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Information Sheet
Feline Upper Respiratory Infection (URI)

bar Table of Contents

Introduction
Signs of URI
Agents of Feline URI (brief overview)

Prevention of feline URI
Treatment
Detailed profiles of common URI pathogens and available diagnostic tools
Information for Foster Homes
Information for New Adopters
Treatment Forms

Introduction

Feline upper respiratory infection (URI) is perhaps the most frustrating illness facing shelter veterinarians, managers and staff. Many cats are chronically infected, vaccines are partially effective at best, and specific treatments are limited. URI is very easily spread by fomites or droplet transmission, and some URI agents are resistant to disinfection. Factors such as overcrowding, poor air quality, poor sanitation, stress, concurrent illness, parasitism, poor nutrition, and other causes of immunosuppression predispose to disease, and many of these factors are difficult or impossible to completely eliminate in a typical shelter, cattery or rescue home.

In spite of these challenges, some shelters and catteries clearly suffer less from URI than others. Although URI can never be totally eradicated, the frequency and severity of cases can be greatly reduced through a systematic management strategy. Reduction of overcrowding, effective cleaning, adequate ventilation, stress control, and good preventive medicine are the cornerstones of URI control in feline populations.

Signs of URI

All of the following are signs of URI. Any cat showing any one of these signs should be suspected of having URI, and should at minimum be isolated from the general population. These symptoms can also indicate a vaccine reaction; however any cat showing these signs, whether due to a vaccine or genuine disease, is potentially infective to other cats:

  • Clear or colored nasal discharge
  • Sneezing
  • Red/inflamed conjunctiva
  • Ulcers/sores on the nose, lips, tongue or gums
  • Fever/lethargy/loss of appetite (these may be signs of many other diseases as well)

 

Specific agents most commonly associated with URI

Any of the agents listed below can be a primary cause of URI. Approximately 80-90% of cases are thoughts to be caused by one of the two viruses listed. Remember, though, that environmental factors and animal immune status play an equally important role in causing actual disease; all the pathogens listed below can also be found in clinically healthy cats.

 

1. Feline Herpesvirus-1 (FHV-1 - probably the most common)

1. Feline Calicivirus (FCV - perhaps not as common as herpes, but potentially more severe)

2. Chlamydophila felis

3. Mycoplasma spp.

4. Bordetella bronchiseptica

 

Diagnosis

 

Most often, a causative agent is not identified in individual cases of URI. Sometimes a best guess can be made based on clinical signs: FCV is more likely to be associated with oral ulceration or limping, FHV-1 is more likely to cause keratitis or corneal ulceration, Chlamydophila and Mycoplasma more often seen with conjunctivitis without other signs. However, all can cause overlapping signs of URI as well as be isolated from clinically normal cats. In spite of this, there are circumstances under which laboratory diagnostics have value. Diagnostic options include viral and bacterial culture and PCR on conjunctival or oropharyngeal swabs (and occasionally other samples, such as tracheal washes or lung tissue). Samples should be obtained from the most prominently affected location. Some circumstances under which diagnostic testing should be considered:

 

  • Unusual signs, severity or frequency of disease in a population of cats
  • Planned husbandry changes (e.g. before investing in vaccines, developing new cleaning protocols, housing, etc.)
  • Legal issues (e.g. hoarding investigation, liability concerns)
  • Detect carriers (e.g. low turnover shelter that has recurrent severe disease)
  • Individual cat that has not responded to empirical therapy, especially before initiating expensive or risky treatment.

Idexx laboratories now offers a diagnostic PCR panel to look for the five common pathogens listed above. Specific diagnostic strategies for each pathogen are listed in the "agents and diagnostic details" section.

Prevention of feline URI

Population management

Crowding and the attendant stress is undoubtedly the single greatest risk factor for severe respiratory (and other) disease outbreaks in populations. Increased population density leads to a greater risk of disease introduction, higher contact rate, reduced air quality, and often, compromises in housing and husbandry. Unfortunately, crowding in shelters is not uncommon, either due to insufficient facilities to provide even minimal care for the stray population, or (as is increasingly common) a well-intended attempt to decrease euthanasia by housing more animals. Tragically, such efforts may not only fail to improve the number of animals adopted, they may actually lead to increased disease and death[1]. Even in a boarding facility or vet clinic, it is important to anticipate times of peak population, recognize that these will be periods of increased risk for respiratory disease outbreaks, and plan sufficient additional staff that husbandry is not compromised.

An under appreciated strategy for respiratory disease prevention is to simply reduce the amount of time each cat spends in the shelter environment. Length of stay has been shown in several studies to be a significant risk factor for development of feline URI[2, 3]. Reducing length of stay may not be possible (or desirable) in a boarding facility or vet hospital, but management practices that increase length of stay for shelter cats should be carefully assessed to ensure the benefit of these practices outweighs the risk of disease they may create. This could include routine quarantine of apparently healthy animals, delays created by backlogs in behavior assessment or surgery, or failure to move cats to public-viewing areas of the shelter as soon as they are available for adoption.  Increased time for each cat in the shelter also contributes substantially to increased crowding with all the associated risks.

Stress reduction

Because clinical signs and shedding of FHV-1 are activated by stress, reduction is crucial to feline URI control. Even moving cats from cage to cage is enough to induce reactivation in some cats[4, 5]. “Spot cleaning” where possible and prioritizing housing for cats that does not require extensive movement or handling for care is likely key to control of URI. Providing hiding places, decreasing noise exposure, maintaining light/dark cycles and comfortable temperatures, and providing toys and scratching surfaces are also important to relieving feline stress. Unnecessary aversive handling should be minimized – the theoretical benefit of interventions that involve handling or forceful medication must be weighed against the certain stress these procedures cause.

 

Feline socialization programs can be helpful in relieving stress but must be implemented and monitored with care. Being removed from a cage, cuddled by a stranger and carried to an unfamiliar room to play may provide welcome relief from boredom for some cats, but may be highly stressful for others, as well as serving to efficiently spread disease.

Vaccination

Vaccination does not prevent infection or development of a carrier state for any URI pathogen, and many strains of feline calicivirus are vaccine resistant. At best, vaccination reduces severity and duration of disease. Vaccines should be given immediately upon shelter entry for best effect, or at least one week prior to entry for boarding kennels and catteries.

Modified live (MLV) parenteral vaccines are available containing feline herpesvirus, feline calicivirus and feline panleukopenia (FVRCP). Intranasal MLV two-way (FVRC) or three-way (FVRCP) vaccines are also available. Modified live vaccines are generally preferred for the more rapid protection induced (5-7 days parenteral, 3-5 days intranasal). However, modified live vaccines (especially intranasal) may cause mild clinical signs. In shelters that euthanize cats for any sign of URI, the risk of these mild signs must be weighed against the likely benefits of modified live vaccines.  

Because URI and panleukopenia vaccines are generally delivered in combination, this is a consideration in vaccine selection. Panleukopenia is recognized with increasing frequency throughout the US, and the superior protection provided by the MLV parenteral vaccine against this disease makes it the best choice in most situations. In one study the 2-way intranasal FVRC vaccine given in addition to a killed SC FVRCP vaccine provided modestly improved protection against URI. No data has been published regarding the efficacy of combing SC modified live with an intranasal modified live vaccine for herpes/calici, although the possibility exists that administration by both routes simultaneously would provide superior protection.  Anecdotal reports from shelters are extremely varied regarding the efficacy of this strategy  (from those that report a significant apparent decrease to those that report no change or even increased URI). If a modified live intranasal vaccine is used in addition to a subcutaneous 3 way FVRCP vaccine, an effort should be made to track the impact on URI within an individual shelter (see data collection section below).

A MLV Bordetella vaccine for cats is available, but is not generally recommended for shelters except when repeated problems are demonstrated by laboratory diagnostics. Killed and modified live vaccines are available for C.  felis (often given in combination with FVRCP). This vaccine is not generally recommended, as it has a short duration of effect, is only partially effective, and may have a relatively high frequency of adverse reactions. Frequent recognition of clinical Bordetella or Chlamydophila in cats is often an indicator of overall husbandry problems, and prevention should focus on improvement of environmental management, rather than control of these agents specifically. The need for this vaccine, if used, should be periodically revisited. No Mycoplasma vaccine is available for cats. For more information on vaccination for feline URI, see the American Association of Feline Practitioners Vaccine Guidelines, available online. This document includes specific recommendations for shelter cats.

Air Quality

Air quality is undoubtedly important to URI control. The relevant air quality is at the level of the cat’s nose, not the room at large. Although fresh air exchange is often emphasized, reduction of airborne contaminants is equally or more effective (e.g. through reducing population density, frequent litter box cleaning, low dust litter, use of disinfectants at correct dilution).  Air filtration (i.e. HEPA filter) may be tried, although it is less effective than fresh air exchange or contaminant reduction. Filters need to be replaced frequently to prevent them from becoming a nidus of infection in themselves. Ozone based air filters should be avoided, as ozone itself may be a respiratory irritant.

Disinfection

Most URI pathogens survive in the environment no more than a few hours (FHV-1) to a few weeks (Bordetella) and are inactivated by routinely used disinfectants. Feline calicivirus is a notable exception, and may survive for up to a month or even longer in dried discharge. FCV is inactivated by household bleach (5% sodium hypochlorite) diluted at 1:32, or by potassium peroxymonosulfate (Virkon® or Trifectant®).[6, 7] Calicivirus is NOT reliably inactivated by alcohols, and hand sanitizers commonly used in shelters may not be completely effective. Sanitizers containing 60-90% ethanol and propanol are more effective than other alcohols.[8]  As noted above, the stress and fomite transmission associated with cleaning a typical box style single cat cage may outweigh the benefit of thorough disinfection. If possible, cages should be spot-cleaned while cats are in residence, and thoroughly cleaned, disinfected and dried between residents.

Isolation

Many cats shed URI pathogens without showing clinical signs, hence the need for careful hygienic precautions even when handling apparently healthy cats. Cats with active signs of infection are likely to be shedding much greater amounts, and isolation of these cats from the general population is a requirement for even a minimal disease control program. Many cats are still shedding increased amounts for a few weeks following recovery. Although not always practical, ideally these cats will not be mixed directly back into the general population, or at least not with vulnerable populations such as kittens or recent arrivals.

Monitoring – arguably the most important part!

Countless dollars, hours and endless heartache are spent in efforts to control URI in shelters, yet we often rely solely on vague clinical impressions to determine whether our efforts are justified by the result. We would never think of doing this with an individual patient. Before even starting treatment, baseline measurements are taken to determine the initial condition. These include qualitative observations and quantitative measures such as temperature, pulse, CBC and blood chemistry results. Even in the most constrained circumstances, we would not think of initiating treatment without at least performing a thorough physical exam, and in all but the most minor cases we recheck baseline values to ensure response to treatment.

Just as we do for the individual patient, we need measures to monitor the success of our “population treatment plan”. Although this sounds simple enough, this crucial aspect of population disease control is often overlooked. As in the individual patient, we need both quantitative and qualitative information: how many cats are sick (out of how many at risk), for how long, how bad is it, what are the prevailing signs?

There are two common methods used specifically to describe disease levels in a population: incidence and prevalence. Each measure has certain strengths and weaknesses.

Prevalence is defined as the number of cases of disease present in a population at risk at a given point in time.

Example: 20 cases of URI out of a total of 100 cats in the shelter that day = 20/100 = .2 =  20% prevalence.

Prevalence is simple to calculate: count total sick and total population daily, weekly, etc, and plot results over time. Prevalence goes up with an increase in either the number of new cases of disease or increased duration of disease. Because prevalence is influenced by duration, it can not be used to measure a disease for which animals are euthanized, sent to foster care or otherwise removed from the population before recovery. In such cases, “duration” is artificially controlled by facility policy, and resulting prevalence levels will be misleading.

Incidence is defined as the number of new cases of a disease occurring in a population at risk over a period of time.

Example: Shelter that cared for 100 cats for 10 days apiece in a given month (100*10 = 1000 cat days at risk). 20 cats developed URI out of 1000 cat days at risk that month = 20/1000 = .02 cases of URI per cat day at risk.

Incidence is independent of duration, and is therefore a useful measure in cases where prevalence is unreliable. Determining incidence requires calculation of population time at risk. This is defined as the total time contributed by all disease-free individuals in the facility during the period under consideration. Population time at risk is obtained by taking a daily head count of “healthy cats” (cats without the disease in question) and summing that for the time period under consideration.

Duration and severity of disease

Neither incidence nor prevalence indicates duration or severity of disease. Both these measures should be considered when assessing the benefits of some interventions. For instance, some vaccines claim to decrease duration and severity of disease, although a greater number of mild cases of disease/vaccine reaction may be seen. If one considered only incidence, such a vaccine would seem harmful, but considering duration will give a more realistic assessment of possible benefit. Duration can easily be tracked, and a simple scoring system allows measurement of disease severity.

More details on disease measurement in small animal populations can be found in the chapter on implementing a population health plan in the book Shelter Medicine for Veterinarians and Staff. (Blackwell Publishing, 2004).

References:

 

1.               Borrud, H. and T. Prophet, No Kill Movement Killing Some Pets, in Victorville Daily Press. 2007: Victorville, CA.

2.               Scarlett, J.M. Upper respiratory tract infections in cats in animal shelters. in Cornell Feline Symposium. 2003. Ithaca, NY.

3.               Bannasch, M.J. and J.E. Foley, Epidemiologic evaluation of multiple respiratory pathogens in cats in animal shelters. J Feline Med Surg, 2005. 7(2): p. 109-19.

4.               Gaskell, R.M. and R.C. Povey, Experimental induction of feline viral rhinotracheitis virus re- excretion in FVR-recovered cats. Vet Rec, 1977. 100(7): p. 128-33.

5.               Maggs, D.J., M.P. Nasisse, and P.H. Kass, Efficacy of oral supplementation with L-lysine in cats latently infected with feline herpesvirus. Am J Vet Res, 2003. 64(1): p. 37-42.

6.               Scott, F.W., Virucidal disinfectants and feline viruses. Am J Vet Res, 1980. 41(3): p. 410-4.

7.               Eleraky, N.Z., L.N. Potgieter, and M.A. Kennedy, Virucidal efficacy of four new disinfectants. J Am Anim Hosp Assoc, 2002. 38(3): p. 231-4.

8.               Gehrke, C., J. Steinmann, and P. Goroncy-Bermes, Inactivation of feline calicivirus, a surrogate of norovirus (formerly Norwalk-like viruses), by different types of alcohol in vitro and in vivo*1. Journal of Hospital Infection, 2004. 56(1): p. 49-55.

Treatment of feline upper respiratory infections in an animal shelter

Treatment

Prevention must be the cornerstone of  population URI management. Once cats become ill, more than half the battle is lost: even at shelters able to provide treatment, sick cats will suffer through a spell in isolation, crowding and costs will increase as cats are held for treatment, public trust may decrease, and staff time is diverted from preventive efforts and adoptions. Some cats suffer chronic and even fatal complications from URI.

That said, treatment is an important component of URI management, for the population as well as the individual cat. Staff compliance and community support often improves when sick cats can at least sometimes be treated.

While we want to do all we can to speed recovery, it’s important to recognize that treatment itself is associated with risks and costs, especially in a shelter. Over-use of antibiotics compromises normal gastrointestinal flora, leaving cats vulnerable to the many GI pathogens lurking in shelters. Antibiotics also cause undesirable side effects, and the risk of selecting for antibiotic resistant organisms is a constant concern. With any treatment that involves handling and manipulation of cats, the risk of spreading disease is increased, and treatment itself can be quite stressful for cats and caretakers alike. Overtreatment should therefore be avoided. While it can be tempting to try a variety of anecdotal treatments or give antibiotics just to be doing something about this frustrating disease, treatment should ideally be limited to therapies for which there is a reasonably strong clinical justification.

 

Goal of Treatment

The decision tree below reflects an assumption that cats are being treated for URI with the intention of continuing treatment until the cat recovers and is placed for adoption. In some shelters, this is not the case. When overcrowding is a problem, shelters may hold cats with URI only for the legally required period. If a cat is going to be euthanized at the end of a stray holding period, then treatment should be directed only at making the cat as comfortable as possible. It is rarely indicated (or practical) to treat with antibiotics in such cases.

Sample protocol showing how one shelter decided to apply the decision tree below. Note that this is only intended to be an example; your choice of specific antibiotics and supportive care may be different, but the general idea is to have a consistent plan for treatment based on presentation, such that staff can become familiar with drugs, dosages and side effects; and the efficacy of treatment can be more readily assessed and modified if needed.

Accessing Treatment Candidates

When selecting cats to place on treatment, consider both the overall status of your shelter and your ability to deliver appropriate medical care. If your shelter is not able to find homes for every healthy, behaviorally sound cat, consider carefully the adoptability of cats that are started on treatment for URI. It does not make sense to invest large amounts of time and energy, or to subject cats to a long course of treatment, if they are unlikely to be adopted after it is all over or if another adoptable cat will have to be euthanized to make space to move the recovered cat out of isolation. At minimum, cats should be tested for FeLV/FIV prior to initiating treatment for URI.

The availability of medical care also determines which cats should be considered for treatment. For instance, if there is inadequate staff (including veterinary supervision) to deliver antibiotics or fluid/nutritional support, it is not fair to keep cats requiring such treatment in the shelter. In such a case, in-house treatment candidates should be limited to those needing only minimal support and isolation. If being able to treat sicker cats is a priority, staffing (paid or volunteer) should be in place before initiating such a program. At minimum, a URI treatment program must have a veterinarian available for consultation and a skilled technician on staff to implement any treatment plan provided by the veterinarian.

Treatment rationale

The two most common causes of feline URI, accounting for 80-90% of cases, are feline herpes virus and feline calicivirus. Less commonly, bacterial species may be the primary cause, including chlamydophila, mycoplasma, and bordetella. Cats with primary viral URI may also suffer from secondary bacterial infection. By definition, the signs of infection with any one of the possible agents of URI are similar. All can cause sneezing and ocular and nasal irritation and discharge, and definitive diagnosis is generally impractical in a shelter setting.  However, some signs are more common with one or another agent. For instance, limping and oral ulceration are more common with feline calicivirus infection, while ocular ulcers and pain are more often associated with feline herpes infection.  Initial treatment should be based on the most likely cause of the observed signs, and this is the basis for the recommendations given below. Blanket treatment with antibacterial agents is inappropriate when evidence of a bacterial infection is lacking, and may even be harmful.

 

Category one

Signs are limited to one or more of the following: Clear (not yellow, green or bloody) discharge from the nose or eye, sneezing, oral ulcerations.

Assessment: Most likely mild viral infection or vaccine reaction or without significant bacterial component.

Treatment:

  • Isolate
  • Offer wet cat food BID
  • Assess daily for appetite, fecal quality , hydration, progression of signs

Category two

Signs: Signs as in category one (clear nasal or ocular discharge and/or sneezing, oral ulcers) accompanied by more severe systemic signs such as fever, inappetance, dehydration, lethargy.

Assessment: Most likely more severe primary viral infection.

Treatment:

  • Same as for category one AND
  • Check hydration and body temperature at least twice daily
  • SQ fluids as needed to maintain hydration
  • Antipyretic if fever >106o Fahrenheit
  • Nutritional support if not eating > 48 hours: heat food, offer variety of  food, force feed/tube feeding if needed.
  • All severely depressed/dehydrated cats in shelters should be assessed for possible panleukopenia

Category Three A (respiratory)

Signs: Green/colored nasal discharge (may be accompanied by other signs as in category two).

Assessment: Most likely viral infection with non-specific secondary bacterial infection.

Treatment:

Same as for category one/two (depending on severity) AND oral antibiotics that provide reasonable gram positive coverage with a dosing frequency that shelter staff is able to maintain) often limited to SID or BID treatment. Reasonable choices include: first generation cephalosporins, amoxicillin, clavamox, clindamycin, doxycycline. Drugs may lose efficacy when used over time in a population; first choice may need to be changed periodically. Broader spectrum and more expensive drugs can be reserved for cases that fail to respond to the above antibiotics i.e. fluoroquinolones,  trimethoprim sulfa.

Category Three B (Ocular)

Signs: Marked eye signs along with URI: clear or colored ocular discharge and/or moderate to severe conjunctivitis along with other signs of URI as described above. May be combined with category 3A, above.

Assessment: : Most likely primary viral URI with secondary non-specific bacterial infection of the eyes.

Treatment:

Same as for category one/two (depending on severity) AND broad spectrum topical eye ointment such as neomycin-polymixin-bacitracin. Other acceptable choices include Terramycin or Chloramphenicol ointment, but these may be more costly. Ointments containing steroids should be avoided unless a veterinarian has specifically determined there is no corneal ulceration present and steroids are indicated. If ocular inflammation  worsens after administration of topical therapy, treatment should be discontinued or a different treatment tried at the discretion of the veterinarian.  (Eye ointments can actually worsen irritation in some cats.) 

  • Broad spectrum topical eye ointment such as neomycin-polymixin-bacitracin. Other acceptable choices include Terramycin or Chloramphenicol ointment, but these may be more costly

Category Four

Signs: Eye signs only: clear or colored ocular discharge/conjunctivitis with no other signs of URI:

Assessment: Most like primary bacterial eye infection by Chlamydophila or Mycoplasma, or chronic feline herpes viral infection. Marked swelling of the conjunctival tissues is more likely to be caused by a bacterial infection, while corneal ulceration suggests feline herpes infection. If condition worsens with treatment or persists for more than two weeks, medications should be discontinued or changed, and definitive diagnostics should be performed.

Treatment of suspected primary bacterial infection:

  • As for category one/two (depending on severity) AND
  • Topical eye ointment with good intracellular penetration (Terramycin or chloramphenicol).
  • In severe or persistent cases, oral antibiotics effective against intracellular organisms should be used. Recommended choices include doxycycline and azythromycin (zithromaxä). Doxycycline is preferred over tetracycline in kittens because it is less likely to cause tooth staining. Azythromycin was found ineffective in clearing Chlamydophila infection in one study when given at 10-15 mg/kg daily for 3 days and then twice weekly, so doxycycline may be the better choice if this bacteria is suspected.
  • If response to treatment is observed in first 7 days, continue treatment for a minimum of 3 weeks. Cats are not likely to be infectious once clinical signs have resolved, and may be placed for adoption while treatment course is completed.

Treatment of suspected chronic ocular herpes infection:

  • As for category one/two (depending on severity) AND
  • Topical antiviral ocular eye ointment or drops (availability varies; some drugs may be available from compounding pharmacies only). Choices (in order of efficacy) include Trifluridine (Viroptic), Idoxuridine, and Vidarabine (Vira-A). More effective agents are also more likely to be irritating.
  • L-lysine nutritional supplements orally (500 mgs twice a day) may reduce length and severity of clinical signs.
  • Removal from shelter environment; signs may resolve with decrease in stress.

Category Five

Signs: Additional signs not consistent with typical URI, such as severe diarrhea or vomiting, coughing, or URI that does not respond to treatment as expected.

Assessment: These cases should be worked up individually by a veterinarian.  Cases of URI that have not improved significantly after two weeks of appropriate treatment should receive a further work-up, including testing for FeLV/FIV if not already performed. URI is uncommonly fatal except in very young kittens; older kittens and cats that are found dead or severely ill should be tested for other infectious diseases, particularly panleukopenia.

Other treatment options : Anecdotal supportive treatments include vitamin supplements (e.g. vitamin B in fluids) and alpha interferon (30U once daily and/or 1 drop of 30-50 U/ml solution in artificial tears once daily for suspected herpes conjuncitivitis). While apparently safe, the efficacy of these treatments is unknown. Drugs used to treat various specific symptoms include fever reducers, pain killers, decongestants, and appetite stimulants. These drugs should be used only on an as-needed basis under the direction of a veterinarian. Any medicating of cats causes stress, costs money, and uses staff or volunteer time, and most drugs have the potential for undesirable side effects. Therefore, blanket treatment regardless of clinical signs should be avoided, and risks of treatment should be considered when weighing the possible benefits of unproven or anecdotal treatments.

Agents and diagnosis of Feline URI

 

Note on diagnosis: All agents listed below may be isolated from clinically normal cats. Isolation from a nasal or oropharyngeal swab from a single affected animal does not necessarily indicate a causal association with disease. Isolation from an unusual percentage of affected cats, identification of a consistent strain within affected cats, and/or isolation from the lower respiratory tract or from necropsy specimens is supportive of a causal association.

Feline Calicivirus (FCV)
Feline Calicivirus (FCV) is a single stranded non-eve loped RNA virus and is a major cause of acute, oral and upper respiratory tract disease in domestic cats (1). Other signs associated with FCV include oral ulcers, gingivitis and lymphoplasmacytic stigmatism, conjunctivitis, and in rare cases virulent systemic disease. The incubation period of FCV ranges from 1-5 days and the half life of shedding post recovery is approximately 75 days; some cats remain chronically infected and shed the virus continuously. Likelihood of transmission from asymptomatic carriers is significantly less than from acutely infected cats, but is possible and may serve to maintain a severe strain of FCV in a population. Calicivirus is highly contagious, and moderately environmentally persistent. It is spread by direct contact, by fomites over significant time and distance, and through droplets from sneezing animals over distances of less than 5 feet. Vaccination against FCV is available and provides moderate protection against severe disease, but does not prevent infection, and may cause mild, contagious disease. In addition , vaccine resistant strains exist.

Diagnostic tools available for identifying FCV include:

Viral Culture: Using a viral culturette swab the facues and larynx area and/or eyes and nose and/or collect blood or feces. Break the bulb of the culturette releasing the media and make sure that the swab is sufficiently moistened by the media. The culturette can then be frozen or submitted to a laboratory with in 24. Results usually take about 4 days.

PCR: Less optimal. Use any sterile swab, collect same samples as above and place swab in small amount of sterile saline. Must be frozen and handled promptly. Submit to a laboratory that performs calicivirus RT-PCR. Include vaccine history in information sent to the lab.

 

Feline Herpesvirus (FHV-1)
Feline Herpesvirus (FHV-1) is a double stranded enveloped DNA virus and is an important and ubiquitous pathogen of domestic cats which accounts for approximately 50% of upper respiratory tract infections world wide and has been incriminated in many chronic ocular disease symptoms (2,3). The incubation period of FHV ranges from 2-6 days with clinical disease apparent within 10-20 days and shedding of FHV lasting from 1-3 weeks post recovery. Herpes infection is a lifelong condition for infected cats. The virus can become reactivated and is shed in approximately 50% of infected cats within one week of a stressful event. Many cats are chronic carriers and the virus is spread though direct contact, by fomites over a moderate time and distance, and through droplets from sneezing animals over distances of less than 5 feet. It is not particularly hardy in the environment and is killed by routine disinfection. Vaccination against FHV is available and provides moderate protection against severe disease, but does not prevent infection, and may cause mild, contagious disease.

Diagnostic tools available for identifying FHV include:

Viral Culture: Using a viral culturette swab the facues and larynx area and/or eyes and nose and/or collect blood or feces. Break the bulb of the culturette releasing the media and make sure that the swab is sufficiently moistened by the media. The culturette can then be frozen or submitted to a laboratory with in 24. Results usually take about 4-7 days.

PCR: Less optimal. Use any sterile swab, collect same samples as above and place swab in small amount of sterile saline. Must be frozen and handled promptly. Submit to a laboratory that performs herpesvirus PCR. Include vaccine history in information sent to the lab.

Bordetella bronchiseptica
This gram negative bacteria is most commonly associated with kennel cough in dogs, however cats may be reservoirs of Bordetella in shelters (6). Clinical signs in Bordetella positive cats are usually mild URI, but can include conjunctivitis and tracheobronchitis. Pneumonia in young kittens or secondary to viral infection or immunosuppression have been reported. The incubation period of Bordetella ranges from 3-10 days in dogs with shedding of Bordetella lasting up to 3 months post recovery. Bordetella is commonly spread among dogs and cats through direct transmission, by fomites over significant time and distance, and through droplets from sneezing cats over distances of less than 5 feet due to cats. It does not survive well in the environment and is killed by routine disinfection. Vaccination against Bordetella bronchiseptica for cats is available and provides moderate protection against severe disease, but does not prevent infection, and may cause mild, contagious disease. Vaccination of shelter cats against Bordetella is not generally indicated. Good sanitation and timely isolation of symptomatic animals are the preferred methods to limit the transmission of this disease between dogs and cats within a shelter. However, vaccination may be warranted if Bordetella-associated disease is confirmed by laboratory diagnostics. Husbandry factors should also be assessed, and the need for this vaccine periodically re-evaluated in a population,as an outbreak may be transient.

Diagnostic tools available for identifying Bordetella bronchiseptica include:

Culture: Use bacterial culturette. Swab of faucets or TTW fluid (better), preferably of a cat that is not receiving antibiotics. Keep cool but do not freeze. Submit to microbiology for culture.

Chlamydophila felis (formerly known as Chlamydia psittici)
This obligate intracellular bacteria has been established as an important cause of upper respiratory tract disease in cats worldwide, accounting for between 13 and 30% of cases (4). Chlamydophila felis infections are primarily associated with conjunctivitis (often unilateral) and mild URI. However it has been reported that approximately 4-6% of cats with Chlamydophila felis appear clinically normal. A recent study complete by the shelter medicine program here at Davis found that although only a small percentage of cats with URI had Chlamydophila felis the clinical signs of URI in these cats was severe. The incubation period of Chlamydophila felis ranges from 3-14 days and shedding of Chlamydophila felis may persist for 18 months post recovery. Chlamydophila felis is most commonly spread by direct transmission ( often neonatal), with minimal transmission occurring due to fomites or by droplets from sneezing animals over distances of less than 5 feet. It does not survive well the environment and is killed by routine disinfection. Both modified live and killed vaccines against C. felis for cats are available and provide moderate protection against severe disease, but may not prevent infection or mild signs of illness. Historically this vaccine may have been associated with a greater incidence of adverse vaccine reactions than FVRCP vaccines alone. Newer purified-antigen products may be less problematic. Vaccination of shelter cats against C. felis is not generally indicated. Good sanitation, effective treatment and timely isolation of symptomatic animals are the preferred methods to limit the transmission of this disease within a shelter. However, vaccination may be warranted if Chlamydophila-associated disease is confirmed by laboratory diagnostics. If used, a modified live vaccine is preferred due to the more rapid onset of immunity. The need for this vaccine should be periodically re-evaluated in a population, as an outbreak may be transient.

 

Diagnostic tools available for identifying Chlamydophila felis include:

PCR: Scrape conjunctival cells using back of scalpel blade. Wipe blade with sterile swab into small amount of sterile saline. Can be frozen. Submit to a laboratory that performs Chlamydophila PCR.

Cytology: Scrape conjunctival cells, smear onto glass slide. Quickly air dry. Submit to laboratory for Clinical pathology.

Immunological staining: Same procedure as for cytology.

Mycoplasma spp.
This obligate intracellular bacteria can be commonly isolated from the oropharynx of clinically normal cats. There have been reports of Mycoplasma being recovered from the infected conjunctiva of cats (5) but the role that Mycoplasma plays in feline upper respiratory disease has not been fully established as of yet. Mycoplasma is most commonly spread by direct transmission with minimal transmission occurring due to fomites or by droplets from sneezing animals over distances of less than 5 feet. It does not survive well the environment and is killed by routine disinfection. No vaccination against Mycoplasma is available but routine disinfection and timely isolation of symptomatic animals are reliable methods that can limit the transmission of this disease within a shelter.

Diagnostic tools available for identifying Mycoplasma spp. include:

PCR: Scrape conjunctival cells using back of scalpel blade. Wipe blade with sterile swab into small amount of sterile saline. Can be frozen. Submit to a laboratory that performs Mycoplasma PCR.

Culture: Use bacterial culturette. Swab eyes, nose, and mouth. Keep cool but do not freeze. Submit to Microbiology lab.

References

1.    Gaskill, RM. & Dawson, S. (1994). Viral-induced upper respiratory tract disease. In Feline Medicine and Theraputics, 2nd edn, pp. 453-472. Edited by E.A. Chandler, C.J. Gaskiill & R.M. Gaskill. Oxford: Blackweill

2.    Nasisse MP. (1982). Feline herpesvirus ocular disease. In Veterinary Clinics of North merical Small Animal Practice, pp. 667-680.

3.    Nasisse MP. (1982). Manifestations, diagnosis and treatment of ocular herpes infection in the cat. In Compend Contim Educ Pract Vet, pp.962-970.

4.    Sykes JE., et al. (1999). Comparison of the Polymerase Chain Reaction and Culture for the Detection of Feline Chlamydia psittici in Untreated and Doxycycline-Treated Experimentally Infected Cats. In Journal of Veterinary Internal Medicine, pp.146-152.

5.    Cole, BC, et al.(1967). Characterization of Mycoplasma strains from cats. In Journal of Veterinary Internal Medicine, pp.146-152.

6   Foley, JE , et al.(2002) . Molecular epidemiology of feline bordetellosis in two animal shelters in California, US A.. In Pev Vet Med, pp.141-156.

Information for Foster Homes

Feline Upper Respiratory Infection (URI) is similar to a common cold in humans. It is especially common in cats that have been exposed to a lot of other cats, such as at an animal shelter. URI is very rarely fatal, and usually resolves within one to three weeks. Treatment generally consists of supportive care. In addition, antibiotics are sometimes given to treat possible bacterial infections. However, although secondary bacterial infections can make the problem worse, the underlying cause is often a viral infection. Viral infections are not cured by antibiotics – as with the common cold, there is no completely effective treatment besides time and allowing the cat's own immune system to do its job.

In rare cases, URI can cause serious disease such as pneumonia. Also, sick cats may not eat or drink adequate amounts and may become severely dehydrated. In such cases, hospitalization and fluid supplementation may be needed.

How contagious is URI and can your own pets contract it?

URI is contagious to other cats. Most cats are vaccinated against it (it's part of the standard yearly vaccination program recommended by most vets). However, the vaccine is not 100% protective, so it's a good idea to isolate cats that are showing signs of the disease, and wash hands after handling sick cats. (In general we recommend isolating all new arrivals in your household for 8-10 days after adoption, to give them a chance to settle in and make sure they are not coming down with anything.) URI is not contagious to people or other animals.

What are the signs of URI?

  • Clear or colored nasal discharge
  • Sneezing
  • Red/inflamed conjunctiva
  • Ulcers/sores on the nose, lips, tongue or gums
  • Fever/lethargy/loss of appetite (these may be signs of many other diseases as well)

How should you care for a cat with URI?

Mild cases of URI can often be treated at home with supportive care.

  • Provide the cat with a quiet, warm place to rest
  • Make sure the cat is eating. When cats get stuffy noses, they can't smell their food very well and may not want to eat. Offer smelly, wet food such as fish flavored canned cat food. Warming it up often helps.
  • Gently clean the cat's nose and eyes with a soft cloth moistened with warm water.
  • If the cat is very congested, use a humidifier or put the cat in the bathroom and run hot water in the shower for a few minutes a couple of times a day. Moderate to severe congestion if often a sign of a secondary bacterial infection, so contact your veterinarian to discuss treatment.
  • If any medicine has been prescribed, be sure and give the full course as directed, even if the symptoms seem to have gone away.
  • If you have any questions, contact your veterinarian or the animal shelter from which you obtained your cat

When should you contact a veterinarian?

Every animal released from a shelter to a foster home should be examined by the shelter's vet before it leaves the shelter. If the shelter does not have a veterinarian on staff and using an off site veterinarian is not the shelter's policy, the shelter should at minimum provide the foster care giver with written guidelines that clearly state the shelter's policy regarding who is to be contact at the shelter if medical issues arises, which veterinarian, if any, the shelter would prefer the foster care give use in the event of illness or injury, and how will exam, treatment, and medication fees will be covered in the event a foster animal is taken to a veterinarian.

With rest and good care, many cats will recover from mild URI in one or two weeks. Sometimes cats need additional help, however. If your foster cat has any of the following signs, contact your veterinarian or the contact person at the shelter your foster cat came from if it is the shelters policy that you contact them first.

  • Not eating for more than 24 hours.
  • Green or yellow discharge from the nose or eyes (your veterinarian may prescribe antibiotics for this).
  • Gently clean the cat's nose and eyes with a soft cloth moistened with warm water.
  • Difficulty breathing, especially panting or breathing through an open mouth.
  • Depressed or unresponsive cat: a slight decrease in activity is expected, but contact your vet if the cat is much less active than usual or than you would expect.
  • Vomiting or diarrhea that lasts more than 24 hours.
  • Little or no improvement after a week of home care

Information for new adopters

Feline Upper Respiratory Infection (URI) is similar to a common cold in humans. It is especially common in cats that have been exposed to a lot of other cats, such as at an animal shelter. URI is very rarely fatal, and usually resolves within one to three weeks. Treatment generally consists of supportive care. In addition, antibiotics are sometimes given to treat possible bacterial infections. However, although secondary bacterial infections can make the problem worse, the underlying cause is often a viral infection. Viral infections are not cured by antibiotics as with the common cold, there is no completely effective treatment besides time and allowing the cat's own immune system to do its job.

In rare cases, URI can cause serious disease such as pneumonia. Also, sick cats may not eat or drink adequate amounts and may become severely dehydrated. In such cases, hospitalization and fluid supplementation may be needed.

How contagious is URI and can your own pets contract it?

URI is contagious to other cats. Most cats are vaccinated against it (it's part of the standard yearly vaccination program recommended by most vets). However, the vaccine is not 100% protective, so it's a good idea to isolate cats that are showing signs of the disease, and wash hands after handling sick cats. (In general we recommend isolating all new arrivals in your household for 8-10 days after adoption, to give them a chance to settle in and make sure they are not coming down with anything.) URI is not contagious to people or other animals.

What are the signs of URI?
  • Sneezing
  • Runny nose
  • Red and or runny eyes
  • Sores on the tongue, lips, nose or roof of mouth
  • Fever
  • Lack of appetite
  • Decreased energy
When should you contact a veterinarian?

First, it important to state that every animal adopted from a shelter should be taken for an examination by your regular vet within at most 3 days of adoption. With rest and good care, many cats will recover from mild URI in one or two weeks. Sometimes cats need additional help, however. If your cat has any of the following signs, contact your veterinarian.

  • Not eating for more than 24 hours.
  • Green or yellow discharge from the nose or eyes (your veterinarian may prescribe antibiotics for this).
  • Gently clean the cat’s nose and eyes with a soft cloth moistened with warm water.
  • Difficulty breathing, especially panting or breathing through an open mouth.
  • Depressed or unresponsive cat: a slight decrease in activity is expected, but contact your vet if the cat is much less active than usual or than you would expect.
  • Vomiting or diarrhea that lasts more than 24 hours.
  • Little or no improvement after a week of home care

Treatment Sheets Developed by the UC Davis Shelter Medicine Program

In response to frequent inquires, we have developed treatment and observation sheets for cats with Upper Respiratory Infections. You are welcomed to download these sheets for your use in your organization or to serve as an example of a treatment sheet for you to use as a model to help you to develop your own sheets tailored to your needs. These sheets are intended to be printed double sided and used a single case form that can be hung on the cats cage or kept in a binder in your treatment area.

download this form (pdf)