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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Veterinary
Satisfied Customers: 25691
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My persian 3yo cat was diagnosed with HERPES eye infection.

Customer Question

My persian 3yo cat was diagnosed with HERPES eye infection. I am an ophthalmologist. I trust the diagnosis- it makes sense as she is under a lot of stress with new kitten in our home. But she has had it for a month now and no improvement. The vet put her on topical antibiotic (for superinfection?) but at this point i would like to put her on oral meds. I can send photos.
JA: I'm sorry to hear that. There are all sorts of infestations your kitten can pick up. I'll have you talk to the Veterinarian who'll sort out what is wrong and help you decide what to do about it. What is the kitten's name?
Customer: Are there oral antiherpes meds? I have given her 500mg Lysine orally as her breeder recommended and I use for people for prevention of herpes. Adult cat has eye infection- and her name is*****: Is there anything else important you think the Veterinarian should know about Luna?
Customer: She is otherwise healthy. But absolutely anxious with introduction of new kitten. I have noticed a considerable improvement in her anxiety with feline pheromone diffuser, also recommended by vet.
Submitted: 1 month ago.
Category: Veterinary
Expert:  Dr. Michael Salkin replied 1 month ago.

You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Customer: replied 1 month ago.
See photos attached. Her lids seem inflamed/swollen and the dark discharge is constant. This, per my vet, is herpes. But only treatment recommended was topical antibiotic for superinfection. I would like to treat the actual herpes as it has been ONE month of this.
Expert:  Dr. Michael Salkin replied 1 month ago.

I'm sorry to hear of this with Luna. I would very much like to see photos. You can upload them by using the paperclip icon in the toolbar above your message box (if you can see that icon) or you can use an external app such as dropbox.com/

To answer you directly, yes, I can prescribe a compounded cidofovir ophthalmic solution or ointment as well as the systemic famciclovir. Lysine is no longer recommended following two large-scale studies of FHV-1 confirmed shelter cats who experience increased morbidity while being administered lysine as opposed to those cats who weren't administered the lysine.

Thank you! Give me a moment to take a look...

Customer: replied 1 month ago.
I attached photos. please let me know if it you cannot see them.
thankyou for above feedback!
Expert:  Dr. Michael Salkin replied 1 month ago.

FHV-1 is certainly most likely. Chlamydophila and Mycoplasma may be contributory or act as sole infectious agents. Testing (PCR) is available but previous vaccination against FHV-1 will confound the diagnosis. I regret that my state board of veterinary examiners doesn't allow me to speak to customers by phone in this venue but other experts in this category may be able to assist you in this regard. Please let me know if you'd like another expert to do so and I'll opt out of this conversation. Please stay in the conversation if you wish.

Customer: replied 1 month ago.
WOW- very helpful information.
How would you treat her then?
Customer: replied 1 month ago.
She has had FHV-1 vaccine.
Customer: replied 1 month ago.
I would LOVE this:
compounded cidofovir ophthalmic solution or ointment as well as the systemic famciclovir.
Expert:  Dr. Michael Salkin replied 1 month ago.

I would first see how the over the counter Terramycin opthalmic ointment (please see here: https://www.amazon.com/Peak-Marketing-Terramycin-Ophthalmic-Ointment/dp/B00063KGUK) affected her when administered thrice daily for a minimum of 10 days. Both Chlamydophila and Mycoplasma should respond to the oxytetracycline in that ointment. If you didn't see a positive change, the antivirals I mentioned above should be considered.

Please continue our conversation if you wish. I regret that we're not allowed to prescribe through this venue.

Customer: replied 1 month ago.
SHE HAS BEEN ON TERRAMYCIN. First given to her a month ago when I brought her to vet. I was diligent about treating twice daily. I did not notice any change. I have been giving to her daily as am almost out of it.
Customer: replied 1 month ago.
She got twice daily for two weeks, roughly
Expert:  Dr. Michael Salkin replied 1 month ago.

Thank you. It's time for the the antivirals. Luna's vet will need to prescribe them.

Customer: replied 1 month ago.
OK thank you so much!
Customer: replied 1 month ago.
curious. as an ophthalmologist, I have samples of VIROPTIC= trifluridine. Have you ever heard of anyone using this in cats? (for humans)
Expert:  Dr. Michael Salkin replied 1 month ago.

You're quite welcome, Dr. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

Trifluridine too often causes unacceptable signs of toxicity in cats - keratoconjunctivitis and apparent stinging on application. It's a shame becuase it's the most potent drug against FHV-1 in vitro.

Customer: replied 1 month ago.
YOU HAVE BEEN INCREDIBLY HELPFUL! Thank you so much!
Expert:  Dr. Michael Salkin replied 1 month ago.

Thank you for your kind words.