What's the next move for a URI?

I had another thread, but it was long and it got buried...

We brought in a 5 year old outside kitty named Mike who had a terrible URI. He was given 2 doses of Convenia, which he did well on. His nose cleared up and looked pretty normal, but he still could barely breathe. The vet suspected a polyup, so they put him under and checked for one but found nothing. At that time he was put on Clavamox. He's done about the same on it...nose is great, breathing the same terrible story. Eyes were watery and icky on all drugs as well. His course of Clavamox ended yesterday. Maybe I'm just paranoid, but I think his nose is getting worse again already. So if it is, where do we go from here?

Each dose of antibiotics has lasted 2 weeks, so we're about 6 weeks into antibiotics here. I've also been using Lysine powder in all my cat's meals. Does that mean it's not a URI? If not, what else could it be? What other tests/procedures should we have done? Or are some URI's really this persistent? He does go into ridiculously crazy sneezing spells where he sneezes at least 10 times. However, I have the advantage of knowing he did this when living outside too, so I don't think he's allergic to anything in my house. Could this be asthma? I really know nothing about asthma (in cats or humans) so I'm not exactly sure the symptoms.

I'm just preparing myself to have to take him back to the vet next week. We should know by Monday whether his nose is going to start getting icky again. Just wondering what else to expect.

edit to add: He also has a drinking problem. He drinks a LOT. Pees the size of baseballs.

Originally Posted by RIccaDawn  

Or are some URI's really this persistent? He does go into ridiculously crazy sneezing spells where he sneezes at least 10 times. However, I have the advantage of knowing he did this when living outside too, so I don't think he's allergic to anything in my house. Could this be asthma? I really know nothing about asthma (in cats or humans) so I'm not exactly sure the symptoms.

Click to expand...

I'm more holistically inclined, and since you mentioned L-Lysine, here's a link to some things that you can try (and also a bit more info regarding L-Lysine use): Upper Respiratory Infections.

As for asthma, does he have a cough and wheezing? (A couple of the main symptoms.)

Since he is having a hard time breathing, did the vet ever check his heart and lungs for fluid retention, heart size, any abnormalities, etc.?

I had a kitty with a recurring URI for 8 very long months!  We finally found a vet who really helped us rather than throwing meds at us.  If he still has nasal and/or eye drainage (esp if green or yellow), ask the vet to do a culture & sensitivity test.  This will tell you a couple of things.  First it will tell you what kind of infection you're dealing with, viral or bacterial.  The sensitivity test will tell you which med(s) will most accurately treat the infection.  I also suspect that your kitty might have feline herpes.  The Real PCR/URD test will give you that answer and will also test for other Upper Respiratory Diseases (URD).  It tests for:  Bordetella bronchiseptica, Chlamydophila felis, feline calicivirus, feline herpesvirus type 1 (FHV-1), H1N1 influenza virus and Mycoplasma felis.  You can read more info on the IDEXX labs website.  There's also info you can print out and take to your vet.  http://www.idexx.com/view/xhtml/en_...menu/innovative-tests/real-pcr.jsf?SSOTOKEN=0
 

You might ask your vet for some eye/nose drops.  We used Gentimycin drops in Hannah's eyes and nose when she was so very sick.  Now we just do the drops in her nose when she is exceptionally sneezy.  You might also want to look into going to a grain-free diet, esp. if he ends up being diagnosed with Herpes.  Also, avoid prednisone and prednisolone for the time being.  These are steroids and they suppress the immune system and can lead to perpetuation of the illness. 

To help with the stuffed up nose, you can either put him in a room with a vaporizer OR steam him several times a day in a steamy bathroom.  Just get the bathroom nice and steamy and sit in the bathroom with him until the steam dissipates.  I have known people who have used plain saline nose drops to help break up the stuff in the nose. 

I'm not sure what a cough sounds like in a cat. (I've been a cat owner for less than a year now - this cat I've had for 2 months and the other 2 are kittens who are healthy.) I think I've read somewhere that cat coughs sound kind of like them wanting to hack up a hairball? If that's the case, then yes, he does that. But I'm not sure how exactly you tell the difference between a cough and them actually trying to hack up a hairball. As far as wheezing...I'm not sure if I'd call it wheezing or not? If he was a person, I'd say it sounds like he has a chest cold. The antibiotics have cleared up his nose, so it doesn't look so stuffy anymore, but he can barely breathe. Pretty sure we'll be going back to the vet, I'm just wondering what else to expect.

Have they checked for CRF?  Large pee balls and thirst are often signs.  The other symptoms don't fit CRF.

They haven't checked for CRF. What kind of tests need to happen for that to be diagnosed?

But I'm not sure how exactly you tell the difference between a cough and them actually trying to hack up a hairball.

Click to expand...

From my limited experience (also less than 2 years) I think a hairball cough is more rhythmic and they usually hunch down to the ground.  My Eko had what I think was a cough related to a cold and it would be one big hack at a time...sometimes it sounded so strange, almost like a bit of a scream.

Sneezing is not indicative of asthma.  Sneezing is indicative of either allergens or infection, just like in humans.  The repetative sneezing sounds like what my Hannah had when she has a serious nasal infection.  Kitty coughing sounds like a cough.  He may also have exaggerated swallowing (sticks neck out and then swallows "big") if he's got excess drainage.  Wheezing sounds like air being forced through a small hole, kinda squeaky.  I would guess that perhaps he's got something akin to pneumonia which has also affected his lungs.  Poor guy!! 

Has he had blood work done?  If not, ask for a full panel.  That will also give you a clue about his kidney function.  Do you feed wet or dry or both?
 

RIccaDawn said:

... but he can barely breathe. Pretty sure we'll be going back to the vet, I'm just wondering what else to expect.

Click to expand...

Here's a video of a kitty having an asthma attack:



There are many more videos on YouTube, just do a search for 'cat with asthma' on YouTube. Some kitties may present differently from this kitty, but this is pretty typical.

That being said, the fact that he can barely breathe is really concerning. Any number of illnesses can be the cause (heart problems, lung problems, nose/throat polyps, etc.). Here's some info from PetMD (go to the link to read descriptions of each of these listed below):

Dyspnea (difficulty breathing)

• Diseases of the nose
  • Small nostrils
  • Infection with bacteria or viruses
  • Tumors
  • Bleeding

• Diseases of the throat and upper windpipe (trachea)
  • Roof of the mouth is too long (enlongated soft palate)
  • Tumors
  • Foreign object stuck in the throat

• Diseases of the lungs and lower windpipe
  • Infection with bacteria or viruses (pneumonia)
  • Heart failure with fluid in the lungs (pulmonary edema)
  • Enlarged heart
  • Infection with heartworms
  • Tumors
  • Bleeding into the lungs

• Diseases of the small airways in the lungs (bronchi and bronchioles)
  • Infection with bacteria or viruses
  • Tumors
  • Allergies
  • Asthma

• Diseases in the space in the chest surrounding the lungs (pleural space)
  • Fluid caused by heart failure
  • Air (pneumothorax)
  • Blood in the chest (hemothorax)
  • Tumors in the chest

• Diseases of the chest wall
  • Injury to the chest wall (trauma)
  • Toxins from tick bites paralyze the chest wall
  • Botulism toxins paralyzes the chest

• Diseases that make the belly enlarged or bloated
  • Enlarged liver
  • Stomach filled with air (bloat)
  • Fluid in the belly (ascites)

Tachypnea (fast breathing)

• Low oxygen level in the blood (hypoxemia)
• Low red blood cell level (anemia)
• Asthma
• Fluid in the lungs because of heart failure (pulmonary edema)
• Fluid in the chest space surrounding the lungs (pleural effusion)
• Bleeding into the lungs
• Tumors

Panting

• Pain
• Medications
• High body temperature (fever)

Having trouble breathing can be life threatening, so the bottom line, he should be seen by a vet ASAP and have all necessary tests done. The drinking/peeing more could be signs of an underlying illness, or related illness. Have a full panel of tests run, including Hyperthyroidism (they normally don't include that unless asked or have a reason to). Diabetes and CRF/CKD should be included in the tests.

Sending major headbutts and purrs!

Wow! Thanks WhollyCat, that was really helpful. When I get time, I will see if I can find a video on youtube of a cat hacking up a hairball so I can see the difference, but for right now, I'm thinking that video of the asthma attack looks JUST like what happens to Mike from time to time. We're going to make another vet appointment asap just as soon as I get a day off work to do it. (On day 10 and counting...ugh. But yes, thankful to have a good job.)

Also, with URI, sometimes it just takes time to get over it.  You do want to watch for any discolored discharge from either the eyes or nose, but it really does take time.  Also watch for any change in litter box habits, eating, or playing.
 

that everything is ok!

Please forgive me, while I get used to this board, and get to know the kitties, and learn their names, lol. 

You want to be careful when using Convenia. Its a shot, antibiotic, that lasts 2 weeks in the system. Some evidence points to it lasting alot longer. The problem is, if the kitty has a reaction, to antibiotics, which can happen with cats, you have no way to stop it. Its already in their system.  Here is a site, regarding Convenia.

http://www.catinfo.org/?link=convenia

When a URI just won't go away, or goes away, but keeps coming back, you want to test for Bartonella.  They have to specifically test for it, its a blood test, and does not show up on the normal CBC and Wellness blood panel.  They usually give Baytril, its a stronger antibiotic.

Being that one poster brought up CFR, I would ask for a CBC and Wellness blood panel, if the kitty has elevated BUN or Creatine, that is an indication of kidney issues. I would also insist, it be sent to Antech, its a lab. They also have specialists there, that work with your vet, to help determine diagnosis and treatment.

How much L-Lysine are you giving? The dosage is determined by the weight of the cat. If the kitty is over 9 lbs, he/she can have 500 mgs a day, most split it into 250 mgs twice a day. If the kitty is under 9 lbs, it would be 250 mgs, once a day. Kittens would get 250 mgs, once a day, but it depends on their age, and that one, you would have to run by your vet.  

I would get the CBC and Wellness blood panel, and send it to Antech and test for Bartonella.

I also thought, the others gave you very good advice. Best of luck and hope your kitty is feeling better soon.    :-)