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He is coughing and had no energy. Fluffy and he is 2

Customer Question
He is coughing and...

He is coughing and had no energy

Veterinarian's Assistant: I'll do all I can to help. Could be a lot of things that cause lethargy. The Expert will know how to help the cat. What is the cat's name and age?

Fluffy and he is 2

Submitted: 7 months ago.Category: Cat Veterinary
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Answered in 1 minute by:
12/16/2017
Cat Veterinarian: Dr. Kara, Veterinarian replied 7 months ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 18,842
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 7 months ago

I am sorry to hear about Fluffy's cough and lethargy.

If his cough is seeming to linger without any nasal or eye discharge a bacterial or viral infection seems very unlikely.

A dry cough can be a sign of heartworm disease. The most common symptoms for heartworm disease in a cat are coughing or gagging/vomiting. A simple blood test will help diagnose heartworm.

Another possibility, especially if he is allowed outdoors to hunt, is a lungworm infection. These can be more difficult to diagnose but checking several stool samples for eggs or trying a course of fenbenadazole (Panacur) worming medication may be diagnostic if he gets better.

Of course the other possibility is feline asthma. We can usually diagnose asthma with radiographs of the chest when they are showing symptoms. But if we don't catch them during an episode radiographs can look clear.

Heart disease is another possibility. Cats with heart disease have a consistent cough, are lethargic, and often eat poorly. If he seemed relatively normal otherwise, eating and drinking well, and active than heart disease would be less likely.

If this came up suddenly, he has a nasal and/or eye discharge, and/or is running a fever, 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.

You can help him feel better by adding warm water to his 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 any mucous in his airways making it easier to breathe.
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.
Some lethargy is understandable, let him rest as he needs rest to get better. If your cats normally go outdoors keep him (them) inside until they are back to their normal playful selves.
If he runs a high fever (more than 104F), has a green or yellow nasal or eye discharge, stops eating even with coaxing and clearing his nose and eyes, or starts coughing or having difficulty breathing such that he is open mouth breathing then he needs a veterinary exam.
Sometimes these upper airway infections turn into pneumonia so that's what we need to guard against. In most cases antibiotics aren't needed and can contribute to a decrease in appetite so I don't tend to prescribe them unless I feel there is evidence of a secondary bacterial component. These include a green or yellow eye or nasal discharge, evidence of pneumonia upon listening to their lungs or an infection that lingers beyond the normal 7 to 10 days.
I highly recommend testing him for feline leukemia and feline immunodeficiency viruses if his respiratory infection lingers. These immunosuppressive viruses will make a simple infection much worse as they stop the immune system from fighting infections the way it was designed to do.
Other reasons for coughing and nasal congestion are an infected tooth root, a foreign body inhaled into the nose or a nasal polyp. If he isn't much better in 7 to 10 days he needs a veterinary visit.

If he does not have a nasal discharge it would be very reasonable to check a heartworm test as well as a stool sample and worm him with fenbendazole. If those aren't diagnostic and he isn't improving the next step would be to take chest radiographs and look for changes consistent with asthma and compare them to the previous ones taken to see if there have been any changes if he has ever had radiographs taken before.

If his radiographs look suspicious for asthma or even if they look clear when he isn't coughing then try a course of bronchodilators (oral like theophylline or inhaled) and inhaled cortisone (like fluticasone). In most cases inhaled formulation of both drugs work best. In some cases your veterinarian may start with an injection of steroids to get him some immediate relief. Inhaled formulations can work directly on the lungs, and thus tend to work better in the long run, and because they aren't systemic they have less side effects.

Rarely a nasopharyngeal polyp or a fungal infection can be the cause of a cough, so looking further with sedation and a nasal scope, as well as a look behind the soft palate may be needed, if he isn't coming along.

There aren't any good over the counter medications to give a cat with a cough, other than a wormer like fenbendazole, but hopefully I have given you the information you need to approach his cough and the diagnostic testing that will help pin the cause down and get him appropriate treatment.

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

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