Chronic Nasal Disease in Cats
By Margaret Muns, DVM
In cats, chronic viral nasal disease develops from one of two viruses
involved in upper-respiratory tract diseases. Both the feline rhinotracheitis
virus (FVR) and feline calici virus (FCV) are extremely contagious.
Clinically, the difference between these two viruses is unnecessary for
diagnosis and treatment.
Symptoms and Causes
The typical signs associated with chronic viral disease include sneezing,
bilateral nasal discharge, nasal bleeding, increased breathing sounds, and
discharge from the eyes. Any bleeding associated with viral disease is usually
very minimal; however, if nasal bleeding becomes extreme, it may be suggestive
of a tumor.
Nasal discharge from one side of the nose is more typical of a foreign
body, tumor, or tooth-root abscess. Moderate to severe bleeding or deformity
of the facial bones suggests an erosive process, such as cancer fungal or a
foreign body.
To differentiate chronic viral nasal disease from other causes of feline
upper-respiratory disease, you must know the past health of the cat. Any
previous signs of acute infection would be expected with viral disease. An old
injury or prior trauma might have healed externally but resulted in deep bone
damage or changes in the nasal anatomy which can lead a patient to be
predisposed to nasal disease.
Diagnosis
A cat with chronic viral nasal disease is generally in good condition.
Chronic viral nasal disease can be diagnosed only by the elimination of other
upper respiratory conditions, such as cancer, foreign bodies, bacterial
disease, allergic disease, fungal disease, polyps, dental disease, and prior
trauma. Not only will this guide your veterinarian in the proper course of
treatment, but will also give you an accurate prognosis. If the diagnosis
becomes chronic viral nasal disease, you may expect a long-term treatment or
potentially negative results.
Your veterinarian will examine the skull and hard palate very carefully,
along with an eye examination. The viruses involved in upper-respiratory
diseases do not cause mass lesions or inflammation of the inner structures of
the eye. If these problems are identified, then viral disease is unlikely.
To rule out the possibility of cancer, the lymph nodes around the cat's head
and neck are also carefully examined. Your veterinarian may also look for a
discharge from both sides of the nose or from the cat's eyes. After
antibiotics are discontinued, there may be sneezing and relapse of symptoms.
These signs are similar to what would be seen in a cat with a polyp.
If the history suggest a systemic cause, then a complete blood count, serum
chemistry profile, urinalysis, and chest x-rays are indicated. These tests
should also be done if there is any concern about anesthetic risk for the next
phase of the examination.
The second phase of examination involves more aggressive testing, such as
skull x-rays, endoscopy, and nasal biopsies to eliminate non-viral causes for
the nasal disease. You may or may not want to continue with this aggressive
diagnostic path, depending on the severity of clinical signs and the evidence
provided by the history, physical examination, and other less invasive tests.
Treatment
Some form of antibiotic treatment is often prescribed for a cat with chronic
viral nasal disease. If the chosen antibiotic is going to be effective,
symptoms should improve noticeably in three to five days.
If improvement is evident, your veterinarian will determine the length of
time that the antibiotics should be continued. Normally, the dose is tapered
off slowly. In some cats, intermittent bouts of sneezing can be controlled by
continued administration of low-dose antibiotics.
Symptomatic treatment also includes the use of decongestants, cortisone,
and humidification. Your veterinarian will determine the best treatment for
your cat. Local decongestant therapy can be very helpful. Local treatment also
decreases the chance of systemic side effects. Decongestants can be given
topically or orally.
The problem of using cortisone is that it can mask the development of other
problems or decrease the ability of the abnormal nasal cavity to cope with
infection. Cats who are virus carriers may start actively shedding the virus.
Consequently, cortisone should only be used if absolutely necessary and with
close monitoring.
Humidification is a very simple way to provide relief to some patients.
Increasing the moisture content of the nasal secretions makes it easier for
all the material in the nose to drain. Home vaporizers are inexpensive and
easily obtainable from local drug stores. Placing the cat in a bathroom while
the shower runs may also be helpful.
To increase your cat's comfort, frequently clean your cat's face, nose, and
eyes with cotton balls and water. You can also heat the food to help your cat
smell it and increase the appetite.
Although cats with chronic viral nasal disease are prone to intermittent
attacks of upper-respiratory symptoms, they can lead normal lives. As with any
chronic disease, open communication with your veterinarian and realistic
therapeutic goals are essential.
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