Recurrent Sinus Infection/Ataxia

CatladyJan

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I just wondered if anyone familiar with these drugs could advise which would be the wiser course of action: a long steady course of doxy or "off and on" erythro. I'm not inclined to put him -- or me -- through anything uber stressful, invasive, or expensive; I just want him to have some relief!
I had to give one of my foster kittens doxy and I was told to make sure I 'rinse' meaning wash it down as it can cause damage to the esophagous.
 

CatladyJan

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Has he had a history of sinus infections before? Was there any improvement with the other antibiotics or steroid? Also, look up histoplasmosis- depending where you live it is a common fungal infection that can even infect our indoor only cats. Histo can mimic a bacterial/viral upper res infection but is much more serious. Testing is easy via urine. Wishing you the best. I too have a chronic snuffler but he responded to steroids.

(And finally, I would not pulse an antibiotic as that can lead to resistance. Some uri cats need long term therapy (6 weeks) but typically there is improvement seen early on. As far as doxy vs erythromycin…. I would not use erythromycin - azithromycin yes but erythromycin is not commonly used in small animals) Doxy has better coverage for mycoplasma bacteria. But it also can cause stricture of the esophagus if not flushed with water after medicating. Personally, I would test for histoplasmosis if region indicates and do a 6 - 8 week trial with azithromycin)
I have to agree here, it seems antiobiotics are always prescribed even when there isn't an actual bacterial infection and/or overuse which causes resistant bacteria.

I think you really not to find out the cause and take it from there.
 
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all4mom2

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I probably misunderstood azithromycin (she said "Z-pack"). He does have a history, and her theory is that the sinus/nasal tissues are probably damaged/scarred from that and, being older, he now has less immunity, so it will be a recurring problem without pulsing, as you say, antibiotics. However, he didn't have a fever with his last flare-up -- yet he has greenish, milky discharge with blood at times; how can that be if there's no infection???
 
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all4mom2

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Is the test for histoplasmosis expensive? That's a fungal infection requiring an antifungal instead of antibiotic, I realize, and, yes, we do have it around here. Could a viral infection cause the pus and blood in the discharge just as a bacterial infection would? And again, given his age and gender (males are more apt to develop it), sinus cancer is a possibility.
 

BlackCatOp

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Unfortunately I do not know the cost of the histoplasmosis antigen urine test. If he has had a history of sinus problems then I think it makes histo less likely but still not impossible. I don’t think using azithrimycin (it is a z-pak) is necessary wrong or harmful but I would closely watch for improvement just in case something else is going on.
 
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all4mom2

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He had all the usual screening tests when I adopted him (FIV, etc.) and nothing was found, but he also had a UTI when I adopted him.
 

CatladyJan

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He had all the usual screening tests when I adopted him (FIV, etc.) and nothing was found, but he also had a UTI when I adopted him.
I don’t think they test for Feline Herpes and calcicavirus.
 
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all4mom2

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So the prescribed treatment is five days of azithromycin, and then administer every three days for 4-6 weeks. Anyone familiar with this regimen?
 

CatladyJan

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So the prescribed treatment is five days of azithromycin, and then administer every three days for 4-6 weeks. Anyone familiar with this regimen?
I am not, but that doesn't mean anything. Each situation is unique. Please keep us posted.
 
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all4mom2

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I'm happy to report that after just one dose (24 hours), he seems much better; amazing! I'm very happy with this second vet and will be sticking with her. Will keep you posted...
 
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all4mom2

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The course of azithromycin worked, but another question: should cat medicine be fruit-flavored and sweet? I threw away the box, but the bottle says nothing about it being for veterinary use, specifically.
 

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Human medication is used for cats all the time. I'm not sure about the flavored meds, though. I wouldn't be comfortable with that.
 

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Unfortunately the Azithromycin is a Human product. It is flavored for human babies. It sucks a lot but for now it’s the only way to get it. Most likely in a few years it will be able to be obtained and cat friendly flavors but for now fruit flavors. There are a lot of medication’s that are used in feline medicine that are human medication’s.
 

BlackCatOp

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If easier to administer, human medicine tablets could be prescribed. Or ask your vet about compound. However, while compounded meds can be made into pet friendly flavors - they are not fda approved like the human generics.
 
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all4mom2

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I don't have any complaint with it (it worked), although I suppose it contains sugar or another sweetener, which may or may not be good for certain pets? It's an oral medication (administered by dropper), so I suppose it has to be palatable to humans.

I was just surprised and didn't even notice until his whiskers got sticky from a squirt!
 
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all4mom2

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As long as it works, we're happy (it was reasonably priced, too, unlike the injection and the "new" antibiotic).
 

CatladyJan

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The amoxicillin is bubblegum flavored, doxycycline is grape flavored and there is an over the counter dewormer that is orange flavored. It’s never been an issue.
 
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all4mom2

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I followed the vet's instructions to begin giving the medication only once every three days after a prescribed period, and his symptoms returned the second day I skipped a dose. I administered it on the third, but he now has a repeat of the sneezing and blood-tinged discharge, primarily from one nostril. Is it feasible for him to remain on it indefinitely if that's what it takes to keep this at bay? Again, it's the weekend, so no chance of calling the vet to report the development or ask the question.
 

stephanietx

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Ask the vet to do a culture and sensitivity test of the nasal discharge. The culture will tell the vet what you're dealing with, viral or bacterial, and the sensitivity test will tell the vet which medication best treats it. It's the best option rather than continuing to guess and have meds not be effective. You could also ask them to run the PCR URD (upper respiratory disease) panel that will diagnose for feline herpes as well as several other upper respiratory diseases.

I had a chronic sneezer with some really gross discharge. We discovered she had feline herpes as well as a secondary psuedomonas infection. It took us 2 rounds of antibiotics to get it under control. She continued sneezing the rest of her life. Diagnosed at 2, died at 15. We gave her a lot of supplements as well as changed her diet and a daily antihistamine.
 
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