FIV+ cat with recurring chin acne and UTIs

One of our foster cats, Effie, is FIV+ and keeps getting really bad chin acne and UTIs. The vet is reluctant to give her steroid shots as it is an immunosuppressant but we've been through several rounds of antibiotics and it doesn't seem to help. Well, the UTIs seem to get better but this last time the chin isn't really improving (it's better but by no means cured). We've also been applying Panalog ointment to her chin.

Have other folks found a way to deal with this? She eats only from ceramic dishes changed at every meal and eats canned Wellness chicken. 

Awe, bless you for fostering an FIV+ cat   I think you might be able to treat the chin acne without any medication at all, especially since the Vet doesn't want to give him any steroids.

Here are a threads that gives some helpful tips for what you could try.

http://www.thecatsite.com/t/251544/acne

http://www.thecatsite.com/t/250146/11-month-old-has-cat-acne

Since she appears to have recurring UTI's, did the Vet recommend a different diet?  I know Wellness is a good brand, but maybe in her case, it's the wrong food?

jimmylegs said:

Have other folks found a way to deal with this?

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jimmylegs, I think you'll get the very best advice about managing her FIV from the folks here http://pets.groups.yahoo.com/group/FIVCats/?v=1&t=search&ch=web&pub=groups&sec=group&slk=2 IF I were in your position, that's where I'd be. These folks have been successfully managing their FIV+ kitties for years - they're on top of the latest treatments, and often have info on new clinical trials etc. There ARE immune-strengthening strategies available. (If you're reluctant, you could always join the group and simply read the back-and-forths between the experienced members - a "test-drive, so to speak!) The collective experience of these groups is definately well beyond that of the "average" Veterinarian.

About the recurrent UTIs...there's excellent coverage of UTIs in a well-respected website devoted to kidney compromised kitties (for whom UTIs are a constant challenge, as well). Here it is with the direct link *Note in particular the piece about D-Mannose. And, I think the section on Antibiotics is critical too, as it speaks to the recurrence issue. (I'd be asking both my Vet AND the group members about D-Mannose)

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Quote:

Urinary Tract Infections

These are relatively common in CKD cats because their dilute urine allows bacteria to thrive. One human study, Establishment of a persistent Escherichia coli reservoir during the acute phase of a bladder infection (2001) Mulvey MA, Schilling JD & Hultgren SJ Infection and Immunity 69(7) pp 4572-9 found that in some cases the bacteria that cause urinary tract infections can burrow so deep into the bladder lining that they cannot be detected in the usual tests. In a later (2004) study reported by Science Daily, researchers found that the bacteria commonly involved in UTIs pass through four distinct developmental stages, including a dormant stage in some cases which may help explain why UTIs often recur.

Mar Vista Vet has an overview of UTIs in cats.

http://Antibiotics

UTIs are usually treated with antibiotics. In order to be sure that the bacteria are completely eradicated and the infection completely cured, CKD cats are often given a prolonged course of antibiotics, for four weeks or longer. This is even more important for a cat with a kidney infection, where a 4-6 week course of antibiotics should be given. Urinary tract infection: how to diagnose and treat correctly (2003) is a presentation by Claudio Brovida to the World Small Animal Veterinary Association World Congress, which explains why lengthy courses of treatment are sometimes necessary.

 

Some vets choose to put CKD cats on a low level dose of antibiotics on an ongoing basis, or recommend pulse dosing, where the cat is given antibiotics at regular intervals for several days at a time, e.g. for the first five days of every month. If your vet wishes to do this, discuss it and decide whether you think it is a reasonable treatment for your cat: infections can be hard for the weakened immune system of a CKD cat to cope with and to recover from, so in some cases this is not an unreasonable option.

 

The British Medical Journal has information about a human study which showed that lactulose (which is normally used for constipation) may help prevent urinary tract infections in humans.

 

http://D-Mannose

If your CKD cat is prone to persistent, ongoing or repeated UTIs, speak to your vet about using D-mannose, a simple sugar treatment which is supposed to be very helpful when dealing with infections where the bacteria have burrowed into the bladder wall (see above). There is more information about it on the Holistic Treatments page. If your vet recommends antibiotics, you can use D-Mannose as well, but it should not take the place of antibiotics.

 http://www.felinecrf.org/treatments_fluid_and_urinary_issues.htm#utis

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And, about the acne, I am certain that the group's collective experience also dealing with EGC and whether/not to use steroids.

Here's something I came across a while back...if I were in a position where steroids were not an option, I'd explore it for sure through a reputable holistic Vet http://www.omeopatia.org/upload/Image/my_operatori/CGE .pdf (who knows, maybe someone in that group has info on that)

Personally, I'd be very cautious on a diet change, but I might do some "taste trials" first to simply see if she might like one of the "novel proteins". If it were well accepted, then perhaps have a go with it....I just wouldn't want to upset any applecarts by a cold-turkey switching.

Jimmy, try purchasing this colloidal silver:
Tear off a small piece of cotton ball, and soak it in the CS. Dab it on her chin. It should clear it up inside of a few days, and can be used as needed.

Given your work in rescue and fostering, I expect you'll be able to use it frequently. You can use it on cuts on the cats, on yourself, ring worm, ear mites, etc. It's great for just about anything topical. I often have cat scratches or light bites, and this literally clears them up overnight.

I wanted to thank everybody for the advice and give a little follow-up: I took Effie to a different vet and he put her on a medicine called Megace. It's a synthetic female hormone, it's used to keep female cats from going into heat (!) normally, but he thought it would help her condition. It's essentially a steroid but much milder than the usual Depo shots. Anyway, it seems to work! The dosage schedule was 1 quarter of a pill a day for 1 week, then every other day for 1 week, then every 3 days and finally once a week. We're heading into the last step of the treatment and she has been issue-free for the past 2 weeks!

The vet said her 'chin acne' was actually a severe allergic reaction (it wasn't just some black crud, it was raw and scabby and super gross). We're trying to determine the cause of the reaction but for right now she is doing great. 

Additionally, Megace is used in humans as an appetite stimulant for cancer patients, it seems to have the same effect on cats. Effie has been eating a ton, before this she wasn't eating well at all so it's kind of a nice side benefit. I'd never heard of this treatment before, I thought others might benefit from hearing about it. Here's some more info on it:

http://www.petplace.com/drug-library/megestrol-acetate-ovaban/page1.aspx

Thanks for the great advice too, I will check out that Yahoo group!