Chronic Uri

[honigkatze]

My cat is 1.5 years old and suffers from chronic URI. When I rescued her as a 5/6-week old kitten, she was very ill and they weren't sure she would make it. Up until now, it's been a long road, including several vet visits to board-certified specialists and a 2-day stay in the hospital. When I first got her, she was put on the standard Clavimox drops and also had a Convenia shot previous to that. She got better, but it never fully went away. My first vet said this is difficult to treat and there wasn't much he could do. Several months later I noticed she had labored breathing and took her back to the vet yet again. After finally doing an xray, my vet said to take her to a hospital immediately because her lungs were in bad shape. She had to stay in an oxygen tank for 2 days and was given terbutaline, prednisone and IV antibiotics. She had a complete cardiac and respiratory workup, ultrasounds, xrays, etc. The results said she either has pneumonia, bronchitis or feline asthma and a possible heart murmur. The board-certified cardiologist/pulmonologist said she has asthma and put her on long term oral medications to control it. Since her hospitalization, she had one bad episode where her face was swollen and she had an ear infection from it. She was put on Orbax for 1-2 months to eradicate the bacterial infection. As soon as I stopped the antibiotics though, sure enough the URI came back within a couple of weeks. It has never been as bad since then, but still returns. I try to stay on top of it and give her antibiotics for 1-2 weeks. I ended up weaning her off the prednisone and limited the amount of terbutaline I gave her since it didn't seem to make much difference. During her follow up visit in December, her xrays were completely clear and the vet was amazed. By this point she was completely off the predinsone for about 2 months and had limited amounts of asthma meds. I asked if she still needed her asthma meds and he said no and wasn't sure if she truly had asthma or not. He said to keep her on the Orbax as needed.

Now it's 4 months later and I'm right back where I started. She has a sinus infection again from the URI and the last time I gave her Orbax it didn't seem to work as well anymore and she started vomiting every day that I gave it to her. I decided to take her to yet another vet this week for another opinion. The new vet (not a specialist) did a complete check up on her - bloodwork, stool sample, etc. Everything was normal except her white blood count was slightly elevated due to the sinus infection which was to be expected. The new vet put her on Azithromycin cherry liquid for 5 days and wants to give her FVRCP vaccines (one now and a booster 3 weeks later). The theory is that the vaccines will lesson the symptoms and keep her from reinfecting herself and then we can possibly control it with lysine. Also, the new vet doesn't think she has asthma but isn't 100% sure either. No xrays were done during this visit.

My questions/concerns:

I have researched a lot on this topic and want to see if anyone has ever heard of this or had experience with it? I'm concerned that if she does has asthma, even if it's a mild case, I've read that it's best not to introduce vaccines.

Also, is the Azithromycin effect and can it be used long term? I tried it on her once previously and her skin turned pink so I discontinued it after one dose. The vet said not to worry about this as it probably was unrelated. Could this be an allergy?

I'm so worried that if it continues this way, she will end up back in the hospital and resistant to antibiotics in the long run. Ideally, I'd like to get this under control by other means rather than just treating her symptoms with antibiotics.

Also, just as a side note, there are times when she seems really stuffed up, then once she gets the mucus out, she seems fine, running around like nothing is wrong at all. This also led me to thinking if it's possible allergies as it seems to come and go. In addition, when I tried the lysine (about 125mg/day) that seemed to help, but she eventually started throwing up after I gave it to her (gel). She won't eat the treats and I haven't tried the powder because she prefers mostly dry food. Could it be a food allergy? I know there are many things it could be, but any ideas/experiences you could share would be helpful.

Thank you for your time and any suggestions you may provide

 

[denice]

This is something I haven't dealt with but this will bump your post back up to the top. The only thing I know is the Herpes virus but you said your kitty had issues with lysine. I know there are some other things that can be tried but I don't know enough about this to start making suggestions. Hopefully someone with more experience will see this.

 

[mrsgreenjeens]

I'm thinking it's possibly pseudamonas. Has she ever been cultured for that? Here is a thread on it which you might find helpful: Pseudomonas aeruginosa

 

[honigkatze]

Thank you for your replies, I really appreciate it! The information on Pseudomonas is very helpful. I'm still in the process of researching to figure out what my next step is. She is currently on the Azithromycin and is doing well on it, but I fear once the course of the medication is completed, the URI will return.

I read they have to perform a nose or throat swab to test for this bacteria. Do you know how it is done? Do they have to sedate her? She's never been sedated due to the possible asthma and I worry about putting her under any anesthesia.

 

[Cerraigh]

My cat was by diagnosed with chronic rhinitis 2 years ago and for months it seems he couldn't get much relief from antibiotics. He would get better temporarily and then worse after the course ended. I consulted with a specialist veterinarian and he ran a URI panel and didn't find anything. My cat was perfectly healthy yet miserable with congestion and stuffy nose. Then my vet tried him on a high dose of azithromycin for a week and his response to it was extraordinary. He was symptom-free after a week and still is to this day. He is currently on a low maintenance dose of azithromycin twice weekly. I had some reservations about keeping my cat on long term antibiotics but my vet weighed this against a possible recurrence of rhinitis symptoms.

Chronic rhinitis is a frustrating condition to treat and what worked for my cat might not work for yours but there is hope in managing the symptoms.

Best of luck with your kitty.

Steph

 

[honigkatze]

Hi Steph,

Wow, thank you so very much for your post! I'm glad to hear your kitty is doing better! I've been researching so much on this topic and have found that Azithromycin seems to be the antibiotic of choice. I had another vet tell me the same as your vet - that it can be used long term for maintenance. I have not discussed this option with my own vet yet, but am happy to hear that it might be a solution for us. Like you, I'm also very concerned about the long term use of antibiotics, but your experience has put my mind at ease. She's been on Azithromycin for a week now and is doing so much better than when she was on the Orbax.

Also, you mentioned you had a URI panel done? Is this a blood test and what exactly does it test for? I want to do more testing on her and this seems very helpful, but don't want to run any tests that require sedation due to her possible asthma.

Oh and one more thing... what was the dosage of Azithromycin your cat was on and what dose is your cat on now?

Thanks again!

 

[Cerraigh]

Hi again,

The URI panel that my vet did included a blood test and an analysis of nasal discharge. He tested for all the usual suspects: FIV and FeLV (which I knew he didn't have), feline herpes, calicivirus, chlamydophila, mycoplasma and bortedella. He tested negative to all of these which surprised my vet a little considering the type of symptoms he was exhibiting. In light of these results my vet opted to try a more generic approach to symptom management by starting him on azithromycin. He was put on a high dose for 7 days. I'm not sure what the standard dose is as it's calculated based on weight. My cat took one and a half 25 mg pill for the first 7 days (about 38mg daily). He weighs 13 pounds. After that the vet gradually lowered the dosage to his current maintenance dose which is a 25mg pill two times a week and he's been doing wonderful ever since.

Just to give you some more background, my cat also has a history of ear infections. He had to have polyps removed from his ears at two different times. The other vet who treated him for this diagnosed him with a persisting low level inflammation. This low level inflammation creates a good environment for polyps to form and she posited it might also explain why my cat's nasal mucosa appears to be overly reactive. We tested for food allergy to try to find the source of this inflammation but the results were inconclusive. We might never know exactly what causes this low level inflammation he exhibits. All this to say that right now what the vet is focusing on is controlling the inflammation which is key to managing both his ear and nose issues.

The perspective of lifelong management of symptoms might be scary to some people but I'm lucky to have such a good patient. My cat is really easy to care for which facilitates giving medication. I was much more stressed when I felt like I was totally helpless to help him.

Hope your cat feels better.

Stephanie

 

[stephanietx]

Your situation sounds very similar to what we've gone through with my Hannah. If you read through the post someone linked above, you'll see I commented on it.

First thing, has your kitty been tested for Feline Herpes with the PCR URD test? It's very accurate and it also tests for a few other underlying upper respiratory diseases (URD). This is how Hannah was diagnosed with Feline Herpes. It's not a life-ending illness, but it is chronic and causes her to take extra time recovering from any illness. There are many ways to manage it, and once managed, outbreaks can be drastically reduced. Hannah was diagnosed 10 years ago and she's only had a few flare ups over the years.

Secondly, ask your vet to do a culture and sensitivity test of any nasal discharge or drainage down her throat. The culture will tell the vet if there is a bacterial or viral infection present and the sensitivity test will tell the vet which antibiotic(s) will best treat it. This is how we discovered Hannah's psuedomonas infection.

Some other things you can try is eliminating grains from her diet and feeding a grain-free diet. You could also give a daily antihistamine to combat any airborne allergy reactions. Hannah is allergic to stuff that blows in when the seasons change. I also have a cat diagnosed with asthma and the daily antihistamine helps her as well as the shot she gets twice a year. We give either Claritin (loratadine) or Zyrtec (certrizine). You could also add L-Lysine twice a day. Lastly, work on keeping your home stress-free and on a regular schedule. Cats thrive on routine. We run Feliway diffusers 23/7 in 3 rooms in our house and sometimes use other calming agents as needed. Stress can trigger an outbreak, URIs, as well as urinary tract infections.

 

[Ntrope]

Wow, both of your cases Steph and honigkatze, are so similar to my Flower. She has been very congested for months now. She tested negative for all the common viruses. The stuff they flushed out of her nose was thick, white and mucousy and her sinuses were very inflamed. She felt better for about 4 days, and then got stuffed back up again. We tried a couple of different antibiotics, which she threw up and couldn't continue, and she is on her 2nd round of depo/covenia now. After the first round, she felt great..almost back to her old self for about 4 weeks, and then the symptoms returned. I've taken her to several vets, and the latest one seems to be the best so far. Previous vets were just throwing different antibiotics at her to see if one would work without really trying to figure out the cause.

She is scheduled for a biopsy next month after the covenia wears off, but I am really wondering if Azithromax is going to be the one that works now! There seems to be strong evidence here that supports that theory.

Until then, she is on Cyproheptadine daily which seems like it might be helping a little bit.

 

[Cerraigh]

My Houdini was on a series of antibiotics for several months before he was finally put on Azithromycin. I brought him to my neighborhood vet several times and they tried him originally on doxycycline, and then Clavamox and after that he was on Convenia for a while and they also tried prednisolone for the inflammation. I also suspect that he was on Erythromycin at some point in the past as it was the antibiotic that was most commonly used in the shelter I adopted him from. My neighborhood vet had started telling me that it was a chronic condition that I would have to learn to live with. At that point I decided to bring Houdini to a specialist veterinarian at a local “high tech” animal hospital as I couldn’t accept that nothing could be done to improve his quality of life. I love my neighbourhood vet clinic (I’ve been going there for many years) and for traditional vet care they do a good job but his case was beyond their ability to help. The specialist vet I consulted with after that confirmed that it was most likely a chronic condition but he also gave me hope that we would be able to find ways to manage it. He mentioned that it would be a trial and error process but that there were many things that we could attempt to help him. We ended up being lucky that the first thing he tried (the Azithromycin course) worked right away. It was kind of miraculous really or it certainly felt that way. For the first time in 8-9 months (since I adopted him) my cat was no longer breathing loudly, feeling congested and sneezing. He was for the first time since I had him symptom-free and I didn’t have to worry so much anymore.

If I learned anything from this experience is that you should always ask for a second opinion. It didn’t feel right to me to be told by a vet to just learn to live it, that they had pretty much tried everything they could. I don’t necessarily expect my local vet clinic to be able to handle the complexities of a case like Houdini’s but they should have a responsibility to refer you elsewhere.

I’ve spent probably a few thousand dollars on my cat on both his ear and nose issues at this point. The great service I got at the animal hospital came at a cost but had I known to go there right away I would probably have saved some time and a few hundred dollars. I feel lucky that I had enough money to give him the best care possible. I cannot imagine what it would feel like to love your cat and be unable to afford proper vet care. It would be heartbreaking.

Houdini now goes to the vet maybe once or twice a year for his prescription renewals. My vet is very intent on keeping the dosage and the timing of the medication regular. He believes that the start/stop/start again approach to antibiotic treatment greatly increases the risk of building antibiotic resistance so I expect Houdini to stay on a steady dose for a long period of time.

I know we tend to anthropomorphize our animals at times but every time I look at him he seems so happy to be alive and healthy. He’s living life to the fullest and I enjoy watching it.

 

[Ntrope]

OH my goodness, he is beautiful! What is the method of delivery for Azithromycin and how often? I know it's different for every cat but my Flowercat is very hard to pill. I thought I had read it comes in a cherry flavored liquid. I'm so happy for you and Houdini. It breaks my heart to think about how beautiful and active Flower was, and how bad she's been feeling lately. I need to find something that works soon. I think based on all the anecdotal stories I have seen here, I will be asking my vet about this as an option for her.

 

[Cerraigh]

I use a pill gun for Houdini. He gets one 25 mg pill two times a week. He's very easy to pill though. You might want to try a pill pocket if your cat is less inclined. They also offer antibiotics in liquid form I believe.

 

[jdollprincess]

I agree with the recommendation to have your vet run a URD PCR. All they do is swab the nose and throat, no sedation required, and it will rule in or out the usual viruses that cause upper respiratory symptoms. If she tests positive for feline herpes you could inquire about a drug called famciclovir which is an antiviral drug that worked wonders for my herpes kitty.

 

[stephanietx]

Before throwing antibiotics at your cat, have a culture and sensitivity test run to make sure that the antibiotic will actually treat the infection. Otherwise, you're running the risk of your cat developing resistance to the various antibiotics. We tried azithro on Hannah and it had no effect.

 

[Cerraigh]

I don't think they prescribed azithromycin without the PCR test and culture. My vet says it's not usually the first one they try but definitely find out whether your cat has herpes or not. My cat doesn't have herpes so lysine is totally useless for him.

 

[honigkatze]

Wow thank you all for your messages! Houdini is very beautiful! I completely agree with you on getting a second opinion! I'm glad things worked out for you and Houdini and that you found a knowledgeable vet.

I'm so frustrated with this situation I want to cry I love my cat more than anything and just want her to get better. I have also been to several vets who give me all sorts of suggestions/answers that never work. I was told she had asthma and then after a year, her lungs cleared up. Then they said they weren't sure if she really had asthma or not. This was a board certified cardiologist at a specialty hospital! I spent thousands there! I was told never to sedate her, give shots etc. In an attempt to find a much closer vet and someone more reasonably priced, I saw a vet who told me to give her vaccines because it sounds like she is reinfecting herself with the herpes virus. Thankfully I didn't do it. I've had cats for a long time, spoken to several vets and have researched profusely and I know that once you have the herpes virus, there is no cure and that vaccines won't eradicate or lessen the symptoms. I really don't want to go back there. The only good thing was that they gave me the azithromycin, but that was only to cure the bacterial infection she had.

I am trying to decide now on which vet to go to for her follow up and long term care. The specialty hospital I had her at originally has a new internist there that they referred me to. I might have to go back there, it's just really far away and very pricey. Or I can try another couple of other regular clinics in my area, but I'm with you.. I don't really want to mess around anymore. I also had vets tell me there is nothing more they can do, or it's difficult to treat, etc. It's so difficult to find a trustworthy and experienced vet. I've just had some bad experiences in the past with some vets and I am trying to approach this with as much knowledge as possible. I'm surprised not one vet I've taken her to asked to test her for the URI panel. Once I decide who I'm taking her to, I'll definitely ask about these tests and recommendations you've all provided here.

Thank you all for the support, I really appreciate it!

I"ll keep you posted.

 

[honigkatze]

Hi again,

My cat is still on the azithromycin and is doing well. She is still a little bit stuffy, definitely not as bad as before. I had a phone consultation with a vet today. I asked about doing an URI panel and she agreed that would be a good idea.

Just a question for those who have had that procedure done... Can anyone provide details on how they do it? I know it's without sedation and it's a nose swab, but is it pretty quick and safe? How deep do they have to go in with the swab? How did your cats handle it? My cat squirms a lot and hates behind touched around the nose area. I'm just worried about her getting injured if she moved while they were doing it.

 

[tobrien]

Hi everyone. I just wanted to post my experience in case it can help someone. My cat Precious has had a chronic upper respiratory infection for months now. The vet will prescribe Clavamox, it goes away. It comes back again in a couple weeks. She is currently on her fourth round of antibiotics as this is the fourth time it has come back again. The vet did the nasal discharge test and the results were negative for all 6-7 things it tested for. He has told me it may be chronic because she is an older cat and it is difficult to know what is causing it. And that other cats have the same problem. So, I have researched online for anything I can do at home to possibly help. I recently bought colloidal silver and a cool mist ultrasonic humidifier. I added about 2 ounces of colloidal silver and just enough distilled water for the machine to run. Held my baby over the mist for about 5 minutes so she could breathe it into her lungs. People commonly do this for colds and there is a good youtube video by earth clinic that explains how to do it. I am going to do this for the next few days and see how it helps. I also just started adding 1/2 tsp colloidal silver to her wet food. I am hopeful that this will help, it certainly can't hurt. I am desperate to help my baby.

 

[mrsgreenjeens]

Hi everyone. I just wanted to post my experience in case it can help someone. My cat Precious has had a chronic upper respiratory infection for months now. The vet will prescribe Clavamox, it goes away. It comes back again in a couple weeks. She is currently on her fourth round of antibiotics as this is the fourth time it has come back again. The vet did the nasal discharge test and the results were negative for all 6-7 things it tested for. He has told me it may be chronic because she is an older cat and it is difficult to know what is causing it. And that other cats have the same problem. So, I have researched online for anything I can do at home to possibly help. I recently bought colloidal silver and a cool mist ultrasonic humidifier. I added about 2 ounces of colloidal silver and just enough distilled water for the machine to run. Held my baby over the mist for about 5 minutes so she could breathe it into her lungs. People commonly do this for colds and there is a good youtube video by earth clinic that explains how to do it. I am going to do this for the next few days and see how it helps. I also just started adding 1/2 tsp colloidal silver to her wet food. I am hopeful that this will help, it certainly can't hurt. I am desperate to help my baby.

You mentioned they checked for 6 - 7 things and they came b back negative? Do you know if they tested for pseudomonas? It sounds like that may be the issue here, as it's hard to get rid of, that's for certain! And it does take a special test to diagnose.

Anyway, let us know how the colloidal silver works out. I know it works very well on wounds.

Oh, and BTW, Welcome