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Cat Forum / Health and Behavior / November 2005Mixing cats with and without ocular herpes
A situation has arisen for me in which I've moved into a friend's apartment with my two 1.5 year old cats (sisters) who do not show any signs of ocular herpes, and to my knowledge (based on numerous checkups with a vet) are healthy and disease free. My roommate has a cat that has in the past shown signs of ocular herpes (red, swollen eye with dripping goo). Unfortunately, this cat was supposed to be living elsewhere but will now remain in the same apartment for the time being. For the past few months the ocular herpes infected cat has not shown outward signs of the virus, but I'm extremely concerned about letting my non-infected cats out of their quarantine zone (my room!) and letting them into contact with this other cat. My questions: 1) Can my cats contract the herpes virus only if they're in contact with the other cat while it happens to be shedding the virus (similar to the manner in which humans pass it on)? 2) Given that the infected cat shows no *outward* signs of the virus, how likely is this cat to pass ocular herpes on to my cats? 3) I've heard that up to 80% or so of all cats actually have ocular herpes already, obviously with varying degrees of severity. Is this true? 4) Will vets test cats for ocular herpes? How expensive is this procedure? 5) If it turns out that my apparently non-infected cats actually do have ocular herpes, could they suddenly develop outbreaks (from whence there was none before) simply by being in contact with a cat whose ocular herpes symptoms are manifestly worse? I really need some help with these questions! This issue is suddenly creating havoc around the apartment, because I'm sick of having to keep my cats cooped up all the time, and I don't relish the prospect of letting the cats out in shifts. That's not the way I'd like for them (and me) to live their lives! Any other advice out there? Thanks, JB I know of many households where cats that have suffered a severe herpes related eye infection live with cats that haven't. I've never once heard of transmission of eye problems to other healthy cats in the household. The only time the cat might shed the virus would be if it has a flare-up, and if the owner of the cat keeps it healthy, keeps stress levels down, and gives the cat a daily, lifetime dose of 250-500 mg of Lysine, an outbreak should be a very rare occurrence, if at all, and you could talk precautions at that time. I wouldn't worry about it. Megan  Signature"The only thing necessary for the triumph of evil is for good men to do nothing." -Edmund Burke Learn The TRUTH About Declawing http://www.stopdeclaw.com Zuzu's Cats Photo Album: http://www.PictureTrail.com/zuzu22 "Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then providence moves too. A whole stream of events issues from the decision, raising in one's favor all manner of unforeseen incidents, meetings and material assistance, which no man could have dreamt would have come his way." - W.H. Murray <snip> > My questions: > [quoted text clipped - 27 lines] > Thanks, > JB Believe most vets diagnose herpes by counting eyes -- one eye infected means herpes, two eyes means something else, usually chlamydia in these parts. Translated, that means that the herpes is too weak to get to the second eye in the same cat. I have handled many hundreds of rescues and only once seen a cat with diagnosed herpes in both eyes. So I'd say your cats are not in real danger. It's an aside but a young cat with herpes (and stable leukemia) sleeps on my pillow. I don't really recommend that to others. doubleHump > Believe most vets diagnose herpes by counting eyes -- one eye infected > means herpes, two eyes means something else, usually chlamydia in these [quoted text clipped - 9 lines] > > doubleHump Thanks to all those who have replied thus far. I'd still appreciate it if anyone who had something to say about this matter weighed in, because I'm still nervous about it. It'd kill me if I knowingly put my cats in a situation where they were at risk of catching herpes, and then they actually got it. So far the vote is: Other cats's herpes is not a serious worry for non-infected cats: 2 Other cats's herpes is a serious worry for non-infected cats: 0 JB > A situation has arisen for me in which I've moved into a friend's > apartment with my two 1.5 year old cats (sisters) who do not show any [quoted text clipped - 13 lines] > with the other cat while it happens to be shedding the virus (similar > to the manner in which humans pass it on)? Yes. But there's more- read on. > 2) Given that the infected cat shows no *outward* signs of the virus, > how likely is this cat to pass ocular herpes on to my cats? The other cat is probably a life-long asymptomatic carrier- IOW, displays no symptoms but can be infectious to other cats. However, - this is very important- reactivation of a latent infection in an asymptomatic carrier can be precipitated by stress- *especially* by the addition of *another cat* into the household. IOW, bringing your cat into your friend's home can reactivate his cat's FHV-1 infection. > 3) I've heard that up to 80% or so of all cats actually have ocular > herpes already, obviously with varying degrees of severity. Is this > true? Yes. >80% of FHV-1 infected cats become life-long carriers. They usually carry virus in the trigeminal ganglia (nerve connection in the face) and the optic nerve and/or nasal turbinates and/or tonsils. > 4) Will vets test cats for ocular herpes? How expensive is this > procedure? It takes conjunctival scrapings and virus isolation- you really don't want to do this- and its really not necessary since you already know the other cat was infected and is probably a life-long carrier. > 5) If it turns out that my apparently non-infected cats actually do > have ocular herpes, could they suddenly develop outbreaks (from whence > there was none before) simply by being in contact with a cat whose > ocular herpes symptoms are manifestly worse? Yes. But vaccination should prevent the development of severe disease. See below. > I really need some help with these questions! This issue is suddenly > creating havoc around the apartment, because I'm sick of having to keep [quoted text clipped - 3 lines] > > Any other advice out there? Get your cats vaccinated with the Heska UltraNasal *bivalent* (FHV/FCV) vaccine. The UltraNasal confers *rapid* local immunity to the mucosal points of virus entry-- much more rapid immunity than injectible vaccines and without the risk. No vaccine can prevent FHV-1 infection- but the UltraNasal prevents the development of severe disease. As added insurance, you can dose your cats with l-lysine at 250 mg. b.i.d. Lysine interferes with viral replication. If you're as neurotic as I am, you might also want to think about interferon (rHuIFN-a) - 30 IU/day. If you decide to go with interferon, let me know, I'll give the instructions for diluting it- very easy. It comes in 3 million unit syringes that you dilute down to 30 IU/ml. Just get a script from your vet and by the interferon in any pharmacy. One syringe will last a year after its diluted and costs <$50. If you buy the premix from your vet, it will cost you at least 5x as much for less solution. Best of luck, Phil. Thanks Phil! That's some serious food for thought. I'm disappointed that you're not in the camp of "it's no big deal, let the cats mix without worries," but I had a feeling that your point of view is more likely to be the case. Namely, that there is a non-trivial likelihood of the ocular herpes spreading to (my) non-infected cats. It doesn't sound like a high risk if one takes the precautions you mention, but it's still high enough to make me reconsider whether to allow these cats to interact at all. Anyway, much thanks for the information. > Thanks Phil! That's some serious food for thought. I'm disappointed > that you're not in the camp of "it's no big deal, let the cats mix [quoted text clipped - 4 lines] > it's still high enough to make me reconsider whether to allow these > cats to interact at all. I'm not saying your cats will definitely become infected and symptomatic. I just wanted to you know what the risks are and the precautions you can take to minimize the risks. Herpesvirus infection isn't as serious for an adult as it is for a kitten. Primary FHV is usually self-limiting inside of 2-3 weeks. However, following recovery, they could also become asymptomatic carriers and the infection could reactivate if they're stressed or develop another disease that stresses the immune system. OR- they could be just fine. Almost every cat in my shelter has been exposed to FHV- but only a few develop symptoms. The problem is you don't know which cats will resist infection and which will become symptomatic. As I said, vaccination will prevent your cats from developing serious disease, but it won't prevent infection. Keeping the cats separated might be more stressful for all of them and it probably wouldn't be practical if the other cat remains there for any length of time. If you decide to let them mix, at least make sure you have your cats inoculated with the UltraNasal vaccine. L-lysine would be a good idea, too. Phil > Thanks Phil! That's some serious food for thought. I'm disappointed > that you're not in the camp of "it's no big deal, let the cats mix [quoted text clipped - 4 lines] > it's still high enough to make me reconsider whether to allow these > cats to interact at all. I'm not saying your cats will definitely become infected and symptomatic. I just wanted to you know what the risks are and the precautions you can take to minimize the risks. Herpesvirus infection isn't as serious for an adult as it is for a kitten. Primary FHV is usually self-limiting inside of 2-3 weeks. However, following recovery, they could also become asymptomatic carriers and the infection could reactivate if they're stressed or develop another disease that stresses the immune system. OR- they could be just fine. Almost every cat in my shelter has been exposed to FHV- but only a few develop symptoms. The problem is you don't know which cats will resist infection and which will become symptomatic. As I said, vaccination will prevent your cats from developing serious disease, but it won't prevent infection. Keeping the cats separated might be more stressful for all of them and it probably wouldn't be practical if the other cat remains there for any length of time. If you decide to let them mix, at least make sure you have your cats inoculated with the UltraNasal vaccine. L-lysine would be a good idea, too. Phil Our Koko has herpes,and Kady came to live with us as a stray..... Keeping the kitten (kady) separate from Koko was next to impossible..... Koko was had respiratory problems since day one ( a rescue from spca ) and an eye with constant discharge. Even tho Kady was tiny, and not so well off herself... Kady has shown no problems with the herpes. Koko has been getting llysine every day for a year........ yes she still has outbreaks. She was diagnosed 'officially' in July of this year , and is on interferon orally once/ day and another antiviral eyedrop - Idoxuridine - 2 to 3 times a day , and this will be for life. At our website, www.richandlaurie.com I have put up some pics of Koko's eyes. After this more 'major' outbreak, the opthamologist did say that she had a scar on her cornea, which is the most 'definite' diagnosis of having the virus, other than the very expensive dna testing. Since she has been on the antiviral meds, she still has had one or two less serious outbreaks. She is in the midst of one now, actually. I guess I just figured that if Kady got the herpes also, since I already know how to deal with the disease, and since I already have to get the med, dosing one cat or two cats really didn't make a huge difference, other than the pocketbook, of course. And you are right, it costs about $300 bucks for 3 months of meds.... however, she will not need another course of some of the original meds, unless she has another more severe outbreaks. If there is green gunk in the eye discharge, I add an antibiotic drop, but one that does NOT contain any steroidal meds, even tho they often help eyes to feel better quickly. It makes the anti viral meds not able to work as well. I guess we are in a whole different category than 'occasional' stress related outbreaks of the virus. It seems no matter the 'stress' in Koko's life, she just almost constantly has some eye irritation and discharge, and also 'snotiness' in her nose. I can lay in bed at night and hear her breathe. laurie www.richandlaurie.com > Our Koko has herpes,and Kady came to live with us as a stray..... > Keeping the kitten (kady) separate from Koko was next to impossible..... [quoted text clipped - 5 lines] > on interferon orally once/ day and another antiviral eyedrop - > Idoxuridine - 2 to 3 times a day , and this will be for life. I also prefer Idoxuridine. Trifluridine is more potent than Idoxuridine and penetrates the cornea much better, but I absolutely do not like the cats' reaction to it- it seems to *really* irritate their eyes- which in itself is very stressful for the cat (and for me to watch). Trifluridine also must be applied more frequently- which again is stressful. So, even though Trifluridine is techincally better, Idoxuridine is practically better. The last thing you want to do is stress-out a cat that has herpesvirus. You may hear some idiots recommending Acyclovir- the drug used to treat herpes in humans. It doesn't work the same way in cats as it does in humans. The bioavialibility is is very, very poor in cats and it can cause leukopenia and anemia. So, I'd definitely avoid it. At our > website, www.richandlaurie.com I have put up some pics of Koko's eyes. Her eyes don't look very bad at all. I've seen much worse. The treatment seems to be working. ;-) > After this more 'major' outbreak, the opthamologist did say that she > had a scar on her cornea, which is the most 'definite' diagnosis of [quoted text clipped - 6 lines] > med, dosing one cat or two cats really didn't make a huge difference, > other than the pocketbook, of course. > And you are right, it costs about $300 bucks for 3 months of meds.... > however, she will not need another course of some of the original meds, [quoted text clipped - 8 lines] > discharge, and also 'snotiness' in her nose. I can lay in bed at night > and hear her breathe. The new Heska UltraNasal FHV/FCV vaccine does seem to help a lot- the outbreaks might not be as severe-so, you might want to try it. Mention it to your vet. Best of luck, Phil The vaccine helps in cats that already have the virus? >> Our Koko has herpes,and Kady came to live with us as a stray..... >> Keeping the kitten (kady) separate from Koko was next to impossible..... [quoted text clipped - 61 lines] > > Phil > The vaccine helps in cats that already have the virus? No. I was referring to the other cat, Kady. The vaccine won't prevent Kady from becoming infected, but it should lessen the severity of the outbreaks. I wouldn't vaccinate a cat that was already infected with herpesvirus. The UltraNasal vaccine uses a modified-live virus that might exacerbate the disease. Phil. > Our Koko has herpes,and Kady came to live with us as a stray..... > Keeping the kitten (kady) separate from Koko was next to impossible..... [quoted text clipped - 5 lines] > on interferon orally once/ day and another antiviral eyedrop - > Idoxuridine - 2 to 3 times a day , and this will be for life. I also prefer Idoxuridine. Trifluridine is more potent than Idoxuridine and penetrates the cornea much better, but I absolutely do not like the cats' reaction to it- it seems to *really* irritate their eyes- which in itself is very stressful for the cat (and for me to watch). Trifluridine also must be applied more frequently- which again is stressful. So, even though Trifluridine is techincally better, Idoxuridine is practically better. The last thing you want to do is stress-out a cat that has herpesvirus. You may hear some idiots recommending Acyclovir- the drug used to treat herpes in humans. It doesn't work the same way in cats as it does in humans. The bioavialibility is is very, very poor in cats and it can cause leukopenia and anemia. So, I'd definitely avoid it. At our > website, www.richandlaurie.com I have put up some pics of Koko's eyes. Her eyes don't look very bad at all. I've seen much worse. The treatment seems to be working. ;-) > After this more 'major' outbreak, the opthamologist did say that she > had a scar on her cornea, which is the most 'definite' diagnosis of [quoted text clipped - 6 lines] > med, dosing one cat or two cats really didn't make a huge difference, > other than the pocketbook, of course. > And you are right, it costs about $300 bucks for 3 months of meds.... > however, she will not need another course of some of the original meds, [quoted text clipped - 8 lines] > discharge, and also 'snotiness' in her nose. I can lay in bed at night > and hear her breathe. The new Heska UltraNasal FHV/FCV vaccine does seem to help a lot- the outbreaks might not be as severe-so, you might want to try it. Mention it to your vet. Best of luck, Phil Thanks for the tip , I will print it out... I am not sure which she (Kady) got when she was vacinnated the first time. The idiot eye vet for the cat did put Koko on Acyclovir.... just for 2 weeks, I don't know why I didn't open my mouth more, and say that most of the websites I read said that it didn't work in cats.... I will not put her on it again, thats for sure. And I made sure that she just barely got the dosage she recommended, not a drop over. Also , i guess sometimes they use the interferon topically in the eye ? I am not sure, she is on a dose of ophthalmic interferon, but takes it orally (.10 cc ) once per day. The concentration of the solution is not listed. The idoxuridine is listed as .1%, and we use it from 2-4 times / day, one drop in each eye per dosage, treating both eyes, even though usually just the left has discharge. Then for green/ yellow goopy discharge, she gets enrofloxcin .5% solution one drop for each eye twice per day (for 2 weeks). Since her 'diagnosis' at the eye vet in July, this is the 3rd time we have used the antibiotic drops as well as the other everyday meds, because of her stuffy nose and runny,goopy (not just clear runny like normal) eyes. So, it seems even tho we are doing the 'right' things...... she still is sick pretty often. You can hear her breath from a distance of prob 15 feet away - her nose and sinuses are that stuffed up. Would the leukopenia and anemia give any physical signs ?... she has never had any routine bloodwork done. And what routine vaccinations would u recommend and not recommend ? She is overdue for her yearly shots. When they were due, she was having an active outbreak, and I was at least smart enough to say no to the regular vet when he wanted to vaccinate her anyways. Here in Florida, rabies shots are also yearly. I don't know enough about the vaccinations to know which to ask for FOR Koko, so that she is not getting the 'live' ones vs the 'killed' ones.... so not to make her even more sick. Koko also seems to eat LOTS more food than Kady, granted, Kady is still a 'kitten' but Koko is just a year older. I have a daughter with fairly severe asthma, and she seems to have a 'fast' metabolism... she can eat and eat and not gain weight... I wonder if it is because they are constantly just trying to move air and breathe. Koko weighs 13 lbs... but I think you can tell from the pics that she is not 'FAT' - she does have the little female hangy pouch thingy on her belly, but its all skin - its not fatty feeling in it at all. Any suggestions, ideas, I will take all the help I can get, she is a beautiful kitty and very loving and affectionate...... it breaks our hearts that she suffers so much. Well , to us it seems like suffering, to her it is normal - she just goes about her daily business ;-) . Thanks much, laurie > Thanks for the tip , I will print it out... I am not sure which she > (Kady) got when she was vacinnated the first time. [quoted text clipped - 3 lines] > put her on it again, thats for sure. And I made sure that she just > barely got the dosage she recommended, not a drop over. One of the problems with acyclovir in cats is the dose required to produce any beneficial effects is so high that it can be toxic to feline blood. Frequent blood tests are necessary to avoid toxicity- which in themselves are stressful for the cat and can exacerbate the infection. I don't think the slight, if any benefits outweight the risks. Acyclovir interferes with viral replication-- which is basically what l-lysine does- just without the risk of toxicity. Too much l-lysine (>500 mg/day) can be dangerous, too, because it competes with another amino acid- arginine- which is crucial for cats. One of the reasons why herpesvirus is difficult to treat in cats is because the herpesvirus needs arginine, too. We can't reduce arginine levels enough to stop the virus completely without killing the cat. Idoxuridine is definitely the first choice antiviral for FHV-1. The only problem with Ido is that is causes conjunctivitis in some cats. If she has persistant conjuctivitis, you might want to speak to your vet about suspending therapy for awhile to see if her conjunctivitis clears up a little. > Also , i guess sometimes they use the interferon topically in the eye ? > I am not sure, she is on a dose of ophthalmic interferon, but takes it > orally (.10 cc ) once per day. The concentration of the solution is > not listed. IFN is used in the eyes in humans, but I don't know how efficacious it is in cats. Do you buy the IFN from your vet or do you mix it up yourself? Its a lot cheaper if you dilute it yourself- one 3 million unit syringe costs <$50 and will last you a year after you dilute it down to theraputic doses. Its very easy to dilute- only two steps and you can freeze the mix and thaw it out as needed. If you're interested, I'll explain how. The idoxuridine is listed as .1%, and we use it from 2-4 > times / day, one drop in each eye per dosage, treating both eyes, even > though usually just the left has discharge. Do you have a compounding pharmacist or do you buy ido from your vet? Then for green/ yellow > goopy discharge, she gets enrofloxcin .5% solution one drop for each > eye twice per day (for 2 weeks). .5% enro solution is an ear med- that's sometimes used in the eyes off-label. I've had better luck with azithromycin. I read a study on Zithromax in cats with herpesvirus that found therapeutic concentrations in the the cat's conjunctiva 14 days after a single dose. So we tried it- cleared up the eye discharge after a single dose in several cats. Now, I won't use anything else- even Orbax which is in the same drug class as Baytril (only better and less toxic). In some cats we had to dose every day for 2-3 days then evey 5-7 days thereafter. Zithro is more efficacious than Baytril and less stressful because you don't have to pill the cat as frequently. You might want to speak to your vet about Zithromax. Since her 'diagnosis' at the eye vet > in July, this is the 3rd time we have used the antibiotic drops as > well as the other everyday meds, because of her stuffy nose and > runny,goopy (not just clear runny like normal) eyes. So, it seems even > tho we are doing the 'right' things...... she still is sick pretty > often. You can hear her breath from a distance of prob 15 feet away - > her nose and sinuses are that stuffed up. Have you tried a vaporizer or steam inhalation or a nebulizer? Bring her in your bathroom and turn the shower on as hot as it goes. Stay in the bathroom and play with her or brush her if likes it- it will distract her from the steam building up. I find cats don't get stressed if you bring them into a clear bathroom and let the steam build up rather than bringing them into a bathroom that's already steamed. Steam works wonders on stuffy noses very quickly. You can also make a good nebulizing chamber out of a Rubbermaid storage bin, cat carrier,or small aquarium. Rubbermaid storage bins are cheaper and work the best- all you have to do is cut a small hole in one side for the nebulizer unit. http://www.maxshouse.com/Equipment/Rubbermaid_nebulizing%20chamber.jpg The disposable nebulizer units cost about $2-3 but you can reuse them many times if you wash them out after each use. You'll need a nebulizing compressor that you can buy at a pharmacy that carries asthma supplies. The nebulizing compressors are quiet and small- about 5"x 8" by 2" high and cost between $30-$50. The advantage of nebulized antibiotics is that they're inhaled directly into the nasal passages and respiratory tract and overwhelm bacteria almost immediately. You can also speak to your vet about adding a bronchial dilator to the mix to help her breathe easier. > Would the leukopenia and anemia give any physical signs ?... she has > never had any routine bloodwork done. Anemia can cause anorexia and general weakness- not wanting to play or exercise intolerance. Look at her gums- they should be a deep pink or red. If they look pale, she could be anemic. If she was on Acyclovir, I'm surprised the vet didn't check her blood before prescribing it and while she was on it. And what routine vaccinations > would u recommend and not recommend ? She is overdue for her yearly > shots. If she received her FVRCP last year, she doesn't need any vaccinations for another 3-4 years- if then, and probably never again for feline parvovirus (distemper). The new vaccination guidelines recommend *triennial* vaccinations instead of yearly. I certainly wouldn't vaccinate a cat while she is symptomatic, When they were due, she was having an active outbreak, and I > was at least smart enough to say no to the regular vet when he wanted to > vaccinate her anyways. Here in Florida, rabies shots are also yearly. Do you live near the U of FLA in Gainesville? I > don't know enough about the vaccinations to know which to ask for FOR > Koko, so that she is not getting the 'live' ones vs the 'killed' [quoted text clipped - 3 lines] > a 'kitten' but Koko is just a year older. I have a daughter with > fairly severe asthma, Does she use a nebulizer? If so, you can use the same compressor! and she seems to have a 'fast' metabolism... she > can eat and eat and not gain weight... I wonder if it is because they > are constantly just trying to move air and breathe. Koko weighs 13 > lbs... but I think you can tell from the pics that she is not 'FAT' - > she does have the little female hangy pouch thingy on her belly, That's called the 'primordial pouch'- protects the stomach in a fight. but its > all skin - its not fatty feeling in it at all. > > Any suggestions, ideas, I will take all the help I can get, she is a > beautiful kitty and very loving and affectionate...... it breaks our > hearts that she suffers so much. Well , to us it seems like suffering, > to her it is normal - she just goes about her daily business ;-) . Try steam in the bathroom and speak to your vet about nebulized antibiotics. Best of luck, Phil I have 11 cats. Two have ocular herpes with discharge. I've been giving Lysine but they still have flares. These two have had problems for many years, and no other cat has gotten it. > A situation has arisen for me in which I've moved into a friend's > apartment with my two 1.5 year old cats (sisters) who do not show any [quoted text clipped - 39 lines] > Thanks, > JB |
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