Once the medical history, which is sometimes incomplete, is obtained, diagnosis continues with a physical exam. Often, examination of a particularly painful eye can be facilitated by administering a topical anesthetic such as proparacaine. This also gives the patient temporary relief.
However, a Schirmer tear test should not be performed subsequently, as the topical anesthetic can alter results of the tear test. Fortunately, Dr. Glaze noted, dry eye is not very common in cats with FHV-1 conjunctivitis, so the topical anesthetic has more value than risk. Physical exam findings are often as expected e. She discussed two diagnostic paradigms when dealing with these cases.
First, when a cat presents with conjunctivitis, it should be presumed infectious until proven otherwise. Second, feline corneal ulceration should be considered a consequence of herpesvirus infection until proven otherwise. Unlike other species we deal with, cats have primary conjunctival and corneal pathogens, so they don't require any other predisposing factor or precipitating event to get conjunctivitis or ulceration. FHV-1 is frequently implicated, but Chlamydia felis may also be involved in feline conjunctivitis.
However, chlamydia is not ulcerative. Adnexal disease, entropion, foreign bodies, and other conditions are also possible. When trying to distinguish physical exam findings, Dr. If there is deeper corneal pathology, other factors, such as secondary bacterial infection, are at play. Your vet may perform a test called a fluorescein stain to check for a corneal ulcer caused by severe keratitis.
They may also perform a Schirmer tear test to see if your cat's tear production is abnormally low. This test allows the viral particles to be amplified and thus isolated and identified. However, if your cat isn't in an active stage of infection, there won't be any viral particles being shed and this PCR test will be inconclusive. Cats with an active flare-up of herpes virus will be treated symptomatically. The most common treatment is topical ointment or drops for your cat's eyes.
Your vet will also recommend you start your cat on the supplement L-lysine. This is an amino acid that works to boost your cat's immune system and it is something your cat can safely take long term. There are antiviral medications out there, but they can be hard on your cat's kidney and liver enzymes, so they aren't prescribed as often.
Feline herpes virus is quite common in cats, but that doesn't mean you can't have a herpes positive cat living with herpes negative cats. Also, with the right treatment, a herpes positive cat can still have a long and healthy life. Good hygiene practices are the best defence against this virus. All bedding and blankets should be laundered with detergent and warm water.
Shared bowls, toys, and litterboxes should also be cleaned with warm, soapy water. You should also make sure to properly wash your hands with warm soapy water after handling a cat with feline herpes virus. It is essential that certain measures be taken to avoid the development of feline flu.
Most importantly, the vaccination program against herpesvirus and caliciviruses must be followed. These vaccinations stimulate the immune system, helping to fight infection and therefore prevent the appearance of symptoms.
Although vaccines can prevent more severe cases, it does not usually provide complete effectiveness in the prevention of transmission. In fact, some vaccinated cats may suffer some mild infections. Vaccination for all cats within the household is recommended, especially if they go out to the street sometimes, or come into contact with other cats.
Kittens are protected by their mother's antibodies passed on through their milk until 4 or 8 weeks old, after that period the protection declines. Vaccinations should be given to kittens of 6 to 12 weeks old to be effective.
A deworming and vaccination plan should be set by the veterinarian in accordance to the state of the immune system and the environment in which the cat lives.
Finally, to treat and prevent transmission, a sanitary hygiene routine should be established. To prevent the virus from spreading, infected cats should undergo certain health checks. Clinical challenges: Treatment of FHV-1 ocular disease is challenging. Antiviral medications may be expensive, and require good owner and patient compliance. Clinical responses in patients can be variable.
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