Rhinotracheitis (Herpes Virus, FVR)
Updated: Apr 9
This type of herpes virus causes inflammation (“-itis”) of the windpipe, nose (“Rhino-”) and trachea (“Trach-”) and is responsible for 80-90% of respiratory diseases. (1) This is NOT a sexually transmitted disease like in humans.
Up to 97% of cats are exposed to FVR at some point in their life and most kittens are infected BEFORE any vaccine is ever given (vaccines can be given as early as 6-8 weeks).
Kittens and senior cats are most susceptible to FVR infection, cats and kittens that are solely outdoor or indoor/outdoor cats as well as those in shelter or cattery settings are most susceptible. Up to 80% acquire a lifelong infection with up to 45% of those shedding the virus under stress.
(2, 3, 4)
Inflammation of the inner eyelids
Discharge from the eyes
Loss of appetite
If left untreated or poorly treated keratitis can occur. Symptoms include:
Scarring of the cornea
Chronic dry eye
The incubation period is 2-5 days (7) Shedding or spread of the virus can last 10-20 days while a cat is actively shedding (8).
Any cats with FVR should be isolated for 1-2 weeks to prevent spreading the virus to other cats or kittens.(9)
It is a self limiting virus and can run its course in 2-3 weeks if secondary bacterial infections do not occur as well. (10)
Direct contact with an infected cat’s nasal or ocular secretions (11) including via hissing and mutual grooming.
In addition contact with communal food and water bowls can transmit the virus. (5)
Anything that is moist will increase the survival of this virus however good news secretions dry in a few hours. (9)
Mothers can also pass the virus to their kittens as well.
While clinical signs can give an idea of what respiratory strain an animal has, a polymerase chain reaction amplification (PCR) test is the most reliable test to identify the specific virus. This test takes swabbed secretions from the eyes, mouth and nose, then sent to a lab to be cultured for about a week to identify the specific strain. This helps administer the proper treatment. NOTE: A positive test does NOT indicate an active infection (5)
NATURAL The key in managing this virus is to reduce stress as much as possible in, on and around the body.
Species Appropriate Raw Diet
Immune boosting foods
Bovine Lactoferrin (raw bovine colostrum) (12)
Vitamin E- antioxidant Vitamin A- speeds up healing and helps other vitamins and minerals to better function
*Vitamin A, C and E are full of antioxidants that fight free radicals (13)
Zinc- antiviral, antioxidant
Foods like liver and heart as well as beef, pork, chicken, and fatty fish rich in Coenzyme Q-10-an antioxidant protecting cells against free radical damage. (14)
Medicinal Herbs and Mushrooms
Astragalus -antibacterial, anti-inflammatory and antiviral effects, and works by increasing the white blood cell production
Bilberry extract (Vacciuium myritllus)-eye promoting health and vision benefits
Olive Leaf-antiviral and antimicrobial properties which help to reduce the ability of the herpes virus to invade surrounding cells
Cat’s Claw- contains oxindole alkaloids that aid the immune system (15)
Pau D’Arco- antiviral
Aloe vera- anti-inflammatory, antibacterial, and also antiviral properties
Goldenseal- immune stimulator and antibiotic
Marshmallow- help relieve respiratory irritation
Nettle- whole body support, relieve allergies
Reishi Mushrooms- antioxidant, immune support, relieve allergies, support against viruses, increases white blood cells, anti-viral
Shiitake Mushrooms- antioxidant, stimulate white blood cells, antiviral, immune boosting
St. John’s Wort- antiviral
Turmeric- antioxidant, anti-inflammatory, antiviral, antibacterial
Yellow Dock- reduce inflammation of the respiratory tract and nasal passage, treating bacterial infections (16, 17, 18, 19)
Quercetin- an antioxidant that is naturally found in herbs and berries. It is known to protect cells from free radicals as well
Aconitum napellus 30C, Nux vomica 30C, Natrum muriaticum 6C, or Pulsatilla 30C followed by Silicea 30C
Homeopathic Nosodes Other Products
Oxycat- a pH balancer, anti viral, free radical and toxin cleanser
Vira X- a natural anti viral
Cat Calm- an herbal liquid with 80 herbs, 21 minerals and 7 exotic plant extracts (including many herbs we listed above)
Steam or a cool vaporizer treatments
If appetite is reduced which is common if the cat or kitten is congested and can’t smell their food, forced/syringe feeding or an appetite stimulant may be required. Check out our Kitten Glop recipe for a natural food supplement and B-12 for a natural appetite stimulant. You may also need to supply Subcutaneous fluids (Sub Q Fluids) if your cat or kitten is dehydrated or not drinking water on their own. If severe enough they may need intensive care through a veterinarian. It’s important to keep them eating and hydrated in order to heal! CONVENTIONAL
Similar to the treatment for any virus, typically only the symptoms and underlying bacterial infections are treated. There are no conventional antiviral drugs to treat FVR (20) Antibiotics are typically prescribed such as doxycycline, azithromycin, and clavamox. NOTE: If you are able, only get the liquid form of doxycycline. The pill form can damage the esophagus UNLESS water (about 6 mL) is administered immediately after the pill. (8). Eye ointments may also be prescribed such as terramycin or neomycin, bacitracin, and polymyxin (neo-poly-bac ophthalmic ointment)
Despite popular belief among pet owners and veterinarians lysine is NOT recommended. It can make FVR symptoms worse, has been proven to make little difference and actually promote shedding of the virus. (2, 12, 22, 23, 24, 25)
NOTE: Medication administration can stress a cat more than otherwise what could resolve on its own so it's important to weigh this pros and cons
TREATMENT: ENVIRONMENT This virus is easily killed with common disinfectants. 1:32 bleach to water can be used for cleaning as well as cleaning blankets, bedding, toys etc. Regular hot water and soap can also be used as well. (11)
While treatment often is very successful, any cat that has been infected with FVR will continue its life as a carrier. Unfortunately, stress including illness can induce the virus to activate again.
A few precautions should be noted first. An already sickly cat or kitten should NOT be vaccinated. Vaccines in general cause additional stress on the immune system so its best to weigh the pros and cons and risk of infection before vaccinating ESPECIALLY if your cat already is compromised in some way. While this vaccination can reduce the symptoms of FVR, it is NOT 100% protective. Your cat or kitten can still be infected with the FVR virus despite vaccination (5, 9)
In addition most kittens and cats are infected BEFORE any vaccine is ever given (26)
This vaccine thus far has been challenged for duration of immunity (DOI) and confirmed at a minimum of 3 years (27) so yearly vaccination is unnecessary.
VACCINE PRECAUTIONS If the intranasal vaccination is used, sneezing often occurs after administration Please view our article on the FVRCP vaccine for full details on the risks.
Homeopathic nosodes Serology testing/Titer testing to determine FHV antibodies (28)
1. American Association of Feline Practitioners. Vaccine-Associated Feline Sarcoma Task Force. Feline vaccines: benefits and risks. Available at: http://www.avma.org/vafstf/rbbroch.asp. Accessed December 29, 2011.
2. “Respiratory Infections.” Cornell University College of Veterinary Medicine, June 2018, www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/respiratory-infections.
3. Gaskell R, Dawson S, Radford A. Feline respiratory disease. In: Greene CE, ed. Infectious Diseases of the Dog and Cat. 3rd ed. St. Louis, MO: Saunders/Elsevier; 2006:149
4. American Association of Feline Practitioners. Vaccine-Associated Feline Sarcoma Task Force. Feline vaccines: benefits and risks. Available at: http://www.avma.org/vafstf/rbbroch.asp. Accessed December 29, 2011 5. Williams, Krista, and Cheryl Yuill. “Herpesvirus Infection in Cats (Feline Viral Rhinotracheitis).” vca_corporate, 2018, vcahospitals.com/know-your-pet/feline-herpesvirus-infection-or-feline-viral-rhinotracheitis.
6. Stiles, J (1995). "Treatment of cats with ocular disease attributable to herpesvirus infection: 17 cases (1983–1993)". Journal of the American Veterinary Medical Association. 207 (5): 599–603. PMID 7649774.
7. Carter, G.R.; Flores, E.F.; Wise, D.J. (2006). "Herpesviridae". A Concise Review of Veterinary Virology. Retrieved 2006-06-08.
10.Fontenelle JP, Powell CC, Veir JK, et al. Effect of topical ophthalmic application of cidofovir on experimentally induced primary ocular feline herpesvirus-1 infection in cats. Am J Vet Res 2008;69:289-293.
11. Thiry, Etienne; Addie, Diane; Belák, Sándor; Boucraut-Baralon, Corine; Egberink, Herman; Frymus, Tadeusz; Gruffydd-Jones, Tim; Hartmann, Katrin; et al. (2009). "Feline herpesvirus infection. ABCD guidelines on prevention and management". Journal of Feline Medicine & Surgery. 11 (7): 547–55. doi:10.1016/j.jfms.2009.05.003. PMID 19481034
12. Effects of bovine lactoferrin on in vitro replication of feline herpesvirus. Beaumont SL, Maggs DJ, Clarke HE Vet Ophthalmol. 2003 Sep; 6(3):245-50.
13. Schoen, Allen M. “Upper Respiratory Infections in Cats: An Integrative Approach:” Dr. Allen Schoen – Holistic Integrative Veterinary Healthcare, 11 Jan. 2020, www.drschoen.com/2012/07/31/upper-respiratory-infections-in-cats-an-integrative-approach/.
14. Andrus, Julie. “Home.” Holistic Pet Info, 10 Oct. 2019, www.holisticpetinfo.com/Feline-Herpes-Keratitis-Lysine.html.
15. Caon, Thiago, et al. “Antimutagenic and Antiherpetic Activities of Different Preparations from Uncaria Tomentosa (Cat's Claw).” Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association, U.S. National Library of Medicine, Apr. 2014, www.ncbi.nlm.nih.gov/pubmed/24447975.
16. “The Natural Remedy Book for Dogs & Cats.” The Natural Remedy Book for Dogs & Cats, by Diane Stein, Healthy Harmony, 2004, pp. 37
17. “Feline Upper Respiration Tract Infection.” The Natural Remedy Book for Dogs & Cats, by Diane Stein, Healthy Harmony, 2004, p. 89.
18. McKinnon, Melody. “Natural Treatment of Feline Upper Respiratory Tract Infections.” All Natural Pet Care, 8 June 2019, allnaturalpetcare.com/blog/2014/03/21/natural-treatment-feline-upper-respiratory-tract-infection/.
19. Becker, Karen. “Did My Cat Catch the Flu?: Feline Herpes Virus.” Mercola.com, 7 Mar. 2012, healthypets.mercola.com/sites/healthypets/archive/2012/03/07/feline-herpes-virus-in-pet-cats.aspx.
20. Van Der Meulen, K; Garré, B; Croubels, S; Nauwynck, H (2006). "In vitro comparison of antiviral drugs against feline herpesvirus 1". BMC Veterinary Research. 2: 13. doi:10.1186/1746-6148-2-13. PMC 1475582. PMID 16640781
21. Bol, Sebastiaan; Bunnik, Evelien M. (2015). "Lysine supplementation is not effective for the prevention or treatment of feline herpesvirus 1 infection in cats: a systematic review". BMC Veterinary Research. 11: 284. doi:10.1186/s12917-015-0594-3. PMC 4647294. PMID 26573523
22. L-lysine for FHV? Researchers Say Don't Bother (Veterinary Practice News - 2016)
23. Effects of physiologic concentrations of l-lysine on in vitro replication of feline herpesvirus 1 (AVMA - American Journal of Veterinary Research - 2014)
24. lysine supplementation is not effective for the prevention or treatment of feline herpesvirus 1 infection in cats: a systematic review (BCM Veterinary Research - 2015)
25. Study Finds L-lysine Does Not Decrease Symptoms of Feline Upper Respiratory Infections (The Conscious Cat - 2016)
26 DeBiasio, Thomas. “Feline Herpes.” Metropolitan Veterinary Associates, Metropolitan Veterinary Associates, 29 Mar. 2019, metro-vet.com/references/feline-herpes/.
27. Gore, TC; Lakshmanan, N; Williams, JR; Jirjis, FF; Chester, ST; Duncan, KL; Coyne, MJ; Lum, MA; Sterner, FJ (2006). "Three-year duration of immunity in cats following vaccination against feline rhinotracheitis virus, feline calicivirus, and feline panleukopenia virus". Veterinary Therapeutics : Research in Applied Veterinary Medicine. 7 (3): 213–22. PMID 17039444.
28. Lappin, Michael R. (2006). Use of serological tests to determine vaccine needs. Proceedings of the North American Veterinary Conference