Supplementing with Lysine NOT recommended for Herpes Kitties

A newly published systematic review of all available studies shows that not only is supplementing with Lysine not effective in preventing or treating Feline Herpes, it can actually be harmful and make infections worse.

Please take a minute to read this - 

http://www.biomedcentral.com/1746-6148/11/284#

The conclusion is fairly clear - 

We recommend an immediate stop of lysine supplementation because of the complete lack of any scientific evidence for its efficacy.       

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Editing this post to add - 

1. This is not to suggest that you make any changes to treating your cat without consulting your veterinarian. What I would suggest is emailing this link to your vet and giving them a few days to read and assess this new information, then follow up with them to see how this affects the treatment recommendations for your cat.

2. This is not a new study or experiment. It is a systematic review of all existing studies, including those carried out with human subjects. A systematic review offers a higher degree of validity, taking into account all existing studies, assessing them for quality and then offering conclusions based on all available material.

I hope that clarifies some!

Very interesting. It's definitely made me think twice about lysine supplementation.

Very interesting article @Anne  .   Thank you for posting it.

I'm not due to visit our vets with Mouse any time soon but the next time we go I will certainly be interested to hear what they have made of this information.  While they have been happy for me to try L Lysine as an alternative to short term anti-viral medication (which I found ineffective and hugely expensive) for active symptoms when present, they were clear that they did not believe in long term supplementation due to the potential strains on a cat's body described here in the attached article.  

This literature review does look to be thorough, and clearly identifies the need for more research.  While I would still consider the short term (2 to 3 week) use of L Lysine in active phases of FHV1 for Mouse until we next visit our vet, I am happy that I have not opted for any longer term use.  It is definitely worth a read for anyone considering use of L Lysine with kittens and younger cats, and for those considering or already using on a longer term basis with their cats.

That is interesting.  I don't have a kitty with herpes so I hadn't really looked into it beyond how the lysine works.  I admit I wondered about starving the virus by lowering the level of an amino acid, especially as a long term supplement.  I had wondered about the effects of lowering that amino acid beyond starving the virus.  I guess because it was so widely accepted and it didn't affect me personally it didn't go beyond idle curiosity for me.

Very interesting. Sending a link of this to both my primary vet and opthahmologist for their take on this.

Thank you, Anne. Robin has what the vet believes is a mild case of herpes that seemed to flare up last week in one eye. I was able to get it under control by putting a drop of vinegar in his water for 4-5 days, applying applying moisturizing plain tear replacement drops, baby nose drops (plain saline), and finally, just a wee bit of Curad silver ointment on/around the affected eye(not in) with a q tip. After 4 or 5 days the moderate weeping reverted to the normal bits of dark, dry eye discharge (eye snots).

Very interesting! And, for me, interesting also because my kitten came from a rescue org that has the very strong mindset that giving daily supplementation of l-lysine prophylactically, whether or not a kitten or cat had symptoms of FHV-1, was a daily requirement of shelter care.

But now, I wonder if the fact that my kitten Milly has been having certain chronic eye issues, and a few other respiratory symptoms, since I got her at 11 weeks of age (she's now 8 months), could have been exacerbated by the huge reliance upon l-lysine that that shelter demonstrated (and the associated human foster parents working with the rescue org demonstrated, who also gave l-lysine to the kittens they helped to raise).

In any case, I guess I've always been a contrarian about the idea giving l-lysine as a supposed generalized "immune-booster". I just never saw the science behind that idea.

Anne , wasn't this fascinating?

I was a real skeptic at first - I thought there is so much overwhelming anecdotal evidence that it works .... but is there, really? Obviously I have no training to explore why it might work in some cases, because it sure does seem to help some cats. But having gone through the paper, I have assured myself that the results weren't skewed by selective inclusion / exclusion.

Of course, I've been an advocate of the use of bovine lactoferrin for a number of years now - many found that it worked alone, or when lysine didn't... and it has been shown to have antiviral activity.

I've read some very interesting articles on the use of Bovine Lactoferin @LDG   (mostly when searching for information about treatment resistant dental issues) , and would love to see more research being done, with thorough literature reviews like the Lysine one linked here.   It can be so hard finding wide sources or information, never mind the time and complexity of then comparing them all and trying to decide what to do.   

Is it possible to buy bovine lactoferrin at this point in time? In this study, it was administered externally. Would be wonderful if it was--this study was on FIV+ cats, but I would assume it would help in herpesvirus as well.
http://www.ncbi.nlm.nih.gov/m/pubmed/8896681/

This is a surprise, I'll have to show my vet because she said it was ok to give both my cat and kitten beings they are from a cattery which makes them prone to eye conjunctivitis and the lysine helps a lot. Plus she's a homeopathic vet so I would think she'd know if it wasn't ok.

LDG said:

@Anne, wasn't this fascinating?

I was a real skeptic at first - I thought there is so much overwhelming anecdotal evidence that it works .... but is there, really? Obviously I have no training to explore why it might work in some cases, because it sure does seem to help some cats. But having gone through the paper, I have assured myself that the results weren't skewed by selective inclusion / exclusion.

Of course, I've been an advocate of the use of bovine lactoferrin for a number of years now - many found that it worked alone, or when lysine didn't... and it has been shown to have antiviral activity.

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I agree it is fascinating!

It's not difficult explaining how it seemed to have helped so many cats. Placebo is a known phenomenon in pets (via the owners, of course) and there's always the body's amazing ability to fight off flare-ups on its own. That it would all coincide with giving any kind of supplement is to be expected, especially with so many people trying the treatment. Add to that the fact that we humans tend to remember the anecdotal stories which fit "our story" and you get myths like this one with lysine, going all the way through to the medical practitioners.

That's why I don't buy into bovine lactoferrin either, sorry. I need concrete evidence, in the form of repetitive double blind studies, conducted in a way that produces statistically-significant results and published in peer reviewed journals. Lather, rinse, repeat for enough evidence. Then conduct a meta-analysis or at least a systematic review, again, published in the appropriate channels for peer review. 

And yes, I realize many of the lab-synthesized medical treatments don't necessarily meet these criteria for veterinary care. I just have a feeling some people tend to accept that more readily in what they see as "natural" treatments, forgetting that these can be as harmful as any synthesized product. There's a HUGE industry for supplements and alternative medicine and they're having a field day with pet owners, I'm afraid, encouraged by so called alternative or holistic vets, and some of that definitely seeps into mainstream vet care   

This is disheartening to those of us whose cats may or do have feline herpesvirus.

misterwhiskers said:

This is disheartening to those of us whose cats may or do have feline herpesvirus.

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I agree.  It did feel better to me - feeling I could give Mouse the Lysine gel which he liked and help him get through his flare ups as quickly as possible and to ward them off at the first signs.  But at the same time I had it in the back of my mind that the time it took to clear seemed pretty similar to when I gave him the anti-viral medication which was also similar to how long it cleared up on its own before the diagnosis was made.   It just feels better when you have something concrete you can do to help, and hope for your cat be more healthy.

One thing I am not going to give up believing inn is the role stress has to play in FHV, and while that is harder still to evidence it is certainly something I can actively influence.

Another element I would love to see researched more is the role of vaccination in flare ups as I prefer to maintain Mouse's vaccinations and keep them up to date but I am also conscious that he always seems to have a flare up shortly after he has them (fitting with comments I have read recently).    What has to be good for carts with FHV is decent research being undertaken and evaluated so the health and quality of life of a vast number of cats around the world can be improved. 

Herpes viruses are nasty tricky little things. My son (a human  ) has recurrent herpes near the eye which is very worrying (eye herpes is the leading cause of blindness in the 1st world). I hate herpes viruses with a passion, believe me. I had looked into lysine therapy for humans a while ago, as well as into antiviral therapies. I consulted with four physicians and one scientist friend, a virologist who studies the herpes virus.

From all I gathered, antiviral drugs can help but only if taken before actual herpetic lesions form. I really don't know about their effect on cats but if it's a similar thing, then I imagine they wouldn't be very helpful when administered after the cat is showing the symptoms of a flare-up.

I totally relate to what you're saying @MServant. It is extremely frustrating watching someone you love, cat or human, suffer through a medical crisis and not being able to do anything about it. Sometimes, that's all we can do though. Providing treatment that isn't really working may make us feel better but not only is it not helping the patient, it has the potential to harm. So, I prefer to live with the frustration rather than insist on treating with something that isn't proven to help (or properly checked for safety).

As for stress and vaccinations, herpes viruses are opportunistic. They do take advantage of the body when its defense systems are down due to stress. I've been studying vaccines in-depth over the past two years, taking courses and working with immunologists, virologists and a bunch of other "gists"   and physicians as well. I can tell you for a fact that vaccines do not overload the immune system in any way. They certainly can have adverse reactions but they're not opening up the body to other infections somehow by "keeping the immune system busy" or anything like that. However, especially with cats, it is entirely feasible that the vet visit in itself will be stressful enough to open the doorway for a herpes flare-up. I wonder if you noticed any flare-ups after routine visits which didn't include vaccinations?

I think stress is a huge issue with cats, so yes, when vet visits are concerned, even for vaccines, they should be carefully weighed against the stress issue. A lot depends on how much exposure a cat has to disease too. After all, it's the vaccine-preventable disease that will be the most stressful (and dangerous). It's all about risk management and there's probably no "one size fit all" solution here.

Anne said:

I totally relate to what you're saying @MServant. However, especially with cats, it is entirely feasible that the vet visit in itself will be stressful enough to open the doorway for a herpes flare-up. I wonder if you noticed any flare-ups after routine visits which didn't include vaccinations?

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This was my first thought.
It's a concern to me as Pushy is going into the vet today. He has chronic eye weeping from herpes, so I'm going to monitor him closely to see if he has a flare up after the vet visit. He gets so stressed out! Coincidentally we're out of lysine and it's on my shopping list! I'm going to hold off on that for now after seeing this thread. Very timely thread for me!

@Anne  , it is a hard question to work out, the stress of vet visit vs vaccine, as Mouse's immune system seems to have strengthened as he has matured (and I have been less stressed in my life).  He tends not to have many visits to the vet now unless his eyes are running and not recovering within the usual 2 week time frame.      The best thing for Mouse does seem to be a calm home environment.     I appreciate the stress of vet visits for cats, having had a previous cat who was vet phobic and vets advised not to take her unless she was critically ill and they couldn't advise over the phone.  They also advised no regular vaccinations or check ups, because the stress involved for her always triggered flare ups in her bladder inflammation and she would end up with an infection almost instantly and be really sick, blood in urine etc.  

With you son's HHV close to his eye - have the doctors advised whether the dermatome affected by the virus involves his eye or not?   If not, it is worth asking them, or your friend who specializes in herpes research.  Due to a former friend's young child being severely affected by the virus over a large % of her body I attended a specialist medical conference some time ago  (being an allied health professional my self).   At that time information was that for HHV, the virus would not spread to additional dermatomes after the initial infection.  Ie, only those areas infected during the initial viral infection would carry and be affected by the virus in any future outbreak.  

@pushylady    I am with you - I know the L Lysine gel in my fridge is running low but I am not now planning to buy further supplies, and will hold off using unless my vets say they have further information following on from the link Anne has shared which supports its use.    

It's very interesting.  I saw a similar study but hesitated to post it.  The study i saw was very  small.  I am at a loss as to what to do about recommending or not recommending it for herpes.  Thoughts ?

StephenQ said:

 
It's very interesting.  I saw a similar study but hesitated to post it.  The study i saw was very  small.  I am at a loss as to what to do about recommending or not recommending it for herpes.  Thoughts ?

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The link I posted is to a systematic review of all published studies. It means it covers all studies which were published in peer-review journals, taking into account the study's quality. 

Fortunately, at least here on TCS, we neither recommend nor condemn any treatment. It's just something I feel people should know about and share with their vets. In the end, you need to find a veterinarian you trust and work with them.

Anne said:

 
The link I posted is to a systematic review of all published studies. It means it covers all studies which were published in peer-review journals, taking into account the study's quality. 

Fortunately, at least here on TCS, we neither recommend nor condemn any treatment. It's just something I feel people should know about and share with their vets. In the end, you need to find a veterinarian you trust and work with them.

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I just sent the article to 2 vet friends of mine and a technician at ASPCA's poison control for their comments....