Saturday, April 16, 2011

Treatment of Calicivirus Stomatitis in Cats

We have treated three cats in the past six weeks that had calicivirus stomatitis.  They all responded well to treatment, which may be encouraging news for other cats and their caring owners.  The first case was a six-year-old spayed female that lived out of doors.  She had been lethargic, not playing for five days, and eating very little.  Her temperature was normal but there were thick mucous masses on the surface of her eyes, no nasal discharge, but a large ulcer was on the middle of her tongue.  By the fourth day of treatment her eyes were clear, her appetite had returned and she was playing again.  But the tongue ulcer remained.  Treatment was stopped after seven days and the ulcer was healed by day 14.  With antibiotic-based treatment regimens recovery may take two weeks or more if it occurs at all.
            The second cat was very sick.  Temperature 105°.  His eyes were sealed closed with mucous, which also plugged the nostrils inhibiting breathing.  The cat drooled fetid saliva and there were extensive deep ulcers in the mouth.  He lived outdoors and could not eat because of illness and mouth pain.  With seven days of treatment he had almost recovered, drooling had stopped and he was eating.  Two days after treatment ceased clinical illness returned.  Treatment resumed but was limited to every other day. He now appears to have recovered but this may be transitory, dependent upon perpetual medication.   In my experience such dramatic response is unusual.  Most cases become chronic and severely emaciated, for the virus survives in the tissues.  The fact that this cat required prolonged treatment indicates the disease had already become chronic but the treatment limited extent of lesions and made the cat comfortable.  Only time will tell whether or not a cure has been affected. 
The third case was a cat with large open, raw lesions in the angle of the jaw at the rear of the mouth.  The lesions extended forward along the gums almost to the canine teeth.  This poor cat had been afflicted for several years.   In the past I had tried unsuccessfully to treat it with different regimens.   The cat had become quite thin, it could not chew its food, only swallow the kibbles whole.  With one week of treatment the cat was much livelier and crunching its kibbles.  One week without treatment and lassitude and difficulty eating had returned.  But, when treatment was resumed every other day the cat behaved normally again.  The condition is chronic in this cat and continuous low-levels or intermittent treatment may be required for life to control clinical disease.
 Treatment of these cases was the same, how levels of interferon once daily administered in the mouth.   Interferon is a small protein produced in virus infected cells.  It circulates through the body of the infected animal and inhibits virus development.   As a drug interferon is not generally considered an effective treatment against calicivirus infection.  For that matter, there is only one other effective treatment that I am aware of for this disease and it is experimental.  However, in my judgment, these three cats were benefited by interferon treatment.  Their symptoms diminished and their quality of life improved. 

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