C09978780 / invoice 10000

28/02/2026 Reason: Coughing

Hx:
Had workup (chest rads, echo) in Oct 2025 for coughing. Echo borderline for possible HCM. Chest rads: most likely bronchitis.
Coughing then subsided, but recurred 2 weeks ago. Coughing now daily and paroxysmal episodes. No laboured breathing at home.
No change in envt. O has air purifier and stopped using essential oils. Does change candles from time to time.
No other toxins.
Coughing and cat flu signs first started 9 months ago when other cat in family got cat flu signs, and lymphoma and died. Coughing then was intermittent and infreq. Freq increased with time.
Was started on some medication in the past, but O can't remember which one. O reluctant to start oral pred (due to experience with previous cat) but had bought Aerokat. Compliance difficult with getting cat to acceptance face mask, so O stopped.
Vacc: as a kitten, none since
Parasite control: nil
Diet: weight loss diet.
Indoor cat with supervised visits in garden. In contact with other cat who is symptom-free

Exam:
BAR. Submandibular LNs more prominent. BCS 7/9.
No palpable goitre.
Mild-moderate tartar
No heart murmur or arrhythmia. HR 144
Normal lung sounds. 
Abdomen NAD.
Eyes, ears, nose, skin NAD.

Assessment: Chronic bronchitis most likely as cause of cough. Hx of cat flu, hence may have latent herpes?
O worried about starting oral pred. So to tx for possible infectious dz (e.g. mycoplasma, lung worns) before commencing pred.

Tx:
Doxycycline 25mg q12h PO x 10d.
Advocate monthly for at least 2 doses.
Discussed famciclovir if planning to start pred.
To start desensitising to face mask.

Plan: recheck in 7-10d. If no better, consider maybe starting famciclovir plus oral pred with aim to weaning off upon inhalational fluticasone becoming efficacious