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Upper Respiratory Infection (URI) Won't Go Away  

post #1 of 36
Thread Starter 
I'm hoping that someone can provide some insight into an issue that I am having with my 10 yo Calico.

She was diagnosed with mammary cancer a few months back and was undergoing chemo. Unfortunately, a latent virus kicked up and she developed a URI that we cannot seem to defeat.

To date she has been on two different antihistamines, Clavamox and Bactryl antibiotics, has undergone a sinus flush, but all to no avail. We have also been using a nebulizer with little effect.

Last night she became extremely congested after her nebulizer treatment and we had to run her to the vet. She was only able to breath through her mouth...both nostrils were completely clogged.

Does anyone have any experience with the use of Medrol or other steroids to reduce the inflammation in feline sinuses?

I'm drawing upon my own allergy/URI treatments and steroids are the only thing haven't been tried yet. I'm also open to any other treatment options that you may have seen have an effect on what I've described above.

Thanks in advance for your help. I'm out of ideas.
post #2 of 36
Welcome to TCS!

There are other antibiotics that could be tried....Clavamox isn't overly strong, IMO it's kind of a "general" antibiotic. I'm not familiar with Bactryl, did you mean Baytril?

You could also try Orbax, IMO it's one step up from Baytril. Another one to talk to your vet about using is Tetracycline.
post #3 of 36
The thing to do is doing a culture and sensitivity test to find out what kind of organism is causing the infection. If it is one that requires treatment with a cephalosporin antibiotic, for instance, it will not respond to clavamox and other antibiotics. It is crucial to do a culture and sensitivity test because the results will tell what kind of organism is causing the infection and which medication(s) it will respond to.
post #4 of 36
Thread Starter 
Sorry...I should have mentioned before. When they did the nasal flush, they did a culture and found two different strains (pseudomonas & one that the vet was less worried about) and yes, it was Baytril that she was put on for the second round after Clavamox proved ineffective.
post #5 of 36
Thread Starter 
BTW, thank you for the insight into the use of Orbax and/or Tetracycline. I'll discuss those as new options with her Vet.

I asked about the Medrol simply because in humans, most of the time URIs are treated with an antibiotic, antihistamines, and a steroid such as Medrol or Prednisone (esp if the root cause was allergic rhinitis). Was just wondering if it translated over into the feline world as well.

Agan, thank you for your insight and assistance. It's very much appreciated!
post #6 of 36
Getting rid of a pseudamonas infection is difficult. My Hannah had a pseudamonas infection in her nasal passages almost 2 years ago and the vet treated her with Zenequin, 25 mig. We did a 21-day round, twice a day, then did another culture and sensitivity test. The test showed that the infection was better, but not within acceptable levels, so we did another 21-day round. The vet also gave us Gentamicin nose drops, which also helped clear up the infection.

I don't want to be a downer, but pseudamonas is one of the most drug-resistant infections. It can lead to death in humans and cats. Hope all goes well and your girl gets better!

ETA: If you have questions, you can inbox me.
post #7 of 36
How long has she been on Baytril? Was told min is abt 3 days before you see if the antibiotics is working.

My little girl had pneumonia but no discharge to do any culture. She was also given Clavamox initially, no effect so we changed to Baytril a week ago. The pneumonia is starting to clear up now.
post #8 of 36
Thread Starter 
As of today, she's been on it for two weeks and we really haven't seen any improvement. I am going to ask about the Gentamicin nose drops mentioned earlier by Stephanietx and see if a two pronged attack might improve our odds.

The last update from the vet this morning is that she is breathing again and was able to self feed last night. I'm trying to keep my hopes in check as we've been down this path already where she looks like she is turning the corner and then crashes again a day later.

Thank you for your advice, it is very much appreciated!
post #9 of 36
Something else to remember is that your kitty's immune system is already under attack from the cancer, so it's going to take her longer to recover from any type of illness. Do all the things you would do for a healthy cat who has an URI (vaporizer, steaming, elevating the food dish, warming up wet food to enhance the aroma) and give her lots of TLC. One other thing you might want to talk to your vet about is an appetite stimulant. Oh! And ask about feeding her Science Diet a/d food. That stuff is like kitty crack!
post #10 of 36
Thread Starter 
Just got an update from the vet. She's going to start her on Interferon and is going to consider the Gentamicin nose drops to use in conjunction with the other antibiotics. Thankfully she's already on Cyproheptadine for her appetite so hopefully once the new meds kick in she'll be ready to eat.

Keeping my fingers crossed!
post #11 of 36
Have your cat tested for Bordetello. It's what causes kennel cough in dogs. I had a very rough 3 months with some kittens last year with upper respiratory infections. We finally figured out through testing that it was bordetello causing it. Once they knew they were able to treat it correctly and get rid of it.
post #12 of 36

Hi!  I need some help for my kitty Gracie. 


She is at least 12 yrs old, a stray/feral mom of 6 kittens when I found her in 2004.  About one week after I had some kind of sinus drainage that didn't last but about a week, I noticed she had an infrequent cough.  Sounded weird to me.  Like a back of the throat kind of cough, not a deep airy asthmatic kind of cough.  I asked her then if she had a kitty cold, and she just looked at me like "what?" Lol.  


Then about 2 weeks after that, I noticed more noisy breathing where she seemed to have difficulty pulling the breaths in, no drainage.  Took her to vet #1 on a Saturday.  Wanted X-ray, started her on Orbax 30mg/ml - 1.3 mil once a day.  Two days later, noticed improvement in breathing - less noisy and no cough - but an increase in difficulty breathing.  Took her to vet #2 (her normal vet) where she had a panic attack complete with open mouth breathing, pale gums.  They gave her O2 and a shot of Dexamethasone (steroid).  Then the vet did the Xray and said "she has asthma".  So started on Prednisolone and Theophylline.  This vet gave her an additional shot of Dex before sending her home.  That night she seemed greatly improved by the steroids.  Seemed to improve over the next week.  Her appetite was good, almost too good for a kitty with an URI.   I quit giving her the Orbax after the 5th dose.  I regret that now.  


The next Monday, she started getting worse, noisy breathing, pulling in breaths.  Went to ER vet (vet #3) who said she has asthma but wanted to keep her and do a full workup.  She gave another shot of Dex to improve her breathing.  We went home.


Then Friday morning that same week (week 2 of this) I took her back to ER vet (vet #4) thinking I was going to be putting her to sleep.  This vet took another X-ray and sent it to a radiologist to interpret.  The diagnosis came back: pneumonia.  So she gave her shot #4 of Dexamethasone and we went home on Clavamox twice a day and restarted Orbax.  This vet D/c'd the Theophylline and said to wean the Prednisolone slowly as I started her on Flovent inhaler through a spacer twice a day.  Then I began noticing a little bloody drainage out of the left side of her nose, which turned to off whitish.  Thick, and infrequent.  Gave a dose or two of Chorpheniramine which didn't seem to help and it made her drool and struggle to breathe excessively while dealing with the drooling.  I was scared she would choke.  So I didn't continue that.  


About 2 or 3 weeks later, Went back to vet #2 for another X-ray.  This one showed NO improvement.  She still maintains Gracie has asthma.  Kidney values on high end of normal.  


I'm looking for vet # 5 because I don't think her real problem is being addressed here or if it is, the meds aren't really helping.  Overall, slight improvement, but still continues to have intermittent drainage and now the drainage is thick yellow and slightly greenish.  Her appetite is ravenous!  You'd think all this drainage would dampen her appetite but it hasn't.  I'm thinking the steroids (the shots/ the oral pred/ and inhaled steroid) have something to do with her appetite, but maybe there is something else going on here.  Wondering if it's diabetes or even thyroid issues?  But she doesn't show all the signs you'd expect to see.  She doesn't drink more than the other kitties, but she never misses a meal.  She no longer has any interest in dry food or her Temptations treats which may be why she is eating more, I don't know.  


So I'm back to looking for a really good vet to take her to, but I don't know who.  Searching Angie's list and asking people for recommendations.  She's sitting beside me quiet but can tell she's not feeling great.  Just wiped her nose of a little drainage - no change or worsening in color.  


Any suggestions?

post #13 of 36

Ask the vet to do a culture and sensitivity test of the drainage and/or discharge to determine what's going on.  There could be an underlying secondary infection.  The culture will tell the vet if it's viral or bacterial and the sensitivity test will tell which med will best treat it.  No sense throwing medication at the kitty to just have the symptoms return. 


If she's congested, she's not going to want to eat because she can't smell the food.  Try steaming her in the bathroom to help break up the congestion in her nose and try getting her some original (classic) Fancy Feast pate and warming that up with a little bit of water added to make it the consistency of oatmeal.  Or if she eats wet food daily, warm up a small serving to enhance the aroma.


Lastly, you have to give the meds time to work.  It takes a good 3 days of being on meds to see any significant improvement, in my experience.  Look for baby step improvements, not huge improvements.  Also, with her age, it might take her longer to recuperate, so be patient while the meds do their thing. 

post #14 of 36

Hi Stephanie,


Thanks for your reply.  I know that what I wrote was really long, and that people reading it might skim over it and miss a few things.  There is nothing wrong with Gracie's appetite, even though she is congested she is ravenous, and she already eats pate'.  She just does not like her dry food anymore since the congestion.  But thanks for the suggestion to help decongest her, that is helpful.  I wonder if her being ravenous is a symptom of either diabetes or high thyroid.  


The first vet put her on Orbax and she was only on that initially for 5 days, but later the 3rd vet put her back on it and she stayed on it daily for over 3 weeks  So she has had a good run of it with little improvement.  Her main doctor still thinks she only has asthma.  When I asked about polyps, she said "those are hard to find." 


Kinda at my wits end.  Today, she hasn't been sleeping much and it's got me worried.  I worked the whole weekend and had my sister come check on her during the day.  Each day she reported Gracie ate well.  So she may not be resting well here lately.  Oddly the snorting breathing seems a bit better today.  It's always better right after she's had drainage.  I am at a loss who to take her to.  Four vets she has seen so far, and all have slightly differing opinions and now I'm thinking of taking her to a new one in the morning because she isn't getting better after nearly 2 months of being sick.  I don't know what else to do.  

post #15 of 36

Sounds like there's a secondary infection going on that's causing all these other complications.  It's possible that the steroid shots have caused the ravenous appetite. I know that's one of the side effects of steroids in humans.  If she hasn't already had one, a senior blood panel would help diagnose or check for any thyroid problems or diabetes.  It would also check her liver function and kidney levels. 

post #16 of 36

Gracie had Chem12 and CBC at recheck with vet #2.  Kidney values are high normal, the rest normal. 


I'm going to consult with another vet for a 5th opinion.  As for right now, she is stable.  Despite drainage, still has a very good appetite.  All I can think is that she must have a viral sinusitis not resolving quickly due to age or whatever else is going on with her.  Never had her tested for FIV or FLV. 


Not sure how to post a pic of her and her nose drainage but will try.  



** WARNING **  Might be offensive! 




post #17 of 36



Took Gracie back to vet #1 who may well be her new vet.  He said her vet, the one who did the last x ray and labs in May, had done a test for leukemia and Aids and she was negative on both of them.  Thyroid and glucose numbers were fine also.  He still hasn't ruled out the possibility of a mass or polyps, but started her on a new antibiotic called Azithromycin once a day X5 then every 3rd day for the next month, recheck in 10 days.  I feel like this vet is at least doing something for her.  He also let me have some more Fortiflora to give her while she's on the antibiotic.  Today makes the 3rd day.  Can't really tell if there's improvement or not, yet.  <sigh>  She seems to be snorting a bit less.  

post #18 of 36

Another update:


It's now day 6 after starting the Azithromycin and Gracie is getting better!!  Very little snorting today and when she did it was much quieter than it was.  And there's no longer any drainage coming from her nose.  I'm so relieved!

post #19 of 36

And another update:  


So last night the noisy breathing and snorting started back again.  :(


Took her back to the vet this morning.  He suspects a mass or a polyp.  Will need to have a flex scope either way.  I can't believe this isn't resolved yet.  


What I don't understand is if this is a polyp or a mass, why did a steroid injection help so much?  I don't think steroids can reduce masses or polyps, can they?

post #20 of 36

Steroids have anti-inflammatory properties, so it would help to shrink any inflammation including a mass. 

post #21 of 36

Did you ever request a culture & sensitivity test?  Might explain why the meds worked initially and then then symptoms returned.

post #22 of 36

Yes I did request a C&S, but the vet didn't want to do that, saying there will always be bacteria in the sinuses and we'd be chasing our tails, so to speak.  He said most sinus problems would respond well to Azithromax.  So he put her on it for 5 days, then decreasing to every 3rd day for a month.  She did get better after 5 days.  Then after the 2nd day off it, she started snorting and getting congested again.  Maybe she just needs time to adjust to every 3rd day?  


She is continuing on the Flovent once a day for her asthma.


The vet told me I could give the Azithromax  every other day for a week then back to every 3rd day.  He is concerned about gut dysbiosis and so am I.  She's taking the Fortiflora once a day at the evening meal, and her antibiotic in the morning on days its due.  I'd like to keep her on fortiflora until she is off the antibiotic.


I want to give her more time to see if she improves or gets worse or just stays the same, before agreeing to the flex scope.  Besides, the only guy in town who can do that is on vacation right now, so it wouldn't happen this week anyway.  

post #23 of 36

Followed up with a different doctor at the same vet office.  He thinks she has either a mass or a polyp.  Suggested referral to another vet in town who can use a flex-scope to look in her ear.  Of course that vet is on vacation, until this coming week.  She is ok at the moment.  Still snorty when walking around.  Fairly quite when still.  Some drainage but it's clear yellow, not cloudy yellow green anymore. 

post #24 of 36

Latest update:  


Gracie is now seeing a local vet internal medicine doctor today.  He thinks she may have Herpes virus, not a polyp, but won't know without further very expensive diagnostic tests.  This is getting too expensive for me.   She's still there now so I won't know until this afternoon later. 


He asked if my other kitties have drainage.  Nat does.  He has some intermittent drainage from his right eye that will clear up and then come back.  He also has seizures.  Connection?  Can herpes virus cause Nat's seizures?  If that's what he has.  If so, will Gracie also develop seizures?  


More later.

post #25 of 36

Yet another update:


The latest vet (vet #6) says he does not believe Gracie has a polyp because if she did, she would be mouth breathing all the time and the snorting would never go away.  Right now she only snorts when she gets up and walks.  While seated she is relatively quiet.  He tried to clean out her left ear.  For a while now, she has been bending that ear down, scratching at it, and flapping her head when that left ear gets touched.  He said there was a large amount of crusty black matter, like old blood.  And it was hard.  He tried softening it down to remove it but could not while she was awake.  So, he wants to anesthetize her and clean out her ear and then do a CT to view her upper respiratory tract and make a proper diagnosis and treatment plan.  He suspects she has a chronic viral respiratory infection that can only be minimally treated, but not cured.  :(

post #26 of 36

It's very possible that she has herpes and that's causing a lot of the respiratory/ear problems.  It would be good to get her ears cleaned out and see if she has a yeast infection going on in there.  If so, the doctor can give her BNT ointment in her ear to help clear that up.  Things might also be aggravated by any seasonal allergies.  Do you give your kitty a daily antihistamine?  While she's under, ask him to do the culture and see if the pseudomonas has cleared up or if it is still raging.  If it's not cleared up, it will cause ongoing problems.

post #27 of 36

He said bacterial infections are likely to be ongoing,  but not usually the primary cause.  He said Herpes is most likely responsible and there's not much that can be done about it.  I'm worried about putting her under.  She's 14.  She is still taking the Fortiflora at suppertime. 

post #28 of 36

I saw Dr. Helms again with Gracie about a week or 2 ago for follow up.  Went over medical options.  He said to keep her on low-dose Azithyromycin, every 3rd day, for now.  So, now after 2 weeks it seems like every 3rd day is not enough as the snottiness has worsened, sometimes there's blood mixed in, sometimes it's just a dark greenish boogery looking snot.  Before, her runny nose was clearing with the antibiotic.  This doesn't happen all day long, what happens is she snorts for a while - usually when she gets up and moves around - if she shorts while sitting then the snorting slowly improves and that's when I see her nose start to run.  


I never would have believed she would get sick and just stay sick forever like this.  I'm very disappointed that there's no way to treat this.   

post #29 of 36

Again, I would really push for the culture & sensitivity test since this isn't clearing up with the azithro.  That's a pretty heavy duty antibiotic.  Also, you might look up the PCR URD test and have that run.

post #30 of 36

Thanks Stepanie.  Dr. Helms (the internal med vet) checked her out, he removed a small amount of dried black matter - old blood - and he checked it out under the microscope and found nothing.  He could not see in to the inner ear due to swelling and says this can only be done under anesthesia.  He wants to do a CT and use the flex scope to diagnose her properly - $2000 for that.  THEN surgery, which will be another thousand dollars.  I have asked for the C&S but they maintain (Dr. Helms and 2 others have told me this on different occasions) that it would not help.  The Azithromax is the only thing that did help, but after she finished her 5 day run she only had 2 days without snorting and the drainage had gone, then it started coming back.  There is something deep in her ear/nasal cavity which is the problem.  Until that is removed, she will continue to have this.  I'm at my wits end.  I'm also at the end of my care credit balance because of so many vet visits.  I lost my mom a year ago and I'm still devastated at her loss, very depressed.  I'm also trying desperately to get a better job, but depression is fighting me.  Finances are strained after 2 1/2 yrs of keeping my mom here at home.  I'm seeing a counselor too.   I am not prepared for yet another loss.  Gracie is my baby.  I have suicidal ideations at times because I get so overwhelmed.  Then I pray to my mom and it helps me have some hope.  

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