She probably has FHV but is this normal?

I was told that my cat probably has FHV but that it's extremely difficult to definitively diagnose. However, I'm becoming concerned because, more often than not, she is congested and sneezes thick projectile mucus. I don't mean to be gross but it's true. It was my understanding that FHV causes flareups from time to time but not chronic congestion and sneezing like this. Even before I adopted her she was making a hacking sound. It looks like she's coughing and she does 6-7 times but never coughs up a hairball or anything else.

I was reading about heartworm in cats and it also cannot definitively be diagnosed through blood work. I'm really becoming concerned that there is something going on in addition to the FHV that she may or may not have at this point. It seems like the vets in my area are just interested in money and multiple visits, rather than getting at the root of the problem. 

What course of action would you be pursuing if your cat had these symptoms?

wannahelp said:

 
I was told that my cat probably has FHV but that it's extremely difficult to definitively diagnose. However, I'm becoming concerned because, more often than not, she is congested and sneezes thick projectile mucus. I don't mean to be gross but it's true. It was my understanding that FHV causes flareups from time to time but not chronic congestion and sneezing like this. Even before I adopted her she was making a hacking sound. It looks like she's coughing and she does 6-7 times but never coughs up a hairball or anything else.

I was reading about heartworm in cats and it also cannot definitively be diagnosed through blood work. I'm really becoming concerned that there is something going on in addition to the FHV that she may or may not have at this point. It seems like the vets in my area are just interested in money and multiple visits, rather than getting at the root of the problem. 

What course of action would you be pursuing if your cat had these symptoms?

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I would consider asking for a PCR test for FHV.  Heartworm isn't common in cats and generally you would see difficulty in breathing and coughing without other symptoms of a URI like you would not see mucus discharge at all.  Your cat has a lot of mucus which is strongly suggestive of a URI not heartworm.  If your cat does have FHV, most vets would give antibiotics to prevent a bacterial infection, eye meds as needed, and supportive therapy.  If your cat is coughing it may be in the lungs which is serious and merits additional treatment.  One way to deal with this is to "steam bath" your cat in the bathroom several times a day to loosen the phlegm and if its FHV and not another URI adding L-Lysine to the diet daily for life can help reduce frequency, duration and seriousness of recurring bouts.

The links below on FHV and Heartworm show the differences in symptoms.

FHV Links

http://zoologix.com/dogcat/Datasheets/FelineHerpes1.htm

http://en.wikipedia.org/wiki/Feline_viral_rhinotracheitis

http://www.cat-world.com.au/feline-herpesvirus

Heartworm Links

http://www.aspca.org/pet-care/cat-care/heartworm

http://www.2ndchance.info/heartwormsCat.htm

http://www.cat-world.com.au/heartworm-in-cats

I would also suggest the Real PRC URD test to accurately diagnose herpes.  It's extremely accurate.

Actually, it's common for herpes kitties to be snotty and sneezy.  She may also be suffering from airborne allergies and/or a secondary infection.  You can have any of the discharge tested and cultured to see if there's a secondary infection going on.  If the discharge is clear, then she's probably just got allergies.  If there's any green or yellowish discharge, then something else is going on.

If she's not on a grain-free diet, then that's a starting point.  You can also give her lysine daily as well as a daily antihistamine. 

She is on a grain-free diet. I was giving her chewable lysine tablets but after a while, she started vomiting, so I had to discontinue them. I'm thinking about grinding lysine tablets up in her food but I know it tastes bitter so I don't know if that would work.

There are Lysine products that are cat specific that might work for your kitty (there is a powder form and a treat form.)

I use L-Lysine that comes in capsule form...open up and sprinkle it on food...cats don't seem to have a problem with it.

As for FHV being chronic vs flare-ups...it comes both ways. I also suggest the Upper Respiratory Panel be run. We did this about 2.5 yrs ago when on of my cats had a severe URI (with some atypical symptoms.) Several vets thought he surely had herpes...nope...he tested positive for Calicivirus and Mycoplasma.

CatPack said:

There are Lysine products that are cat specific that might work for your kitty (there is a powder form and a treat form.)

I use L-Lysine that comes in capsule form...open up and sprinkle it on food...cats don't seem to have a problem with it.

As for FHV being chronic vs flare-ups...it comes both ways. I also suggest the Upper Respiratory Panel be run. We did this about 2.5 yrs ago when on of my cats had a severe URI (with some atypical symptoms.) Several vets thought he surely had herpes...nope...he tested positive for Calicivirus and Mycoplasma.

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Lysine comes in a paste as well and you can just rub it on their gums.  I have two kittens with herpes and that is what I was told to do.

My cat has FHV too and was getting sick frome the lysine.  A very nice member here, LDG, linked me to this thread about Bovine Lactoferrin.  It's helped my kitty greatly.

I was told to use Jarrow brand lactoferrin, 250mg. The dose is 1/2 capsule 2x a day.

http://www.thecatsite.com/t/267703/stubborn-herpes-infection-add-lactoferrin-in-addition-to-lysine

When I just got my cat, he was somewhat sneezy. When his eyes got inflamed for the first time, the vet gave him a "probable FVH diagnosis" and told me to give him lysine supplements. I give him 250 mg of lysine power twice a day. He doesn't sneeze anymore, but still gets flare ups from time to time (I up the dosage of the lysine). He just turned one, and is doing pretty well. 

I use the NOW or VitaCost brand powdered Lysine.  It comes in a one pound jar.  Just a 1/4 teaspoon equals 500 mg.  It dissolves super easily and my kitties never know it's in their wet food slurry.

I use a vet who specializes in cats. Yet, he has never run the PCR test. The appointment was a wasted trip. Another thing that irritates me is when I go into a vet's office and he or she has no recollection of the problems the animal has had in the past or the medications and procedures that were tried. Review the chart beforehand. The only reason I contiinue to go there is that the vet(s) and staff handle cats well, whereas another vet that I tried does not. However, I now have to find a vet that can run this test and is especially good with handling cats because my cat trnds to be very apprehensive at the vet's office. I don't how to accomplosh this without making one appointment aftet another and seeing who interacts well with her. In the meantime, I'm afraid to try lysine again because she may also have irritable bowel and I don't want to irritate her stomach. Of course, the vet can't tell me for sure if she has that either.

I'm a little hesitant to try the lactoferrin because she has not tolerated beef well in the past. I don't know if that would have any bearing on whether she tolerated this or not.

wannahelp said:

I use a vet who specializes in cats. Yet, he has never run the PCR test. The appointment was a wasted trip. Another thing that irritates me is when I go into a vet's office and he or she has no recollection of the problems the animal has had in the past or the medications and procedures that were tried. Review the chart beforehand. The only reason I contiinue to go there is that the vet(s) and staff handle cats well, whereas another vet that I tried does not. However, I now have to find a vet that can run this test and is especially good with handling cats because my cat trnds to be very apprehensive at the vet's office. I don't how to accomplosh this without making one appointment aftet another and seeing who interacts well with her. In the meantime, I'm afraid to try lysine again because she may also have irritable bowel and I don't want to irritate her stomach. Of course, the vet can't tell me for sure if she has that either.

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1. Most vets don't run the PCR test because the symptoms can tell the story: running eyes, sneezing, eye flare ups. FIV can't ever be cured, so all that really matters is controlling the symptoms. Besides, even though a positive PCR result will confirm the diagnoses, the negative PCR does not rule out the infection.  

2. The vet has to see a lot of patients everyday. Did you really expect your vet to remember everything about you cat? It's your job to remind her. 

3. In my experience, lysine does not cause upset stomachs. My cat has loose stool once in a while, and adding lysine to his diet has never made it worse. Everybody is telling you that lysine works, but you won't try it? I give my cat 500 mg per day on normal days and increase the dosage to 1000 mg -- it really does make his flare ups less frequent. He used to sneeze (no mucus) and get red eyes every month or so... but not for the past four months. 

1. I'm only interested in FHV not FIV.

2.

Purplemilkywayy said:

 
1. Most vets don't run the PCR test because the symptoms can tell the story: running eyes, sneezing, eye flare ups. FIV can't ever be cured, so all that really matters is controlling the symptoms. Besides, even though a positive PCR result will confirm the diagnoses, the negative PCR does not rule out the infection.  

2. The vet has to see a lot of patients everyday. Did you really expect your vet to remember everything about you cat? It's your job to remind her. 

3. In my experience, lysine does not cause upset stomachs. My cat has loose stool once in a while, and adding lysine to his diet has never made it worse. Everybody is telling you that lysine works, but you won't try it? I give my cat 500 mg per day on normal days and increase the dosage to 1000 mg -- it really does make his flare ups less frequent. He used to sneeze (no mucus) and get red eyes every month or so... but not for the past four months. 

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1. Despite my cat's symptoms, the vet is still not sure whether it's FHV or some type of chronic sinus issue.

2. My dog's vet sees twice as many dogs AND cats everyday and he DOES remember. At the very least, he reviews his chart before making any recommendations. 

3. If you'd read the posts, you'd see that I HAVE tried lysine and my cat has vomited when I've had her on it. I've tried a few times with a few different brands and types of lysine and she has vomited every time.

wannahelp said:

I'm a little hesitant to try the lactoferrin because she has not tolerated beef well in the past. I don't know if that would have any bearing on whether she tolerated this or not.

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I too have a cat that cannot have beef (highly allergic) and I say clear of anything that has any beef ingredient, flavoring or origin.

I've scrolled back through the thread and don't see what medications she has had to treat her symptoms.

Have you used Doxycycline, Famciclovir or Idoxuridine? The latter two are antiviral medications. Famciclovir is oral, Idox is an eye drop, but it enters via the eyes and coats the nasal cavity...so, not just treating an eye problem.

Also, these meds work for most all chronic URI problems (Herpes, Calici, Mycoplasma...)

Ask your current vet to run the test.  S/he should be able to.  Most vets don't run the test and just go on symptoms, but when you've tried several different things, then the test should be run to see better what you're dealing with.  You could also suggest a culture and sensitivity test on any nasal or eye discharge.  The culture tells the vet exactly what you're dealing with (bacterial or viral) and which med(s) will best treat the infection.  You could actually be dealing with a secondary, or underlying, infection as well as the respiratory issues.

The vet has never suggested any antivirals. He hasn't suggested a culture either. Up to this point, my cat hasn't really had significant eye involvement. I don't know if that would point to one thing more than another. She has been on Doxy and Clavimox. At this point, the vet isn't really interested in doing anything. I know it's difficult to get a definitive diagnosis but my cat has thick discolored mucus all the time and I'd feel better if we could at least rule some tings out.The only thing he did suggest was sending her for an invasive sinus scope. I really don't want to put her through that and he'd have to send me to a specialist to havrle it done. I'd much rather find someone to run the PCR test if I can.

Sometimes, you have to be proactive for your pet.  If your vet isn't willing to do further testing, then it's time to find a new one who will work with you to get to the bottom of the issue.  We took Hannah to 3 vets before finding one that actually helped us.  The first vet, whom I respect immensely and recommend to friends and others looking for a good vet, didn't suggest the culture test, but did suggest the URD test.  That's when we discovered Hannah did have FHV.  It took us about 8 more months to find a vet who suggested a culture and sensitivity test to get to the root cause of her continual URI.  She was projectile sneezing yellowish-greenish-brownish mucus and sneezing repeatedly.  She also was chronically congested and sounded stuffy.  Sometimes she was even wheezy.  It turns out that she had a very serious and potentially life-threatening bacterial infection that required a specific medication. 

Many FHV kitties have chronic respiratory issues involving both eyes and nose/sinuses/lungs.  When the FHV flares up, they get conjunctivitis, upper respiratory infections, excessive sneezing with discolored discharge which can move into something similar to pneumonia if left untreated.  Chronic weepy eyes are also common.  You know your pet best and know when she's not well and when she is.  Go with your gut and request the tests.  If your vet refuses you, start looking for a vet who will help you and your cat better.

Wow ive never heard of this! Hope kits ok. Can this be a reason cats have "crying eyes" ?

I too have a cat with 'probable' FHV.  I feel confident with the vets' diagnosis given their explanation of how my boy's symptoms fit with the condition, and also how he has or has not responded to different treatments for various symptoms over his 3 1/2 year life-span.  I haven't pushed for any formal testing because of this.

My vet did prescribe Famcilovir at one point when Mouse was presenting with watering eyes repeatedly and the probable FHV diagnosis was identified but I can't say it had a dramatic effect, and the cost of the tablets was not funny.

I joined TCS as a result of my reading around the FHV diagnosis, and when next back at the vet I discussed L Lysine maintenance and went down this route as opposed to the anti-virals for further outbreaks. I learned much of what I know from @stephanietx.  In my experience the L Lysine for managing outbreaks of symptoms has been as good as the anti-virals, a lot less expensive, and probably more gentle on my cat's body. That said I initially tried tablet form, and then powder with Mouse.  Both resulted in foaming at the mouth, retching and vomiting, a distressed cat and a distressed me.  Further discussion with the vet led to  L Lysine gel which Mouse tolerates very well (unlike me as it smells of fish, I hate fish and he likes to lick it off my finger like a treat so I get left with a fish scented finger).  From being something he would run away from and get distressed about he now thinks it is treat time. @wannahelp  , if you haven't tried the gel it is worth a go.

@Cass  , 'crying eyes' as you describe them may be due to the herpes virus.  The virus can cause tiny ulcers on the eyes and the constant irritation (and pain) causes the eyes to water.  It will normally appear clear although often leaves brownish crusting in the angle of the eye or on fur around the eye.  It often affects just one eye at a time.  If a cat's immune system is not strong and or the cat is not in good health generally then secondary infections set in so you get conjunctivitis with bacterial infection.  This requires appropriate (antibiotic) treatment to resolve the bacterial infection before severe damage to the eye/s happens.  The watering eyes, like other symptoms and signs of herpes virus, will often be triggered by stress so it's best to keep kittie with FHV as stress free as possible.

To me, having a trusting relationship with your cat's vet is very important and if this is not present, then if you do have choice in your area it seems sensible to look in to a change. You are your cat's advocate and if you do not believe they are getting the best veterinary care available you are the person responsible for changing this.  On line advice / support is one thing but it is your cat's vet who is able to make diagnoses, undertake necessary tests and investigations, physically examine your cat with full knowledge and relevant training, and prescribe necessary treatments. That said, it can take a very experienced and knowledgeable vet over a year to put together an accurate pattern of presenting symptoms to make a diagnosis of something like FHV, it just depends on the health issues your cat presents with, and if bacterial infections are present these will make diagnosis more complicated. Tests cost money and sometimes don't give answers any more definitive or any more quickly than a good vet's clinical judgement built up over time. 

I really hope your little cat's health improves and you start to feel happier about the vet care available for her.