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Hello, again this is Dr. Kara.
I'm sorry to hear that Pipkin is still sneezing and breathing loudly. Because most URI are caused by viruses while antibiotics will help treat the secondary bacterial invaders they won't change the course of the viral infection much.
And in some cats that have had horrible infections as youngsters permanent damage can be done to the nose and sinuses making them chronic "loud" breathers due to the destruction of normal anatomy. I am happy to hear that he is improving, and it may help to go a little longer with antibiotic therapy then we would in an uncomplicated case, with a cat with normal anatomy. I would discuss using antibiotics a little longer with your veterinarian.
The only way to know if a polyp is there is to look for it. If he still seems more nasal then normal, and continues to bother the ear on that side after 3 weeks time I believe it is time to look further with sedation, physically looking behind his soft palate and radiographs of his nose, sinuses, tooth roots and bullae (the bony middle ear).
Please let me know if you have any further questions.
Thanks! This is helpful in establishing a time-line. I'm disappointed that the Clavamox is not resolving his sneezing and ear discomfort. I read that on average it takes about nine days to see improvements with Clavamox. I'm anxious to get a diagnosis. I might request imaging this week. It's hard to be patient. I have the week off, and it is a good time to find resolution. I will go three more days with Clavomox, then it is time for further investigation. My instincts tell me there is obstruction in his respiratory system. The hard swallow, and the throat clearing is disturbing. I hope it is only a URI, but, I think maybe there is ore to this. My nature is to be concise and expedient. But, I will try to wait.
You are very welcome.
I agree that in all probability there is more then a simple URI going on here, but I like to give them the benefit of long enough therapy before putting them through sedation and all the poking and prodding we need to do to look further.
If I had to guess I would say that a polyp seems likely, and given his history we probably have some sinus destruction as well. I hope not, but that seems quite probable.
Please let me know how things turn out for your fellow.