How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 24468
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
55012488
Type Your Cat Veterinary Question Here...
Dr. Michael Salkin is online now
A new question is answered every 9 seconds

I need possible diagnosis 18 yr. old cat

Customer Question

I need possible diagnosis for my 18 yr. old cat
Submitted: 6 months ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 6 months ago.

Amy, if just the one ear is involved an inflammatory polyp originating in the middle ear is a very important differential diagnosis. At his age, however, there's often more than one disorder existing concomitantly. His congestion is most likely due to chronic rhinosinusitis of cats which I describe more fully here:

Chronic rhinosinusitis is a diagnosis of exclusion when other etiologies have been ruled out (fungal infection by culture, malignancy by biopsy, bacterial or viral infections by a pure culture or PCR of common respiratory pathogens). This syndrome is actually a constellation of diagnoses made by biopsy, culture, and PCR (DNA-based) testing. The three broad groups we see are lymphocytic-plasmacytic-, eosinophilic-, and idiopathic (unknown cause/the most common) rhinosinusitis. This syndrome is one of the most significant causes of sneezing and nasal discharge in the cat. The nasal discharge is generally serous (clear serum-like), but secondary bacterial infections can result in the development of mucopurulent (mucus + pus) discharge and inflammation can be severe enough to cause intermittent hemorrhage. The clinical signs can persist for years.

It's postulated that an early severe viral infection may trigger chronic disease. In addition, it's estimated that approximately 80% of cats are latently infected with FHV-1 (herpesvirus), and so another possible scenario for chronic infection is that Boots is exhibiting the symptoms of persistent herpesvirus infection. If FHV-1 can be confirmed by PCR testing, the antiviral drug famciclovir might be helpful.

In general, these cases are somewhat refractory to treatment and palliation of clinical signs rather than cure is the goal of medical management. Broad-spectrum antibiotics are often prescribed to manage secondary infections. Administration of antihistamines such as chlorpheniramine at 1-2mg/cat orally every 12-24 hours may lessen clinical signs of disease in some cats. Moistening therapies such as nebulization and saline nasal drops can help loosen secretions and soothe mucosa, particularly in dryer climates. The anti-inflammatory glucocorticoids such as prednisolone may be helpful as well. Prednisolone may be used at a maximum dose of 1-2mg/kg orally every 12 hours. If a positive response is noted, the lowest dose and the longest dosing interval that is effective should be determined by adjusting the dose over time. Inhaled glucocorticoids can be used as an alternative to decrease the systemic side effects of oral glucocorticoid use and have the benefit of directly affecting the nasal mucosa. Beclomethasone or fluticasone can be administered by metered dose inhaler (MDI) with an inhalation chamber at 1-2 puffs once to twice daily.

This syndrome is the bane of too many cats and their vets but hopefully the above approaches will be at least palliative if not curative. Please respond with further questions or concerns if you wish.

(His difficulty walking is at least partially due to advanced geriatric osteoarthritis. I can't rule out an overall weakness at his age and with his other infections.)

Related Cat Veterinary Questions