Thanks so much for your reply! I greatly appreciate your help.
1. Yes, they performed a tracheal wash at one point (when he was symptomatic) but the results were negative. They also found a small nodule on his upper palate which they thought was "necrotic tissue." It was benign.
2. I can't remember the last time he had a fecal test for parasites so it has probably been several years. I should note that he is an indoor-only cat, and over the years he has never had any others symptoms-- his appetite, energy levels, activities, etc, have always been completely normal.
3. He has never had an echocardiogram (or whatever the appropriate test is) but the various doctors he has seen have never noted any abnormalities during exams. He is currently 6-years-old.
4. He generally responds to the Clavamox within 3 days or so, and the cough quickly disappears. I can't remember the exact dosing but it is BID.
5. No, steroids have never been prescribed. I'm guessing you ask that because of the chance that his symptoms may be related to asthma? His Xrays have shown a "bronchial pattern" that can be indicative of mild asthma, I've been told, but given that his symptoms respond to the antibiotics the doctors believe that it is bacteria-related.
6. I don't recall discussions about chronic bronchitis.
7. Yes, he had a heartworm test recently-- earlier this year, I believe. He also takes Heartguard.
8. See response #1 above.
9. That doesn't sound familiar. I would have to check his records to be sure, though.
Thanks again!! Carla (and Cisco)
Very helpful! I will definitely discuss your thoughts/ suggestions with our vet. Just one more question if you don't mind-- are chronic bronchitis and/ or asthma associated with a phlegmy-sounding cough? His cough has never produced mucus but it definitely sounds like he is trying to cough something up. Also, the cough sounds more like it's along his throat (as opposed to in his lungs), although years ago he had one Xray that showed what looked like a localized pneumonia. When symptomatic he also "gurgles" a bit, which can be heard from time to time, and which seems to interfere with his ability to purr (i.e., it seems like purring can sometimes trigger a cough). Does that change your impressions at all? Thanks again.
Hi Dr. Keller, I received a copy of the cytology report based on the sample obtained from the tracheal wash, and I was wondering if it would help guide your impressions at all? These are the results:
The sample contains a moderate amount of mucus with a moderately increased cellularity, consisting almost entirely of neutrophils. A few clusters of deeply basophilic epithelial cells were also found. Some of the neutrophils appear slightly to moderately degenerate. Small numbers of neutrophils contain variably sized, irregularly shaped, metachromatci inclusions suggestive of celluar debris or immunoglobulins. An etiological agent is not apparent.
Also, after you mentioned the association between eosinophils and that parasite, I think I remember hearing that one of his blood tests revealed a slight elevation in eosinophils-- could that also suggest the lungworm, or not so much?
Both of my vets (local and at Tufts) are out this week so I thought I'd try to do some research before bringing Cisco for an appointment. I really appreciate your help. This situation has been very frustrating and worrisome.
Hi Dr. Keller,
I just thought I'd write to give you an update on Cisco, my kitty with the mysterious phlegmy-sounding cough. Almost immediately after his last round of antibiotics his cough returned, which was especially concerning, since he usually experiences a longer period of remission between episodes. I vet tech I spoke with during his opthalmology visit -- yes, he has an eye issue too -- suggested trying holistic medicines, which I had never considered. I started doing some research and found a company that sells many different holistic remedies for both pets and humans -- Pet Alive -- and decided to try one of their products which they claimed both cured and prevented bacterial respiratory infections. I did some research on the company online, to ensure that their products were safe, and started giving Cisco the "medicine."
Believe it or not, it worked!! It seems like a miracle. After YEARS of repeated rounds of all types of antibiotics, Xrays, and other tests, his coughing decreased significantly, and ultimately disappeared! At first I was giving him the product regularly, as directed, but once the cough improved I started giving it to him less often, and then not at all. He will occasionally begin to cough, so I start giving him doses again, and again it improves. It's amazing. I still can't believe it.
I realize that we still don't know the cause of the coughing, which is a concern, but I'd rather treat the cough with a holistic medicine than put him through endless tests and rounds of antibiotics, running the risk that he will eventually (if he hasn't already) develop immunity to them. I'm so relieved about it, I can't express it enough.
Anyway, just thought I'd share that with you.