Dilemma re: possible pemphigus foliaceus in cat with FIV and FHV

cheeser

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In the 'when it rains, it pours' department...

Buddy has always had what appeared to be dirty toenails ever since he was a stray that we took in a few years ago, and the vet has never expressed any concern about it before.

Well, to make a long story short, it has now been determined that it's possibly a fungal infection or pemphigus foliaceus.  If it does indeed turn out to be PF, looks like we're going to be between the proverbial rock and a hard place.

Buddy has FIV and FHV and his immune system is pretty much shot, and it's often hard to tell if he's still getting over the last infection, or has developed a new one.

From what we understand, these are our options:

1.  If Buddy does have pemphigus foliaceus and the vet has to treat him with steroids, that's going to suppress his already fragile immune system even more, and he might not be able to fight off any more infections.

2.  If he does have PF and we don't treat it, that could potentially be life-threatening, too.

3.  If we give Buddy anything to try to improve his immune system and help fight off infections, that could make the PF worse.

So because we get easily flustered when we're at the vet's office, we just want to get our ducks in a row before we have to make any decisions.

Other than a small amount of black gunk around the nail sheath on some of Buddy's toes, he doesn't have any other symptoms of PF.  The only reason it even became an issue recently was because we kept finding little clumps of what looked like dirt between a few toes after we got a weird batch of cat litter, and the clumps kept coming back after we cleaned his toenails and changed the litter boxes.

And despite the frequent herpes outbreaks, infections, etc., Buddy acts totally normal, has his usual hearty appetite, and plays with the exuberance of a kitten on speed.  Also, from what we understand, stress can be a factor re: pemphigus foliaceus just like it is for the FLUTD that Buddy suffered from in the past (until we discovered catinfo.org).  But the vet already has Buddy on Zylkene for that, and we have some Feliway diffusers that he recommended.

Is there such a thing as the lesser of three evils?  We just want Buddy to enjoy the best quality of life that he can under the circumstances, and would greatly appreciate any suggestions (including holistic options), questions we need to be asking, etc.

Thanks in advance. :-)
 

stephanietx

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Has the vet done a culture to test the toenails? That would be a starting point. I don't know anything about this condition, to be honest. 

I would think that if you could get him to a healthy point dietary wise, introducing the steroid would be okay.  Just keep his stress level down to prevent a flare up. I've had my herpes girl on steroids for a week at a time over the past 10 years and she's never had a flare up from that, but it's been short-term and she was already healthy (for her). We also give her Missing Link to help her overall health mixed with her wet food as well as L-Lysine. If your guy's not on Lysine, he should be on it at the flare up dose for the duration of the treatment.
 
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cheeser

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Has the vet done a culture to test the toenails? That would be a starting point. I don't know anything about this condition, to be honest. 

I would think that if you could get him to a healthy point dietary wise, introducing the steroid would be okay.  Just keep his stress level down to prevent a flare up. I've had my herpes girl on steroids for a week at a time over the past 10 years and she's never had a flare up from that, but it's been short-term and she was already healthy (for her). We also give her Missing Link to help her overall health mixed with her wet food as well as L-Lysine. If your guy's not on Lysine, he should be on it at the flare up dose for the duration of the treatment.
Oh, I'm so, so VERY glad you replied!

I saw a reference to Missing Link on one of the threads on this site, and was wanting to learn more about it from someone who's had some purrsonal experience with it, rather than just rely on marketing hype.  Could you please tell me a little about it?  Buddy only eats non-fish flavored canned food, mostly from Weruva and Tiki Cat (he loves those shredded textures!), but we're certainly willing to entertain the idea of nutritional supplements if it might help improve his ability to fight off infections.

Buddy has been taking L-Lysine forever, although we can't tell that it does that much good.  He gets 250 mg. twice a day, and 500 mg. twice a day during flare-ups.  We recently started him on Jarrow lactoferrin in addition to L-Lysine, and he seemed to show some improvement re: his general health after only a few days, including the issue re: the nail gunk.  In fact, we were so encouraged, that's why we were considering swapping out the lactoferrin with Transfer Factor.  But after today, we've thrown on the brakes for now until we know exactly what we're dealing with.

Obviously the next step is a culture, and hopefully...well, to be honest, I don't know what to hope for. ;-)

It just seems like we're always playing Whac-A-Mole on a seesaw.  Every time we think we're starting to get a handle on one problem, Buddy develops another one, and it's a tricky balance to try to resolve one problem without making another one worse. ;-)
 

stephanietx

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My kitties all like The Missing Link.  I get the professional strength from CalVet Supply.  I just add 1/4 t to each wet food serving, morning and evening. We add a little bit of water and mix it all together and down the hatch it goes.  It's really just a good overall supplement. One of the biggest things we've noticed is the increased fur health. Even our vet comments on all our kitties' fur every time we take them in.  I have heard that some kitties don't like it, but even our stray cat gets some and he eats it.
 
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cheeser

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My kitties all like The Missing Link.  I get the professional strength from CalVet Supply.  I just add 1/4 t to each wet food serving, morning and evening. We add a little bit of water and mix it all together and down the hatch it goes.  It's really just a good overall supplement.
Thanks oodles for the info!  It always gives us hope when learn about something that might help to improve our cats' quality of life.
 
 

white shadow

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Hi cheeser !

A few  suggestions.........

This thread might be of interest to you (it's an active thread, as well):  http://www.thecatsite.com/t/267703/stubborn-herpes-infection-add-lactoferrin-in-addition-to-lysine

The OP there - LDG - has tonnes of experience with FIV.........you might want to message her for input/experience/advice.

There are two specialized online communities for FIV felines that I'm aware of.....if I were in your position, I'd join both of them in a flash (if only to play "fly on the wall):
  1.     https://groups.yahoo.com/neo/groups/FIVCats/info?v=1&t=search&ch=web&pub=groups&sec=group&slk=2    Formed in 2001, 1000+ total members (which suggests collective experience), still active but 'quieter - which can be a benefit by providing more 'personalized' focus, a more 'traditional' (cautious) approach I suspect (see my comments on #2) 
  2.    https://groups.yahoo.com/neo/groups/fiv-healthscience/info    The 'new kids' on the block, very aggressive treatment approach, 'evangelical'-like from some reports that I've read (translation: adopt a thick-skin and stand your ground while evaluating/assessing any advice given - don't be intimidated/put-off). These people have a website, and the site has an 'explainer' about the group. The 'explainer: http://www.fivtherapy.com/fiv_healthforum.htm   The website: http://www.fivtherapy.com/
Just so you know, I found the love, passion and caring palpable in this:
Oh, I'm so, so VERY glad you replied! 
It really resonated with me.
 
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cheeser

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Originally Posted by White Shadow  

This thread might be of interest to you (it's an active thread, as well):  http://www.thecatsite.com/t/267703/stubborn-herpes-infection-add-lactoferrin-in-addition-to-lysine

The OP there - LDG - has tonnes of experience with FIV.........you might want to message her for input/experience/advice.

There are two specialized online communities for FIV felines that I'm aware of.....if I were in your position, I'd join both of them in a flash (if only to play "fly on the wall):
  1.     https://groups.yahoo.com/neo/groups/FIVCats/info?v=1&t=search&ch=web&pub=groups&sec=group&slk=2    Formed in 2001, 1000+ total members (which suggests collective experience), still active but 'quieter - which can be a benefit by providing more 'personalized' focus, a more 'traditional' (cautious) approach I suspect (see my comments on #2) 
  2.    https://groups.yahoo.com/neo/groups/fiv-healthscience/info    The 'new kids' on the block, very aggressive treatment approach, 'evangelical'-like from some reports that I've read (translation: adopt a thick-skin and stand your ground while evaluating/assessing any advice given - don't be intimidated/put-off). These people have a website, and the site has an 'explainer' about the group. The 'explainer: http://www.fivtherapy.com/fiv_healthforum.htm   The website: http://www.fivtherapy.com/
Thanks bunches!  I sincerely appreciate your most helpful suggestions.  *hearts you with the fiery intensity of a thousand supernovas*

It's been awhile since I've browsed through the first link, so maybe there's something new since I last looked, or something I just overlooked before. ;-)

And thanks much for the other links, especially the heads up re: the general culture of each Yahoo community.  Hopefully that foreknowledge will help me to keep from embarrassing myself -- well, any more than usual. ;-)

It's amazing how much our furry companions can touch our hearts.  I've had lots of pets over the years, but this particular cat that someone left on our doorstep to die has touched my heart in a way I can't explain.  With all of his health issues, challenges, and ups and downs like a roller coaster, every day I feel blessed to still have him with us. :-)
 
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