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MHe has a sinus infection now for close to 3 months, at his

hi mHe has a...
hi mHe has a sinus infection now for close to 3 months, at his worst he has nose bleeds bad so they gave him a shot of antibiotics, He seemed to be a little better so we went another three weeks he got bad again I got 5 days worth of anti drops supposed to las a week the shots lasted two then after a week or so poor guy was really bad again so to the vet and got another shot...it has only been in him about five days but he is not very much better.
JA: I'm sorry to hear that. There are all sorts of infections the cat 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 cat's name?
Customer: Neptune
JA: Is there anything else the Veterinarian should be aware of about Neptune?
Customer: i also have two other caTS WHO ARE FINE AND Neptune IS ALMOST 16 His sister is fine as well oh and also..... he has sooo much energy and became very cuddly wich he never was before
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Answered in 7 minutes by:
8/24/2017
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 31,165
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.

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I'm sorry to hear of this with Neptune. I understand your frustration and commiserate with you. You’ve described chronic rhinosinusitis which 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 Neptune is exhibiting the symptoms of persistent herpesvirus infection. If FHV-1 is suggested 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.

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Customer reply replied 3 months ago
I forgot to let you know that he has always seemed to have sinus issues since he was a baby the vet agreed he did and at the time just told me to watch it

That's supportive evidence of FHV-1 which has come out of its carrier state at Neptune's advanced age. Please speak to his vet about a famciclovir trial. Please continue our conversation if you wish.

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Customer reply replied 3 months ago
Cost is a huge factor here
Customer reply replied 3 months ago
I am sorry I lost you before
Customer reply replied 3 months ago
I think the vet mentioned this
Customer reply replied 3 months ago
R u still here

Have Neptune's vet price out a 3 week course of famciclovir. It might not be prohibitive for you.

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Customer reply replied 3 months ago
I have some human fluticasone could I us this
Customer reply replied 3 months ago
Will they give that three week treatment without a test?

Yes, you can see how fluticasone affects Neptune. As mentioned above, it can be administered by a MDI but it doesn't need to be. Yes, Neptune's vet can authorize a famciclovir trial without a test. It's no different than seeing how an antibiotic affects Neptune.

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Customer reply replied 3 months ago
I have the spray

Let Neptune's vet know that you want to see how the spray affects Neptune.

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Customer reply replied 3 months ago
Wow you have been great thank you very much

You're quite welcome. 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.

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Customer reply replied 3 months ago
Will your answ
Customer reply replied 3 months ago
That's what I was just asking
Customer reply replied 3 months ago
Have a good evening. Btw my name is Candi

I hope to hear from you soon, Candi.

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 31,165
Experience: University of California at Davis graduate veterinarian with 45 years of experience.
Verified
Dr. Michael Salkin and 87 other Cat Veterinary Specialists are ready to help you
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Thank you for your kind accept. I appreciate it.

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Dr. Michael Salkin
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 31,165
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Experience: University of California at Davis graduate veterinarian with 45 years of experience.

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