What are Cryptococcosis?
Once a fungal infection has set in, it can turn into a systemic disease affecting multiple internal organs. It often spreads to the central nervous system, the skin (especially on the face and neck), the eyes, bone marrow, liver and kidneys. If these organs begin to fail, the infection can be life-threatening. There is a possibility that spores can infect an open wound, although this is rare. The upper respiratory aspect of the infection can progress into pneumonia. Granuloma masses can grow in the nasal cavity due to cryptococcosis. Veterinary attention is needed to relieve and cure a cryptococcosis infection in a cat.
The fungi Cryptococcus neoformans is a yeast-like growth that releases infectious spores into the air. It can be present in decomposing plant or animal material but is most often found in pigeon droppings. The spores cause severe upper respiratory and nasal problems in affected cats. Only a small number of exposed cats develop infection. Generally, these cats are suffering from a suppressed immune system. It is estimated that up to seven percent of all cats have cryptococcus spores present in their body, but only a very small amount of these cats will produce symptoms.
Symptoms of Cryptococcosis in Cats
Upper respiratory symptoms are the most common signs of a cryptococcosis infection. Other signs will become present as the infection progresses. It is important to identify this fungal infection before it starts to impact the function of major internal organs. Symptoms are as follows:
- Nasal discharge
- Breathing difficulties
- Growths in the nostrils
- Swelling over the bridge of the nose
- Skin lesions
- Change in behavior
- Head tilting
- Partial paralysis
- Dilated pupils
- Nystagmus (involuntary rapid movement of the eye)
- Blindness (caused by the retina detaching or other related issues)
- Loss of appetite
- Weight loss
Causes of Cryptococcosis in Cats
As the cryptococcus fungus grows in decomposing organic material, all outdoor cats are at risk of exposure. Infection is generally a sign of an underlying immune system issue. All known factors of cryptococcosis infection are listed below.
- Exposure to infected soil
- Exposure to fowl manure
- Feline leukemia virus
- Feline immunodeficiency virus
- Genetic predisposition (as sometimes seen in the Siamese cat breed)
Diagnosis of Cryptococcosis in Cats
At your veterinary appointment, you will be required to provide your cat’s medical history to the vet. The veterinarian will then perform a complete physical examination to note all symptoms showing in the cat. Cryptococcosis can be easily diagnosed with a variety of tests. Cytologic evaluation of nasal or ocular discharge, skin scrapings or granuloma masses can provide a fast confirmation of cryptococcosis infection.
Gram stains may be useful to identify the fungus, as organisms will show as a crystal violet color, while capsules will turn light red, making an obvious distinction between the two. Wright stains, while more common, may be less effective as they can cause organisms to shrink and capsules to distort. Making an impression smear during staining can help for further examination of samples at a later time.
Biopsies of lesional tissue may also be helpful for the diagnosing process. Testing blood serum and urine can reveal secondary bacterial infections from open wounds and a suppressed immune system. FeLV and FIV should be tested for at this time.
Treatment of Cryptococcosis in Cats
The goal of treatment of cryptococcosis in cats is to rid the body of the infectious fungi. If an underlying cause of immune suppression is found, it too should be treated. Secondary bacterial infections should also be rectified to restore health to the cat.
A prescription of antifungal medication will be needed to eradicate cryptococcosis from the body. Medications such as fluconazole, itraconazole or ketoconazole may be prescribed for several months or more to eliminate the infection.
If a secondary infection is found in the body, the corresponding antibiotics will be prescribed to rid the body of the harmful bacteria.
Recovery of Cryptococcosis in Cats
It is important to administer the full course of medication for treatment to be effective. You may need to monitor your cat for the development of side effects from the antifungal medication. Dosage of the prescription may need to be adjusted depending on the side effect severity. Follow-up appointments with the veterinarian will be necessary to evaluate if the infection is dissipating.
The only way to fully prevent exposure to cryptococcus fungus is to keep your cat indoors. You need to prevent the cat from entering contaminated environments, especially damp structures. Infected droppings can emit spores for several years. Keeping your cat indoors will also shelter it from feline leukemia virus and feline immunodeficiency virus exposure.
Cryptococcosis Questions and Advice from Veterinary Professionals
Hayden is a 16 year old feline who has beat thyroid cancer after a third treatment of radioiodine about 2 years ago. He began sneezing about May. About three weeks ago came a growth in his nostril that looked like the outside of nostril was swelling. He went in for a biopsy last Monday and now seems to have near total vision loss. He just got fluconozole compounded today. Not sure why the vet took so long. Seems that this condition deteriorates fastvenough that any delay could be catastrophic. I’m wondering how soon I can expect to see improvement and how much I can expect. I’m worried about kidney damage as well as he has elevated kidney numbers already. Will he regain eyesight? How often should I have him rechecked?
Milk thistle 100 mg not grams in previous comment.
Hello Hayden, Im wondering if you have had any support at all and how your cat is doing. My cat is 16 and am dealing with the same issues. Flucanazole got rid of the legions within 2 weeks, but it stays in the system and you continue the drug at 50mg twice daily for 6 months. After this time, even after much liver and kidney support with Denamarin, Azydol and Epakitin, I had to stop the drug for 2 months or she was about to die due to elevated liver enzymes and organ failure. I kept her alive with daily fluid injections subcutaneously (100mls) , and weekly b12 injections and intravenous fluids once a week to keep her alive during these critical 2 months until I found another solution. Blood work showed massive improvement to her liver from having a break from the Flucanazole and the continued immune support I was giving her which includes Chloryoxygen (green juice drops 3 drops three times daily), Digestive enzymes as she had pancreatic failure (mix with food and wait 20 minutes before feeding. For 2 weeks, I had to syringe feed her 4 times a day as she lost half her body weight in a month until I started giving her digestive enzymes. SHe is also on Milk Thistle 100 grams a day one hour before food as I discovered that the denamarin only has 30 grams of milk thistle in it and not enough for a cat in critical condition. Most importantly is Fish Oils, and a diet rich in good fats and not so much proteins and low carb. My cat does not have hyperthyroidism at all, so take note of that if your cat does, as she will need different dietary supplements. Also 100mg of tumeric a day for inflammation. A good quality colloidal silver with at least 10 parts per million. Chelidonium 100 mg per day for healing and hydration. CBD oil 0.1mls of a pet formulation to deal with any pain or stress issues. After 2 months of nursing her around the clock and keeping her warm with a heating pad, I started the flucanazole again and to some success for the past week. Next week, she will start a new drug called Noxafil (expensive) and she will start with a 30gm dose for one day and then 14mg dose after that but it has to be professionally dosed by a compounding pharmacy in s liquid suspension, at the direction of your vet. I went to 5 vets until I found answers, and most of my answers I had to research intensely myself. All I know is that she would have died and so glad she is stable again now where I have finally found a possible treatment option, as all the vets had strongly suggested euthanasia. But her appetite has always been strong, and she loves being with us and is still trotting around happily, purring when she jumps on our laps. She starts the Noxafil next week, and can let you know if its successful or not. Its for cats that have built up a resistance to other fungal drugs. Best wishes
I'm so sorry thought people above were so insensitive. I hope your cat is doing well and you don't have to put him down!
I have never heard of crypto deteriorating a cat so quickly. Im sorry, it seems to be a tough disease to pin point and there seems to have a possible multitude of secondary infections. uggggg
I guess there is no longer an expert posting on this subject. :-(
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Our 16 year old orange tabby, Neemo had his teeth cleaned, with 3 extractions, last November. In January he started exhibiting signs of nasal congestion. He was misdiagnosed until April this year. He has taken Fluconazole for 1 month. Also an appetite stimulant, Mirataz was prescribed. Over the weekend he started to stumble and his head was tilting to his left. We thought he'd had a stroke. We took him to the ER Specialty clinic in Tualatin, Oregon. The doctor there, Dr. Andy, consulted with the Vet Specialist, Dr. Tobin at Sun Stone Vet who diagnosed Neemo. They concluded the fungus had migrated to his brain and there was really nothing that could be done. I see that the recent symptoms are all symptoms of Crytococcus. We are feeding him food and water via a syringe. Their recommendation is to euthanize Neemo as any other care and diagnostics would likely not be treatable and be very expensive. They gave him fluids and sent us home. Are they correct? Is there nothing to be done?
I've read that as the infection is breaking up (from treatment) they may become disoriented and stumble around, but that it's a sign that they're improving. It's that not true? 😕
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i rescued my little 2 year old girl a year ago as my last kitty died at 19 and my other 19 year old kitty was so sad. The two of them loved each other at first mew. we were all so happy and then about two months later she became so ill. I took her to a specialist and we did a series of tests. at first they thought she had a cancerous mass on her lung but it turned out to be crypto. :(. this was 6 months ago. the first month i was cyringe feeding but it was so stressful for my girl and me so we went the feeding tube route. her mass has shrunken a lot but her liver values raised because of the meds so now she is on liver support along with her Intrafungal, prednes. low dose and clavamox. about a month ago she started to eat on her own but we kept the tube in just in case and now she has not eaten in three weeks. this is a very very hard thing to get rid of but i am trying to stay positive. I take her for bookwork often to see if it going away. my vet said it can take 8-9 months. I want to get another cat as I know she will like it as she can't even groom herself properly.
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Hello. My cat was diagnosed with cryptococcas at the beginning of March. She was put on fluconazole and prednisolone. The disease took her vision, unfortunately. She now has an extremely low titer, like 1-39. She was taken off of the prednisolone a few weeks ago, so she’s had a little less energy. She has improved significantly since March but she still doesn’t eat on her own (we syringe feed her) and doesn’t purr. Those were the last two things to go before we took her into the hospital, but I’m hoping they will be the last to return. If they haven’t returned yet, will they ever return? It’s hard to research this disease, there isn’t a lot out there about this. Will she never eat on her own or purr ever again?
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My cat has been diagnosed with cryptococcosis. She had an enlarged lymph node & difficulty breathing . We’ve been prescribed fluconazole
It had shrunk the lymph node. Now she is having trouble with balance. The vet has doubled the dosage of fluconazole
Is there anything else we can do ? It’s horrible to see her having trouble walking. She is about 2 years old. She is managing to eat & drink some despite the congestion
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