The four-month-old kitten was sold with a 24-hour return guarantee that the money would be refunded if the cattery's veterinarian certified that it was suffering from a bacterial or viral infection within 24 hours of purchase.  It was sold with the information that the kitten had been on two types of medication - one being an antibiotic and one to stop runny nose for the last eight days.

Now it was four days after purchase and the guarantee would not apply.  The right lower eyelid of this Ragdoll was redder than the left eye as it had conjunctivitis.  A thick and moist greenish black crescent of tears stained the side of nose on each side below the eye. 

"The kitten has a dark green discharge from its nose and is sneezing. It was not so active the last two days. What's the problem?" the Owners asked me. I could see the mucus oozing from the small nostrils and hear the faint sneezing.  The Ragdoll was not well but it was not terribly sick at the time of examination. 

"The Ragdoll has an upper respiratory tract infection," I said. "There is a bacterial and possibly a viral infection of the nose and throat. The kitten objected to any thermometer being placed into its rectum to check whether it had a fever or not. It was still strong to resist such nonsense from the veterinarian. I looked at the tongue. It was redder than normal and this could be a sign of fever.  

I auscultated the chest of this quiet blue-eyed kitten with my stethoscope. "The lungs are normal presently, but the infection may go further into the lungs causing pneumonia and death. Much depends on the kitten's immunity to infections."

What was the cause of this upper respiratory tract infection?  Singapore catteries sell kittens brought in from various sources - local and imported ones. It would be difficult to prevent viral infections.  Feline herpes virus 1 and caliciviruses are the most common ones causing runny noses and sneezing.

"Was the kitten vaccinated twice?" I asked the Owners. Usually the pet dealer would provide a vaccination certificate during sale but there was none in this case. The cat dealer was contacted by mobile phone but there was a voice mail. 

Now, what should I do?  An antibiotic injection was necessary. More oral medication for the next few days? It would not be easy for many new kitten owners in Singapore to medicate a kitten. 

Ideally, the kitten should be warded and given injections for the next three days but would the Owners bear the separation?  What if the viral infection, for which there was no effective drug cause the kitten's health to deteriorate and kill the kitten?  The veterinarian would be blamed.

Signs of upper respiratory tract infection may recur although the kitten may be vaccinated. It may be vaccinated when it had maternal antibodies and therefore, the vaccination would not be effective. 

At week 6, the first vaccination is usually given in reputable catteries in Singapore.  and most kittens would not have maternal antibodies to make vaccination ineffective.

Blocked nose with greenish discharge and tear stains from sore eyes in a sick Ragdoll kitten when first seen by the veterinarian.	Usually the viral cause is the rhinotracheitis and the calicivirus infections complicated by bacterial infections like chalmydosis.	Ragdoll recovered after 7 days and went home to a happy owner.
	Clear eyes and nose in another healthy Ragdoll	Clear eyes and nose in another healthy Ragdoll

VIRAL INFECTIONS OF CATS IN SINGAPORE

The commonest complaint of viral infection is the runny eyes, coughing and sneezing in kittens and cats.  This upper respiratory tract infection is usually not fatal and is caused by the rhinotracheitis virus (also known as the feline herpes virus 1).  A vaccinated cat may not show signs of runny eyes and sneezing.  Calicivirus also cause upper respiratory tract infection.

Panleukopenia, or feline distemper are viral infections which can kill cats. Vaccination works well as there are few cases seen in practice.

Feline corona virus is a common intestinal virus that may cause no
clinical signs or may cause diarrhea in cats who are infected with it. This is
considered to be a minor viral infection in most cases, but when feline
corona virus mutates, it can become deadly. If the mutant virus can
invade the rest of the cat's body it is referred to as feline infectious
peritonitis (FIP), which is almost always a fatal infection. There is a
vaccination for this virus but there are some questions about how well
it works and most veterinarians do not use the vaccine on a routine basis.

Over the last five or six years it has become apparent that some cats
vaccinated against feline leukemia virus developed cancers where the
vaccines were given. The cancer is usually fatal if untreated somewhere
between 50 and 70% of cats in which the cancer is treated will die from
it. The rate of development of this cancer is thought to be between 1 in
2500 and 1 in 10,000 cats who are vaccinated against FeLV. Due to this
problem, veterinarians are trying much harder to figure out if a cat is at risk
for getting feline leukemia virus before giving the vaccine. In young cats,
it is usually better to give the vaccine if there is any suspected risk. In
older cats (over 2 years of age) it is probably better not to give the
vaccine unless there is a definite risk of exposure to an infected cat.