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Dr. B.
Dr. B., Board Certified Veterinarian
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Experience:  General practice veterinary surgeon with extensive experience in a wide range of species.
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Hi our 16 year old cat caught cat flu in Spain and was treated

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Hi our 16 year old cat caught cat flu in Spain and was treated there using antibiotic and L lysine based natural product with b glucanase,quercitin and coenzyme .She has acute rhinitis and loss of appetite.She is being given biosolvon and ronaxan and periactin though this one in low dose.We are concerned that the bisolvon is affecting her appetite.
No other growths etc have been found.
Help please.

Thank you for your question.

 

Have they diagnosed which agent of cat flu Sapphire has (since there are viral and bacterial causes)?

 

Bisolvin doesn't tend to impact appetite (rather the congestion from the rhinitis is more likely to do so). That said, can you tell me what other congestion treatments you are giving/performing?

 

How long has she not been eating?

 

 

 

 

Hello again,

 

I have not heard back from you and you do appear to be offline.

I have to be away to see some kitty patients of my own just now, but promise to check back on you when I return. In the meantime, I do want to leave my thoughts about Sapphire so far.

 

As I hinted before, cat flu is an umbrella term for a range of agents that can cause flu like symptoms. The main agents of this group are the viruses known as Herpes and Calicivirus; as well as the bacterial agents, Chlamydophila felis, Bordetella, and occasionally Mycoplasma.

 

Now I suspect that she has not been tested to pinpoint which is to blame since I can see some treatments that are specific to particular agents (ie L-lysine is a feline herpes treatment & Ronaxan is something we' d use for C. felis or Mycoplasma). And while it looks like a lot of bases are being covered, if she is struggling to get over this and response to treatment, then you might want to discuss diagnostics with her vet. Because if you can pinpoint the agent, you can perhaps target treatment to that agent and discontinue any non-necessary treatments (which perhaps wil make her feel less harrassed and perhaps be more inclined to eat for you).

 

As I noted before, the Bisolvin doesn't typically affect appetite (unless you are putting it directly into her food an she is a picky kitty. And in that case, you can mix the small dose with water and syringe it separately.). Rather cats that have rhinitis and are congested will often be off their food because they cannot smell it (Feline logic dictates that if they cannot smell it, then it may not be food. And often that means that they will not eat it). Furthermore, with agents like the feline herpes or calicivirus, we can see viral induced oral ulcers. And in those cases, the associated oral discomfort can lead to a reluctance to eat.

 

In these cases, if congestion is to blame, we can usually get them eating by using smelly wet foods or even warming the food up a bit in the microwave. If the cat has oral ulcers, then sometimes pain relief needs to also be initiated. And if the cat is still resistant, then sometimes we do need to syringe feed them through this, support them with IV fluids (or even IV nutrition at some specialist practices) or even place a feeding tube (This is typically reserved for severe cases). In regards XXXXX XXXXX feeding, we often use Hill's A/D (LINK). This is a critical care diet that is comes as a soft, palatable pate. It is calorically dense, so a little goes a long way nutrition-wise and it's a means of getting calories into them even if we can't get a huge volume of food in. Some cats will eat it (since it is soft) when warmed up. But it can be made into a gruel by adding water, which they can then lap or we can syringe into them.

 

Alternatively, there is an animal version of Ensure (balanced for animals dietary requirements) called Clinicare Canine/Feline Liquid Diet (LINK). It is actually by the same people who make Ensure, but is formulated to meet out pet's dietary needs. Your vet should be able to order it for you but it is available without a prescription (some pet stores and even Amazon stock it). They also make one specifically for older cats with kidney troubles, and this could be an alternative for an older cat. And again it is a means of providing nutrition for them if we cannot get them to eat properly on their own.

 

Otherwise, when I had asked after the use of supportive care here, I was referring to some of the non-medicinal supportive measures that we do find useful for cats with these conditions. If she is congested, then we do often find steam treatment can be helpful for them. If she is at home with you, then you can take her in the bathroom while you run a hot shower. The steam will help loosen and clear some of the snot congesting her. You can also use a baby nebulizer, but often cats don't like things held up to their faces. That said, you can alternatively make little ‘steam tents' with her in their carrier, the nebulizer, and a bed sheet covering them both.

 

If she is building up mucus that the steam isn't shifting, use a cotton ball moistened with warm water to wipe away crust and mucus. Use saline nasal drops (like Ocean Mist) but not anything medicated. Tilt the head back and drop two to three drops in one nostril. Cats hate this, but it helps. After the drops go down, you can let the head up and wipe away any discharge that gets loosened. Then repeat with the other nostril.

 

Overall, anorexia is not an unusual feature of cat flu. Often it is secondary to congestion or to oral ulcer induced discomfort. But no matter the cause, we do have to persevere with treatment against the flu agent, potentially modify treatment to relieve congestion or pain, and also maintain nutritional support (even if it means syringe feedings, IV fluids or a feeding tube). So, I would consider any of the above you are not already doing. And if Sapphire is struggling with her aged immune system to fight this agent, then do consider taking steps to identify which cat flu agent is causing her troubles to then target her treatment effectively.

 

 

I hope this information is helpful.
Please do let me know if you have any further questions.
If you have no further questions, feedback is always appreciated.

All the best,

Dr. B.

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Customer: replied 5 years ago.
Sapphire has been very picky with her food for weeks and was only eating a small number of hills mature biscuits on the floor, no bowls or plates! She really hasn't eaten anything yesterday morning, on thurs last she weighed 2.5kgs and she must be less now. She will not eat soft food even warmed slightly, just turns away.

Hi again,

 

I do suspect that her appetite situation may be due to congestion with her eating off the floor (since just like people with congestion, some head positions will be more comfortable for eating and breathing at the same time). So, I'd really suggest initiating those supportive care measures for decongesting her if you are not doing them already to see if you can get her a bit less congested.

 

Furthermore, since she is turning her nose up at other food items and sounds to not be eating enough of the mature biscuits to keep her weight on, we need to think about supplemental feeding at this stage. And even though she won't appreciate it, this would be our cue to start syringe feeding at the very least. Because it does her immune system no good in fighting off this infection if she is wasting away at the same time. Rather the wasting due to her poor appetite will cause not just the obvious problems with for her body but also will deprive her immune system of the energy it needs to fight this cat flu agent and clear it.

 

Therefore, I'd strongly advise those supportive care measures I have noted above along with syringe feeding. If you do this until you can revisit her vet after the holiday, you can hopefully gain some ground against this agent. If you cannot and she is still struggling, then IV fluids or even a feeding tube would need to be considered for her.

 

Dr. B.

Customer: replied 5 years ago.
Thank you, XXXXX XXXXX see my other email re virus and sinus wash?
You are welcome.
I don't see any results. Perhaps try posting them again ?
Dr B
Customer: replied 5 years ago.
My previous reply was that she has had a blood test which shows she has calcivirus and rhinovirus.. What are your thoughts on biosolvon? And possible sinus wash?

Many thanks for your help.

You are very welcome.

 

I am a bit confused by your listing the test for the viruses (calcivirus and rhinovirus --which is the old fashioned name for herpes virus) since you noted that it was a blood test. I would advise double checking that is the case, since blood tests for these viruses would only tell us of antibody levels (which just says the cat has been exposed and any vaccinated cat would have a blood antibody titre to these viruses). Rather the kinds of tests we tend to do for diagnosing those two viruses are via oral swap (which is then tested with PCR or via a culture technique called virus isolation). So, it is worth a double check on these (and whether she was also tested for those bacterial agents I have also noted.)

 

In any case, assuming that she is truly positive for both viruses, we can turn our thoughts to the treatments for her circumstance. Now again, I don't think the Bisolvin is a problem. It is uncommon that this causes anorexia. More often it is helpful with decongestion and settling that often gets cat's eating sooner. That said, if you are concerned about it, you can try her without the Bisolvin for a few days to see if does have any bearing (since it is only a support measure and not imperative for treating the disease). If you do choose to stop the Bisolvin, then the steam and saline drops I noted may be substituted to keep her as decongested as possible. Or you could even try her off the Bisolvin if you do decide to have a sinus wash (which can be helpful for these kitties but can sometimes be just a short term fix if the immune system cannot get the infection under control).

 

That all said, I would advise speaking to her vet about the Ronaxan. It may be that they are using the Ronaxan against secondary bacterial opportunists (which is often what causes nasal discharges to go from clear to snotty colored) or if C. felis is suspected as well as the viruses. In either case, it is worth discussing this antibiotic choice here. Because while it is a very good antibiotic for respiratory conditions and C. felis, it can have the side effects of nausea and sickness. And it could actually be this side effect of the antibiotic that is partly to blame for her lack of appetite. Therefore, if they can rule out C. felis (which is a bacteria that responds best to treatment with the Ronaxan), then they might want to consider using a different antibiotic to see if this makes a difference for her. Or even seeing if the vet wants to add an anti-nausea treatment for her.

 

Finally, since you have noted that she is being bombarded with two cat flu viruses and with her being an old lady with an aged immune system, it would be worth speaking to her vet about the potential for anti-viral treatments (ie feline interferon omega, famciclovir) . While the supportive care and the treatments she is on are key and what we typically use in standard flu causes, we can sometimes see the immune modulating effects of anti-viral treatments aid kitties who are really struggling with a respiratory virus.

 

Dr. B.

 

 

 

 

Customer: replied 5 years ago.
Thanks very much for your help,we have a few things to try and also to talk to the vet about.There was no chlamdia found in the samples but another bug can't remember maybe pasteurella.Also if we get a different viral diagnosis using another method,would it effect treatment?
We thank you again for your help.

You are very welcome

Apologies for the wee delay, its seems the website was struggling for a wee bit this afternoon.

Still I think that sounds like a good plan.

In regards XXXXX XXXXX it is worth confirming what testing modality was used (most UK vets will use the oral swab PCR or VI that I had noted). If the diagnosis were to change, then it does depend on what was found to whether it would change the treatment regimen for her. Supportive care would be unlikely to change and most of the treatments will likely be the same. But as I noted before L-lysine is feline herpes specific, anti-virals would be specific for the viral agents, and antibiotic use would depend on what is isolated and what is not.

Otherwise, I am glad that she was tested for Chlamydophilia and that was negative. Pasteurella is a bacterial agent that we can see with respiratory disease (more lung based but can be associated with rhinitis as well). I do wonder if they have chosen the Ronaxan based off the antibiotic sensitivity testing that would have been done on the culture test that identified the bacteria's presence.

And while we often want to use the first choice in the culture sensitivity, if her poor appetite is being triggered by side effects of these antibiotics, then it would be worth having them check the culture results to see what other options could be tried for her. So, if there were another antibiotic that the bacteria is sensitive to on those culture results, then that would be an ideal alternative. Though if it were a nasty bacteria that was resistant to all else (uncommon but possible), then we'd want to consider adding in an anti-nausea medication with the Ronaxan to see if that settled her stomach and perhaps helped this poor appetite.

 

All the best,

Dr. B.

Customer: replied 5 years ago.
Brilliant thanks so much,maybe you could be our vet here ?

You are very welcome.

Thank you for your kind words, but I would suspect that Sapphire would not appreciate the travel of coming to see me. ; ) In clinical practice, I am locum veterinary surgeon (meaning I travel around the country helping vet practices that are short on veterinary surgeons). Therefore, I am often in a different locale each week, which most kitty patients would not approve of moving around the country just to see me.

Still you do have my help here. And if there is any further guidance I can provide you with helping Sapphire, just let me know.
Take care,
Dr. B.

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