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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 29031
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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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.

I'd be pleased to review your description and advise.

Customer: replied 3 months ago.
I do not get it. I do not see a response anywhere.
Customer: replied 3 months ago.
Sorry about the confusion. I keep getting E-mails, texts, saying "you have a response". You may not have written one yet, which is fine.

My only reply so far was timestamped 11:33AM my time as follows: "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."

You haven't posted the "description" you mentioned.

Customer: replied 3 months ago.
Does this work? I thought I had copied and pasted before. Obviously it didn't get through. Now, I can see everything on this screen. Let me know if it works. If not, I may have to add an attachment. It is quite lengthy, so you cn take your time with an answer. We live on Long Island, NY. Let me know if you need further information
For background information: We have a population of seven cats living in the house. Most of them are 6-7 years old. They are of feral origin, in the sense that they were raised by their feral mother and later adopted. However, their taming is incomplete. They can all be petted by people they know. However, when strangers enter the house, they are out of sight. Few of them can be picked up and none carried for any distance. None of them has ever visited a veterinarian, except when they were spayed/neutered as kittens. It is really infeasible getting them into a carrier. A few attempts have been made with serious injury to the handler. In addition, the relationship with the cat is disturbed after the failed attempts. Finally, all cats can leave the house as they please through a cat door.About two-three months ago one of our male cats started sneezing intermittently. Then, about six weeks ago he made a turn for the worse. The sneezing progressed into a full-fledged respiratory infection with constant sneezing, wheezing and respiratory distress. We now repeatedly tried to get him into a carrier. As this was unsuccessful, we tried to force-feed him antibiotics, but that did not work either. Needless to say, this caused serious stress to the sick animal and ourselves, so we abandoned further attempts. At this point the breathing had become so laborious and noisy that we feared he would suffocate. Suddenly, one night the mucous “came loose”. It morphed from a thick consistency to a more liquid form. This greatly increased his ability to breathe. Over the next week, his respiratory condition seemed to improve until it subsided completely [he still sneezes occasionally, particularly while drinking water]. That was about four weeks ago. HOWEVER, since then his general condition has worsened. He is loosing weight, presumably because he is not eating. His behavior has also changed. He is more withdrawn and may at times seem confused. He does no longer appreciate activities he previously liked, e.g. brushing, belly and head rubs, etc. Lastly, abnormalities in the pupils were observed [different sizes]. It is unclear whether this still persists. It should also be added that his nose mucous was mostly clear, watery. Pain is at this point not obvious, but it can not be excluded.From our perspective, the symptoms seem to indicate a viral infection with possible central nervous system involvement as a late sequela. However, none of the other cats , including his presumed identical twin, have as yet been affected and since it is impossible to separate them, or their feeding stations, litter boxes, etc., they must almost certainly all have been exposed.Our questions are as follows: Do you have any idea what disease entity this may be? Might he survive? Might he be suffering? What about the other cats? Importantly, all other cats have been treated with advantage II, can this cat also be treated? Finally, is there anything we can do, short of taking him to the vet?

Looks good. Give me a moment to take a look, please...

Your thinking is apt. Feline herpervirus (FHV-1) is the most likely of the respiratory infectious agents and anisocoria (unequal pupils) is often associated with the feline leukemia virus (FeLV) which does infect the central nervous system. Here's a more complete synopsis of anisocoria in cats for you:

The two most common causes are the leukemia (FeLV) virus and the spastic pupil syndrome - a condition unique to cats in which owners report anisocoria, which may sometimes be transient and independent of ambient light levels. Clinically, cats with this syndrome appear to be healthy, are visual, and have no ocular abnormalities beside unusual behavior of the pupils. Unfortunately, most affected cats test positive for FeLV at the initial presentation but not all which confounds the diagnosis.

Anisocoria also results from primary iridal (iris) disease - an example of an inflammatory process causing miosis (an abnormally small pupil); and primary neurologic disorders involving cranial nerve III and Horner's syndrome. Retinal disease - hemorrhage and/or detachment needs to be considered as well. If the retina isn’t perceiving light or telling the brain that light has been perceived, the pupil will become mydriatic – larger than usual. Retinal disease is relatively common in hypertensive cats and so blood pressure assessment is important in these cats.

The initial database should involve testing for FeLV and a complete ophthalmic examination including menace response, dazzle, palpebral, pupillary light, and vestibulo-ocular reflexes. Fluoroscein staining of the cornea should be performed looking for corneal trauma and intraocular pressure should be measured (the elevated pressure of glaucoma will enlarge the pupil (mydriasis) and the lowered pressures of uveitis will make the pupil miotic).

I understand that diagnostics appear to be out of the question.

Customer: replied 3 months ago.
Well, for the time being. I have a standing appointment with the vet, should we be able to catch him. The problem is, he is onto us and seriously sensitive to any perceived "foul play". I assume FeLV is fatal? Or is it chronic and the current disease process due to the aforementioned herpes virus? In any case, at some point we will take him in, namely when he is weak enough to be handled in such a way. If another cat develops problems, it may be possible to indirectly diagnose him, because some of the cats may be more amenable to being put into a carrier. Then there was the question about the topical flea treatment.....it is suggested that it is not applied to "decrepit" cats..One more thing, if it is FeLV, can one safely assume that all cats are infected?

Not necessarily. It's not a death sentence but it would require intensive treatment of concurrent infections. It can become a a chronic disease process. It's difficult to know if he were infected first with one virus or the other but FHV-1 does come out of its carrier state when my patient is stressed and exacerbation of FeLV would qualify as a stressor. Correct, topical flea treatments are best avoided in debilitated cats. The exception would be fipronil-containing products such as Frontline (or generics) as they're not absorbed into the system; regretfully, many populations of fleas are now resistant to fipronil. Yes, it's likely the others would be carrying FeLV at this time. Please continue our conversation if you wish.

Customer: replied 3 months ago.
Thank you for your information it has been very helpful. I am ready to give you an evaluation. One last question, if you don't mind. I remember when the cats were spayed/neutered, they were given some vaccinations. One of them was likely against rabies. Might FeLV have been included? I assume I can call up the clinic and ask them.Again, thank you for your help.

Perhaps, and if so, I would hope that they were tested for FeLV first which is standard of care. Please do give the clinic a call and let me know what you find out.

You're quite welcome.

Dr. Michael Salkin and other Cat Veterinary Specialists are ready to help you
Customer: replied 3 months ago.
If I can add a comment at a later time, I will do so. A last piece of information - no need to respond. Before we had the feral female population under control, the same mother as Joe [the sick cat] dropped another litter of six kittens. Graciously, she left those in the middle of the garage floor, so we had unrestricted access. We proceeded to pick up two kittens at a time and played with them in the house for 30 minutes each day. Those kittens turned out perfectly, as far as sociability was concerned. Since we were already overwhelmed with cats, we had to give them up for adoption at a place called the North Shore Animal League. The kittens were tested for behavioral issues and subjected to a blood test. THOSE kittens were free of disease and they passed with flying colors. We assumed at that time that FeLV was not an issue in the neighborhood, but who knows what has happened since then.Thank you again. It has been a pleasure communicating with you. I will sign off now.

Thank you for your kind accept. I appreciate it. 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.

Hi,

I'm just following up on our conversation about Joe. How is everything going?

Dr. Michael Salkin