. American Journal Translation Research, 14(3), 2037–2050.
Zwueste, D. M., & Grahn, B. H. (2019). A review of Horner’s syndrome in small animals. Canadian Veterinary Journal, 60(1), 81–88.

Downloads
Published
Issue
Section
License
Copyright (c) 2025 Vivian rocha de Almeida, Amanda Regina Nadalin

This work is licensed under a Creative Commons Attribution 4.0 International License.
Você tem o direito de:
Compartilhar — copiar e redistribuir o material em qualquer suporte ou formato
Adaptar — remixar, transformar, e criar a partir do material para qualquer fim, mesmo que comercial.
O licenciante não pode revogar estes direitos desde que você respeite os termos da licença. De acordo com os termos seguintes:
Atribuição
— Você deve dar o crédito apropriado, prover um link para a licença e indicar se mudanças foram feitas. Você deve fazê-lo em qualquer circunstância razoável, mas de nenhuma maneira que sugira que o licenciante apoia você ou o seu uso. Sem restrições adicionais
— Você não pode aplicar termos jurídicos ou medidas de caráter tecnológico que restrinjam legalmente outros de fazerem algo que a licença permita.