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Cat with ocular herpes

Caroline'sEmma
January 23rd, 2010, 09:54 PM
I have a cat that has had ocular herpes since her eyes opened after birth. She saw a vet opthamologist at age 3 weeks and again at 14 weeks. Her eye is cloudy and I'm not sure how much she can see out of it at all.

She has had more and more breakouts over the last 9 months (she is only 9 months old now). She is on Oflaxicin drops and idoxiuridine during her outbreaks, but I am concerned that she is in real pain. She acts normally, playing and eating without issue, but her eye just looks painful. The medicine she is on is difficult to administer as the Oflaxicin has to be given 10 - 12 times a day and the Idoxiuridine 4 times a day.

My vet suggested (and wrote a prescription for) Famciclavir (which is pill form). I understand that this is exepensive (although I have no idea exactly how much). Can anyone tell me if they have tried and had any success with this?

I fostered her with her mother and siblings since they were 1 week old as I am a volunteer for the local animal shelter. She had a brother with the same issue although he died at 3 weeks old.

I am new to this community, but I am looking for some help - any would be appreciated.

By the way, she is on wet and dry Instinct food and I have been adding probiotics from the local natural petstore as I believe her immune system is compromised. They also gave me some bovine colostrum from New Zealand. She has also had diarreha for the last two months - almost nonstop. She has seen two vets and had a fecal culture which showed only an excess of bacteria.

Again, any experience with Famciclavir would be helpful.

Thanks,
Caroline (Emma's mama)

TeriM
January 23rd, 2010, 11:13 PM
Awww, poor girl :(, she is lucky to have you. I have no advice but I'm sure a few of our cat gurus will be along to help you out soon :thumbs up.

I will also pm Dr. Lee to see if he might be able to help.

:grouphug:

sugarcatmom
January 23rd, 2010, 11:54 PM
Sorry your kitty is going through this, it must be so frustrating. She might benefit from the addition of L-lysine (http://www.nowfoods.com/Products/M002917.htm) to her wet food. I think for kittens you can start with 250mg per day (split between 2 meals).

Some info for you:
http://www.veterinarypartner.com/Content.plx?P=A&A=1327
http://www.hcvma.org/articles/Feline%20Infectious%20Conjunctivitis.PDF

Dr Lee
January 24th, 2010, 01:46 AM
The medicine she is on is difficult to administer as the Oflaxicin has to be given 10 - 12 times a day and the Idoxiuridine 4 times a day.

My vet suggested (and wrote a prescription for) Famciclavir (which is pill form). I understand that this is exepensive (although I have no idea exactly how much). Can anyone tell me if they have tried and had any success with this?

I am sorry to hear about the problems that your cat is having.

L-Lysine. A great recommendation by sugarcatmom.

Idoxyuridine is also known as herplex. This is a great medication and at 0.1% it can be used at one drop onto the affected eye up to every hour. This is the one drawback - it needs to be used frequently. This does bring me to one note on your post. Ofloxacin is generally recommended every 2-6 hours and idoxyuridine is used every 1 hour or as needed.

Famvir (Famciclovir) is an oral antiviral medication. It is typically given for a 10-14 day course. It is a good medication albiet expensive. I would say that this not typically used by the rescues I work with but it is a good medication.

I hope that helps.:pawprint:

Caroline'sEmma
January 24th, 2010, 07:42 AM
.

gel form: Viralys (http://acerlux.com/amazonshop.html). For cats that have chronic or recurrent symptoms, I recommend its long term use. It is very safe. For many rescue groups, all fostered or housed cats are automatically placed on lysine.

Idoxyuridine. This is a topical ophthalmic drop used to treat viral infections. It is also known as herplex. This is a great medication and at 0.1% it can be used at one drop onto the affected eye up to every hour. This is the one drawback - it needs to be used frequently. This does bring me to one note on your post. Ofloxacin is generally recommended every 2-6 hours and idoxyuridine is used every 1 hour or as needed. You may want to talk to your veterinarian about increasing the frequency of the idoxy. For the Arizone Welfare League, Idoxy is their main drug in the treatment of feline herpes.

There is a new drug called Cidofivir 0.5% This can be used in place of idoxyuridine. The advantage is that it is used twice a day. The downside is that it is expensive. FWIW - our compounding pharmacy sells far more idoxy than cidofivir. But if the dosing is a problem, it is a great alternative.

Famvir (Famciclovir) is an oral antiviral medication. It is typically given for a 10-14 day course. It is a good medication albiet expensive. I would say that this not typically used by the rescues I work with but it is a good medication.

So how do we put it all together?:confused:

Treatment Goals
1) Supportive care. Make sure pet is eating, drinking and pain free. If there is pain present, buprenorphine is a safe and 30 times more potent than morphine without the effects of vomiting.

2) Treat secondary infections. Use topical and/or oral antibiotics as needed

3) Lysine. Use for short or long term. It is a nutriceudical and very safe and effective.

4) Medical Antivirals. Topical and/or systemic antivirals. I recommend Idoxy to start with and should be given as often as every hour until signs resolve.

5) Stress relief. Often stress is a contributing factor. Feliway spray is a common method to help reduce stress. Other options are based off of what the underlying stress may be.

I hope that helps explain the common approach to feline herpes and that it may help with your kitten.:pawprint:

Thank you Dr. Lee - just a few more comments that I forgot. My vet did give me Viralys, but I thought with everything else I was putting in her food for diarreha (colostrum & probiotics) she wouldn't get much food taste - but I guess I need to start this again. The reason the Ofloxacin was given as many times as possible is she has ulcers on her eye and the opthamologist said that it only lasts a few minutes because it is a drop that is absorbed quickly unlike the Idoxy which is in gel form. I usually can't give it that often because I work and live alone. I usually give the Ofloxacin and Idoxy 4 to 5 times a day. The vet says that it's possible that at some point we will need to remove her eye altogether. Sometimes I wonder if this isn't a better solution only because I'm not sure if she can even see out of her eye (it's so small compared to the other one and is covered by a cloudy film)

My question regarding the Famciclovir is that my vet prescribed 125 mg (11 pills) I am to give 1/2 pill once a day for 21 days. Is this too long? Also, will I stop all other medicines at the time or continue with the Idoxy and Oflox? Is this supposed to work longer term than the others? The Famciclovir pill form seems like an easier mode of treatment (not that I am looking for the easy way out, but she has been suffering for 9 months with no real sign of long term relief. She fights me when I put the Idoxy and Oflox in her eye - I feel I stress her out just putting these in her eyes...

Cidofivir 0.5% is a good idea to try and I will ask my vet about it.

Thank you again for your help with my kitty - Emma.
Caroline

Caroline'sEmma
January 24th, 2010, 07:56 AM
Thank you Sugarmom (by the way, I too have a diabetic kitty whom is diet controlled, but was on insulin for about 9 months). My vet gave me the gel form of L-Lysine (Viralys). But for some reason, I stopped using it -- this same kitten has other problems - diarreha for the last two months. I've tried everything, and the only thing that is just now starting to work is adding probiotics & bovine colostrum to her food. Adding the Viralys just seemed too much in her food! I guess I need to add it back. She is also overweight at 9 months! I have tried everything, but for some reason she gobbles her food and will then fight my other two adult cats for their food. I have a 15 year old male maine coon mix who is twice her size, but she isn't affraid of him at all...I've had her since she was 1 week old so I know she was never starved!!! Anyway, thanks for your reply. I also got a nice email from Dr. Lee.

Caroline

diandpat
January 24th, 2010, 08:04 AM
Welcome to the Board Caroline's Emma...sorry to hear about your kitten.

Thank you Dr. Lee for your response. I adopted two cats from the SPCA in October and both came down with the sneezing, runny eyes, snotty noses too. Ziggy was worse than Zuzu and did end up with a URI too :( Of course, the advice of members on this board was fantastic. I also found a feline herpes group on Yahoo that has very very knowledgeable members. Many of them are in rescue and deal with this all the time.

I did not get the Viralys from the vet but the Lysine capsules from the pharmacy. They both get 500mg/day. I split the capsule and mix the powder in with their food. Around the Holidays we ran out of pills and did not restock for about a week and withing that time they both started getting crusty eyes again and sneezing so we got them right back on it and life was good. Interesting to note, my SO gets cold sores and also takes the Lysine and if he stops it is inevitable that he will have a cold sore within the week.

Hope you stick around and really hope you can post some pics of your crew really soon ;)

sugarcatmom
January 24th, 2010, 10:39 AM
My vet gave me the gel form of L-Lysine (Viralys).

I'd recommend trying just the 100% pure L-lysine (capsules or loose powder) from a health food store or pharmacy. There are some ingredients in the gel Viralys that I find dubious (like "maple flavour" and "artificial sweetener"? seriously?). Forgot to mention, the dosage for cats over 6 months is actually 250mg twice a day. Some people go as high as 500mg twice a day for short periods of time, but maybe start with the 250 x2 and see what that does.

As for your little one already being overweight, it might be a good idea to eliminate the dry Instinct from her diet. It's quite high in calories at about 500 cal/cup, so it doesn't take much to pack on the pounds. Cats really don't need kibble anyway, wet food is the way to go (good choice on that, by the way).

Caroline'sEmma
January 24th, 2010, 05:00 PM
Can I get the powder form at GNC?

diandpat
January 24th, 2010, 05:14 PM
Can I get the powder form at GNC?

I don't know what GNC is but it is an amino acid. You should be able to get it wherever vitamins/food supplements are sold.

It comes in a capsule and you open the capsule and sprinkle it on the food. Do a google search or Lysine or L-Lysine so you can see what the different brands are.

Good luck!

kungfuMao
April 5th, 2010, 11:52 PM
Lysine capsules can easily be found at health food stores (GNC is one, I think). I found a bottle of 60 capsules 500mg at my local grocery store for about $12-14 bucks. Hope your kitty feels better soon!