The Patient
Ninja, a 6 month old male intact Burmese kitten, came to see me for chronic sneezing and eye problems. He had been purchased from a breeder at 10 weeks of age and had been showing clinical signs of sneezing (sometimes up to 100 times per day), cloudy eye discharge, squinting of the eyes, and sometimes a clear nasal discharge since the owner acquired him.
The Case
On examination, Ninja was bright and alert and did not seem to be in any distress from his respiratory illness. He had a clear nasal discharge coming from both nostrils, a cloudy white eye discharge coming from both eyes, mild squinting of the eyes, and he sneezed a few times while in the exam room. His temperature was normal and his heart and lungs sounded normal with my stethoscope. I asked the owner about any recent vaccinations since we had not seen him before. She told me that the breeder had vaccinated him prior to purchase and he had not had any since. I educated the owner that kittens require a series of vaccines between the ages of 8 and 16 weeks of age to protect them against many illnesses. I let her know that I was most concerned about a disease called Feline Herpesvirus (FHV-1). The FVRCP vaccine is a combination vaccine that protects against Feline Viral Rhinotracheitis (FVR) otherwise known as Herpesvirus, Calicivirus (C), and Feline Panleukopenia Virus (P) in cats. The vaccine should be given every 3 weeks starting at 8 weeks until 16 weeks of age. I recommended that we test Ninja for several different respiratory diseases with a simple throat swab PCR test which detects the DNA of viruses and bacteria in saliva. We also drew blood to check his metabolic health and also to prepare to get him neutered soon. I started Ninja on an oral antibiotic as well as a topical antibacterial eye drop to help treat his current infections. A few days later the results were back. Ninja tested positive for Feline Herpesvirus and Feline Mycoplasmosis. FHV-1 is a highly contagious upper respiratory virus that affects a large percentage of cats coming from breeders and shelters. Once a cat is infected with the virus, it will always be in the cat's body. It cannot be cured. The virus lies dormant in the nervous system kept under control by the cat's immune system. During times of stress, when the immune system is suppressed or busy doing something else, the virus becomes active again leading to clinical signs. The most common signs are sneezing, rhinitis (inflammation in the nose/sinus), and conjunctivitis (inflammation of the lining of the eyes). Signs are typically most obvious in young kittens and can cause such severe eye disease that it can lead to corneal damage or even blindness. FHV-1 is only contagious to other cats (not people or dogs) and is spread in the form of respiratory and ocular secretions. Because FHV-1 is a virus and not a bacteria, antibiotics only help if there is a secondary bacterial component to the clinical signs. I often have to put these cats on long term antiviral medications to help control symptoms. Ninja also tested positive for feline Mycoplasmosis which is a bacterial disease that may or may not be playing a role is his disease. Many cats test positive for this and do not show any symptoms.
The Treatment Plan
I let the owner know that while we were treating Ninja with an antibiotic, I didn't necessarily think the mycoplasma was causing any of the clinical signs. I also let her know that we should booster Ninja for FVRCP to help protect against the other viruses in this vaccine as well as a rabies vaccine. There is also a supplement I always recommend when I diagnose FHV-1. L-lysine is an amino acid supplement shown to reduce the duration and severity of herpesvirus flare-ups in cats. It can also lessen the shedding of the virus making it less contagious to other cats. There are many L-lysine products on the market for cats including gels, powders and chewy treats.
The Outcome
I recommended a recheck with me in 4 weeks to assess his need for an antiviral medication. If you are unsure of your cat's vaccine status or your cat is showing signs similar to Ninja, don't hesitate to reach out to us.
The Drake Center for Veterinary Care is an AAHA-accredited animal hospital located in Encinitas, CA. The Drake Center loves being a source of information for all pet owners across the country; however, if you have any questions regarding pet care and do not live in Encinitas, CA or surrounding cities, we encourage you to contact your local veterinarian.