Chronic Kitty Coughs. Tackling Persistent Upper Respiratory Infections in Cats

Definition of Chronic Upper Respiratory Infection

A chronic upper respiratory infection in cats refers to an inflammation of the upper airways and sinuses that lasts longer than 3 weeks. The most common causes are the feline herpesvirus or calicivirus [1]. Typical symptoms include nasal discharge, sneezing, and eye discharge. Unlike an acute upper respiratory infection that resolves within 2-3 weeks, a chronic infection persists over a longer period.


A veterinarian will perform a thorough physical exam on a cat suspected of having a chronic upper respiratory infection. They will look for symptoms such as nasal discharge, eye discharge, sneezing, and congestion. The color, consistency, and bilaterality of any nasal discharge provides clues to help reach a diagnosis. Bloodwork may be recommended to check for underlying conditions.

Radiographs of the chest and sinuses may be taken to check for pneumonia or other issues like tooth root abscesses that could cause or worsen respiratory infections. X-rays allow the vet to examine the nasal passages, sinuses and lungs for any abnormalities.

Viral PCR (polymerase chain reaction) testing of nasal and eye discharge can help identify the underlying causative agent, such as feline herpesvirus or calicivirus. PCR tests look for the presence of viral DNA and can differentiate between active viral infections versus inactive carriers.

A biopsy of the nasal tissue may occasionally be needed if cancer is a potential concern.

With a combination of a thorough physical examination, diagnostic imaging, and laboratory testing, veterinarians can determine the underlying cause and best course of treatment.

Treatment Goals

The main treatment goals for chronic upper respiratory infections in cats are:

  • Reduce severity of symptoms – Medications can help open airways, reduce nasal congestion and discharge, and make breathing easier.
  • Prevent secondary infections – Chronic infections can damage tissues and make cats prone to secondary bacterial or fungal infections, which need to be prevented.
  • Improve quality of life – Enabling cats to breathe, eat, and sleep comfortably greatly improves their well-being and quality of life.

Veterinarians aim to find an effective medication regimen to manage symptoms long-term. This may involve antibiotics, steroids, antivirals, and more. Treatment is considered successful if the cat has minimal congestion and discharge and can breathe comfortably most of the time.


Antibiotics like amoxicillin-clavulanate may be prescribed to treat secondary bacterial infections that can occur with chronic URI in cats (Chronic Upper Respiratory Tract Disease, Feline Viral Upper Respiratory Disease: Herpesvirus and …). Antivirals like famciclovir may help suppress viral replication and reduce symptoms. Anti-inflammatories like prednisolone can reduce swelling and inflammation in the upper airways. Nebulization and coupage with sterile saline can help mobilize secretions and open up the airways.

Home Care

Home care is an important part of treating a cat with chronic upper respiratory infection. Here are some tips for caring for a cat at home:

Keep the cat isolated during infections – Cats with upper respiratory infections are very contagious to other cats. It’s important to keep the sick cat isolated in a separate room away from other pets in the home. This helps prevent spreading the infection to other cats in the household.

Use a humidifier to ease breathing – Upper respiratory infections in cats can cause congestion, making it hard for them to breathe. Running a cool mist humidifier in the room with the sick cat can help keep their airways moist and make breathing easier. Make sure the humidity level stays around 30-50%.

Gently clean discharge from nose/eyes – Gently wipe away any discharge coming from the nose or eyes with a soft, warm, damp cloth. This keeps the nostrils and eyes clear. Do not use cotton swabs inside the nose.

Monitoring eating and litter box habits – Make sure the cat is eating, drinking, and using the litter box normally. Call the vet if appetite decreases or litter box habits change.

Follow vet’s treatment plan – Give all medications as prescribed by the veterinarian. Call the vet if symptoms get worse or don’t improve within a few days of starting treatment.


Proper nutrition is essential for cats with chronic upper respiratory infections. Since these cats often have difficulty eating and swallowing due to nasal congestion and inflammation, it’s important to feed them easily digestible foods that don’t require much chewing 1. Canned or wet foods are ideal as they are easier to lap up and swallow. It’s also a good idea to warm the food slightly to bring out the aroma and flavor which can encourage eating.

Because chronic URI often suppresses the appetite, ensuring the cat takes in adequate calories is critical. Feeding calorie-dense foods can help compensate for the decreased intake. Adding nutritional gel supplements or broths to the food can also boost caloric intake. If the cat still refuses food, your vet may recommend assisted feeding with a syringe or feeding tube.

Staying hydrated is also very important. Offering canned foods with high moisture content can help with hydration. You can also add extra water to the food to make it soupy. Providing multiple fresh water bowls around the house encourages drinking. In severe cases, subcutaneous fluid therapy may be necessary to maintain hydration.2.


Unfortunately, chronic upper respiratory infections in cats are very difficult to fully cure. The symptoms often wax and wane over time. However, with proper treatment from a veterinarian, most cats can manage their chronic URI relatively well at home.

Veterinarians state that “a complete cure is unlikely” for chronic URI in cats. The feline herpesvirus and other causative pathogens tend to remain dormant in the body and recrudesce during times of stress. While antibiotics and antivirals may temporarily suppress symptoms, they do not completely eliminate the underlying infection. The URI will often relapse in the future when the cat’s immune system is compromised.

The prognosis is generally good if the chronic URI can be well-managed at home. With medications prescribed by a vet to relieve congestion, inflammation, and secondary infections, most cats can breathe comfortably day-to-day. L-lysine supplements may help reduce viral flare-ups. Avoiding stressors and poor air quality is also recommended. With supportive care, cats with chronic URI often have a good quality of life for years.



There are several ways to help prevent upper respiratory infections in cats:

  • Vaccinate against common URIs – Vaccines are available for some of the viral and bacterial causes of URI in cats, including feline herpesvirus, calicivirus, Chlamydia, and Bordetella. Keeping your cat up-to-date on these vaccines can help reduce their risk of developing URI. Some vaccines may need boosters every 1-3 years for maximum protection.
  • Reduce stress – Stress can weaken the immune system and make cats more prone to infections. Try to minimize stressful events like changes in environment, diet, housing, or routine. Provide environmental enrichment with toys, scratching posts, and hideouts.
  • Limit exposure to infected cats – URI can be highly contagious between cats. Adopting new cats from shelters risks exposure. Limit contact with stray or unfamiliar cats who may carry infections. Separate cats in a multi-cat home if one develops URI.

Talk to your veterinarian about the best vaccination schedule and prevention plan for your individual cat based on health status and risk factors.

When to Seek Help

Cats with chronic upper respiratory infections require veterinary attention if their condition worsens. Some signs that indicate you need to take your cat to the vet or emergency animal hospital include:

  • Trouble breathing – Labored breathing, wheezing, open-mouth breathing, or pale or blue gums indicate your cat may not be getting enough oxygen.
  • Not eating – Loss of appetite can lead to liver problems in cats. Bring your cat in if they go more than 1-2 days without eating.
  • Lethargy – Excessive tiredness and lack of interest in normal activities may signal your cat’s infection is getting worse.
  • Green/yellow discharge – Pus coming from the eyes or nose points to a bacterial infection that requires antibiotics.

Severe upper respiratory infections can progress to pneumonia, so it’s important to monitor your cat closely and watch for these signs of deterioration. Don’t hesitate to seek emergency vet care if your cat is struggling to breathe or seems very ill.


Chronic upper respiratory infections in cats can often be managed with the right treatment and care. The main goals are to reduce the severity of symptoms, prevent complications, and improve your cat’s quality of life. With close partnership between you and your veterinarian, most cats with chronic URI can live happily and comfortably.

Treatment focuses on managing symptoms and keeping your cat as healthy as possible. This involves medications to reduce congestion, coughing, sneezing and eye/nasal discharge. Excellent at-home care, nutrition and supplements are also important. Monitor your cat closely and alert your vet if symptoms worsen or any complications arise.

While chronic URI can’t be cured, it can often be controlled. With diligent treatment guided by your veterinarian, your cat can enjoy a good quality of life for years to come. The key is partnering with your vet to find the right treatment plan for your feline friend.

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