The 4-year-old petite, orange tabby presented to me (Dr. Perry Jameson) with a history of sneezing and occasional clear fluid draining form her eyes. Mom said this had been going on since they obtained her. Antibiotics never helped nor did antihistamines.
My physical examination revealed her to be in good shape with a well-groomed coat, indicating she felt well. The only abnormalities were a small amount of clear fluid from each eye and a mild increase in nasal sounds.
After getting her history and finishing my examination, I started making a list of causes for her symptoms. For the nasal symptoms, foreign bodies, tumors, fungal infections, and tooth root abscesses are the first problems I thought of. However these should not cause her eyes to drain.
The combination of ocular discharge, nasal symptoms and lack of response to the antibiotics made me think viral, herpes virus in particular.
Herpes virus infections cause conditions we call feline viral rhinopneumonitis, feline viral rhinotracheitis and feline herpes virus type I. An infected cat will usually have symptoms similar to those we get with a cold, such as sneezing "attacks," nasal congestion, watery eyes and nose, inflamed swollen eyelids, fever, loss of energy and a poor appetite.
In severe eye infections, serious corneal ulcers can develop that if not treated can result in permanent vision impairment or even loss of the eye itself.
Secondary bacterial infections may develop, too. You know this is occurring when the discharge changes from clear to a thick green/yellow.
Cats become infected from exposure to an infected cat. Herpes is highly contagious and can be a major problem where multiple cats are kept together such as shelters and multicat households. The virus is shed in secretions from the eyes, nose and mouth. Sharing of food and water bowls and litter boxes, as well as mutual grooming are the primary means it is passed from cat to cat. People can transmit the virus from one cat to another on their hands and clothing.
All cats are susceptible but especially those stressed by their environment or another disease. Kittens, Persians and the flat-face breeds may develop more severe symptoms.
Once infected, a cat has the virus for life. Most cats never show symptoms again and remain asymptomatic carriers. These cats still may shed the virus periodically throughout their lives. Environmental stress or another disease can allow symptoms to recur.
An additional problem when kittens are infected is that they may become "chronic snufflers." Being infected at an early age results in damage and distortion of the nasal turbinates and epithelium. This change in the nasal cavity anatomy and defense mechanisms sets these cats up for chronic bacterial infections for the rest of their lives.
Herpes is usually diagnosed based on history and physical examination findings. If the cat is actively shedding the virus, there are several techniques to identify it in nose and eye secretions. This is the only way to know for sure that herpes is the cause for the symptoms.
Supportive care treatment is the same as for a human with a cold. This includes maintaining hydration and nutritional support and cleaning eye and nose secretions. Keeping the nose open will not only help them breath but improves appetite since they can smell and taste their food. Removing the cat from any stress that could affect her immune system may shorten disease duration.
If symptoms are severe, antivirals can be prescribed to shorten the episode. We have some patients who have a bout annually requiring a week or two of antiviral therapy. If a secondary bacterial infection is suspected, antibiotics may be started. Hospitalization to administer intravenous fluids and antibiotics may be required in severe cases.
The best prevention is to never let your cat get infected. Separate a cat that may be shedding and keep them separated for a week following resolution of symptoms. Wash your hands and clothing after coming into contact with infected cats. Vaccination against the virus is recommended as well. This may not totally eliminate an infection, but it will reduce the severity of symptoms.
The best way to prevent flare-ups is to avoid stress. Cats do not like changes to their environments. Changes in daily routine, a new pet in the home, new visitors, a move and loud noises are all examples of things that can stress your cat. Make sure your cats have clean bedding, access to natural light and places they can hide.
Fortunately, herpes viruses are species specific. This means you cannot get it from your cat or give it to them either.
My little tabby patient tested positive for herpes and responded well after a few days of an antiviral. Mom separated her from her other 3 cats and so far no one else is showing signs of infection. She also got their vaccines boostered as a precaution.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to firstname.lastname@example.org.