Page 23 - Problem-Based Feline Medicine

2 – THE CAT WITH ACUTE SNEEZING OR NASAL DISCHARGE 15

Infection appears widespread in the feline popula- Differential diagnosis
tion. B. bronchiseptica may be a normal commensal in
Herpesvirus and calicivirus can have similar signs, and
the respiratory tract of cats, because it can be isolated
mixed infections are common, making definitive diag-
from many healthy cats. It can be isolated from as many
nosis impossible based solely on signs.
as 20% of cats in rescue catteries. The lowest rates of
isolation are from one- and two-cat households.
Treatment
Overgrowth of the organism may produce upper res-
piratory tract inflammation or pneumonia. Use appropriate antibiotics based on susceptibility
data and the ability to reach therapeutic concentra-
Severe cases with bronchopneumonia have occurred
tions in respiratory secretions such as oxytetracy-
in situations of overcrowding and other stress factors.
cline, doxycycline or enrofloxacin. Beware of
The incidence in cats is reported to be higher in house- sudden retinal degeneration if using enrofloxacin.
holds where signs were present in dogs.
Montelukast (Singulaire, 0.25–1 mg/kg SID) is a
In most cats, signs resolve after approximately leukotriene receptor blocker. Although the cat has insuf-
10 days. Occasionally, coughing persists longer. ficient leukotriene receptors for cysteinyl leukotrienes to
cause bronchoconstriction, anecdotal evidence suggests
that montelukast may reduce sneezing and nasal dis-
charge associated with Bordetella. This effect may be
Clinical signs
mediated through blockage of leukotriene-mediated
Signs are most likely to occur in cats from multi-cat attraction of inflammatory cells such as eosinophils and
environments, especially rescue or shelter catteries, neutrophils, and their subsequent release of inflamma-
where calicivirus and herpesvirus are also a problem. tory cytokines and other chemicals.
Typically there is an acute onset of pyrexia, and
Prevention
sneezing and nasal discharge.
An intranasal modified live vaccine is available which
Mandibular lymphadenopathy may be palpable.
does not prevent or eliminate infection with Bordetella,
Coughing may be spontaneous, or only evident on tra- but usually prevents severe overgrowth and clinical signs.
cheal pressure. Generally, coughing is not as pro- It is most useful in catteries or shelters with culture-
nounced as in dogs. proven outbreaks of disease. It is effective in 3–5 days.

Dyspnea, cyanosis, crackles and wheezes may be aus- The rate of adverse signs (e.g. sneezing) associated
cultated over lung fields in some cats. Death from with Bordetella vaccination probably exceeds the fre-
pneumonia may occur, especially in young kittens less quency of disease caused by the organism in cats living
than 8 weeks old. in one- or two-cat households.
Improve cattery/shelter conditions to decrease over-
crowding if the organism appears to be causing recur-
Diagnosis rent problems.

Bacteria can be isolated from the nasal discharge,
oropharyngeal secretions, tonsillar swabs, or a transtra- FOREIGN BODY
cheal wash.
● Samples should be transported in special medium Classical signs
(e.g. charcoal Amies transport medium), and need
● Acute onset of sneezing and face rubbing,
special media for culture.
progressing to chronic signs.
● Although B. bronchiseptica is a normal commensal
● Unilateral discharge.
in many cats, in cats with disease from the organism,
● Gagging.
large numbers of organisms are often isolated.