URI or aspiration pneumonia?

[lynne8832]

Hi all.
I posted another thread recently about my 14 year-old cat, Shyla, and her recent diagnosis of pancreatitis. Shyla has been home for 2 weeks now and overall, she is doing well. She has a follow-up with her internist in 6 days to discuss her treatment plan moving forward for management of her IBD and pancreatitis.
A few days ago, she started having fits of sneezing and some watery discharge from her right eye. She seemed totally normal otherwise, so we figured it was just something environmental that irritated her. She has continued to sneeze regularly for the past few days and this morning, my mom noticed that she was making a wheezing/whistling sound when she was breathing. She wasn't having any trouble breathing, just sneezing and making the wheezing sound, so we decided not to take her back to the ER and instead, took her to her regular vet. Her regular vet listened to her and said that her heart and lungs sound "crystal clear" and she thinks that the wheezing sound is coming from her being congested. I asked about possible aspiration pneumonia since she has been getting some liquid medications, but her vet felt confident that it was just a URI. She sent her home with 14 days of antibiotics (Zeniquin). My question is - would it have been more obvious if she had aspiration pneumonia? For example, I assume that she would have had crackling or wheezing lung sounds when she listened to her and she would have other symptoms if she had aspiration pneumonia? Her vet said that sneezing and clear/watery eye discharge is usually more related to a URI and aspiration pneumonia usually would not cause those things. I just want to make sure that it would have been obvious if she had pneumonia and we are not missing anything, as my poor girl has been through a lot in the past few weeks with her IBD, pancreatitis, and now this. I have also read that the prognosis for aspiration pneumonia is generally poor, so I have been worried about her all day.
Thank you so much for any advice!

 

[fionasmom]

It is very good that you consulted your vet. In the case of Shyla, it seems that the only chance of aspiration pneumonia would be from the liquid medication as she is not going around inhaling foreign objects or getting into mischief on her own. Vomiting and then aspirating some of the material can also result in this condition. The symptoms of aspiration pneumonia often include labored breathing in a very noticeable way, blue membranes, suspicious nasal discharge.

The treatment for aspiration and infectious pneumonia usually entails an antibiotic. If the condition does not improve, there are second steps in determining if the cause might be viral or fungal.

We can't diagnose Shyla, but it sounds as if your vet is taking the right steps. If she does not improve or worsens, let the vet know immediately.

Do you think that she aspirated any medication? Or that there is an environmental allergen or source of infection?

 

[lynne8832]

It is very good that you consulted your vet. In the case of Shyla, it seems that the only chance of aspiration pneumonia would be from the liquid medication as she is not going around inhaling foreign objects or getting into mischief on her own. Vomiting and then aspirating some of the material can also result in this condition. The symptoms of aspiration pneumonia often include labored breathing in a very noticeable way, blue membranes, suspicious nasal discharge.

The treatment for aspiration and infectious pneumonia usually entails an antibiotic. If the condition does not improve, there are second steps in determining if the cause might be viral or fungal.

We can't diagnose Shyla, but it sounds as if your vet is taking the right steps. If she does not improve or worsens, let the vet know immediately.

Do you think that she aspirated any medication? Or that there is an environmental allergen or source of infection?

Hi! Thank you so much for your reply. I agree that the only chance of aspiration would have been from the medications. The only liquid that she is taking right now is her appetite stimulant, Entyce. I am away at school, so my parents have been giving her the medications, but they said that there haven't been any signs that she aspirated any of it, as she never coughed or choked after they administered any of her medications. The only other thing I can think of is that she picked up a URI while she was at the ER/ICU a few weeks ago, but I can't think of anything else in terms of environmental allergens or things that could be irritating her. She seems okay otherwise, so we will plan to give her the antibiotics for the next few days until her recheck on the 23rd with her internist!

 

[fionasmom]

She could have picked up a URI very easily at the ER, even if they were following all the correct protocols for cleanliness. I have used Entyce/Elura for cats and dogs and it is a little bit viscous. Not that it could not go down the wrong way, but it is not as thin as some liquid medications.

Let us know how Shyla does when she sees her internist.

 

[lynne8832]

She could have picked up a URI very easily at the ER, even if they were following all the correct protocols for cleanliness. I have used Entyce/Elura for cats and dogs and it is a little bit viscous. Not that it could not go down the wrong way, but it is not as thin as some liquid medications.

Let us know how Shyla does when she sees her internist.

That's a good point - it's definitely a thicker liquid medication, and since her vet didn't hear anything in her lungs and it all sounded more like "congestion," I agreed that it sounded more like a URI rather than pneumonia. She took her first dose of antibiotics tonight, so we will continue to monitor her to see how she does!
I will definitely update this thread after Shyla's appointment with her internist on Monday - I assume he will do a recheck ultrasound to look at her pancreas and he will recheck her URI since it will have been 5-6 days since she started the antibiotics at that point!

 

[lynne8832]

fionasmom I also saw another thread on this site of an older cat that had pancreatitis and then started to have URI signs out of the blue and they suspected FIP, so now I am really worried. I could just be reading into it too much, but now I am worried about possible FIP

 

[fionasmom]

FIP is very serious and can develop at any age, but is usually seen in very young cats or kittens. According to Cornell University, 70% of the cats diagnosed are under a year and a half and 50% are under 7 months. A cat can certainly have a URI and pancreatitis without it amounting to FIP.

You are very vigilant about Shyla and I would ask, or have your parents ask, the vet. Even if you have overestimated the chances of Shyla ever having FIP, there are no silly questions. Having said that, FIP is hard to diagnose conclusively and can be a rule out/rule in, false negative/false positive kind of result. However, your vet should have enough experience in general to know if there seems to be anything suspicious in what Shyla is experiencing.

I have never had an FIP cat and given that all of mine except one have been reformed ferals, there certainly would have been enough chance for me to have encountered the infected colony/crowded and unsanitary conditions.

 

[lynne8832]

FIP is very serious and can develop at any age, but is usually seen in very young cats or kittens. According to Cornell University, 70% of the cats diagnosed are under a year and a half and 50% are under 7 months. A cat can certainly have a URI and pancreatitis without it amounting to FIP.

You are very vigilant about Shyla and I would ask, or have your parents ask, the vet. Even if you have overestimated the chances of Shyla ever having FIP, there are no silly questions. Having said that, FIP is hard to diagnose conclusively and can be a rule out/rule in, false negative/false positive kind of result. However, your vet should have enough experience in general to know if there seems to be anything suspicious in what Shyla is experiencing.

I have never had an FIP cat and given that all of mine except one have been reformed ferals, there certainly would have been enough chance for me to have encountered the infected colony/crowded and unsanitary conditions.

That makes me feel better, thank you so much. I'm so relieved that she will see her internist on Monday.
I do feel that it is probably more likely that she has pancreatitis and a URI - I assume it is possible that she could be having a herpesvirus flare-up because she has had a recent illness and the stress of a 4 day ICU stay? As far as I know, congestion, sneezing, and eye discharge can all be possible symptoms of a herpes flare up, especially since her lungs sounded clear at the vet yesterday.
I did ask for an emailed copy of her records from the ER/ICU today - I looked at her bloodwork which was mostly normal, but her albumin:globulin ratio was 0.7. I know that sometimes a low ratio can be attributed to FIP, so this concerned me, but I'm not sure if this is low enough to be worrisome or if it could be caused by something else.
My parents said that Shyla has been doing well today and that she ate earlier and took her antibiotics this morning. I feel like I'm probably just connecting dots that don't connect and it's more likely that the pancreatitis and URI are two separate issues. I'm hoping that since she has been eating and has an appointment with her internist in a few days, we will be able to come up with a plan for her in the long term. I know that pancreatitis/IBD/triaditis can have a good prognosis if it is managed correctly, but I also know that some cats can go downhill very rapidly, so I am hoping that Shyla responds well to her treatment plan.

 

[fionasmom]

Keep us posted as to how she is doing!

 

[silent meowlook]

Can you post her bloodwork?
is the albumin low and the globulin elevated?

 

[lynne8832]

S silent meowlook here is her bloodwork from the ER. Both the albumin and globulins were within the normal range.

 

[di and bob]

The WBC count indicates an infection. An antibiotic would be given, I give mine in a small amount of lickable treat. It sounds like a common 'kitty cold' to me, Feline Herpes, NOT transferrable to humans. Especially where the lungs are not involved. Eevn though it is a virus and antibiotics don't work on those. secondary infections of the lungs and sinus are very common. These viruses can easily be picked up at a vet's office or ER. Or being outside and in contact with an infected cat. I am dealing with it right now! discharge from nose and eye, sneezing and loss of appetite though even a few licks several times a day is good. I give Nose Relief I get at Walmart, Amazon, or Target online and keep it around. Make sure you ask your vet if you give anything extra besides the antibiotic. Some meds interact. All the luck!

 

[lynne8832]

The WBC count indicates an infection. An antibiotic would be given, I give mine in a small amount of lickable treat. It sounds like a common 'kitty cold' to me, Feline Herpes, NOT transferrable to humans. Especially where the lungs are not involved. Eevn though it is a virus and antibiotics don't work on those. secondary infections of the lungs and sinus are very common. These viruses can easily be picked up at a vet's office or ER. Or being outside and in contact with an infected cat. I am dealing with it right now! discharge from nose and eye, sneezing and loss of appetite though even a few licks several times a day is good. I give Nose Relief I get at Walmart, Amazon, or Target online and keep it around. Make sure you ask your vet if you give anything extra besides the antibiotic. Some meds interact. All the luck!

Thank you so much! My parents called me this afternoon and said that Shyla has been doing great today - she is on her third day of the antibiotics for the URI and they are able to get her to take the tablet by hiding it in a piece of cheese. They also said that her URI symptoms (sneezing, congestion, etc.) are still present, but significantly improved, which is great! She is also eating well and looks bright and happy, so it seems that she is on the upward swing after both the pancreatitis and URI. She goes to see her internist on Monday! I'm so glad she's doing better!

 

[di and bob]

So am I! All the luck!

 

[lynne8832]

Hi all! I wanted to give a quick update. Shyla is only on the prednisolone now (for long-term management of her IBD) and is no longer on the Cerenia or Mirtazipine (appetite stimulant) since her ICU stay and diagnosis of pancreatitis. Her appetite has gone back to normal and she has been her normal, happy self! She has a recheck with her internist tomorrow. She's also been on antibiotics for a few days because of her URI symptoms and they have almost completely gone away. However, our 2 other cats in the house have also started sneezing nonstop, just like Shyla did last week. They have no other symptoms, just sneezing constantly. I called the ER/ICU to ask if they had a known outbreak of anything, and they said that they weren't aware of anything. I assume that Shyla brought something home from the ER/ICU, as none of our cats have ever had a true URI and this all started shortly after she came home. I'm wondering if I should bring our two other cats in to their primary vet for antibiotics or if it will self-resolve in a few days. I'm not sure if this could be herpesvirus, calicivirus, bordetella, etc. as their only symptom is sneezing. Thanks in advance for any advice!!

 

[di and bob]

Sounds like feline herpes virus to me. My cats sneeze and get really congested. One cat is finally better after almost a week, but IS better!

 

[lynne8832]

Sounds like feline herpes virus to me. My cats sneeze and get really congested. One cat is finally better after almost a week, but IS better!

That’s what I was thinking too! Is it something that they should just get better from in the coming days/weeks? I’m worried that it could become something like pneumonia - hoping that Shyla just brought something home from the ICU and they all recover quickly! Sneezing constantly has been the only symptom so far

 

[di and bob]

I get that Nose Relief on Amazon. Seems to really help.

 

[fionasmom]

Several years ago I rescued a kitten with a serious URI. I took her to the vet and isolated her outside in a dog crate while she took all the medication and was given an all clear by the vet. I brought her inside and the other cats all got it. This may have been because I carried something in on my clothes despite being extremely careful. The vet gave me antibiotics for the rest of them and everyone recovered.

If this is a URI, it does spread like crazy.

 

[lynne8832]

Several years ago I rescued a kitten with a serious URI. I took her to the vet and isolated her outside in a dog crate while she took all the medication and was given an all clear by the vet. I brought her inside and the other cats all got it. This may have been because I carried something in on my clothes despite being extremely careful. The vet gave me antibiotics for the rest of them and everyone recovered.

If this is a URI, it does spread like crazy.

Oh no! I’m thinking that’s what’s going on here, I just wonder what she could have brought home from the ER/ICU. The good thing is that it sounds like they’re usually mild and go away within a few days? Shyla is completely fine now and it sneezing anymore. I also have a bunny at home so I’m worried about it spreading to him as well