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My cat has feline herpes and about a week ago had a bout of…

Customer Question
My cat has feline...

My cat has feline herpes and about a week ago had a bout of it where he was sneezing a lot. He has a chronic runny eye that we treat with antibiotics from time to time. Now he has bloody tinged snot coming out of his nose. But he's eating and drinking and acting normally. He's also 15.

Veterinarian's Assistant: I'm sorry to hear that. What is the cat's name?

Eddie, he's an amazing black cat...just the best guy.

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Eddie?

We think he's lost his hearing now as well.

Submitted: 5 months ago.Category: Cat Veterinary
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Answered in 13 minutes by:
11/19/2017
Cat Veterinarian: Dr. Kara, Veterinarian replied 5 months ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 18,138
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 5 months ago

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

Is the discharge from both sides of the nose?

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. Cats with hypertension due to kidney disease or hyperthyroidism may also get a bloody nasal discharge.

In your fellow's case it is possible that a long term Herpes infection with secondary bacterial invaders has led to nasal bone deformities/destruction and a bloody nasal discharge.

Another possibility is a sterile inflammatory condition called lymphoplasmacytic rhinitis. This disease process 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 them out, and biopsies for a definitive diagnosis is ideal.

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).

At his age, and because he has never had this before despite a long term history or Herpes, to check general health I would start with a complete blood count and biochemistry profile and T-4 as well as measuring his blood pressure.

If those tests come back normal then looking for a tooth root infection, 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.

I would also 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 you decide that you cannot or would not run any further diagnostics, and his physical examination is relatively normal then asking your veterinarian to try a course of an antibiotic such as Clindamycin, Doxycycline or Clavamox could be an option. These antibiotics are good for treating tooth and respiratory tract infections.

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

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