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My cat starting sneezing and now is sneezing blood. His name

Customer Question
my cat starting sneezing and...
my cat starting sneezing and now is sneezing blood
JA: I'm sorry to hear that. What is the cat's name and age?
Customer: His name is ***** ***** he is 7 yrs
JA: Is there anything else important you think the Veterinarian should know about Pancho?
Customer: He is a rescue and has always been very playful. He still has a very healthy appetite, but now he is sneezing blood from his left nostril.
Submitted: 1 month ago.Category: Cat Veterinary
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Answered in 7 minutes by:
10/31/2017
Cat Veterinarian: Dr. Kara, Veterinarian replied 1 month ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 17,304
Experience: Over 20 years of experience as a veterinarian.
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Cat Veterinarian: Dr. Kara, Veterinarian replied 1 month ago

I understand that you are concerned about Pancho's sneezing/nasal congestion, now with some bloody mucous and I'd like to help.

How long has this been going on?

How is he feeling otherwise? Any loss of appetite, weight loss, lethargy, or fever?

Was the discharge from both sides of his nose initially?

Has the blood always been from one side only or did it seem to start with bilateral (both sided) and then become one sided?

Given his sneezing of course we are concerned with things that cause nasal inflammation.

Sneezing and reverse sneezing are signs of nasal and pharyngeal irritation.

With nasal irritation we can also see a nasal discharge which can be yellow, white, green, mucoid or even bloody in character. In some cases with long term infections or a mass we can even see bleeding and nasal bone destruction and swelling or changes in nose conformation or around the eye.

Possible reasons for these symptoms are bacterial, fungal, or viral infections, a foreign body in the nose, a polyp or mass in the nose or a tooth root infection. Another possibility is a sterile inflammatory condition called lymphoplasmacytic rhinitis.

Lymphoplasmacytic rhinitis is a chronic inflammation and thickening of the nasal mucosa that does not cause any changes in the nasal bones, and is not associated with any sort of infection. It is steroid responsive, but high doses of steroids for long periods of time can be rough on her gastrointestinal tract, liver and kidneys and can cause diabetes. Ideally we get the condition under control with a high dose of steroids and then slowly reduce the dose to the lowest possible to control the condition. Some cats can come off steroids completely for long periods of time without symptoms returning, but most need steroids chronically at lower levels.

Because we need to use immunosuppressive with this disease we want to make sure we look for infectious causes first and rule those out, and get biopsies for a definitive diagnosis.

Allergies are rarely the cause of chronic nasal congestion, cats seem to get itchy with allergies, not nasal congestion.

If this is a very recent issue of short duration then I suspect that he has picked up a contagious upper respiratory infection. An upper respiratory infection in cats is just like a cold in you and I, and these are commonly caused by a virus, the most common one being Herpes virus. These are easily caught by breathing in virus particles in the air from a sneeze or nasal or eye discharge. Some cats get sicker than others and young, healthy adult cats seem to tolerate them and fight them off better than very young kittens or older cats. Symptoms range from a mild runny nose and occasional sneeze to severe congestion, coughing, sneezing, fever, eye discharge, and in some cases fatal pneumonia. Sometimes if they sneeze enough they can break a blood vessel and cause bleeding in the nose, leading to sneezing blood.

If this has been short term and you suspect a viral infection you can help him feel better by adding warm water to him food to make it smell more (they don't eat if they cannot smell) as well as making it easier to swallow.
Also the more fluids he gets the better. Offer tuna juice, low salt chicken broth, run the tap if he likes to drink out of the sink.

Take him into the bathroom with you if you run a hot bath or shower as the steam will soothe his sore throat and airways, and thin the mucous in his respiratory tract.

If his nose become very congested you can use sterile saline to loosen the thick mucous and remove it. He won't like it but it will help him breathe and be able to smell his food better. You can also use sterile saline to remove eye mucous if it accumulates.

You can give him an amino acid supplement called L-lysine at a dose of 500mg orally twice daily. If this infection is due to Herpes this amino acid interferes with virus replication and will shorten the infection's duration and severity. Good supplements to try are made by the Viralys brand which comes in a powder to add to the food or a tasty gel.

If this has been a more chronic condition (weeks to months) then diagnosis of a the problem behind these symptoms can be complicated. We may need to perform radiographs of the nose and sinuses looking for changes in the bones or full sinuses, nasal flushes and scoping to collect culture and biopsy specimens and sometimes blood titers to look for the infection (especially if we are suspicious of a fungal infection).

Ideally we would run some blood tests including a complete blood count, biochemistry profile, T-4 level, and feline leukemia and feline immunodeficiency tests, fungal titers, and testing to check to see if his blood pressure is elevated. I would check for a fungal infection by checking blood titers for fungal infections found in your area, aspergillosis tends to cause nasal congestion and infections throughout the US.

If those tests come back normal then looking for a tooth root infection or retained root, a foreign body or polyp with a nasal scope and radiographs of his tooth roots, nose and sinuses under sedation would be recommended. A biopsy of any abnormal tissue could be diagnostic.

Some cases require a CT scan to get a diagnosis.

I know this may not be what you were looking for but if this has been a chronic issue we really need to run tests on him to determine why he has these symptoms.

If he starts bleeding more than a little bit you can use a cold compress/pack on the outside of his nose for several minutes at a time. If he is bleeding a lot you can also use a drop or two of Neo-Synephrine to try to stop the bleeding, and then get him seen by a veterinarian.

Best of luck with Pancho, please let me know if you have any further questions.

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Customer reply replied 1 month ago
The bleeding is only on the left nostril. The sneezing started in May and by August, I started seeing blood. The nostril is completely covered and his left eye looks damaged. He sounds congested. His appetite is very good and bowel movements are good. He doesn't seem to have a fever.
Cat Veterinarian: Dr. Kara, Veterinarian replied 1 month ago

Thanks very much for the additional information. It sounds like a long term issue that is slowly progressing and encompassing most of his left side of his face including his nostril, left side of his nasal cavity/sinuses and now is affecting his left eye.

Given what you have told me a mass in his nose sounds very likely.

This could be a polyp (benign mass), a fungal granuloma or something more serious such as an aggressive, malignant tumor (most common tumors in cat fibrosarcoma, squamous cell carcinoma or an osteosarcoma).

I highly recommend that he see his veterinarian and have some diagnostic testing done.

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