Goals of Treating Bartonellosis in Cats
There currently is no uniform consensus among veterinarians about how to treat feline bartonellosis. It is well-accepted that the vast majority of domestic cats in the United States (and probably elsewhere world-wide) carry the Bartonella bacteria but show no signs of illness, and that these cats don’t need to be treated. It is also fairly well-accepted that cats with symptoms as a result of their infection probably do need to be treated to resolve their symptoms, hopefully eliminate the Bartonella infection, prevent reinfection and restore them to a comfortable, pain-free quality of life. The confusion is about what that treatment should entail.
Treatment Options for Feline Bartonellosis
Treating bartonellosis in dogs, and cat scratch fever in people, relies primarily upon antibiotic therapies, follow-up testing to ensure that the treatment successfully eliminated the infection and taking steps to prevent reinfection. Unfortunately, no one antibiotic protocol has yet been shown to reliably clear cats of infection with Bartonella. By looking at the treatments that have been successful in humans and sometimes in dogs, it is possible that long-term administration of azithromycin, doxycycline, tetracycline, erythromycin and/or rifampin – or some combination of those antibiotics – could be helpful in treating or at least managing feline bartonellosis. However, the safety and effectiveness of using these drugs in cats with observable signs of bartonellosis has not been established. Moreover, prolonged use of antibiotics can lead to antibiotic resistance, which has become an increasingly serious problem in both veterinary and human medicine. Nonetheless, many veterinarians will treat a cat showing signs of bartonellosis with azithromycin for up to 6 weeks even if a specific diagnosis hasn’t been made, in hopes of reducing or resolving its symptoms. Once a cat has been treated for this disease, it’s important to take steps to prevent the symptoms from coming back - even though current medical therapies are unlikely to clear the Bartonella from the cat’s bloodstream. Flea and tick control are especially important, both inside and outside the home, since the infective organisms are transmitted to cats in the feces of those parasites. Other cats in the household should be tested for the presence of Bartonella; if they test positive (as the vast majority of them will), the veterinarian may recommend that they be given a course of antibiotics to reduce the risk of re-infecting the other cat or cats that they live with. Supportive care, including a high-quality nutritious diet and a safe, warm, quiet living environment, are also important, especially if a cat has severe symptoms.
Prognosis for Cats with Bartonellosis
The outlook for cats with noticeable symptoms of feline bartonellosis is highly variable. However, in cases where treatment delayed, or if the cat is seriously affected by the infection, the prognosis is more guarded. Preventative measures such as flea and tick control and testing other cats in the household for Bartonella are important to managing this disease.