Henry is an estimated 6-month-old intact male cat who was recently found as a stray. Henry was presented to your clinic with signs of sneezing, lethargy, nasal congestion, ptyalism, and a mild fever (103.5 F).  He seemed to be very bright and eating well the first few days, but signs started building about 48 hours ago. Henry is still adjusting to the new home and is still an indoor/outdoor cat. The pet owner has at least 4 other cats in the home.

1.     What would you like to do next?

A.   Auscultate the lungs

B.    Examine the oral cavity

C.    Ask more information about the history of the cat, including vaccination status

D.   All the above

Examination:

Examination reveals that Henry is about 5% dehydrated. Nasal and ocular discharge is yellow and thick with minimal air flow appreciated from both nares. Lungs sound clear; however, referred upper airway noise is appreciated. There are superficial ulcers along the periphery of his tongue and the lining of the mouth. Based on your physical examination, you suspect this is a disease of the upper respiratory tract.

2.     What would you like to do next for diagnosis?

A.    Ultrasound

B.    Chest radiographs

C.    PCR testing

D.    Fecal 

The results of the PCR testing confirm calicivirus. 

Treatment for calicivirus is focused on supportive care including:

·      Use of nebulizer and saline nasal drops to break up the ocular and nasal discharge

·      Broad-spectrum antibiotic to treat for secondary opportunistic bacterial infections.

·      Analgesia for tongue ulcerations

·      Nutritional support and fluid therapy as indicated.

In this case, there are multiple cats in the household and those cats are going outdoors – which means they could infect other cats in the neighborhood.  These cats should be quarantined.

Cats that become carriers will continue to shed the virus in the home, even after they recover from the infection. Owners may need to re-home carrier cats before disinfecting the home to protect the remaining animals from exposure. 

Vaccines are not 100% protective against calicivirus, but they can greatly reduce the severity of the infection if a cat is exposed. Several combination vaccines against FCV, feline herpes virus type 1 and feline panleukopenia virus are available, which can be given nasally or as an injection. 

Answers:
1. D

2. C