Eirevet is a veterinarian specialized in canine and feline internal medicine who owns a small animal veterinary hospital in Ireland.
Signs of Upper Respiratory Problems in Cats
Runny eyes, sneezing, a snotty nose, gagging—at some point in their lives, cats develop signs of cat flu or similar conditions. There are several common upper respiratory tract (URT) diseases of cats, which can cause nasal (nose) and ocular (eye) symptoms.
Many of these diseases are infectious, and most are preventable with routine vaccination. This article aims to help you differentiate the potential causes of your cat's problem and provides suggestions for managing chronic complications of cat flu.
Even relatively simple problems such as viral infections will often debilitate your cat, and as with all illnesses, please seek attention from a veterinarian if your cat appears unwell.
Signs of Upper Respiratory (URT) Disease
The symptoms of URT disease do vary with the underlying problem but include:
- conjunctivitis (sore eyes)
- corneal ulcers (erosions on the front of the eye)
- loss of appetite
- retching or gagging
- discharge from the nostrils and eyes
Causes of URT Disease
The causes can be broadly grouped as:
- chronic rhinosinusitis
- nasopharyngeal polyps
- tumours of the nose (thankfully not common in cats)
- foreign material lodged in the nose or throat
Predisposing Factors for Upper Respiratory Problems in Cats
If your cat has particularly severe signs of illness, or symptoms which do not appear to respond as well as expected to treatment, then one should suspect some underlying defect in your pet's immunity. Stress is a major cause of immune suppression, and cats in multicat households are certainly more prone to upper respiratory disease, both because of increased viral/bacterial challenges, but also because of the territorial tensions that often simmer below the surface. Feliway can be very useful in cases of URT disease in houses with more than one cat, as it soothes and relaxes anxious cats.
Feline Immunodeficiency Virus (FIV) and Feline Leukemia Virus (FeLV) are two infections which mainly cause disease by suppressing the immune system. Testing for them is simple, requiring only a few drops of blood, and your veterinarian should rule these infections out if your cat is proving difficult to cure of his/her symptoms. Click on the links above for more information.
There are two viruses which commonly cause the classic symptoms of 'cat flu'; Feline Calicivirus (FCV) and Feline Herpesvirus (FHV). It is usually possible to tell which organism is involved in your cat's symptoms.
- Reduced appetite
- Fever (often >104F)
- Ulcers on tongue and cheeks
- Reduced appetite
- Mild fever (usually around 103F)
- Discharge from eyes, with or without corneal ulcers
Both of these viruses can cause long term problems for your cat. FCV is thought to be involved in chronic inflammatory conditions of the gums and mouth which can be very painful and difficult to treat, sometimes requiring extraction of all teeth along with long term drug treatment. FHV infection is never cleared from the body, and although most cats will appear to recover, they will be prone to recurrent bouts of infection when stressed or unwell.
Viral infections are generally treated with anti-inflammatory medication to control fever and supportive treatment such as fluids for as long as is necessary. Most otherwise healthy cats will recover within a week from the initial infection. There are several antiviral drugs which have been used to treat these infections, but the evidence to show they help is weak at best. For cats with FHV infection which recurs or have long-term nasal or ocular problems because of the infection, lysine supplementation (250-500mg per day) can be helpful in alleviating symptoms.
Anti-herpes medications such as famciclovir can be extremely useful to treat acute disease or flare-ups and will be available either directly through your veterinary clinic or on prescription from a pharmacy.
Bacteria rarely cause URT problems on their own, but very often complicate the viral infections. A straightforward viral infection with either virus will present with a clear or mucous discharge from the nose or eyes. Yellow or creamy discoloration of the discharge suggests secondary bacterial infection. The symptoms will otherwise be as I described above, with sneezing and possibly ocular discharge although your cat is likely to be more unwell and will certainly require antibiotic treatment in addition to anti-inflammatories and supportive care.
Fungal infection of the URT is thankfully not as common as viral and bacterial infections. Two species of fungi tend to be involved: Cryptococcus neoformans and Aspergillus. Both cause very severe damage to the respiratory tract and can affect other organs in the body including the central nervous system and lymph nodes.
The symptoms of fungal infection are usually more severe: the discharge seen from the nose is often bloody, there may be facial deformity and pain over the bridge of the nose, and often ulceration of the skin of the nose.
Treatment for these infections needs to be prolonged (over several months) but the prognosis for recovery is usually good.
As the name suggests, this condition is responsible for chronic or long-term signs of URT disease or cat flu. Cats with this condition often have a history of nasal discharge and sneezing over many years. The discharge is usually watery as one would see with the viral infections, but it is common to get bouts of secondary bacterial infection requiring occasional antibiotic treatment.
The condition is diagnosed by ruling out all other causes of sneezing. It is unknown what causes chronic rhinosinusitis, but there are various theories postulating that previous viral infections and stress may play a role.
The condition cannot be cured, but it is possible to improve the cat's quality of life and reduce the severity of the symptoms. Finding a successful treatment regime often involves quite a bit of trial and error, as what works for one cat may not work for another. The initial treatment for the condition usually requires a prolonged course of antibiotics to clear well-established bacterial infections.
Steroids and Other Medications to Improve Quality of Life
Glucocorticoid drugs such as prednisolone may be prescribed by your veterinary surgeon. Alternatively, steroid inhalers may be administered using the AeroKat or similar inhalation devices. Antihistamine (chlorpheniramine 1mg twice daily) treatment is sometimes useful. It is important to minimise stress for the cat by avoiding overcrowding and competition for feed, water, and litter trays. Feliway, a synthetic cat pheromone, is also very useful for this purpose.
Nasal and Sinus Congestion
Nasal and sinus congestion is a significant problem, as anybody with chronic sinus problems will attest. Placing your cat in the bathroom while you run a shower or bath is an easy way of providing steam vapour to loosen thickened mucous but needs to be done several times daily if symptoms are severe. Saline drops applied to the nostrils four times daily will also help. Lysine supplementation is recommended (250-500mg per day).
Benign growths, usually found in young cats, which grow in the throat and can extend into the inner ear along the Eustachian tube. They are thought to be a complication of previous viral infection. The symptoms seen with polyps are not typical of cat flu, but include:
- signs of inner ear disease (head tilt, third eyelid protruding in one eye)
Cats with polyps will sometimes have a bacterial infection, and yellow nasal discharge may be seen. Most nasopharyngeal polyps can be removed by traction (pulling) from the throat followed by a course of steroids.
Other more aggressive growths (cancers) are not common in cats, and the signs can vary widely depending on the location; sneezing, gagging, bloody nasal discharge, facial deformity, and weight loss.
Nasal Foreign Bodies
Very often, cats present with symptoms of cat flu or nasal pharyngeal polyps, but the cause is actually material lodged in the throat or nose. Cats that enjoy snacking on grass are particularly at risk. The grass blades very often lodge in the throat, then curl up over the soft palate and lodge at the back of the nasal cavity.
Your cat will have a history of a sudden onset of sneezing or reverse sneezing (see video below). If the problems persists, a bacterial type of nasal discharge may develop. Many cats will clear the foreign body themselves within an hour or two, but if not they will require anaesthesia to flush the material from the nasal chambers.
This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.
Comments/Questions Regarding Cat Flu
tiarra on April 04, 2017:
One of them is cute and one of them is creepy.
LaurieNunley517 from Deep South on January 18, 2016:
This is a really great hub article on feline respiratory issues! My kitty has FHV. I have to be vigilant about his lysine and his antibiotic eye ointment. Thanks so much for addressing this important issue. So many cats are exposed to these "diseases. "
eirevet (author) from Ireland on June 07, 2012:
Thanks christin53. Reverse sneezing is actually more common in dogs, often seen in brachycephalic breeds like CKC or Pugs and usually because of an elongated soft palate. Owners often describe their dog to 'choke', especially when excited. If anybody has a dog that suffers this problem, blowing sharply down the dog's nostrils can help during a severe attack.
Ann-Christin from UK on June 01, 2012:
Really good informative hub I've had cats but I've never heard of reverse sneezing before.
eirevet (author) from Ireland on June 01, 2012:
My pleasure KathyH! Thanks for the lovely comments.
KathyH from Waukesha, Wisconsin on June 01, 2012:
Wow, this is fascinating! I had NEVER heard of reverse sneezing before, it's great to know this! :) Once in a great while our cats will sneeze. We think it's due to dust in the air when we have windows open. It gets dusty here in the desert of Las Vegas! They will usually sneeze just one time then be ok again. Thanks for sharing some very helpful information! :)