What I Know - URI

I've decided to do a new, randomly placed in space and time, segment of this blog. I want to talk about things I have dealt with.  "What I know" seemed to be a very apt title for this (hopefully) group of posts because I don't think that what I know about a subject is all there is to know, I also believe that what I know to be true now could very well be wrong in the future.  Knowledge is ever expanding as we get into the minutia of things. What I know, is simply that, what I know.

So, URI.  URI stands for "Upper Respiratory Infection" and since I can't spell respiratory, I just call it URI.
URI is a catch all phrase for a variety of illnesses that cause problems with mucus membranes of the head and lungs.  Characteristic symptoms are sneezing, nasal discharge, inflamed conjunctiva and discharge from the eyes in a variety of colors and textures.  It can also cause lethargy and less often fever and pneumonia .

Generally, simple URI isn't something to stress over too much. Generally you get a little sneezing, maybe some goop in the corner of an eye.  You want to keep a close eye on these symptoms, but as long as your kitty is eating and generally active you can take a 'wait and see' approach.

Kitties with immunocompromised systems, either because they are young or under nourished or older and facing end of life issues, generally have a harder time with URI.  Kitties in or that came from a shelter environment are often highly stressed and under nourished, and a stressed kitty is usually immunocompromised.
As the URI progresses you can often see the eye become inflamed, the third eyelid is easily showing, and / or the discharge from they eye starts turning white or green. The nasal discharge might start to accumulate on the nose and / or a kitty can become lethargic.  These are all warning signs that more help is going to be needed.

While most URI is viral, antibiotics are given to support the body so it can focus on fighting off the virus.  A body weakened by a viral infection is prone to developing secondary infections.  Eye ointments are given to soothe as well as fight off infection.  Nutrition is key to helping kitties immune system to work as well as possible.  Unfortunately a kitty with a stuffy nose generally can't smell it's food.  Since a cat relies on its sense of smell to know if it's food is safe to eat, a cat that can't smell won't eat.  There are a few tricks to get around this natural instinct.  One is to have an established routine.  If your kitty KNOWS that every day at a certain time yummy food will be fed, then quite often they will just go along with the routine.  This is not fool proof, but it does help. Feeding warmed up food increases the scent as does feeding overly 'stinky' foods like fish and seafood.   Having a second kitty around could also help - for two different reasons.  The first being if your sick kitty sees the healthy kitty eating, he will accept that the foodstuffs in the bowl is food.  The second being competition.  Cats do have a hierarchy and eating last usually means the kitty is the lowest of the pack.  Seeing other kitties getting something good will often spur a "not feeling so well" kitty into attempting to eat to keep their status in the group.

When the infection gets so bad that the kitty starts to feel miserable, it will no longer try to take care of any discharge and it will build up.  Eyes will glue shut from ocular discharge and if left can cause so much damage as to possibly harm the eye; sometimes beyond repair.  Nasal mucus will cake over the nasal passages to the point the cat can't breathe through it's nose. The kitty won't eat and won't have energy to do much of anything. Each one of these symptoms on their own are cause for an immediate trip to the vet for some serious intervention.  The kitty could be given fluids either subq (under the skin) or intravenous if it is very sick.  If need be, the vet can discuss with you the appropriateness of force feeding your kitty, and in the worst cases can discuss a feeding tube with you.  

Any medication that is given needs to be given for the full length of time and if the issue is not cleared up by the time the medication runs out you need to contact your vet about getting more. Antibiotic resistance  issues can pop up if medication is stopped prior to the full course of treatment.  Even if your kitty looks and is acting fine after just three days, be safe and give all of it. Discuss how long you should continue to give medications once the symptoms clear up.

While most of this post is about URI in general, there are a few specifics you should know.  One is calicivirus.  This particularly nasty virus causes blisters in the mouth.  There is a form of calici that causes limping.  Then there is the herpes virus.  This one is not much fun either and is a major source for really bad eye issues, huge lesions on the eyes that cause real damage.  Herpes is known to 'reactivate' so it is something that can reoccur through out the cat's life time.

A lot of the new science of health is finding out that a lot of the immune system starts in the gut.  Again, feeding good quality nutrition is key.  Providing the building blocks of proteins and amino acids will help the kitty's immune system do it's job.  Also providing good quality pro-biotics should help as well.  I am a fan of full fat plain yogurt, but have also used pro-biotic capsules opened up and sprinkled on food.  Another help for viral URI is the amino acid Lysine.  Lysine works by inhibiting the growth of the virus.  Lysine takes the spot of another amino acid Arginine, which the virus needs to replicate.  This has been shown to work for the herpes virus, so it is speculated it will work for all.  I am leery of supplementing with Lysine any longer then necessary because of how it "inhibits" Arginine - I would be concerned about a possible deficiency; not that there is any proof of that.  If you find it is helping your kitty then by all means give it. update 11/23/15 There has finally been a study that shows that using Lysine does not work to inhibit the herpes virus, and giving it can cause problems because of it's ability to inhibit arginine. I can no longer continue to recommend it's use. If you decide you want to give it a try, please do not use it for long periods of time.

I would love to discuss antibiotics in specific with you, but each area of the country has come up with an antibiotic that works for the strain in their area.  From my past experience clavamox is a complete and utter waste of time.  It was not designed for URI... but it does work very well on infections and fevers.  We have used both zithromax and doxycycline in URI in the past.   I mention it because if you have a hard case of URI, switching to a different antibiotic can sometimes help (yes, even though it is viral).  If your vet prescribes medication to you, ask if he sees a lot of URI.. especially if he prescribes clavamox.

The URI seems to be particularly bad this year; some years it is worse then others.  My current fosters can't seem to get over their hard breathing and discharge from their nose.  I'm also reading of other foster homes where it is causing some serious problems.  While it seems like it could just be a 'simple cold' it really is not something to be taken lightly.

There are also a few chronic conditions that can mimic URI.  Cats can and do suffer from allergies and asthma just as people do.  Heart worms can also cause asthmatic symptoms because they have an affect on a cat's lungs more so then the heart.  If ever in doubt it is not unwise to take your kitty to a vet for a check up or even a recheck.  You are not wasting your time nor the vets.  A good relationship with a vet can be invaluable to pet owners, and the more your vet gets her/his hands on your kitty, the better s/he will know your kitty.

Long post summarized: A sneeze or two, wait it out.  Any change in behavior / appetite or any mucus membrane discharge more then a drop or two, get to a vet.

Since this is what I know, I'd love to hear what you know.