Snots and snuffles: rational approach to chronic feline upper respiratory syndromes.

practical relevanceWhile the most common cause of chronic upper respiratory disease signs in cats is viral disease, with subsequent, self-perpetuating inflammation, other, more discrete causes need to be ruled out. These include foreign bodies, bacterial or fungal infections, oral-dental diseases and neoplasia. Any factors contributing to alterations in the structure or function of the upper airways, including inflammation of any cause, will compromise normal function and predispose to chronic damage if the cat is unable to resolve the underlying factors. CLINICAL CHALLENGES: The chronic feline snuffler is a frustrating patient to treat. The longer the course of disease, the more severe the consequences to affected tissues, and the more debilitated the patient becomes. A logical diagnostic plan to differentiate probable etiologies and to rule out non-viral causes results in appropriate therapeutic choices. Even with a viral etiology, therapies to reduce the pathological consequences of infection may modulate and help control the clinical signs. Some novel choices and drug combinations are discussed in this review. PATIENT GROUP: Cats of all ages may be affected. Cats with conformational (breed or malformation) characteristics, such as short or convoluted nasal passages or very small nostrils, are predisposed to unresolving inflammation. Fungal disease is more relevant in specific geographic regions, making inclusion of a travel history important in history collection. Older cats are more likely to have neoplasia-induced signs. AUDIENCE: This review is directed at all veterinarians who see cats with chronic, recurrent upper respiratory disease.