Bartonella?

Question

When I adopted my cat 6 months ago, she was diagnosed with bartonella. She had and still has pretty bad gingevitis in the back of her mouth. When she was diagnosed, she was on a 3 week course of antibiotics; however, I don't think it ever really cleared up. I was told I had to wait 6 months to test her again for it. In that 6 month period, I moved and took her to a new vet this week for testing. This vet had never heard of bartonella. That's weird, right? I should be skeptical of this vet if she didn't know what bartonella is?

Anyway, I was wondering if anyone knew what the normal medical response was in cases like this where the first 3 week round of antibiotics didn't work? Should I expect another 3 weeks of antibiotics or should I plan for something else? I haven't had a lot of luck searching this on the internet.

Also, in general, what is normally done about cat gingevitis? This vet suggested removing all of my cat's teeth? That seems incredibly extreme to me.
Thanks!

When I adopted my cat, she was negative for both feline leukemia and FIV and this vet tested her again this week and happily all of those tests are negative.

Anyway, thank you so much for so much helpful information! I feel a bit calmer after reading these responses.

Answer 1

OMG- forst- I would not be very happy with that veterinarian- he should know what bartonella is for crying out loud! I would seek another vet and get a second opinion. I wold hope that they would do a full panle of bloodwork on her as well as checking for feline leukemia and feline AIDS.

http://www.marvistavet.com/html/body_bartonella.html

Also-

http://www.peteducation.com/article.cfm?articleid=368

Maybe this is what that vet was thinking about- we have done that to one cat in the 14 years Ihave been in the veterinary field, and that poor cats mouth was awful. He did so well after removing his teeth- but that was one rare case. Good Luck!


To the person below me- there is a difference between bartonella and hemobartonella- hembart affects the cats RBC's-
http://www.marvistavet.com/html/feline_infectious_anemia.html

Hey ratlover- you are not "just an rvt" we are a vital part of this profession- give yourself more credit thatn that girl! ;)

Answer 2

Very good advice in the first answer!

I agree--find a new vet immediately. You should be VERY skeptical if that vet says she is unfamiliar with bartonella. I'm 'only' a vet tech and I know about bartonella, so here's some more information.

Bartonella is a genus of bacteria. It can cause various symptoms in cats, including gingivitis, fever, lethargy and even neurologic disease However, many cats carry the bacteria without ever showing any signs.

Bartonella is also a zoonotic disease--this means it can be transferred to humans...'cat scratch fever' is caused by this bacteria. Normally this is not a big deal in a healthy adult, so don't worry. It can be dangerous in an immunocomprised person, in other words someone who has a poor immune system due to HIV infection, chemotherapy treatments, other organ problems, etc. or the very young or very old. Those persons should probably not have contact with your kitty.

Bartonella is spread by fleas. Make sure to use a good flea control on your cat such as Frontline Plus, and use it all year round. Also treat your house if there are fleas present. Keep your kitty indoors...this will not eliminate the possibility of her getting fleas, but does reduce it.

Interestingly, antibiotics can limit the bacteria in the cat's bloodstream but not necessarily cure the infection. In fact, in many cases, antibiotics don't work at all. Your new vet may choose not to give antibiotics, so don't think they're doing something wrong.

Also, testing may not prove anything. The blood test (IFA test performed on serum) shows exposure to Bartonella but can't determine if there are bacteria still present in the blood. The only way to do that is by culturing the blood, which takes several weeks and special methods. Even then, some cats with active infections won't have a positive culture.

Hope this information helps!

added: actually, doodlebug, FIA is a different disease with a different albeit similar cause. FIA is caused by Hemobartonella felis, which is a mycoplasma organism, possibly spread by fleas, but unknown for certain. It attaches to the outside of the red blood cells, which are then removed from the blood stream by white blood cells. This is why it causes anemia. Bartonella, on the other hand, is caused by a rod-shaped bacteria called Bartonella henselae, which actually enters the red blood cells. It goes mostly undetected by the body and thus does not cause an anemia.

Answer 3

A vet darn well better know what Bartonella is!

Most bartonella is treatable with the antibiotic (21 days is the normal treatment). Sometimes it's not cleared up, in which case you can test again and try one more time.

Find a vet who knows the word, a cat specialist if that helps, and talk to them about it. A lot of new research (in the last 5 years) has been done on Bartonella and it's connection to diabetes, stomatitis and several other things. So new info should be available to the vets. Sometimes it's called cat scratch fever, but that's the human connection, not the cat connection.

We treated one of our cats for Bartonella and it cleared up wonderfuly on him. It's passed via fleas and sits in a cat's immune system till the immune system is pushed really low, then can come out and manifest.

Answer 4

Quotes by Dr. Susan Little from a forum for cat breeders I belong to.

"Many, many cats will test positive for Bartonella
as it is a common infection, but almost always it is clinically
silent. There has been an attempt by some veterinarians to blame Bartonella for everything from oral disease to the war in Iraq, but it just ain't so."

"There is considerable scepticism in the feline specialist community about the link between gingivitis and Bartonella. Gingivitis is a multi-factorial problem, and it is very common in cats. Bartonella is also very common in cats. That doesn't mean there is a cause-and-effect relationship. Many cats treated with azithromycin for gingivitis do respond and appear to get better (for a while anyway). But azithromycin is a good broad spectrum antibiotic, so exactly what
organism are we treating? We cannot eliminate Bartonella - there is no antibiotic or drug protocol that will rid a cat of this infection. I think I said before, I don't waste my clients' money on the test."

Answer 5

At the vet hospital where I work we do the blood test for bartonella on cats who show the cluster of symptoms of the disease.

Ordinarily the cats who test positive receive two two-week-long courses of treatment with azithromycin. They get two courses because azithromycin loses its potency very quickly, so a fresh batch is made up for the second two-week course, rather than just having the cat take azithromycin for four weeks.

Then six months after the end of the second course, another blood sample is sent to the lab to determine if bartonella is still present. Usually it is not, but if it is, another antibiotic can be given.

I suspect your cat was a little undertreated, if she received one three-week course of antibiotic. The total length of treatment with the antibiortic was shorter than customary at the vet hospital where I work, plus as I mentioned, azithromycin tends to lose its effectiveness when it is about two weeks old. (It is a powder mixed with sterile water in the clinic the day it is prescribed,) It was azithromycin she got, wasn't it? That is the specific drug for bartonella.

I believe that where I work, the vet would put your cat on azithromycin for two weeks, or perhaps for both two-week courses, before testing her blood again.

And yes, I'd be less than impressed by a vet who had never heard of bartonella. The disease, and its diagnosis and treatment, has been covered in the literature and at conferences for six or seven years now. The vet might consider getting more continuing education. She might also contact the lab that does the testing, National Veterinary Laboratory, for more information.

Removing all the cat's teeth is the treatment for gingivitis that testing for bartonella and treating it can avoid. Curing the bartonella infection should cure the gingivitis and save your cat's teeth, as well as improving her health a great deal. Two of my own cats tested positive and received the treatment with excellent results, and their health is 100% better.

Answer 6

One reason you are having difficulty finding information is because it isnt called bartonella, it is called feline haemobartonella. or FIA (feline infectious anemia). It is a blood parasite that causes anemia and is found in a blood smear. Cats suffer from a decrease in red blood cells progressively, causing weight loss, enlarged spleen, and in some cases liver failure. It is common in cats that have feline leukemia, has your cat been tested? It is very strange that your vet has not heard of this, I am a technician in texas, and we find it about once a month in cats. Usually on top of antibiotics, we treat with doxycycline/tetracycline or another drug that can kill blood parasites. From my experience, you can not get rid of FIA, just control it. As for ginigivitis, removeing all teeth shouldnt be necessary unless the teeth are so bad that they are virtually rotten. A good dental and antibiotics should take care of that.