Feline Colds
Upper Respiratory Disease in Cats

Sinusitis, Colds, and Upper Respiratory Problems in Cats

Sinuses are bony cavities in the skull that communicate with the nasal passages.  Sinus infections are caused by invasion by bacteria, fungi, or viruses; in cats, several viruses working together (respiratory complex) are thought to be the most common cause.  Sometimes the problem is from underlying dental problems.  And sometimes the problem is really related to hair or grasses that migrate up the back of the throat into the nasal passages.  Other foreign bodies such as plant awns sometimes get up the nasal passages.  Reflux from hairballs and other causes of indigestion or upchucking sometimes cause upper respiratory symptoms.  All these possibilities underscore why it's best to go to the vet, even if you think "it's just a cold".

Clinical signs of sinus infection include discharge from the nose or eyes, coughing, gagging, and postnasal drip.  In cats, one of the most common symptoms is sneezing.

Most cases aren't very serious and most of us vets simply shrug the problem off as a "cold" and each of us have various favorite remedies to help reduce the symptoms.  But some cases are more serious, so it's possible that your vet will recommend or offer x-rays or even a CT-scan.  Other tests that may be appropriate might include:

A white blood cell count

A culture and sensitivity

Blood work to rule out underlying diseases like leukemia or Aids

A Heartworm test


Treatment will range from minimal to extensive depending on the severity and nature of the problem.  Duh

The important take home message for you is to be observant for changes for the worse.  You need to tell you vet if your cat stops eating, if the nasal discharge becomes thick and yellow, or the chest becomes obviously congested.  Most upper respiratory problems in cats are successfully treated conservatively, but you have to watch for the exceptions.

Here's a list of possible treatments, again, depending on the severity of the case:

Nothing: that's right, occasionally nothing is needed except time.  Although many cat colds last about a month.

Antibiotics: not a cure, but antibiotics seem to lessen symptoms and prevent the problem from getting worse.  This is probably because while most upper respiratory problems are caused by viruses, there is a bacterial component.  My theory is simply that bacterial organisms in the mouth, throat, and sinuses thrive when those tissues are red and raw from a viral cold.  In addition, this is a time when the cat's immune system will be suppressed.

Afrin Nasal spray, Vapor Rub, Saline Squirts Etc:  I'm not a big fan of any of these, although I suspect they help dilate and open up the sinuses ... it's just that I don't think the result is worth the effort.  Most cats aren't too fond of such treatments.

Virasyl  This is a brand of lysine supplement flavored for cats.  There are probably other brands available

Anti-Histamines:  sometimes small doses  help make the cat more comfortable.

Steroids:  Some vets are totally opposed to steroid use for colds as steroids cause immune suppression to some degree (and can possibly cause other side effects too).  I personally think ...make that know ...that a short acting steroid makes the cat feel better, reduces the nasal irritation, and greatly reduces the symptoms. I think the problem of immune suppression and other side effects is minimal compared to the benefits.

Smelly Diets:  This is no big deal, except that cat appetites are very much associated with smell, so it helps to keep them eating if they're all stuffed up by offering canned food or something with lots of aroma such as canned fish, etc.  If your cat doesn't like such things, try microwaving it's dry food just a little to bring out the aromas.

Immune Stimulants:  Not a likely treatment, but in the experimental stage.  Your vet may offer them.

Feline Kennel Cough Vaccine:  Considered by some to help stimulate the local immune system within the sinus passages and therefore speed healing.  Maybe, most experts don't seem to think this vaccine is very effective

Vitamins and other supplements:  I'm a believer that anti-oxidants, omega 3 fatty acids, vitamins, and other supplements help speed and aid healing, but whether, how much, which brands, and how important are still in debate.

Antibiotic Eye Drops or Ointment: If your kitten or cat has red irritated eyes it's important to treat them aggressively.  Untreated eye irritation makes you miserable, an untreated eye could easily become blind or so badly damaged that it will need to be removed.... AND ... the most common cause of cold associated eye infections in cats is from chlamyida and this germ is contagious to humans.

My Favorite Treatment:  For most of my cat patients suffering from sinus symptoms due to an upper respiratory "cold", here's what I do: (your vet may very well do things differently as my treatment is considered controversial or old fashioned)

After making reasonably sure that there aren't other more serious problems going on, I give a combination injection made up of long acting, high dose penicillin, gentocin, dexamethasone, atropine, and B12.  I repeat this injection, if needed, every 1-3 days for 1-3 times.  Each time the cat comes in for a repeat injection, I recheck the lungs, lymph nodes, eyes, general condition, history, and temperature.  At our practice, these rechecks are free, and very quick, but this allows me to keep on top of any case not improving or getting worse.  Plus the injections are much more potent than oral meds given at home and a lot more convenient for the client who has trouble medicating cats.  Most improve quickly.

Again, whatever your vet prescribes, sinus and upper respiratory conditions occasionally get worse quickly,  so be observant.

Some Feline Colds and Sinus Problems are more serious:

Rhinotracheitis is caused by a herpesvirus that attacks the eyes, nasal passages, and trachea (windpipe) of cats. Once infected, cats develop respiratory signs such as sneezing, coughing, and runny eyes and nose within 2 to 5 days; ulcers on the tongue and cornea and high fever may also be present.

Infection spreads rapidly from one cat to another by contact with discharge from the eyes, nose, or mouth directly from an infected cat, or by contact with contaminated clothing, hands, feeding utensils, or other articles. The virus can live for months in the mouth and nose of a cat after signs of infection have resolved, and can be shed by cats showing no clinical signs.

Human beings and dogs are not susceptible. The Herpes virus in not the same strain that causes herpes infection in humans.

Mild infection usually resolves within 1 to 5 weeks. Adult cats usually recover, but the virus can cause severe damage to the nasal cavity. In kittens, this is particularly dangerous, and kittens not treated early enough may die or lose an eye to these infections.

Some cats become chronically infected and suffer with persistent sneezing, nasal discharge, and periodic relapse. Chronically infected cats may or may not be a source of infection to other cats.
Sometimes this is because they have underlying immune system problems or diseases.

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As humans, we know that sneezing, running nose, red, irritated eyes, mouth sores, & fever can be caused by several different virus'.  And not only that, but these virus' mutate and come in many different "strains".  We're all familiar with this with "flu".

It's the same with cats.  I've listed a few of the common virus' affecting cats and the symptoms that we associate them with.

Feline Viral Rhinitis due to herpes virus (FVR) - sneezing, nasal discharge, coughing, salivation, and corneal ulcers.

Calici Virus (FCV)
oral ulcers, sneezing, and conjunctivitis.

Chlamydiosis - predominately conjunctivitis and eye problems, mild sneezing, nasal discharge.

Bacterial Sinus Infections - thick yellowish nasal discharge
The bacterial infection is usually secondary to an underlying viral infection.
What happens is that the virus invades and causes inflammation and irritation to the mucosa lining of the sinuses .... and this damaged tissue then becomes infected with bacteria.

It's important to note that most colds are due to a combination of one or more virus' AND secondary bacterial invasion.  That's why we often use antibiotics when treating colds, even though virus' are not effected by antibiotics.

We highly recommend vaccinating young kittens against these virus's starting at 6 weeks old. This is easily done using the inexpensive, adjuvant free combination vaccines used by most vets.

Unfortunately, the vaccines don't totally prevent kittens and cats from getting colds... there are way too many viral strains in the environment... but they do protect your cat from the most deadly strains and they do offer at least partial immunity making it likely that the symptoms will be less severe

The Feline Respiratory Viruses are extremely contagious and special considerations must be taken into account.

Close contact between cats is not essential for spreading the disease. Food bowls, water bowls, bedding, and play toys are possible sources of infection. If a cat infected with the respiratory disease organisms is picked up and held, the germs can easily be transmitted to another cat via the person's clothing. It is strongly advisable to wash hands thoroughly (with a good disinfectant soap) after touching a cat that may be a carrier of this disease.

When introducing a new cat into a multicat household, special precautions must be taken.

Resident cats should be up-to-date with their vaccines.

The incoming cat should receive a vaccine and be quarantined for 3 weeks.

Calici virus infection has many similarities to rhinotracheitis. Cats become infected by inhaling or swallowing the virus, and signs of illness develop within 2 to 10 days of exposure. Early signs include runny eyes and nose, sneezing, depression, and poor appetite.

Ulcers may develop on the tongue and hard palate, and most infected cats drool heavily. Illness lasts from 1 to 4 weeks. Most cats recover, but fatalities do occur. Young kittens are most likely to be severely affected. Some cats that recover from the disease may continue to shed the virus for weeks or even years. The virus is hardy and can survive outside the cat on dishes and pans for 8 to 10 days.

This virus' is not transmissible to humans or dogs.

Treatment for such cases will be similar to that discussed above but may also include:

Hospitalization, oxygen therapy, vaporizers, injectable antibiotics etc, tube or forced feeding, nutritional support, and IV fluids.

If you have such a patient at home that you're treating, contact your vet if:

Your cat has trouble breathing or refuses to eat or drink

Your cat shows excessive inactivity, vomiting, or diarrhea

Your cat relapses after apparent recovery or develops new signs

Your cat's fever is higher than 104 F

Your cat's eyes are red, partially closed, or have a discharge

Another cause of cold like symptoms is due to a germ called Chlamydia.

This bacterial disease is responsible for 15 to 20% of all feline respiratory diseases. It is extremely contagious, especially in young kittens and the infection rate is very high. It causes a local infection of the mucous membranes of the eyes, but may also involve the lungs. Chlamydiosis can be transmitted to humans by direct contact. Vaccination is the preferred method for prevention.

Feline Respiratory Complex  (also known as Feline Infectious Respiratory Disease Complex)

So, when a kitten or cat comes into the clinic with sneezing, a runny nose, and irritated eyes, it's a little difficult to tell if the cause is just sinus irritation, a bacterial infection of the nose, or due to herpes virus, calici virus, or chlmydia. 

Well, guess what?  In the real world things aren't that simple.  Most cat colds are some COMBINATION of bacteria and virus's and chlamydia.  And throw in some stress, parasitism, or malnurishment.  That's what we deal with in the real world and we call this problem

Cats and kittens are infected by contaminated material as well as from other cats. The disease is occasionally fatal for kittens, however most cats recover. The respiratory disease organisms are extremely contagious, and cats that recover from the disease are often the principal carriers. Without showing any clinical symptoms, these cats can remain carriers for months and even years. Some cats never fully recover from the disease and show symptoms throughout the rest of their lives. Once several cats becomes infected, the disease is almost impossible to eliminate from multi-cat households.

Tongue and gum ulcers are often seen on kittens and cats with calici or feline herpes virus.  Your vet may also want to test for leukemia.  The diseases are often found together.... probably because cats with leukemia have weak immune systems making them less likely to ward off calici or herpes virus when they are exposed
Most cold virus' that affect cats, including feline herpes virus is not contagious to dogs or humans.  The exception are colds caused by the bacteria Chlamydia... here causing a severe eye infection in a neonatal patient.  But before you blame your cat, the most common reason for getting chlamydia infections in humans is as a sexually transmitted disease (STD) and this baby was probably exposed vaginally during delivery.  On the other hand, the most common cause of infectious conjunctivitis in cats is chlamydia, so if your cat has a bilateral eye infection get it treated and and take other steps (wash your hands after handling the cat) to prevent human contamination.