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My Abyssinian cat is 17 years old and she has been having a…

My Abyssinian cat is 17...
My Abyssinian cat is 17 years old and she has been having a lot of problems with her nasal passages. She makes noise when breathing and sneezes violently. The vet told us to give her antihistamines. But I've been reading and it seems like she needs a decongestant, not an antihistamine. She is not itchy at all. Never had this problem before she had a lot of dental work done. This has been going on for many months. We tried antihistamines for a few days and they did not help.It seems it's getting worse now. I asked if it could be an infection (many months ago) but the vet did not really respond and just suggested antihistamines. They made it sound like nothing more can be done to help her. I can't believe that. She shouldn't have to die like this.
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Answered in 10 minutes by:
10/23/2017
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 32,282
Experience: University of California at Davis graduate veterinarian with 45 years of experience.
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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 Bast is exhibiting the symptoms of persistent herpesvirus infection. If FHV-1 can be confirmed by PCR testing, the systemic 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 (steroids) 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. Feel free to share our conversation with Bast's vet. If he/she isn't interested in pursuing Bast's case please consider another generalist vet or a specialist veterinary internist whom you can find here: www.acvim.org/ Please respond with further questions or concerns if you wish.

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 32,282
Experience: University of California at Davis graduate veterinarian with 45 years of experience.
Verified
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Customer reply replied 4 months ago
Thank you. They have not checked out any of these possibilities, they just suggested trying different antihistamines and if one didn't work, try a different one. The glucocoritcoids sound interesting, and I like the idea of the inhaler directly affecting the nasal mucosa. She needs relief! Thank you.

You're quite welcome. Yes, steroids can make quite a difference. 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.

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Dr. Michael Salkin
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 32,282
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Experience: University of California at Davis graduate veterinarian with 45 years of experience.

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