In our household of multiple cats, you could say we learned the hard way about feline herpes virus infections, how they are triggered and how to prevent them. We came home from a week vacation to a serious herpes virus infection that worsened for months before improving. This is our experience treating a stubborn herpes eye infection and how to avoid an outbreak in your cat in the future.

Feline Herpes Virus is extremely common in cats, with kittens often born with the virus from their mothers. Adult cats can carry the virus for years without showing any symptoms. Feline herpes virus can lie dormant until the immune system is weakened, or the cat experiences a stressful event, or even a particular medication can trigger the infection. In our case, it was our vacation that triggered the “stressful event” that brought on a raging eye infection and stubborn corneal eye ulcer that took five months to treat, heal and overcome.

Back story. It’s very rare for my husband and I to ever take a vacation. With so many cats—some needing twice daily medication (Hyperthyroid) and injections (Lymphoma/Pancreatitis), running a business, and busy work schedules—we just don’t go. But when a friend offered her house in Sausalito for several days over our anniversary, we thought, why not? It’s at least close in case of an emergency, and we really needed to get away.

But when we came home, we found our blind cat, Godiva, had a terrible eye infection. How could this happen? We were barely gone, we said. But that’s all it took to trigger a “stressful event” for our cat. Our pet sitter knows our cats well, but cats are creatures of habit, and change is not something they adapt well to. Our pet sitter is a nurse with long hours, so a morning feeding at 5 am and late evening feeding, was a radical change for our guys. Plus, long hours of no human contact, leading to some kitty boredom, and some bullying behavior undoubtedly, and bingo—problems!

Godiva had never had a herpes virus infection or eye infection since we adopted her in 2005. She had become a hyperthyroid cat in the past year, needing daily medication, and was now in old age at 17. So she could have a weakened immune system due to age and illness, in addition to our absence and the possibility of being bullied some by a particular cat that took advantage of the situation. Or this could be a flare-up from a previous infection from before we adopted her. I had dealt with herpes eye infections with my cat, Angus, who with medication readily overcame it on two different occasions. But this case with Godiva was very different. Way different.

Godiva’s eye was discharging fluid, she was squinting and blinking often, and her eye was very painful for her to keep open. So, off to the vet she went for a diagnosis and treatment. But in hindsight, I wished that I had taken her to the feline eye specialist here called Contra Costa Animal Eye Clinic in Pleasant Hill, CA, with veterinary ophthalmologists on staff. But that’s because in hindsight, I wished that I could have avoided what happened.

At our vet, Godiva was given a Fluorscein Stain, and a herpes infection and eye ulcer was suspected. She was discharged with several medications including: a topical antibiotic for the eye called Gentamicin drops, given (3) times daily; an antiviral called Idoxuridine drops given (6) times daily; the oral antibiotic Azithromycin given (1) daily; an antiviral Enisyle-F (Lysine) given orally (2) daily; and Buprenex for pain given (2) daily. That’s a lot of medication! Some of these had to be compounded for a cat (per her weight). These were given for approximately two months, with rechecks every two weeks to see if the depth and width of the eye ulcer was diminishing in size. It was, but very slowly. After two months, she finally appeared to be much better and was finally off the medication, just before leaving for a week hiking/camping trip to Lake Tahoe.

But when we returned home from our week away, Godiva’s infection had returned with a vengeance, and she appeared to be even worse! Arghhh! How could this happen? Stress is how it can happen, and in hindsight, we should have continued with medications even during our vacation. We should have erred on the conservative side. Instead, it was back to ground zero, only this time I took her straight to the Contra Costa Animal Eye Care clinic, no fooling around! I had already spent well over a thousand to get this infection under control, and now I was about to spend easily over a thousand more. But I had to do it. She was in severe pain again, and eye pain can be some of the worst pain imaginable.

Contra Costa Eye Care gave her a full Ophthalmic Exam, with a Fluorescein Stain, a Cult & Sens Aerobic (Eye Culture), and Cytologic Exam, revealing that now she not only had a herpes virus infection, but she had a severely infected and deep corneal ulcer in her right eye (again) with a rapidly progressing bacterial infection. The doctor explained that a deep eye ulcer often occurs when the surface cells of the eye are lost and bacteria enter the cornea. This type of ulcer can start after relatively minor trauma to the eye. The trauma allows bacteria to gain access to the stroma or middle layers of collagen that make up the structure of the cornea or clear aspect of the front of the eye. The stroma of the cornea is made up of several layers of collagen, similar to layers of an onion. Godiva had a severely infected eye ulcer, which could have quickly led to a rupture of the globe with irreversible vision loss. The eye is a fluid filled ball and once a defect progresses through the entire thickness of the cornea, the fluid will begin to leak out of the eye.

Once again, I came home with more drugs—Cidofovir (compounded); Gentamicin, Vigamox, Plasma, and more Buprenorphine for pain. One of these meds had to be given every hour on the hour from early morning to late at night; one every two hours from early morning to late at night, and one or two given (6) times per day. Thank goodness I telecommute, I could not have succeeded in treating her otherwise. I was home, and to make it easier for me, I kept some of the meds refrigerated in a cooler right by my computer, and moved Godiva into my office, and set two alarm clocks for every hour on the hour and every two hours. It was crazy! I did this for countless weeks—for another two plus months—taking Godiva back for rechecks every two weeks until finally her ulcer was gone. It took another two months of intensive treatment for the ulcer to completely go away. In total, it was five months of treatment that all started with a simple herpes virus infection.

Since Godiva was blind in both eyes there was less concern about the retinal degeneration that had occurred, and more concern about the strong possibility that her eye would have to be removed if the ulcer didn’t completely heal. When she had dental surgery two months later, I again gave her Gentamicin and Idoxuridine for two days following the surgery, just to make sure that her surgery didn’tt trigger a “stressful event” causing the herpes virus to possibly flare up again under the stress of the dental cleaning.

Godiva has healed completely and has been fine ever since, however, given that she has had a herpes virus flare-up now two times, she is very prone to getting it again under the right conditions. So I need to be vigilant about preventing an outbreak again, and avoid all possible stress for her in the future. After this, I will!

How to Avoid Herpes Outbreaks in Cats

• Make sure your kitten or cat has the initial FVRCP (Upper Respiratory) vaccine protocol and one-year booster
• Maintain a low-stress, quiet environment – use Feliway or Rescue Remedy for calming
• Stressful events like boarding, or introducing a new cat or dog or child, sickness or illness, or moving – can all be triggers
• Keep your cat in good health, build a strong immune system
• Be aware of any cats in a multi-cat household that are bullying or being bullied, and separate them – use Feliway to calm them
• Give L-Lysine daily to cats with herpes to build their immune system — you can get this in a vet’s office or online
• Get your cat diagnosed and treated quickly to avoid spreading the virus in a multi-cat household

Giving Eye Medications to Cats

• Wait at least 5 minutes between giving different eye drops, so each drop has time to work
• Wash and sanitize hands before dispensing drops or ointment
• Follow exactly the time described for eye meds – 2x, 6x, or 12x a day — be consistent
• Use a kitchen timer, or alarm clock or iPod/iPhone for a timer
• Watch for increased cloudiness, blinking, keeping eye closed, discharge, or loss of appetite while giving meds – any worsening condition