Use of anti-viral drugs with Cat Flu

Re: Use of anti-viral drugs with Cat Flu

John Flynn — Thu, 26 Sep 2013 17:58:37 GMT

[quote user="Martin Atkinson"]Adneoid tissue is lymphiod tissue similar to tonsils and performing a similar function found in the back of the naso-pharynx so its hidden by the soft palate you can't see it. Until recently it was not thought that animals had it but apparently they do and it can get chronically infected or rather possibly chronically over-stimulated and active. You must have heard of children having their adenoids out it was all the rage when I was a lad like tonsillectomies! [/quote]

Must have been under that Bushel at the time

Thanks for the added info.

If every day continues to be a school day then maybe I'll get concession bus fares all over again

Re: Use of anti-viral drugs with Cat Flu

Martin Atkinson — Thu, 26 Sep 2013 17:37:23 GMT

[quote user="John Flynn"]what is adenoid tissue and what should i know about it![/quote] Adneoid tissue is lymphiod tissue similar to tonsils and performing a similar function found in the back of the naso-pharynx so its hidden by the soft palate you can't see it. Until recently it was not thought that animals had it but apparently they do and it can get chronically infected or rather possibly chronically over-stimulated and active. You must have heard of children having their adenoids out it was all the rage when I was a lad like tonsillectomies!

Re: Use of anti-viral drugs with Cat Flu

Kate Richardson — Thu, 26 Sep 2013 15:50:50 GMT

[quote user="John Flynn"]

[quote user="Kate Richardson"]Doxycycline preferred by myself[/quote]

do you use this as a firstline antibiotic or only after culture?

i typically use oxytet first line.

[/quote]

Yes first line, no culture usually.

Re: Use of anti-viral drugs with Cat Flu

John Flynn — Thu, 26 Sep 2013 15:19:43 GMT

[quote user="Kate Richardson"]Doxycycline preferred by myself[/quote]

do you use this as a firstline antibiotic or only after culture?

i typically use oxytet first line.

Re: Use of anti-viral drugs with Cat Flu

John Flynn — Thu, 26 Sep 2013 15:17:55 GMT

[quote user="Martin Atkinson"]Another possibility is adenoiditis - yes apparently cats do have adenoid tissue and it can be the cause of recurrent URTI but you need a flexible endoscope to look back over the end of the soft palate. As far as I know there is only one (American) vet performing adenoidectomies.[/quote]

I'm learning a lot this week - what is adenoid tissue and what should i know about it!

Re: Use of anti-viral drugs with Cat Flu

Kate Richardson — Thu, 26 Sep 2013 14:50:53 GMT

Yes Lysine only 'effective' versus herpes; used to reduce shedding of virus when symptomatic if I recall correctly. Doxycycline preferred by myself as has some anti-inflammatory/immunomodulatory effect as well and also effective versus bordatella and mycoplasma. Have used clav/amox and cephalexin and trimethoprim potentiated sulphonamides in similar cases as well though but usually further down the track in management having had at least 4 weeks of doxy at some stage previously. In this case though already shows improvement with doxycycline so sensible to continue with it.

Re: Use of anti-viral drugs with Cat Flu

Martin Atkinson — Thu, 26 Sep 2013 10:55:08 GMT

From what I understand Flumax (l-Lysine) is not effective against FCR because it is an RNA virus. I can't see any logic in giving doxycycline as opposed to pot. amoxycillin unless chlamydiosis has been diagnosed or a bacterial sensitivity test has shown there's a bacterial infection sensitive to it alone. It's not going to stop virus flare-up but a 3-4 week course may be reasonable. That said I have one patient with chronic recurrent nasal discharge/reverse sneezing, it had a history of nasal FB which it sneezed out. We investigated with endoscopy and X-ray and couldn't find evidence of another FB but did retrograde flushing, got out a shed load of muco-purulent gunk and put him on four weeks of appropriate antibiotic (from culture) resulting in an immediate improvement and no recurrence yet but we've only gone about 3 months. Another possibility is adenoiditis - yes apparently cats do have adenoid tissue and it can be the cause of recurrent URTI but you need a flexible endoscope to look back over the end of the soft palate. As far as I know there is only one (American) vet performing adenoidectomies.

Re: Use of anti-viral drugs with Cat Flu

Anthony Dennison — Thu, 26 Sep 2013 09:52:10 GMT

It has L-Lysine (?) in it I think, liquid that is pumped onto the food daily

Re: Use of anti-viral drugs with Cat Flu

Kate Richardson — Thu, 26 Sep 2013 09:45:54 GMT

I guess it would be worth checking with the lab re false negatives for FHV and repeating the PCR if you think FHV is still a possibility as famciclovir has only been shown to improve FHV symptoms; however it is a safe drug so you could consider using it if the cat only has FCV- others may have more info on its use versus FCV or in chronic rhinitis cases.

Yes I would definitely try a 4 week course of doxycycline, I usually use 10mg/kg sid, others prefer 5mg/kg bid. Obviously with or immediately followed by food or water. Unlikely to resolve the problem but may give a longer symptom free period.

By the way, whats in Flumax? Am on maternity leave and not aware of it- is it new? I googled it and see its a Vetplus product but no ingredients listed on their website. (The first search brought up human cold and flu medications with paracetomol etc in and I thought yikes!!! then brain kicked in!!!)

Re: Use of anti-viral drugs with Cat Flu

Thomas Johnson — Thu, 26 Sep 2013 09:23:00 GMT

[quote user="Anthony Dennison"]

The longest course of doxy that I can see was for 2 weeks, so would it be worth trying a long course of this before trying famciclovir?

[/quote]

I don't have any experience of using famciclovir, but I think if you are getting some response to antibiotics it might be sensible to try an extended course.

Re: Use of anti-viral drugs with Cat Flu

Anthony Dennison — Thu, 26 Sep 2013 09:20:17 GMT

[quote user="Kate Richardson"]What test was performed for herpes? If it wasn't a PCR test then I would definitely repeat the herpes test and do a PCR. Has the cat been tested for chlamydophila or bordatella as well? Chlamydophila has a PCR test as well now, not sure about bordatella. Has the cat ever had a long course of doxy eg 4 weeks continuous?[/quote]

A PCR was done through IDEXX in April this year. Negative for FHV, Chlamydophila, Mycoplasma felis. Positive for calici. The longest course of doxy that I can see was for 2 weeks, so would it be worth trying a long course of this before trying famciclovir?

Re: Use of anti-viral drugs with Cat Flu

Thomas Johnson — Thu, 26 Sep 2013 09:15:45 GMT

[quote user="Anthony Dennison"]

The cat is on Flumax daily, and usually things resolve with doxycycline and meloxicam, but would any anti-viral drugs be useful in these cases to prevent the regular flare ups?

[/quote]

What length courses of antibiotics are you using? I've found that 4 week courses can greatly extend the time between flare-ups. I went to some CPD a few years ago where they were talking about the secondary bacterial infection leading to an osteomyelitis of the turbinate bones, and shorter courses of antibiotics not treating that effectively.

Re: Use of anti-viral drugs with Cat Flu

Dagmar Steele — Thu, 26 Sep 2013 08:32:01 GMT

I am treating a burmese cat for an corneal ulcer at the moment. He is known to have a herpes infection as a youngster and had ongoing upper respiratory issues ever since. The eye specialist put him on famciclovir with no side effects and the symptoms are improving slowly, I have no clue if due to this medication or due to some of the others he's on.

Re: Use of anti-viral drugs with Cat Flu

Kate Richardson — Wed, 25 Sep 2013 22:34:19 GMT

Hi Anthony

What test was performed for herpes? If it wasn't a PCR test then I would definitely repeat the herpes test and do a PCR. Has the cat been tested for chlamydophila or bordatella as well? Chlamydophila has a PCR test as well now, not sure about bordatella. Has the cat ever had a long course of doxy eg 4 weeks continuous?

Are you thinking of anti-virals such as famciclovir? This appears to be the most effective anti-viral for treating FHV associated ocular disease and is safe and effective. Make sure owners are aware you are managing the problem, not curing it. Not sure about its effect versus Calici virus though but Langford or Glasgow may be able to give you more info.

http://www.icatcare.org/advice-centre/cat-health/cat-flu-%E2%80%93-upper-respiratory-infection

Kate

Re: Use of anti-viral drugs with Cat Flu

Martin Atkinson — Wed, 25 Sep 2013 18:53:46 GMT

I would question the negative for FHV if you are getting URTI, FCV shouldn't do that. I have found Virbagen Omega useful for managing flare ups of FHV to reduce recovery time but at this stage it will do nothing to alter carrier state and likely recurrence. For FCV gingivo-stomatitis it really is only of value in managing chronic cases because it has to be given long term orally but my success is limited and I don't use it anymore for that. In severe cases I've given it by injection and intra-lesional to reduce severity of symptoms but it probably only reduces it to the sort of level you're seeing in this cat quite honestly. I suspect that the best course of action is to continue what you're doing but I would consider repeating the test for FHV from a really rough conjunctival swab taken after some proxymetacaine drops. If you want to give interferon a go you could explain to the owner that you want to try a course of Virbagen Omega but that it costs a fortune and it may not be successful. If you're not sure of the doses and you want to try, PM me and I'll send them to you. For what its worth if you can catch young kittens at the time of their very first symptoms a course of Virbagen IME has 'cured' them with days and reduced the incidence of carrier status but numbers are too low to be certain of the latter - too late for this cat obviously.

Re: Use of anti-viral drugs with Cat Flu

Hannah Wynne Richards — Wed, 25 Sep 2013 18:29:05 GMT

I don't THINK they would prevent flare-ups, but I've found Virbagen definitely useful as a component of the regime in treating gingivitis.

Wynne