Recurring blisters/sores on cat's nose

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martymcjackson

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I haven't posted in several years, but I'm remembering how very helpful it was in the past to receive feedback about issues with my formerly feral kitty, so... I'm back! 😻

Disclaimer: I absolutely will also speak with our veterinarian, but am interested to hear other cat guardians' experiences with this issue as well.

Background: My cat spent his first 6 months feral and living outdoors, and is now 8.5 years old. He has a known history of roundworm infestation in both his bowels and his lungs, and a suspected history of feline herpes virus. His health has been pretty stable overall after the first year of living indoors (he is very strictly an indoor cat, and no other animals are in our household). Lifelong Revolution topical Rx to control the lung-encysted roundworms seems to serve him well.

However, he is now having a second recurrence of some kind of blisters/lesions on his nose. The first time happened just over a year ago, and cleared on its own within 10 days. This second one has appeared out of the blue, just like the first. Not an injury. His eyes are watery, but this isn't unusual for him.

I'm attaching a picture to see if anyone has had this type of lesion on their cat, and if so, what was it? Herpes virus lesion? Eosinophilic granuloma? Fungal infection? Something else? Should I advocate to have the lesion cultured and/or biopsied before accepting a treatment plan? (I'm not thinking cancer since this has been recurrent; seems like more of an immune reaction of some kind.)

Thanks so much for any experiences that y'all can share along these lines! 👍❤😽
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betsygee

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Hi and welcome back. Your poor kitty, that looks uncomfortable. I’ve never seen anything like that—have you been able to speak to your vet yet? I wonder what the heck that is.
 

fionasmom

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What happened the last time? I know that you said it cleared up, but did it go into an actual ulcer before that? Just got smaller and went away?

I think that you more or less answered your own question. Tell the vet that since this is a recurrence you are not willing to go forward without a more definitive diagnosis. If he can give you a good reason for not doing so, discuss that with him. Some vets try to err on the side of not running up a bill if something might go away, not through carelessness, but just some concern for the cost that their patient might incur. He may be glad to hear that you want to have this researched this time around.

Kitty was very lucky to have ended up with you caring for him.
 
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martymcjackson

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Thanks for the responses above. I've been digging and reading online at length, and I strongly believe this is cutaneous feline herpes - basically like a human fever blister in cat form. Once a cat has herpes virus, they can never clear it, and it can episodically cause this and other issues just like herpes virus behaves in humans. It can be treated with antiviral medication just like in humans. I've opened an email dialogue with his vet and will update as things unfold!

Here are some informational links that might helps others whose cats are having this problem:

ACVC 2017: Understanding Skin Disease in Cats

Feline Herpes Virus: Causes, Symptoms & Treatment - Northeast Veterinary Dermatology Specialists

And here are photos of how this has progressed over 24 hours. We've been giving him a little extra l-lysine powder (which he has taken daily for years for respiratory virus prevention), and the ulcered area is already starting to dry up a bit.
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martymcjackson

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catwoman707 catwoman707 - Summoning you again because of your experience with health issues of feral/former feral cats. (Thank you! :angelcat:) So, this recurrent nose ulcer... based on your experience, would you suspect this could be a skin manifestation of feline herpes? Have you had any cats taking famciclovir for cutaneous herpes lesions? If yes, how did they do in terms of side effects, etc? I think I'm going to ask his vet to consider a trial of it after reading and reading and reading some more, including this: http://www.lganimalderm.com/uploads/7/3/3/7/73373237/felineherpesvirus1.pdf
 

fionasmom

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Thank you for posting the update with the information. It certainly may help others with the same issue. I can see improvement in the pics, so hopefully you are on the right track with getting this cleared up.
 
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martymcjackson

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Some updates just over a week later:

We spoke with his vet last Fri 10/12, and she agreed that it could very well be a viral lesion from his feline herpes. She didn't want to stress him at this point by bringing him in for a biopsy for definitive diagnosis, and instead prescribed a 14-day round of Famciclovir (anti-viral med) to see if he responds.

We ended up having the med compounded into a liquid to get it into him more easily, but we have yet to get him up to full dose due to the quantity of liquid required. Regardless, his nose seems to be healing. Unclear if this has anything to do with the med, as the nose sores were scabbing over even before he started it. (I'll post his progress pics below.)

His appetite has remained good/normal throughout, and his behavior has been mostly normal too, other than sleeping a bit more than usual.

Meanwhile, his one ear continues to be itchy and full of dark wax. Vet said likely not directly related to the nose lesion, but just that his immune system is "stirred up" and he's likely experiencing a yeast imbalance. She's having us clean his ears at home for now to see if it clears. He's been leaving chunks of dark ear wax all over the house. Poor guy. 😿

Will continue to update his progress in case this thread can be helpful to others.

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fionasmom

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Definitely a big improvement! The vet probably has a point that the ears are reactive to everything else going on. I hope he makes a full recovery.
 
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martymcjackson

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Update, many months later: Our boy fully recovered from the nose lesion (still believed to be a skin manifestation of feline herpes, like a cold sore), but the ear continued to be problematic. His ear didn't respond to an ointment prescribed by the vet, so instead he was prescribed Tresaderm liquid drops in late December. Sadly the Tresaderm may have caused a fatal side effect. His ear infection cleared right up, but after a week on Tresaderm he stopped eating and his liver enzymes tested very high. He was dead within several days of cholangiohepatitis. We had him euthanized on January 9th, after 3 nights of emergency hospitalization were unable to turn him around and he was suffering terribly. 💔
 

betsygee

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So very sorry to read this news. Our of respect for your loss, we'll close this thread now and we invite you to post a tribute to your sweet boy in our Crossing the Bridge forum.
 
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