Upper Respiratory Infection (URI) Won't Go Away

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

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.  

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. 

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.

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.  

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.

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. 

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.   

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.

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.  

I had thought Gracie's return of drainage (yellow/green) meant the Azithromax wasn't working.  Boy was I wrong.  I accidentally missed a day twice so she went 4 days between doses.  That's when I noticed MORE worsening of the drainage, it's thicker and a little darker.  So I started giving it again, after I talked to her vet, every 3rd day again.  That has helped.  Besides putting her in the bathroom while I shower to help with her thick secretions, what else do you recommend to help?  I have been giving her chicken broth, which she likes, for the benefit of her gut flora along with the Fortiflora once a day.  Perhaps I should take that away and just give her water?  She does drink a good amount of water. 

As I mentioned on another thread, yesterday I came home from work and found her hiding.  When I got her out, I saw both pupils were blown.  She was blind....and terrified.  Today I decided to have her euthanized.  She breathed her last at 1:55pm today.  My heart is broken.  I love you Gracie, I always will.  

My dear sweet Gracie girl!  I would have thought by now someone would have noticed my post about you and offered a kind word of sympathy.  You certainly deserved some kind words, but for some reason that hasn't happened yet.  Know that regardless the reason, you deserved your moment for the passing of your precious life.  Your life is still precious to me and my pain and grief over losing you matters.  I so wish I could have raised the money to at least diagnose you properly, and then to get the proper treatment for you.  

Rest sweetly dear girl.  Godspeed.  

I just saw your post. So very sorry about sweet Gracie. She was beautiful.  Rest in peace, Gracie.

If you are up to it, you might also want to post a tribute to Gracie in the "Crossing the Bridge" forum:  http://www.thecatsite.com/f/19/crossing-the-bridge

I'm so sorry for your heartbreak. Gracie is a gorgeous kitty, love her mustache markings. I'm so sorry, it sounds like you did all you could for her, ((HUGS))

ginny I'm so sorry you lost your sweet Gracie. This thread will now be locked, as per TCS policy.