British Shorthair with runny nose and sneezing

Question
I have a 16 year old neutered male British Shorthair (Marx).  For about a year he has been sneezing (sometimes with blood) and has had a runny nose.  Sometimes his eyes water and get a bit sore.  He has been to the vet where he was given a thorough examination and they flushed his nose through but could find no foreign object in the nasal passages.  They could not find anything wrong after x-rays but gave him a long course of antibiotics which seemed to help initially.  As soon as he stopped the course the sneezing returned.  He has since had another course of tablets but nothing seems to work.  I don't really want to take him back again as I am a pensioner and it has cost me a fortune so far which I can not afford.  Apart from the symptoms I have explained he seems very healthy and eats well.  Please can you tell me what is wrong with him and if it is life threatening.  Thanks.  Pat (England)

Answer
Hi Pat,

While I couldn't be certain, judging by my experience and the tests and treatments you've tried so far, my educated guess would be that Marx is probably dealing with a viral problem that is further complicated by a bacterial infection.  The antibiotic tablets help clear up the bacterial aspect of the issue, which would reduce symptoms significantly, but the underlying problem - I suspect the feline herpes virus - doesn't respond to antibiotics.  Feline herpes is similar in some ways to the human herpes viruses, including that once infected, cats become carriers for life.  However, the disease is not contagious to people or other species - only cats.

Cats with herpes typically have a thick nasal discharge, sometimes bloody, and the membranes around the eyes can become inflamed, red and may produce a discharge.  While suffering from herpes, most cats also become infected with a bacterial infection, because their immune system is busy fighting the herpes.  Most cats suffer periodic flare-ups of about 10 days, but some struggle with it more constantly.  I suspect Marx might be one of those kitties.  For those cats, it's recommended that you supplement them with an amino acid called lysine.  This helps the cat's immune system build antibodies against the virus.  It's not only helpful in that way, but it also prevents the herpes virus from using a different amino acid called arginine, which it requires to replicate.  After supplementing with lysine for several days, you should begin to notice his symptoms are less severe.  Most cats with chronic herpes symptoms will be under decent control in a couple of weeks.  However, it's recommended that you keep these cats supplemented, even when they're asymptomatic, to help prevent a flare-up (although they are inevitable).

There are lysine supplements formulated specifically for cats, such as Viralys and Enisyl-F products (available online).  However, you can also use tablets from the vitamin section at your pharmacy.  These are normally 1000 mg.  You can give Marx 500-1000 mg a day, preferably divided into two doses.  It's best to grind the tablets up and mix them in food.  Even a quarter tablet is too large to give to most cats.

If he still shows no improvement in a couple of weeks, then I would start to wonder if he has a polyp or tumor in his nasal cavities somewhere.  That generally would take an exploratory procedure or CT-scan/MRI to diagnose (the exploratory is much less expensive).  Polyps are not as dangerous as tumors, but both could be considered life-threatening if in the "right" place, because of the close proximity of the sinuses to the brain.  Any abnormal growth in that area has the potential to be dangerous.  Most polyps are easily removed, but tumors can be more invasive.  A biopsy would probably need to be done on any suspicious tissue that was removed, to determine if cancer was present.  

Hopefully, he responds to the lysine.  If so, I would be satisfied that the answer is that he is a herpes sufferer.

Best of luck!

Jessica