# conjunctivitis/corneal ulcers



## bcats (Feb 15, 2014)

My British shorthair has always been prone to odd bouts of conjunctivitis ending up with a corneal ulcer. These bouts have become more frequent in the last year but have always cleared in a few days using the prescribed antibiotic eye drops. On 8th Feb I had to put her in a cattery we have used a couple of times for three days .On getting her home I could see another infection returning with a vengeance. Ended up in both eyes. Back to vet antibiotic drops two types used now and condition no better. Superficial ulcers in both eyes. I also use a homeopathic vet and she is on treatment with him a mixture of pills including euphrasia and aconite also homeopathic eye drops Cineraria Maritima the eye drops not helping. Have any of you tried Assisi homeopathic eyedrops ASSISI EUPHRASIA. They are made up by a homeopathic vet in Cheshire. I have also been giving her vetinary L Lysene. She has tested negative to Chlamydia and herpes.
Any advice would be most helpful as I am now extremely worried about my cat


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## OrientalSlave (Jan 26, 2012)

If the issue is viral then no antibiotic will cure it, and I'm not sure how common false negatives are with the various FHV tests. Dr Google suggests recurrent conjunctivitis is often FHV, and stressful events can cause flare-ups.

Any sign of pus, or just the conjunctivitis & ulcers? Has the vet suggested a culture & sensitivity? Does she have a problem with turned in eyelashes? Is she otherwise well?

Also what are the homeopathic drops made up with? Water? Normal saline? Something else? It's possible they are irritating her eyes. It's also possible if they've been open for a while that there are bugs growing in them.

It might also be worth reading the sticky about chronic cat flu.


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## QOTN (Jan 3, 2014)

Lysine has not been found to be as effective as originally hoped but it was only ever suggested it may *prevent *herpesvirus being activated not that it would treat any symptoms arising from a flare-up. I don't think you can treat this problem by yourself. If her problem is continual bacterial infections it may be she needs a different antibiotic. As Oriental Slave suggests, if the conjunctivitis has a viral cause, the vet will use a different treatment.


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## bcats (Feb 15, 2014)

OrientalSlave said:


> If the issue is viral then no antibiotic will cure it, and I'm not sure how common false negatives are with the various FHV tests. Dr Google suggests recurrent conjunctivitis is often FHV, and stressful events can cause flare-ups.
> 
> Any sign of pus, or just the conjunctivitis & ulcers? Has the vet suggested a culture & sensitivity? Does she have a problem with turned in eyelashes? Is she otherwise well?
> 
> ...


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## bcats (Feb 15, 2014)

Thank you Oriental slave and QOTN for your quick responses.
In answer to questions.
I do know that the negative results to the tests can still be positive.
She has had pus but now gone. Starts with watery eye then pink eye then ulcer. No sign of pus now although eyes very inflamed and she keeps them closed most of the time. Large Superficial corneal ulcers now on both eyes. The Cineraria eye drops are made up in benzalkoniun Chloride, Sodium Chloride and Sodium Bicarbonate ( dont like the look of that) If my homeopathic vet agrees I may try the Euphrasia eye drops which are in pure distilled water.I only use these drops up to four weeks as recommend then through out very careful to keep them closed in box to keep free from bugs
Not heard of the Culture and sensitivity test. They took a culture last week from eyes. Think that was for herpes and chlamydia. Seeing vet this evening so will discuss this with him also see if he will again change her antibiotic drops. As we all know antibiotics do no treat a virus.
Re her general health. Very good eats well just very dejected because of pain. She did have Tritricomono fetus ( spelling mistake ) two years ago which is well under control with diet and homeopathy. Except last week when she was on Metakam which made her stool a bit soft so stopped.
I have no intention of treating this myself. I have a homeopathic and conventional vet treating her. I thought the euphrasia eyedrops would be better than the drops I have been using.
Thanks QOTN for info on Lysene I will stop that now and maybe start again when she recovers from this bout.
Thank you both.


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## QOTN (Jan 3, 2014)

I see your cat is a British Shorthair. Some BSH cats have a flat face similar to Persians and are prone to develop corneal ulcers from slight injuries or similar. Are your cat's eyes rather prominent? @daisysmama has a Persian who recently had this problem. She may be able to give advice.

Incidentally, if you have any faith in Lysine it may be better to use it permanently.


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## bcats (Feb 15, 2014)

QOTN said:


> I see your cat is a British Shorthair. Some BSH cats have a flat face similar to Persians and are prone to develop corneal ulcers from slight injuries or similar. Are your cat's eyes rather prominent? @daisysmama has a Persian who recently had this problem. She may be able to give advice.
> 
> Incidentally, if you have any faith in Lysine it may be better to use it permanently.


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## bcats (Feb 15, 2014)

Thanks. Yes Honey has large prominent eyes. Her condition at the moment looks quite serious. She will be seeing tmy conventional vet this evening to see what other treatment options we have. Not been able to contact @daisysmama yet


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## QOTN (Jan 3, 2014)

www.petforums.co.uk/threads/poorly-ernie.421890/


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## Ceiling Kitty (Mar 7, 2010)

Which antibiotics is Honey receiving at the moment? Do you have any other cats?


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## bcats (Feb 15, 2014)

Ceiling Kitty said:


> Which antibiotics is Honey receiving at the moment? Do you have any other cats?


Honey is the only cat in the house. She only goes out in the garden once a day then only for a short while and she never leaves the garden. She was on Isothol plus Remend. Now she is having Exocin four times a day plus Hypromellose. She does not suffer from dry eye this is only to sooth and to be administered up to one hourly. I am taking her to vet to request a referral to an ophthalmologist.


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## Ceiling Kitty (Mar 7, 2010)

Okay, thanks for the info. Let us know how you get on at the vet's. I think a referral to an ophthalmologist is reasonable if you and your usual vet are struggling on your own; not only will the ophthalmologist have more experience with these problems, but they also have access to more specialist equipment like slit lamps, which can reveal more than the basic ophthalmoscopes most vets are limited to.

Will write a more detailed reply in a minute; need to pee. Sorry TMI!


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## The Wild Bunch (Jul 16, 2014)

Sorry I'm late to the party. My boy did indeed have an ulcer which was caused by some sort of trauma to his face. This was more than likely caused by him running into something and hitting his eye. The vet who is an opthalmic specialist had to peel down the front of his eye to examine it more closely. Has your vet done this yet? If the meds aren't working then I would suggest that further investigation is necessary as Ernie was almost 100% better within a couple of days


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## Ceiling Kitty (Mar 7, 2010)

Ok, as promised.

Corneal ulcers in cats are caused by FHV1 (feline herpesvirus) until proven otherwise. There are other possible causes of ulcers, such as trauma (like in Ernie's case), entropion or dry eye, but FHV1 is by far and away the most common cause. Other infectious agents such as _Chlamydophila felis_ (chlamydia), _Mycoplasma_ and FCV (feline calicivirus) can cause conjunctivitis in the cat, but none of these infect the cornea like FHV1 does. It is, of course, possible to have more than one infectious agent in the eye causing problems together.

As I'm sure you know, FHV1 is never cured but lurks in the trigeminal ganglion (a big collection of nerves in the head). From time to time, usually during periods of stress, the virus flares up again and causes a new round of symptoms. This could explain why the cattery visit seemed to trigger Honey's problems this time around.

As you have already pointed out, antibiotics will do nothing for FHV1. However, they are important to prevent secondary infection of ulcers by 'normal' conjunctival bacteria, which can make the situation much worse. Specific bacteria such as _Pseudomonas_ or certain _Streptococcus_ strains can be particularly catastrophic if they infect an ulcer, because they can result in severe deterioration and perforation of the eye. Hence, we give antibiotics.

Antibiotics are also valuable in cases of chlamydia (and _Mycoplasma_, although the role of these bacteria in feline eye disease is less clear at present). I'm not keen on Isathal (formerly Fucithalmic) for feline conjunctivitis as it has no action against _Chlamydophila_, but I do use it occasionally. I usually reach for chloramphenicol instead, which is not licensed but can successfully treat _Chlamydophila_ and _Mycoplasma_. Exocin and other drops in the same category are a reasonable alternative. If chlamydia is confirmed or highly suspected, I also like oral doxycyline (Ronaxan) for these cats. There has also been published evidence that doxycycline and its family of antibiotics aid corneal healing.

Along these lines, the vet may decide that a change in antibiotic drops and/or the addition of some oral antibiotics is in order. However, I note that Honey tested negative for _Chlamydophila felis_. Assuming they got a good quality swab with plenty of conjunctival cells in the sample (_Chlamydophila_ lives INSIDE conjunctival cells, not on them), the PCR tests for this bug are usually quite good and a negative result is normally pretty reliable.

Anti-virals are definitely an option. The most effective for FHV1 seems to be famciclovir (Famvir). In the UK, this drug is astonishingly expensive (sometimes up to £10 per tablet or more), which does limit its use somewhat. I believe one compounding pharmaceutical company (Veenak) formulates a much cheaper version, which would be worth having your vet look into if you decide to go down the famciclovir route. Interferon (Virbagen Omega) is another anti-viral commonly used for herpetic ulceration in cats and there are well established protocols out there for this condition.

I don't use L-lysine as it's not been proven to be effective; this has already been covered.

For superficial ulcers that fail to heal, gentle debridement (removal) of any loose dead tissue can be helpful. It can remove any FHV1-infected cells and help stimulate the immune response to pay attention to the ulcer. This is usually achieved under local anaesthetic. The more invasive versions such as grid keratotomies (performed regularly in older dogs with non-healing ulcers) are contraindicated in cats because they can result in the formation of a corneal sequestrum (see below). In very refractory cases, a keratectomy (removal of the ulcerated cornea) may be recommended, but this can also predispose to sequestrum formation.

Corneal sequestra (dead sections of corneal tissue that remain trapped on the surface of the eye) can occur secondary to corneal ulcers or injury whatever you do. Cats' eyes like to make them, especially the breeds with prominent eyes such as Persians, Exotics and BSH. These are usually easy to spot as they appear as a big black spot on the surface of the eye. They are a pain when they occur, as their surgical removal can sometimes just result in the formation of a new one. You haven't mentioned this problem with Honey, so hopefully this won't be an issue for her.

In summary, things to consider for cats with recurrent or non-healing ulcers are: a switch up of antibiotic drops, oral antibiotics, anti-viral medications, careful debridement of dead tissue and surgical intervention.

Is Honey on any pain relief? Ulcers are very painful, so pain relief is a must for these kitties.

I hope you get on okay at the vet's tonight!


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## carly87 (Feb 11, 2011)

I know nobody's implied it, but just feel the need to point out that Ernie's ulcer was most certainly not the result of FHV1 Chlammydia or FCV! All of my cats are regularly swabbed for these, particularly before and after mating, and all swabs have been clear. I would never breed with infected cats.

Again, I know nobody has said this is the case, and DM has clearly pointed out that it was trauma that caused the injury, but I want to avoid any possibility for confusion or reading between the lines to go on here.


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## The Wild Bunch (Jul 16, 2014)

carly87 said:


> I know nobody's implied it, but just feel the need to point out that Ernie's ulcer was most certainly not the result of FHV1 Chlammydia or FCV! All of my cats are regularly swabbed for these, particularly before and after mating, and all swabs have been clear. I would never breed with infected cats.
> 
> Again, I know nobody has said this is the case, and DM has clearly pointed out that it was trauma that caused the injury, but I want to avoid any possibility for confusion or reading between the lines to go on here.


Just to reiterate. Mr Kinvig (Ern's opthalmic specialist) confirmed that it was definitely a collision which had caused trauma to the eye. This was all the more apparent as he had been fine then gone upstairs, presumably bumped his face and then come downstairs with a very weepy and sore eye literally in the space of ten minutes. This was on Saturday night and at 9am on Sunday morning we were at the animal hospital


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## OrientalSlave (Jan 26, 2012)

Ceiling Kitty said:


> Ok, as promised.
> <snip>
> I'm not keen on Isathal (formerly Fucithalmic)
> <snip>
> ...


From my own experiences with my own eyes:

1) Fucithalmic ointment stings like billy-oh
2) Ulcers are indeed painful


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## Ceiling Kitty (Mar 7, 2010)

Apologies if I've been unclear about Ernie; no intention whatsoever to imply his corneal injury was infectious.


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## bcats (Feb 15, 2014)

Ceiling Kitty said:


> Ok, as promised.
> 
> Corneal ulcers in cats are caused by FHV1 (feline herpesvirus) until proven otherwise. There are other possible causes of ulcers, such as trauma (like in Ernie's case), entropion or dry eye, but FHV1 is by far and away the most common cause. Other infectious agents such as _Chlamydophila felis_ (chlamydia), _Mycoplasma_ and FCV (feline calicivirus) can cause conjunctivitis in the cat, but none of these infect the cornea like FHV1 does. It is, of course, possible to have more than one infectious agent in the eye causing problems together.
> 
> ...


Wow so much information. Thanks. Honey is going to be referred to an ophthalmologist hopefully her condition will not be too serious


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## gesic (Feb 19, 2009)

Nsaids are great in the initial phase to help alleviate discomfort but in the long-term it may hinder a healing response due to requiring an inflammatory response to heal the cornea. Its worth checking with your vet and discontinuing if not in any pain. Def worth ref to ophthalmologist as could get you on the right track of treatment much quicker. It does sound like Herpes though, classic symptom of the virus brought on by a stressful period in a cattery? Not that the cattery caused the stress but you know cats any change from the normal and they get stressed


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## bcats (Feb 15, 2014)

gesic said:


> Nsaids are great in the initial phase to help alleviate discomfort but in the long-term it may hinder a healing response due to requiring an inflammatory response to heal the cornea. Its worth checking with your vet and discontinuing if not in any pain. Def worth ref to ophthalmologist as could get you on the right track of treatment much quicker. It does sound like Herpes though, classic symptom of the virus brought on by a stressful period in a cattery? Not that the cattery caused the stress but you know cats any change from the normal and they get stressed


I am now waiting for an appointment to see ophthalmologist. Re Metacam. I have been advised by my vet to give Honey a small dose eg for a 3K cat. Honey is over 5K. She is in so much pain because the ulcer is in both eyes. She also has a bit of a digestive problem which can cause very loose stools. Its very much under control but I have to be careful. So see how she is tomorrow only give her this if she is in a lot of pain. I also have homeopathic vet backup. She is on Euphrasia and Aconite plus other pills to help with pain. The vet has put her back on Isathol as its a gel and more lubricating. I think the Exothin was too harsh for her. Anyway I put in the Isothal drops 10 mins ago and she looks more comfortable. Wandering around pestering me for food.


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## The Wild Bunch (Jul 16, 2014)

Ceiling Kitty said:


> Apologies if I've been unclear about Ernie; no intention whatsoever to imply his corneal injury was infectious.


Don't be daft you don't need to apologise think Carly just wanted to get it out there that we were dealing with ulcerations from different causes 

@bcats can your vet give Honey a metacam injection? Thinking it may be work a bit quicker at easing her discomfort. Hopefully they will give her some local anaesthetic before they start fettling with her eye so fingers crossed she is compliant while they examine her


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## Ceiling Kitty (Mar 7, 2010)

daisysmama said:


> Don't be daft you don't need to apologise think Carly just wanted to get it out there that we were dealing with ulcerations from different causes
> 
> @bcats can your vet give Honey a metacam injection? Thinking it may be work a bit quicker at easing her discomfort. Hopefully they will give her some local anaesthetic before they start fettling with her eye so fingers crossed she is compliant while they examine her


Counterintuitively, oral Metacam kicks in much quicker than the injectable version. I always find that weird too!


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## bcats (Feb 15, 2014)

Honey has a lovely temperament I can do anything with her she will be ok when they examine her eyes and they do give a local anesthetic in her eyes


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## bcats (Feb 15, 2014)

Last night I decided to try Assisis Euphrasia eye drops. I had been in touch with Andrew Berwitz the homeopath who hand makes these remedies a[EMAIL='[email protected]'][email protected]eopathy-heals.com[/EMAIL] I was quite desperate about Honeys deteriating condition. I contacted Andrew who was very supported and gave me lots of advice. So last night after visiting my local vet who has refered her to an optholologist I decided to try these drops. Honeys medication has not been changed by vet still giving the antibiotic eyedrops Exocin and Hypromellose as a precaution against more infection. I put one drop of Euphrasia in each eye early evening. Because at that stage her eyes were completely closed and she was in pain I was worried about putting more drops directly into her eyes. So used them as an eye wipe by saturating two small pieces of cotton wool pads with the drops also putting three drops directly into her mouth. This morning she greeted me at the top of stairs. I could see an improvement eyes much more open. After a couple of eye wipes and oral drops the result was as you will see in photo downloads. Very early days yet I will persevere.


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## carly87 (Feb 11, 2011)

Not at all CK. I did realise that you hadn't implied anything at all, but just didn't want others coming on here and half reading rather than taking it all in to get the wrong idea!


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## bcats (Feb 15, 2014)

Ceiling Kitty said:


> Which antibiotics is Honey receiving at the moment? Do you have any other cats?


Hi Ceiling Kitty. Saw the ophthalmologist at Newmarket today regarding Honeys corneal ulcers. Bad news Im afraid and I just dont know what to do. It appears that the ulcers in both eyes need surgery to remove them at a cost of over £2000. They are going to try treating her for with an antivirol drug for FHV even though she has tested negative. I am aware this is often the case with these tests. They have given me a prescription for Famciclovir. Two 250mg twice daily for 10 days. The vet has told me that this virus is highly infectious to other cats. Does this mean that we will be unable to put her in a cattery ? Do you have any idea how successful this drug is ? also are there any know side effects, will she have to be on it at a lower dose for the rest of her life. To be honest I am thinking it might be kinder to have her put to sleep rather than have her suffer having large pills put into her and still the chance of this awful condition recurring. I am feeling very sad. Honey is a beautiful cat who looks very healthy except for her eyes. Will be awful if I have to have her put to sleep. We love her very much.


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## OrientalSlave (Jan 26, 2012)

You can put her in a cattery from an infection point of view as in a properly run cattery cats are well separated. I'd worry more about the stress causing another flare-up. I can't comment on the treatment, hope @Ceiling Kitty can help. Sounds an awful situation to be in.


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## QOTN (Jan 3, 2014)

bcats said:


> Hi Ceiling Kitty. Saw the ophthalmologist at Newmarket today regarding Honeys corneal ulcers. Bad news Im afraid and I just dont know what to do. It appears that the ulcers in both eyes need surgery to remove them at a cost of over £2000. They are going to try treating her for with an antivirol drug for FHV even though she has tested negative. I am aware this is often the case with these tests. They have given me a prescription for Famciclovir. Two 250mg twice daily for 10 days. The vet has told me that this virus is highly infectious to other cats. Does this mean that we will be unable to put her in a cattery ? Do you have any idea how successful this drug is ? also are there any know side effects, will she have to be on it at a lower dose for the rest of her life. To be honest I am thinking it might be kinder to have her put to sleep rather than have her suffer having large pills put into her and still the chance of this awful condition recurring. I am feeling very sad. Honey is a beautiful cat who looks very healthy except for her eyes. Will be awful if I have to have her put to sleep. We love her very much.


Have you looked at the sticky 'Permanent Cat Flu?' Ceiling Kitty has written a very detailed account of the problems of chronic rhinitis and corneal ulcers etc. including a reference to Famciclovir.


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## Ceiling Kitty (Mar 7, 2010)

Sorry to hear about the news regarding Honey's eyes. £2000k!  That's a lot!

Regarding the cattery: yes, FHV1 is very infectious to other cats. So infectious that virtually 100% of cats carry it, and therefore it's impossible to prove whether cats coming out of the cattery with snotty noses etc actually caught FHV1 there or - more likely - simply suffered a flare-up of an existing infection due to the stress.

Personally I wouldn't worry about her going into a cattery from a contagiousness point of view, but I suppose the final decision rests with the cattery owner.

Regarding famciclovir - it seems to be gaining popularity as a treatment for FHV1. Being a human medication, we have no official data from clinical trials in cats to go on, so all the information we have on its use in this species comes from independent veterinary research and from anecdotal experiences in the field.

The trouble with famciclovir is that we aren't entirely clear on what the optimum dose is. Lots of different doses have been used in various published papers, and different experts suggest different doses. The cost of this medication in the UK has led to lots of people trying lower and lower doses to save £££, and while these lower doses seem to be effective it also seems that using too low a dose leads to treatment failure in certain cats.

When used at an effective dose, it doesn't completely eliminate signs of FHV1. Lots of studies have been done and results can vary, but generally it seems effective in improving the symptoms of FHV1. Relapse is not uncommon, but this is not necessarily a failure of famciclovir - it's the nature of FHV1 infection.

Safety wise, we know that famciclovir is definitely safe in cats when used for 30 days at 40mg/kg. Anything beyond that has not been proven, but plenty of people use it for much longer than 30 days and all the anecdotal reports I've seen don't mention any concerns about side effects. Some mention monitoring liver and kidney function as changes in these organs can affect the dose needed.

If the ulcer responds, it's recommended that the famciclovir is continued for a little while afterwards. It can take a few weeks though, so you can't always expect a result right away.

I'm afraid my own personal experience with famciclovir is limited - I've never known many people try it because of the very high cost.


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## chillminx (Nov 22, 2010)

@bcats - just wanted to add - if you're still using Hypromellose drops for Honey's eyes, make sure you are using the preservative free ones, as the other type can cause irritation in the eyes of some people who use them, and the same may apply to cats.

http://www.butterflies-eyecare.co.uk/hypromellose-preservative-free-eye-drops.html


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## The Wild Bunch (Jul 16, 2014)

@bcats I assume honey is not insured? £2000 does seem very high. My vet charges £550 per eye at the most depending on how invasive the surgery is but he does get good results. My mum's dog has various issues including very dry eyes and ulcerations she has to have gel put in her eye daily to keep it moist and has had ulcers removed in both eyes as well as cherry eye correction. 
Have you discussed with your vet the opportunity of agreeing a payment plan? I think PTS should be a very last resort for an otherwise perfectly healthy cat


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## carly87 (Feb 11, 2011)

Really DM? That's incredibly cheap. When I had Mr T done at a specialist, the cost was £1200, and that was reduced! I think £2000 is quite reasonable given the severity of the ulcers and the fact it's being done at a specialist centre, but perhaps I'm just too used to being robbed...


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## Ceiling Kitty (Mar 7, 2010)

What operation are we talking here? Keratectomy?


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## carly87 (Feb 11, 2011)

Corneal graft in MR T's case.


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## bcats (Feb 15, 2014)

Ceiling Kitty said:


> Sorry to hear about the news regarding Honey's eyes. £2000k!  That's a lot!
> 
> Regarding the cattery: yes, FHV1 is very infectious to other cats. So infectious that virtually 100% of cats carry it, and therefore it's impossible to prove whether cats coming out of the cattery with snotty noses etc actually caught FHV1 there or - more likely - simply suffered a flare-up of an existing infection due to the stress.
> 
> ...


Thank you Ceiling Kitty for your helpful information. I have started giving Honey the Famciclovir. She weighs over 5kg and is having dose of 250grams 2x daily. They have given her enough for 10 days and I shall be going back to the hospital a week Monday.Very large pill but I am managing to get her to take using Easy Pill and Greenies Pill pockets. The pill pockets I prefer as its easier to enclose the pill that I cut into four portions.She is now on her fifth day and does seem to be more comfortable. Her eyes are only half open and squinty but no discharge although they are still looking very inflamed. So far I have seen no side effects. I also give her Isothol eye ointment and Hypromellose 0.3% w/v Eye Drops . The vet says these drops I can put in hourly if necessary. Not sure this is wise as I have been told that some of these drops contain preservative that can irritate the eyes. Looking at ingredients not sure if there is preservative in these drops ,are you able to advise me on this please. I shall be speaking to my homeopathic vet on Monday to re access her homeopathic medication. Keeping her relaxed by putting Valarian complex for pets between her shoulders. Dont want her to ingest it at the moment as she has a sensitive digestion and I feel she has enough going into her gut. I have some homeopathic eye drops from my homeopath that I put in three times daily. The hospital vet says ok to do this. Anything that will make her more comfortable to try. I bathe her eyes regularly when she is awake with a cotton wool pad soaked in boiled water or Euphrasia eye drops obviously I use a separate piece for each eye to avoid cross contamination. She is eating very well.


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## bcats (Feb 15, 2014)

Ceiling Kitty said:


> Sorry to hear about the news regarding Honey's eyes. £2000k!  That's a lot!
> 
> Regarding the cattery: yes, FHV1 is very infectious to other cats. So infectious that virtually 100% of cats carry it, and therefore it's impossible to prove whether cats coming out of the cattery with snotty noses etc actually caught FHV1 there or - more likely - simply suffered a flare-up of an existing infection due to the stress.
> 
> ...


PS My cattery says they will put Honey into a quarantine pen should she need boarding. Honey has always been well looked after there the lady is very knowledgeable in cat care. being isolated she wont be stressed by seeing the other cats which is a bonus.


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## bcats (Feb 15, 2014)

daisysmama said:


> @bcats I assume honey is not insured? £2000 does seem very high. My vet charges £550 per eye at the most depending on how invasive the surgery is but he does get good results. My mum's dog has various issues including very dry eyes and ulcerations she has to have gel put in her eye daily to keep it moist and has had ulcers removed in both eyes as well as cherry eye correction.
> Have you discussed with your vet the opportunity of agreeing a payment plan? I think PTS should be a very last resort for an otherwise perfectly healthy cat


Fortunately Honey is insured. My main concern is that all this money is lining there pockets when perhaps the ulcers will heal with the medication she is getting without all the stress of putting her through surgery on both eyes. They wanted to do the operation with no other options until I said I was not prepared to pay out for it then the consultant checked with her boss who then came in and offered us this alternative. PS at the moment she is more comfortable. Certainy will not have her put to sleep if she is not suffering


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## bcats (Feb 15, 2014)

bcats said:


> PS My cattery says they will put Honey into a quarantine pen should she need boarding. Honey has always been well looked after there the lady is very knowledgeable in cat care. being isolated she wont be stressed by seeing the other cats which is a bonus.


Have you heard if anyone has tried Collodial Silver for this condition. I have read that it can be used as eyedrops. Also it is a natural antibiotic ?


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## The Wild Bunch (Jul 16, 2014)

bcats said:


> Fortunately Honey is insured. My main concern is that all this money is lining there pockets when perhaps the ulcers will heal with the medication she is getting without all the stress of putting her through surgery on both eyes. They wanted to do the operation with no other options until I said I was not prepared to pay out for it then the consultant checked with her boss who then came in and offered us this alternative. PS at the moment she is more comfortable. Certainy will not have her put to sleep if she is not suffering


For me, I would just let them do what they think is required. If you only have your excess to pay then does it really matter if you are "lining their pockets" if honey is in pain then I'd be doing everything possible to remedy the situation.

@carly87 I suppose it could be more depending on what needed to be done but in my experience with canines, that's what he charges and is the opthalmic surgeon or "top man" as the other vets refer to him. Maybe geography is involved too as with everything else, darn sarf seems to be more pricey


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## chillminx (Nov 22, 2010)

@bcats - in response to your query about preservative free Hypromellose drops I am reposting the post I made earlier on this thread giving you the link to them:



chillminx said:


> @bcats - just wanted to add - if you're still using Hypromellose drops for Honey's eyes, make sure you are using the preservative free ones, as the other type can cause irritation in the eyes of some people who use them, and the same may apply to cats.
> 
> http://www.butterflies-eyecare.co.uk/hypromellose-preservative-free-eye-drops.html


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## bcats (Feb 15, 2014)

daisysmama said:


> For me, I would just let them do what they think is required. If you only have your excess to pay then does it really matter if you are "lining their pockets" if honey is in pain then I'd be doing everything possible to remedy the situation.
> 
> @carly87 I suppose it could be more depending on what needed to be done but in my experience with canines, that's what he charges and is the opthalmic surgeon or "top man" as the other vets refer to him. Maybe geography is involved too as with everything else, darn sarf seems to be more pricey


I would never allow Honey to be in pain . If they can remove the ulcers which are in both eyes I am going to let them do the operation. Problem is that they have told me that there is no guarantee that it will be successfull. Thats why they are trying the treatment first to see if the ulcers go with the antiviral pills. They told me that it does work but not always. I was very distressed on Wednesday seeing her in so much pain. I did not know what to do for the best. I took her to her usual vet Wednesday evening who assured me her condition had not deteriorated and as her general health is good to continue with the treatment and see what the consultant says when we take her back a week Monday. It's still early days she has been taking the pills for only five days. Today she looks more comfortable but quite a squint. No discharge now but eyes very inflamed. I spoke to the consultant in the hospital yesterday and they are happy with the little progress. I have to phone them next week to report how she is getting on. Fortunately thanks to pill pockets I am getting the huge tablets into her. This is what upset me most to see her so unhappy and stressed giving them to her. She is used to a very peaceful happy life. I will do all I can for herher.


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## bcats (Feb 15, 2014)

chillminx said:


> @bcats - in response to your query about preservative free Hypromellose drops I am reposting the post I made earlier on this thread giving you the link to them:


Thank you for the link I am ordering them now. Why dont the vets stock these ?


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## chillminx (Nov 22, 2010)

Please note the preservative free drops have a short use by date (maybe a month or so, I can't recall exactly), and you need to keep them in the fridge as I remember.


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## bcats (Feb 15, 2014)

chillminx said:


> Please note the preservative free drops have a short use by date (maybe a month or so, I can't recall exactly), and you need to keep them in the fridge as I remember.


Thanks Chillminx. The homeopathic drops I use only last a month once opened and they have to be kept in the fridge. I appreciate your advice very much. They are ordered quick delivery carriage a bit costly so have ordered two. My vet says I can put them in Honeys eyes hourly so I am using them up quickly. I will take the the ones I ordered today back to the vets as they remain unopened.


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## Forester (Dec 2, 2012)

I apologise for not having read each post in this thread in detail . I did ,however, want to let you know what worked for a previous cat of mine who had a non healing corneal ulcer. Various drops ( chloramphenicol and another ab ) as well as debridement ,and a third eyelid flap procedure failed to help.

The treatment which did work however was, after further debridement , to use drops made from his own plasma in addition to the a/b drops. I also gave l lysine powder and used lacrilube ointment to keep the eye moist. HTH


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## bcats (Feb 15, 2014)

Forester said:


> I apologise for not having read each post in this thread in detail . I did ,however, want to let you know what worked for a previous cat of mine who had a non healing corneal ulcer. Various drops ( chloramphenicol and another ab ) as well as debridement ,and a third eyelid flap procedure failed to help.
> 
> The treatment which did work however was, after further debridement , to use drops made from his own plasma in addition to the a/b drops. I also gave l lysine powder and used lacrilube ointment to keep the eye moist. HTH


The problem with Honeys ulcers, which are in both eyes, is that they have adhered to the eye somewhere. She had debridement done twice using a cotton bud by my vet. This has not worked. The consultant at the V Hospital wants to remove them surgically which I am not very happy about. I am hoping there will be an improvement when I take her back a week Monday. You will see from my posts the medication she is on. She is uncomfortable fortunately shows no sign of being ill. Eating well but quieter than usual. To be expected with her very sore eyes. She is a very brave little girl. I did start her on Lysene but the brand I got was full of grains which upset her. I have ordered a powder which has to come from America especially for animals.


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## Forester (Dec 2, 2012)

Would it be worth asking about the use of the cat's own plasma in a drop form ? It worked for my boy.

I hope that you find a way to make her more comfortable as quickly as possible.

Sending healing vibes to Honey.


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## bcats (Feb 15, 2014)

Forester said:


> Would it be worth asking about the use of the cat's own plasma in a drop form ? It worked for my boy.
> 
> I hope that you find a way to make her more comfortable as quickly as possible.
> 
> Sending healing vibes to Honey.


You are the second person so far who has mentioned this. This certainly has not been given to me as an option. I hate the thought of her having this surgery. Would this be Homeopathic or how do they do it ?
Thank you for the healing vibes. I think I need them as well. So upsetting seeing my brave little girl going through so much pain


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## Forester (Dec 2, 2012)

bcats said:


> You are the second person so far who has mentioned this. This certainly has not been given to me as an option. I hate the thought of her having this surgery. Would this be Homeopathic or how do they do it ?
> Thank you for the healing vibes. I think I need them as well. So upsetting seeing my brave little girl going through so much pain


Sorry to have not replied earlier. I've only just logged in.

The plasma drops were made by taking a sample of Eric's blood and then spinning it until it separated. It was done in my vet's surgery and , as far as I remember, I waited whilst they prepared the drops. The drops had to be kept in the fridge and were given about 20 minutes before the chloramphenicol drops.I gave them 4 times a day though my vet said that twice daily would have been sufficient. I was very lucky that my boss allowed me to leave work to administer drops and to work on later to make up the time.

As soon as this treatment regime was instigated, along with the l lysine, and lacrilube, the ulcer started to heal rapidly. It took about 10 days to heal completely. Eric did have to wear a collar to prevent him scratching at his eye but he'd got used to this after wearing one during weeks of previously fruitless treatment.

I think that the plasma drops helped as they were his own cells being put in place and giving his system a bit of a helping hand.

I understand the distress you are going through trying to help Honey and hope that this might help her. If your vet does think that its worth trying I'd love to hear how you get on.

Topping up those healing vibes for Honey and sending a ((( hug ))) for you.


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## bcats (Feb 15, 2014)

Forester said:


> Sorry to have not replied earlier. I've only just logged in.
> 
> The plasma drops were made by taking a sample of Eric's blood and then spinning it until it separated. It was done in my vet's surgery and , as far as I remember, I waited whilst they prepared the drops. The drops had to be kept in the fridge and were given about 20 minutes before the chloramphenicol drops.I gave them 4 times a day though my vet said that twice daily would have been sufficient. I was very lucky that my boss allowed me to leave work to administer drops and to work on later to make up the time.
> 
> ...


Thank you again Forester for all the information, healing vibes and hugs. I certainly will be contacting my vets also my Homeopathic vet Richard Allport. Only the best for our darling Honey. Her eyes are a bit better today and she is much more herself so Honey must be feeling more comfortable. Pill time coming up so far thanks to Pill Pockets no problem at all. 
I certainly will keep you posted on the vets response to my query on the Plasma drops. Better than surgery. The fact that the ulcers have adhered to the edge of the cornea could be a problem.


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## Ceiling Kitty (Mar 7, 2010)

It's not my understanding that serum etc would help in a case such as this one. The point of administering serum to corneal ulcers is to provide anti-collagenases, which are enzymes that slow or arrest the progression of infected 'melting' ulcers. That doesn't sound like the issue here. Could be why it's not been recommended.


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## Forester (Dec 2, 2012)

Ceiling Kitty said:


> It's not my understanding that serum etc would help in a case such as this one. The point of administering serum to corneal ulcers is to provide anti-collagenases, which are enzymes that slow or arrest the progression of infected 'melting' ulcers. That doesn't sound like the issue here. Could be why it's not been recommended.


Ahh, Thanks for pointing out that the plasma drops would not be appropriate in this case. @Ceiling Kitty . Obviously, I had no idea about the medical details. I just didn't want to omit to suggest something which had worked for my cat but in , what I now realise, is clearly a different scenario.


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## Ceiling Kitty (Mar 7, 2010)

I don't think they would do any harm @Forester, I was just trying to think why @bcats's vets haven't suggested it yet.


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## bcats (Feb 15, 2014)

chillminx said:


> @bcats - in response to your query about preservative free Hypromellose drops I am reposting the post I made earlier on this thread giving you the link to them:


Hi chillminx. The non preservative Hypromellose arrived this morning. I immediately put some in Honeys eyes and it looks like it is going to be more soothing. After five minutes her eyes opened wider. I could see when the drop went into her eyes that the consistency was a bit thicker. The one the vet gave me was very watery so most of it ran out of her eyes. Honey is much more comfortable. Eating well but she is quieter than normal. I have got Feliway around the house and applying Valerian Complex between her shoulders so possibly she is more relaxed as she does not appear to be ill. Seeing the Consultant on Friday and hoping she will not need the operation to remove the ulcers. I am prepared that this may be the only option. Fingers crossed.


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## chillminx (Nov 22, 2010)

This is good to hear @bcats.  Very pleased she seems more comfortable.

I hope her eyes continue to improve, and her appointment with the Consultant on Friday goes well.


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## bcats (Feb 15, 2014)

Very sad day yesterday. We took Honey to her appointment at the Newmarket veterinary referal hospital. After a thorough examination by two ophthalmologists they found that there was no improvement. They did a defridement they also explained in he case plasma drops would not work. I was sent home with some virus ointment to apply three times a day.Plus a prescription for a further thirty days of pills. They told us that the prognosis was bad. If she had the operation they could not guarantee that it would be successful and the ulcers could return at anytime if she was under the slightest stress. We arrived home and could see that she was unwell and during the afternoon her condition deteriorated. I booked an emergency appointment with our usual vet and it was agreed that it was kinder to put her to sleep. She was in a lot of pain and no real hope of recovery as the ulcers were very bad both eyes and attached completely covering the cornea. She really was a very sick cat. It was obvious to my vet that she could not tolerate the medication due to Tritricomonofeotus which has left her with a very sensitive digestive system. She had already had three bouts of diarrhea which alone was debilitating. So you must all understand that we made the right decision. It would have been foolish to put her through surgery especially as her health was causing concern. We are very sad Honey was such a beautiful loving and gentle girl. She is now free from pain and at peace.


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## QOTN (Jan 3, 2014)

Poor you. How awful but remember Honey is alright now.​


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## bcats (Feb 15, 2014)

QOTN said:


> Poor you. How awful but remember Honey is alright now.​


It was so peaceful. My husband and I were taken to what they called a quiet room. Really relaxing. I went into the examination room with her and held Honey while the canula was put in a little difficult as the vet could not get a vein so had to go into the other leg but Honey was her usual self and took it without any problem. Once the anesthetic started to go in she went very peacefully in seconds with my arms around her. My feelings today are of grief and guilt. I wish that I could have done more for her. Perhaps give the medication more time to work. But there was no light at the end of the tunnel. How could I have let her go through so much pain. We also think her eyesight was failing as she was walking into things. Not what I wanted for her. A blind cat cope but not the pain.


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## carly87 (Feb 11, 2011)

This thread has really, really upset me. TF is treatable, so shouldn't really have been an issue here. I do understand the need to consider PTS if a cat is in constant pain, but in this case, couldn't the eyes have simply been removed? She sounded like such a dear little soul which just makes this all worse.

Please don't think I'm unsympathetic. Just dreadfully sorry that it reached this point. I'm sorry for your loss.


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## bcats (Feb 15, 2014)

carly87 said:


> This thread has really, really upset me. TF is treatable, so shouldn't really have been an issue here. I do understand the need to consider PTS if a cat is in constant pain, but in this case, couldn't the eyes have simply been removed? She sounded like such a dear little soul which just makes this all worse.
> 
> Please don't think I'm unsympathetic. Just dreadfully sorry that it reached this point. I'm sorry for your loss.


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## bcats (Feb 15, 2014)

It's heartbreaking enough for me I don't need posts like carly87. Honey had FHV which would return anytime under even the slightest stress. She would again have to take these huge tablets twice a day even then the virus never goes it hides in the trigeminal nerve. No cure. Even though I was getting the pills into her in easy pill and pill pockets it was still stressful for her. She was becoming more ill because of the medication and the stress. Re the tri tric that was under control no recurrence for two years it was the medication that caused the diarrhea. How any animal lover could put there cat through this I fail to understand. It was the worst decision I have ever had to make I did it for Honey not for me.


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## moggie14 (Sep 11, 2013)

I'm so sorry to read this. RIP Honey and a big hug for you xx


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## chillminx (Nov 22, 2010)

I am so sorry to read this sad news @bcats.

Thinking of you with sympathy.

RIP beloved Honey x


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## QOTN (Jan 3, 2014)

bcats said:


> It's heartbreaking enough for me I don't need posts like carly87. Honey had FHV which would return anytime under even the slightest stress. She would again have to take these huge tablets twice a day even then the virus never goes it hides in the trigeminal nerve. No cure. Even though I was getting the pills into her in easy pill and pill pockets it was still stressful for her. She was becoming more ill because of the medication and the stress. Re the tri tric that was under control no recurrence for two years it was the medication that caused the diarrhea. How any animal lover could put there cat through this I fail to understand. It was the worst decision I have ever had to make I did it for Honey not for me.


You did what was best for Honey. No cat should live their life in pain. I know only too well how awful FHV can be having watched 10 day old kittens die before I could get them to the vet. Sometimes it is possible to manage the after effects of the virus and sometimes it is not. In any case, I have a cat with PRA and the prospect of two more going blind in the future and I can say that is not an easy situation. Blind cats lose so much of what is important to a cat and can never know why. I am sure my boy thinks we are all in the dark with him and one day he will wake up and the world will have returned. He asks me to pick him up by our big kitchen window because he can still detect the light there but is always disappointed when he still cannot see.


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## carly87 (Feb 11, 2011)

I'm really sorry. On re-reading my post, it does come across as insensitive. Really sorry. I'm genuinely upset on your behalf.


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## bcats (Feb 15, 2014)

carly87 said:


> I'm really sorry. On re-reading my post, it does come across as insensitive. Really sorry. I'm genuinely upset on your behalf.


No problem I wanted to point out to you all that it was the love I felt for Honey made me make the decision of ending her pain and stress. I could not bare to see her suffering. I would rather suffer myself


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## The Wild Bunch (Jul 16, 2014)

So very, very sorry to read this @bcats having pets is rewarding and heart breaking in so many ways. RIP sweet Honey. Play hard at the bridge xxx


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## bcats (Feb 15, 2014)

A home is not a home without a cat. All my life I have had cats around me. I will be picking Honeys ashes up next week which will be very sad for both my husband and myself. I will need a bit of time to recover from this very sad time then I will start to look for a BRITISH SHORTHAIR that needs re homing. This is where I got Honey from. She came from a breeder and because she had to have a CS with her last litter the lady did not want to breed from her again. I am over 70 so do not want to have a kitten as it will out live me. My question is re FHV how long does it stay in the house once the cat has gone ?


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## QOTN (Jan 3, 2014)

FHV does not persist for long in the environment. It is passed from cat to cat and if cats share feeding dishes. It can also be passed to a cat who indirectly ingests the virus from the sneeze of an infected cat. However it is extremely difficult to protect even indoor cats completely as I know to my cost. In 2001 one of my cats (I have many) went to the vet for a dental checkup and caught FHV which passed round all my cats. The severity of their illness tended to increase as the load of virus in the environment increased but there was no correlation between how ill each individual was and their last booster date so presumably the strength of their individual immune system was also a factor. However, I do think it is unlikely (not impossible) that a cat would suffer to the extent that Honey did unless they were infected as unvaccinated kittens but @Ceiling Kitty will be able to advise on that.


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## Ceiling Kitty (Mar 7, 2010)

I'm so sorry to hear about Honey.

FHV1 is a fragile virus and doesn't normally survive in the environment for long - however, this is temperature dependent. At 25 degrees Celsius (room temperature ish) it can survive for up to a month, and in very cold conditions (we're talking 4 degrees) it can survive for five months.

However, it's super susceptible to common disinfectants, so it's not hard to get rid of. Environmental contamination is not a major concern in any case, so I wouldn't worry. The main source of infection is direct transmission from shedding cats.

I would say that FHV1 is ubiquitous and the vast majority of cats will be carriers. They pick it up from their mum when they are small.

Good luck finding your next companion.


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## QOTN (Jan 3, 2014)

I always find it interesting when you say virtually all cats are FHV carriers. I know my vet does not think this because he says he would not be able to use longlasting steroids if this were the case. The surest way to get a cat to shed virus is to give a big dose of steroids and this is what makes me wonder if perhaps we are a little harsh on lysine because I believe it is always tested by administering steroids? Could it maybe work in other stressful situations? Having said that I used it on two girls who were carriers and one always shed when she had kittens and the other never did! Of course that is no real evidence because I neutered the girl who shed and stopped the lysine on the girl who did not and she still never shed when she had kittens.

When you mention shedding do you mean carriers who have an episode of shedding? In my experience a shedding cat has never led either a carrier or a cat who has never been ill before to succumb. The only exception has been when a queen sheds and her kittens become ill.


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## Ceiling Kitty (Mar 7, 2010)

QOTN said:


> I always find it interesting when you say virtually all cats are FHV carriers. I know my vet does not think this because he says he would not be able to use longlasting steroids if this were the case. The surest way to get a cat to shed virus is to give a big dose of steroids and this is what makes me wonder if perhaps we are a little harsh on lysine because I believe it is always tested by administering steroids? Could it maybe work in other stressful situations? Having said that I used it on two girls who were carriers and one always shed when she had kittens and the other never did! Of course that is no real evidence because I neutered the girl who shed and stopped the lysine on the girl who did not and she still never shed when she had kittens.
> 
> When you mention shedding do you mean carriers who have an episode of shedding? In my experience a shedding cat has never led either a carrier or a cat who has never been ill before to succumb. The only exception has been when a queen sheds and her kittens become ill.


The trouble with FHV1 is that its latency in the trigeminal ganglion makes it bloody difficult to estimate its exact prevalence. Various studies in cats with and without symptoms have found low isolation rates (varying from 4% to 22% and all sorts of other figures), but these figures can be misleading because you're only finding the cats undergoing a primary or recrudescent infection and not those with inactive virus in their heads. Educated estimates of true prevalence range from 1 in 3 cats to 9/10 cats.

A definitive figure may be obtained by sampling the trigeminal ganglions of cats, but since this can only be done post-mortem such an undertaking in a decent number of cats wouldn't be straightforward.

You're quite right that steroids can induce recrudesence of FHV1. I get most worried about this in cats with a history of herpetic keratitis or ulcers, but obviously many cats tolerate steroids well without issues. Anecdotally, I've known cats with a history of URT or ocular symptoms have no flare up of their signs with steroids, just as many cats known to have FHV1 cope well with other stressful events such as a cattery stay or vaccination (Bagpuss included).

It may have something to do with how recently the cat was vaccinated, since vaccination boosts the cell-mediated response needed to fight FHV1. This is why the ISFM/AAFP vaccination guidelines recommend boosting cats against 'flu before they enter a cattery if they've not been done in a while.

The L-lysine debate is a muddy one. The best study (to my knowledge) was Drazenovich et al (2009) which evaluated its use in shelter cats with natural infection, and it seemed to make them worse. Some of those cats will have had other pathogens, but their situation better represents the real world than that of SPF cats in a lab. Steroids are often used to induce FHV1 shedding in a research setting but it's not always successful. Maggs et al (2003) found that steroids didn't reliably increase viral shedding in their study.

It has been shown that cats undergoing recrudescence of viral shedding are infectious to other cats, as are those suffering with their first infection.

Overall, as with many things in feline medicine, we seem to have more questions than answers.


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## OrientalSlave (Jan 26, 2012)

_the ISFM/AAFP vaccination guidelines recommend boosting cats against 'flu before they enter a cattery if they've not been done in a while._

Out of curiosity how recent is 'not done in a while?


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## Ceiling Kitty (Mar 7, 2010)

OrientalSlave said:


> _the ISFM/AAFP vaccination guidelines recommend boosting cats against 'flu before they enter a cattery if they've not been done in a while._
> 
> Out of curiosity how recent is 'not done in a while?


Lol now you're asking, I'll have to have a gander.


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## Ceiling Kitty (Mar 7, 2010)

Within the last year.


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## QOTN (Jan 3, 2014)

Is a booster recommended with Purevax even though that flu element DOI is now 3 years?

Many of my carriers have had steroids without any shedding (both my oldies are on pred and have been for years) but the only time one of mine was given a longlasting injection she shed and she never shed when kittening or with any other stress.

Obviously I have been very lucky that my shedders have not caused a problem. I don't think I could live through another struggle like the initial infection. I nearly didn't survive then and I am 15 years older and frail now! Not that we have had any shedding for 8 years now.


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