QUESTION:

Hello:

My 24 week old kitten has had a yellow discharge from her nose for the past 10 weeks. I have taken her for 7 vet visits, and we have been trying various things.

Initially, she was placed on Azithromycin, and she didn't have any further symptoms. Then they came back, initially with clear discharge, and then with the yellow discharge. She was placed on Amoxi, and that didn't help.

Then we tried antihistamines, but that didn't help either. She was then placed on Baytril, which she has been on almost for 6 weeks. She was placed on Prednisone for a week. It seemed to help her breathe clearer for a few days, but then she was back to the regular symptoms. She has been on Lysine for 10 weeks as well.

She has never had a fever, her lungs are clear, her eyes are clear, and there are no other symptoms other than the bilateral nose discharge and sneezing. Her X-rays and Bloodwork were all normal.

We also tried the humidifier, nose drops, and medicated nose drops to see if those helped. Currently, she will be tried back on the Azithromycin, and the vet suggested trying Interferon.

She eats well, drinks well, and plays hard. She has not lost her appetite in the slightest even with her stuffy nose. The vet does not suspect any polyps, tumors, or nasal blockage after thorough examination and given the symptoms.

I was looking for your insight in this situation. Have you had a similar case? Do you think this is reflective of chronic feline herpes rhinitis? Are there any tests that you feel are absolutely necessary to be done? Have you ever used Interferon in the treatment of such a case? Is they any other advice you can offer?

Thank you so much for your help.

Sherin

ANSWER

Hi, Sherin:

I really like the spelling of your name. I've never seen that before.

It appears with 99% certainty that your kitten is a chronic feline herpes virus sufferer. This condition is caused by the feline rhinotracheitis virus, a herpes virus, which is a virus that cats get that affects their upper respiratory system. Feline viral rhinotracheitis, FVR for short, affects almost all cats at some point during their lifetime. However, only a small percentage of cats continue to have intermittent symptoms throughout their lives.

The younger the cat or kitten, the more serious feline herpes can be initially, leaving some kittens with stuffy noses or damaged eyes for the rest of their lives. In my experience, this rarely leads to a shortened lifespan. I have a cat living in my office that is close to 20 years of age and she lost her eye to the feline herpes virus as a young kitten and has had noisy breathing and intermittent nasal infections and discharge her entire life. Yet, obviously she is quite elderly and has led a very happy life.

Your vet has tried pretty much everything that can be tried to control the infection. It is unlikely at this stage that the infection is going to go away and stay away. The goal should be to control it during outbreaks. Usually, as time goes on and the kitten gets older, there will be longer periods that are asymptomatic in between bouts of nasal discharge and sneezing.

It is the norm that chronic feline herpes cats eat well, play hard, and in general are normal and happy.

The usual treatment is L-lysine daily for the rest of the kitty's life and antibiotics as needed for outbreaks. Interferon has been tried and can be useful in some cases. It is certainly worth a try. Given orally, there seems to be no negative effects. It will either help or do nothing. The L-lysine in my experience is more important.

A humidifier can be helpful. Nose drops, such as Afrin, can be used with one drop placed in one nostril in the morning and a 2nd drop placed in the other nostril in the evening, for 3 days at a time only.

The only additional "test" I would suggest if it hasn't been done is to definitely find out if there are any polyps under the palate. A new patient came to me last year that had been suffering from the very symptoms you describe for 2 years. The cat had been to several different vets and had tried many different medications. The vets had looked in the ears and looked up the nose (as far as one can with a cat!) and decided there were no polyps present and the diagnosis was herpes virus. They came to me to see if anything additional could be done.

I sedated the cat and looked under the palate and found a long polyp which we promptly removed and literally as soon as the cat woke up, the problems of 2 years had disappeared.

This is rare and I don't want to get your hopes up, but if your kitten hasn't been sedated and hasn't had this procedure, it should definitely be done.

Again, if nothing else is found and this is Feline Herpes Chronic Rhinitis, do not be too alarmed. These cats live long, healthy, happy lives almost always.

Thank you for writing. This is an important issue and one that should be shared with everyone who lives with a cat. Good luck. If you have any further questions, there is no charge for follow-ups on the same issue.

My best to you and your kitten,
Dr. Neely

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