Bartonella henselae as a cause of acute-onset febrile illness in cats

Breitschwerdt, Edward B; Broadhurst, Jack J; Cherry, Natalie A

An optimal bartonellosis treatment regimen has not been established for bacteremic animals or humans. 29, 35 In a study involving naturally infected febrile cats, both doxycycline and orbifloxacin induced resolution of clinical abnormalities by day 5 of treatment; however, despite a 28 day treatment course, most cats remained Bartonella species PCR positive after antibiotic administration. 10 Experimentally, cats inoculated with B henselae-infected blood remained culture positive despite treatment with 2 or 4 weeks of doxycycline. 36 Relapses after antibiotic withdrawal have also been reported in B henselaeinfected dogs and human patients treated with extended courses of doxycycline. [37] [38] [39] Doxycycline treatment failure (6 week course) was also suspected in a febrile dog from France. 15 Based upon the limited clinical and experimental evidence, we do not recommend doxycycline treatment protocols published to date as the sole antibiotic for treatment of feline bartonellosis, if therapeutic elimination is the primary goal.