Cats severely affected by FCV infection need intensive nursing care and supportive therapy.
The resolution of dehydration and restoration of electrolyte and acid-base disturbances
preferably by intravenous fluid administration is required in cats with severe clinical signs.
Food intake is extremely important. Many cats with FCV infection do not eat mainly because
of pyrexia and/or ulcers in the oral cavity, sometimes also because of their loss of smell due to
nasal congestion. Non-steroidal anti-inflammatory drugs can be used to decrease fever and
oral pain. Food may be blended to cause less pain when eating, should be highly palatable,
and may be warmed up to increase the smell. If the cat is not eating for more than three days,
placement of a feeding tube and enteral nutrition is indicated. At the clinician’s discretion,
antibiotics should be given to cats with severe disease and suspected secondary bacterial
infection. Broad-spectrum antibiotics should be chosen. It is crucial to use antibiotics with
good penetration in the respiratory tract and/or oral cavity.
If there is nasal discharge, this should be cleaned away several times a day with physiological
saline solution, and ointment should be applied locally. If there is a mucous nasal discharge,
drugs with mucolytic effects (e.g. bromhexine) may be helpful, and nebulisation with saline
can be used to combat dehydration of the airways.
Most antivirals used in veterinary medicine only inhibit replication of DNA viruses or
retroviruses, and treatment of FCV infections has not entered clinical practice. Ribavirin is
one of the few antiviral agents able to inhibit FCV replication in vitro. However, it appears to
be very toxic to cats and side effects have precluded its systemic use (Povey, 1978).
Feline interferon-? (licensed for the treatment of canine parvovirus and feline leukaemia virus
infections in some European countries) has been shown to inhibit FCV replication in vitro
(Fulton & Burge, 1985; Mochizuki et al., 1994, Taira et al., 2005). Controlled field studies,
however, are not available.
In outbreaks of VS-FCV, severely affected cats have been treated with intensive care supportive treatment (e.g. fluid therapy, antibiotics) plus steroids and interferon, and clinical improvement was reported anecdotally. However, controlled clinical studies have not been published so specific treatment for the disease is not currently known (Hurley, 2006).
Several modalities have been used to treat chronic ulceroproliferative stomatitis although
controlled studies are lacking. Recommended options depend on the disease severity and
stage and include antibiotics plus rigorous dental cleaning, corticosteroids and/or other
immunosuppressant or immunomodulatory drugs (gold salts, clorambucil, thalidomide and
cyclosporine; White et al., 1992; Addie et al., 2003; Vercelli et al., 2006) and full teeth
extractions (Hennet, 1994). Recently, anecdotal and clinical case reports have suggested the
use of both feline interferon-ω and human interferons to treat cats with chronic stomatitis
associated with FCV shedding, by intra-lesional or combined systemic plus intra-lesional
application (Southerden & Gorrel, 2007). Again, controlled studies on using that treatment are
currently not available.