Iryna Asks: We got an 8 weeks old kitty. We got him from the shelter, fought with his fleas and noticed him sneezing a lot. The vet examined and didn't find anything wrong. She said kitties can have some respiratory virus infection that will go away by itself within 6 weeks. The kitty is 16 weeks old now and still sneezing. Sometimes it looks like he is congested after he wakes up. He makes an "urg" sounds even if he is sleeping. Th sound is more loud when he is playing or grooming himself. It's not purring. It appears when he inhales I think. He is playful, energetic, eats a lot, happy, but the sound bothers us. Any suggestions? The vet has checked him twice and couldn't find anything. Thank you!

Hi Iryna, it’s great you have a new kitty in your life!

I will admit something. I love the idea of solving peoples pet problems or illnesses by knocking the issue right out of the park. Meaning, I’ve so tightly defined and diagnosed the issue, that when I treat that illness or problem, the cat or dog feels SO good SO fast that not only do they feel good, but it makes me look good as a vet as well. It’s like a matter or pride. You know what? Nothing makes me look dumber than feline upper respiratory tract illness (URTI). These guys either get better quickly or they don't…until they get better (usually).

Assuming you have an otherwise healthy kitten (FeLV/FIV negative, eating, drinking ok, litter box situation is good), then there is an 80% chance your kitten has herpes. Yes, good ol’ herpes. It’s a bit different as compared to people (common cold sore to promiscuous 80’s LA band member lifestyle). In cats, herpes (or calicivirus, another virus that can cause what your kitten has) causes feline rhinotracheitis.

So, we’ve gone from herpes to rhinotracheitis. All that congestion you are hearing is most likely from the rhinotracheitis (nasal passage and tracheal inflammation).

Rhinotracheitis is how the body reacts when under attack by the virus. This is sneezing, fever, discharge out of the nose or eyes, and then bacterial infections. As this goes on, some cats eyelids will actually stick together, or the third eyelid can get involved and potentially stick to things as well (see http://www.iwillhelpyourcat.com/dr-kris-qa/#/third-eyelid-and-sneezy/). Then the mouth or gums can get involved, and then sometimes they get pneumonia.

Some cats show ZERO signs of rhinotracheitis, some cat’s show ALL of those symptoms, and some will show different aspects of it every few weeks or months (they look perfect, then one of those symptoms show up).

Some cats are in a chronic carrier state - they have it but never ever show it - but pass it on. So sometimes your cat at home has it, passed it on to your new kitten. Sometimes your new kitten passed it on to your pre-existing adult cat.

You never know what kitten is going to do what if they otherwise look healthy. So for some folks, what you are recommending is interpreted as overkill. As in “hey doc’, why did I pay for BOTH these eye med’s and oral antibiotics, he’s fine and my neighbours cat had the same thing and the NEVER needed this stuff”. And some folks would tell you “hey, you just gave me this saline rinse - but then he just got SICKER - why didn't you treat hime him properly???”.

OMG. It’s confusing for people and that’s not their fault (even if I explain it really well it’s a lot to take in). But I didn't give their cat herpes (or anyone human for that matter) so all I can do is explain the following:

First deal with the rhinotracheitis and it’s complications:

Any sign of a fever or not eating or lethargy? Oral antibiotics like amoxicillin, Azithromycin, or easily doxycycline if I needed to. For those of you yelling “what about teeth discoloration with using doxycycline in young kittens” I might suggest “better to have a slight chance of yellow teeth and beat pneumonia if nothing else is working”! Are they getting extra snorty or raspy with their breathing (but otherwise look ok)? Maybe antibiotics for those guys too if it’s increasing over time despite them looking good.

Goopy eyes? You may need to try several eye ointments until you find the one that works best. I recently had to script out a commonly used human ophthalmic drop, because no licensed veterinary product would work for this particular kitties URTI. So the key message here is sometimes you have to cycle through a couple. A warm compress on the face/eyes can help loosen up eyelids that are sticking together. Some of them get viral keratitis (inflammation of the clear part of their eyes), and then you are into topical antivirals or anti-inflammitories.

Just mild misty sneeze with no other issues? Sometimes you just ride that one out, because it’s gone in 7 days. And they will never show it again until they are middle aged. Are they in a bad way, dehydrated and depressed? Those guys are staying in hospital on IV.

Complex for a little 750gm kitten huh?

Well then you gotta deal with the virus. This is where a lot of people get stuck. Treating the virus does nothing for their kittens current rhinotracheitis. And rhinotracheitis itself can be chronic! So you might be treating the virus with all this stuff your vet gave your, thinking OMG why isn't this working…because the rhinotracheitis is still there and active regardless of what the virus is doing. Clear as mud?

For some cats I use L-lysine. It tries to block production of the virus. You don’t need it for any of the rhinotracheitis symptoms. But if they are coming back every few weeks with similar issues, the thinking is that you have nothing to lose by trying to suppress the underlying instigator. Some vets have used famciclovir. I’ve never personally done that so I don’t really have a comment on it either way.

It should be said that if you have an older cat with new, chronic URTI issues, it’s gotta be considered that the rhinotracheitis is being caused by something other than a virus.

Ok how about the good news for Iryna's kitten? Most kittens and cat’s that I see get better. And your kitten has a great chance of getting better, given there is no report of lethargy, eye or appetite issues, or fever! My cat has this virus, and he's only shown it 3 times in his life. When he was stressed by some other issues. If your kitten starts to not do as well, just be prepared to cycle through a few options until you find what works for him, and chances are he'll do just fine!

Cheers,
Dr. Kris