Chronic Rhinitis In A Cat: A Feline Herpes Outcome
This terrible condition called chronic rhinitis plagues my cat, which is most likely the result of feline herpes. What drugs are best for helping to combat nasal drip and congestion caused by chronic rhinitis that is caused by a) turbinate destruction b) aural polyp c) early stage nasal carcinoma? Nasal swab tests are negative for usual viruses and fungii.
This cat has had sneezing for years. He has in the last year developed an scc mass on his nose. He has an aural polyp. He has lately developed horner's syndrome with blood tinged secretions from one eye and sunken eye.
He also is doing alot of head shaking.
Antibiotics were helping with the nasal congestion which causes inappetance, but his current one is losing it's effectiveness. Cyproheptadine also helps with the congestion.
Can you suggest some possible drug combos that I can suggest to a vet (hard to find a good one here) that might a) dry up the congestion b) reduce any pain c) reduce inflammation of the nare. d) help his appetite
e)slow the progression of the nare mass which now bleeds weekly (he paws at it)
I am so sorry for your kitty's situation.
I can tell you what I would do in this case, but of course without actually seeing your kitty, you should discuss everything with your vet who has first-hand knowledge of the actual situation.
Actually, it sounds like the veterinary care is fairly complete. My additional thoughts are:
(1) Chronic rhinitis in cats is almost always due to early infection with a herpes virus. As you know, herpes cannot be cured and outbreaks occur from time to time. The treatment that seems to work best is antibiotics only when it's absolutely necessary because over years of treatment, resistance will develop. L-lysine is also given to cats with chronic rhinitis on a daily basis for the course of their lifetime. I have seen improvement with L-lysine and a decrease in the frequency of which antibiotics are required.
(2) You said in your email that swabs were negative for viruses and fungi. I assume
bacterial cultures were also taken and probably were negative also if he was on antibiotics at the time. However, if aerobic and anaerobic bacterial cultures have not been performed, they should be.
(3) Aural polyps can occur secondary to chronic ear infections or chronic ear mites or the polyps can cause secondary infection, etc. Is your kitty strong enough and healthy enough otherwise to undergo surgical removal of the polyp? I only mention this because it sounds like the polyp is causing the most problem at the moment.
(4) I don't know if several different antibiotics have been used or the same one repeatedly. I have the most success with Clavamox, but if that has been used frequently, then trying to identify an appropriate one with a culture would be my first choice. If that is not productive, I like a Clavamox/Baytril combination or CefaTabs (or CefaDrops).
(5) Cyproheptadine is very appropriate for the situation and is the best thing for appetite stimulation.
(6) Steroids (prednisolone) has to be used cautiously, but I would most likely be prescribing that. There is so much inflammation associated with both the polyp and rhinitis. Prednisolone would help that as well as stimulate appetite and also slow the growth possibly of the mass.
However, I would definitely cover the immunosuppressive effects of the prednisolone with antibiotics.
(7) Is the squamous cell carcinoma unable to be excised completely? If there was any chance of that and he is ok for anesthesia, that could be considered and removal of the polyp at the same time.
(8) Humidifiers are also helpful.
Again, I cannot say these are absolutely the things to do for your kitty because I don't have first-hand knowledge of his physical condition. I hope though that I have given you some ideas to discuss with your veterinarian.Good luck, Steve. My best wishes are with you and your cat. Feel free to write back any time.