Poxvirus infection

Poxvirus infection in cats, most commonly caused by cowpox virus, is a zoonotic viral disease that primarily affects the skin but can involve multiple organ systems in severe cases. Despite its name, cowpox virus is maintained in wild rodent populations rather than cattle, and cats typically acquire the infection through hunting and contact with infected prey. This condition occurs primarily in Europe and parts of Asia where the virus is endemic in wild rodent reservoirs. While relatively uncommon, poxvirus infection represents an important diagnosis because of its zoonotic potential, meaning infected cats can transmit the virus to humans and other animals.

Cats become infected with poxvirus when they hunt and consume infected rodents, particularly wild voles and wood mice that serve as natural reservoir hosts for cowpox virus. The virus enters through bite wounds sustained during hunting or through ingestion of infected prey. Once in the body, the virus replicates locally before spreading through the bloodstream to cause systemic infection. The incubation period typically ranges from one to three weeks, after which characteristic skin lesions begin to appear. The virus targets epithelial cells, causing the formation of distinctive pox lesions that progress through several stages.

The impact of poxvirus infection on feline health ranges from mild, self-limiting skin disease to severe, potentially fatal systemic illness. Immunocompetent cats often experience localized skin lesions that heal over several weeks without significant complications. However, cats with compromised immune systems, including those with feline immunodeficiency virus or feline leukemia virus, may develop severe disseminated disease affecting the lungs, liver, and other organs. The zoonotic nature of the virus adds another dimension of concern, as infected cats can transmit cowpox virus to their human caretakers through direct contact with lesions.

Treatment for feline poxvirus infection is primarily supportive, as no specific antiviral therapy is available. Most immunocompetent cats recover with nursing care, wound management, and treatment of secondary bacterial infections. Early veterinary evaluation is essential for accurate diagnosis and appropriate management, particularly to assess the cat's immune status and monitor for signs of systemic involvement. Owners of infected cats must be informed about zoonotic risk and instructed in proper hygiene measures to prevent human infection. Isolation of affected cats from other pets and immunocompromised family members is recommended until lesions have completely healed.

The primary cause of poxvirus infection in cats is exposure to cowpox virus, a member of the Orthopoxvirus genus within the Poxviridae family. Cowpox virus is genetically related to variola virus, which causes smallpox in humans, and vaccinia virus, used in smallpox vaccination. The virus is a large, brick-shaped DNA virus that produces characteristic cytoplasmic inclusion bodies in infected cells. While called cowpox, the virus is actually maintained in wild rodent populations, with domestic cats becoming infected as incidental hosts through predatory behavior. Other poxviruses that occasionally affect cats include orthopoxviruses specific to certain geographic regions.

Genetic and hereditary factors do not directly cause poxvirus infection but influence susceptibility and disease severity. Cats do not have inherited resistance or susceptibility to poxvirus infection itself. However, genetic factors that affect immune function can influence how severely a cat responds to infection. Certain breeds may have higher rates of immunodeficiency conditions that would predispose to more severe disease. Inbreeding depression in some cat populations may result in generally weaker immune responses, though specific genetic links to poxvirus susceptibility have not been established.

Environmental and lifestyle factors are the predominant determinants of poxvirus infection risk in cats. Outdoor access is the most significant risk factor, as cats must encounter infected rodents to acquire the virus. Rural and semi-rural environments where wild rodent populations thrive present higher risk than urban settings. Cats that actively hunt are at greatest risk, with infection rates highest during periods of peak rodent activity. Geographic location matters significantly, as cowpox virus is endemic to Europe and western Asia but absent from the Americas, Australia, and most other regions. Seasonal variations occur, with more cases reported in late summer and autumn when rodent populations peak.

Risk factors for severe poxvirus disease include immunosuppression from any cause. Cats infected with feline immunodeficiency virus or feline leukemia virus are at high risk for developing disseminated, potentially fatal poxvirus infection. Cats receiving immunosuppressive medications such as corticosteroids or cyclosporine face elevated risk for severe disease. Young kittens with immature immune systems and geriatric cats with declining immunity may experience more severe infections. Concurrent illness or stress that compromises immune function can also worsen outcomes. Cats that have undergone recent vaccination with modified live vaccines may have transiently altered immune responses.

The mechanism of poxvirus infection involves a complex process of viral entry, replication, and spread throughout the body. Cats typically acquire infection through skin wounds inflicted during hunting or by ingestion of infected rodent tissues. The virus replicates at the initial site of entry, producing a primary lesion. Following local replication, virus enters the bloodstream during a viremic phase, disseminating to skin and other organs. In the skin, the virus infects epithelial cells and causes characteristic pox lesions that progress from macules through papules, vesicles, and pustules before crusting and healing. Immunocompetent hosts typically control viral spread through cell-mediated immunity, while immunocompromised cats may fail to contain viral dissemination, leading to progressive systemic disease.

Early warning signs of poxvirus infection in cats may include subtle behavioral changes and the development of a single primary skin lesion at the site of initial infection. Many cats develop what appears to be a minor bite wound or small skin irritation, typically on the head, forelimbs, or paws where contact with prey is most likely. This primary lesion is often overlooked or attributed to minor trauma. Some cats develop mild fever and lethargy during the early viremic phase before skin lesions become obvious. Decreased appetite may occur during this initial phase. Because cats frequently sustain minor wounds from hunting, early poxvirus infection is easily missed until secondary lesions appear.

Common symptoms of poxvirus infection include the development of multiple skin lesions that progress through characteristic stages. Lesions typically begin as small, raised, red areas that evolve into papules and then into vesicles filled with clear fluid. These vesicles become pustules containing cloudy material before rupturing and forming thick scabs. The classic pox lesion has a central depression or umbilication that distinguishes it from other skin conditions. Lesions are most commonly found on the head, neck, and forelimbs but can occur anywhere on the body. The number of lesions varies from just a few to hundreds in severely affected cats, with immunocompromised cats typically developing more numerous lesions.

Behavioral changes associated with poxvirus infection vary depending on disease severity. Mildly affected cats may show minimal behavioral alterations, continuing normal activities despite visible skin lesions. More severely affected cats often display lethargy, decreased activity, and reduced interest in interaction. Appetite changes are common, ranging from mild decrease to complete anorexia in cats with severe systemic disease or oral lesions. Some cats become more reclusive, hiding and avoiding contact during illness. Cats with respiratory involvement may show decreased willingness to move or exercise due to breathing difficulty.

Physical signs visible during examination include the characteristic skin lesions at various stages of development, reflecting ongoing viral replication. Lesions range from small papules just a few millimeters in diameter to large crusted areas several centimeters across. Surrounding tissue may show inflammation, swelling, or secondary bacterial infection. Lymph nodes draining affected regions may be enlarged and palpable. Cats with respiratory involvement may have audible breathing sounds or visible respiratory effort. Oral lesions can cause drooling and difficulty eating. Examination may reveal fever, dehydration, and weight loss in cats with systemic disease.

Symptom progression in poxvirus infection follows a predictable pattern in most cats but can vary based on immune status. After the initial incubation period, primary lesions develop and progress through vesicular and pustular stages over approximately one to two weeks. Secondary lesions typically appear as the primary lesion begins to crust, resulting from viral dissemination during the viremic phase. In immunocompetent cats, lesions gradually heal over three to six weeks, with scabs eventually falling off to reveal healed skin that may be scarred or depigmented. Immunocompromised cats may develop progressive, non-healing lesions that continue to enlarge and multiply, potentially leading to fatal systemic disease.

Emergency symptoms requiring immediate veterinary care include signs of severe systemic illness or respiratory involvement. Difficulty breathing, rapid or labored respiration, or cyanosis indicate potentially life-threatening pneumonia requiring urgent intervention. Severe lethargy, collapse, or unresponsiveness suggest overwhelming systemic infection. Multiple large, rapidly progressing lesions in an immunocompromised cat represent a medical emergency. Severe oral lesions preventing eating or drinking require prompt attention to prevent dehydration. High fever unresponsive to supportive care, signs of secondary bacterial sepsis, or neurological abnormalities all warrant emergency veterinary assessment. Any cat with known or suspected poxvirus infection that deteriorates rapidly should receive immediate veterinary care.

Initial veterinary examination for suspected poxvirus infection involves careful assessment of skin lesions and overall health status. The veterinarian will document the number, location, size, and stage of all visible lesions, as the characteristic progression and appearance of pox lesions helps distinguish them from other causes of skin disease. A detailed history including the cat's lifestyle, hunting behavior, geographic location, and potential rodent exposure helps assess likelihood of poxvirus infection. Physical examination assesses for systemic signs including fever, enlarged lymph nodes, respiratory abnormalities, and evidence of immunocompromising conditions. The cat's vaccination and health history, including FIV and FeLV status, provides important context for prognosis.

Diagnostic tests for poxvirus infection aim to confirm the viral etiology and assess disease extent. Definitive diagnosis requires laboratory confirmation through various methods. Electron microscopy can visualize characteristic poxvirus particles in lesion material, providing rapid presumptive diagnosis. Virus isolation in cell culture definitively identifies the agent but takes several days. Polymerase chain reaction testing detects viral DNA with high sensitivity and specificity and can differentiate cowpox from other orthopoxviruses. Serological testing can detect antibodies to orthopoxviruses but cannot distinguish current from past infection. Histopathology of biopsied lesions reveals characteristic changes including ballooning degeneration and eosinophilic intracytoplasmic inclusion bodies.

Differential diagnosis for pox-like skin lesions in cats includes several other conditions that must be ruled out. Bacterial skin infections, particularly those causing pustular lesions, can resemble early pox lesions. Cat bite abscesses and other traumatic wounds may initially appear similar to primary pox lesions. Fungal infections including dermatophytosis and cryptococcosis can produce skin nodules requiring differentiation. Eosinophilic granuloma complex creates skin lesions with varied appearances. Neoplastic conditions including squamous cell carcinoma, mast cell tumors, and lymphoma may produce skin masses. Other viral infections such as feline herpesvirus dermatitis can cause ulcerative skin lesions. The characteristic progression and distribution of pox lesions, combined with appropriate laboratory testing, allows accurate diagnosis.

Diagnosis confirmation and staging involves integrating clinical findings with laboratory results. Positive identification of cowpox virus or another orthopoxvirus through PCR, culture, or electron microscopy confirms the diagnosis. Assessment of disease extent through thorough physical examination, thoracic radiographs if respiratory signs are present, and possibly abdominal imaging helps stage disease severity. Testing for concurrent FIV and FeLV infection is essential for prognostication and treatment planning. Complete blood count and serum biochemistry assess overall health status and may reveal systemic effects of infection. Results are typically available within days for PCR testing, while viral culture may take one to two weeks. Following confirmed diagnosis, the veterinarian will discuss prognosis, treatment options, and importantly, zoonotic precautions with the cat's owner.

Emergency and immediate treatment for poxvirus infection focuses on stabilizing cats with severe systemic disease and preventing life-threatening complications. Cats presenting with respiratory distress may require oxygen supplementation and supportive care in an intensive care setting. Intravenous fluid therapy addresses dehydration and supports organ function in cats with severe systemic illness. Cats unable to eat due to oral lesions or severe illness require nutritional support through assisted feeding or feeding tubes. Initial stabilization allows time for diagnostic confirmation while addressing immediate life-threatening concerns. Strict isolation protocols protect other animals and humans from potential exposure to this zoonotic virus.

Medical management of poxvirus infection is primarily supportive, as no specific antiviral medications are approved or routinely available for treating orthopoxvirus infections in cats. Broad-spectrum antibiotics are commonly prescribed to treat or prevent secondary bacterial infections of skin lesions, which are common complications. Non-steroidal anti-inflammatory drugs or other pain medications help manage discomfort from multiple skin lesions. Antihistamines may help reduce pruritus if lesions are itchy. Immunosuppressive medications such as corticosteroids are contraindicated as they can worsen viral replication and disease severity. In research settings, antiviral agents such as cidofovir have shown activity against orthopoxviruses, but these are not routinely available for veterinary use.

Surgical intervention is rarely indicated for poxvirus infection, as the condition primarily requires medical management. In rare cases, severely infected or necrotic tissue may require surgical debridement. Lesions that develop secondary complications such as severe abscessation may benefit from surgical drainage. Biopsy of lesions may be performed for diagnostic purposes when other testing is unavailable or inconclusive. Generally, surgical manipulation of pox lesions is avoided to prevent viral spread and promote natural healing. Any surgical procedures in cats with poxvirus infection require strict attention to biosafety protocols to prevent zoonotic transmission to veterinary personnel.

Supportive care forms the cornerstone of treatment for most cats with poxvirus infection. Wound care involves gentle cleaning of lesions with dilute antiseptic solutions and application of topical antibacterial agents to prevent secondary infection. Elizabethan collars prevent self-trauma to lesions. Nutritional support through appetite stimulants, warming food, or syringe feeding helps maintain caloric intake during illness. Maintaining hydration through oral fluids or subcutaneous fluid administration supports recovery. Environmental modifications including soft bedding, warmth, and reduced stress help comfort affected cats. Nursing care may be required for several weeks until all lesions have healed.

Alternative and complementary approaches to poxvirus treatment focus on supporting immune function and comfort. Some practitioners recommend immunostimulant supplements to help boost the cat's natural defenses against the virus, though scientific evidence for efficacy is limited. Herbal preparations with purported antiviral or immune-supporting properties may be suggested as adjunctive therapy. Omega-3 fatty acid supplementation may support skin healing. Proper nutrition with high-quality protein supports tissue repair. These approaches should complement rather than replace conventional supportive care and are best used under veterinary guidance. The primary goal remains supporting the cat's immune system while preventing complications.

Treatment decisions depend on multiple factors including disease severity, immune status, and owner circumstances. Immunocompetent cats with localized disease typically receive outpatient treatment with good expected outcomes. Severely affected or immunocompromised cats may require hospitalization and intensive supportive care. Treatment costs can be significant for cats requiring prolonged care or hospitalization. The zoonotic nature of the virus requires owner education about transmission risks and hygiene precautions during the treatment period. Owners must be prepared for several weeks of nursing care and isolation while lesions heal. For immunocompromised cats with severe disseminated disease, quality of life considerations may need to be discussed if response to supportive care is poor.

Recovery timeline for poxvirus infection varies considerably based on disease severity and the cat's immune status. Immunocompetent cats with localized skin disease typically show improvement within two to three weeks of lesion appearance, with complete healing occurring over four to six weeks. During recovery, lesions progress through crusting and scab formation before eventually falling off to reveal healed tissue. Secondary lesions may continue to appear for one to two weeks after initial presentation before the immune response controls viral replication. Severely affected cats or those with systemic disease may require two to three months for full recovery. Immunocompromised cats may have prolonged recovery periods or may not fully recover from infection.

Post-treatment care requirements during recovery focus on wound management, preventing secondary complications, and reducing zoonotic transmission risk. Lesions should be monitored daily for signs of secondary bacterial infection, including increased redness, swelling, discharge, or odor. Scabs should be allowed to fall off naturally rather than being removed, as premature scab removal can delay healing and spread virus. Cats must be isolated from other animals and limited in contact with humans, particularly immunocompromised individuals, until all lesions have completely healed. Good hygiene practices including handwashing after handling the cat and wearing gloves during wound care are essential. Follow-up veterinary examinations ensure healing is progressing appropriately.

Prognosis factors for poxvirus infection primarily center on the cat's immune status. Immunocompetent cats with localized skin disease have an excellent prognosis, with most recovering fully without long-term consequences. Mortality in healthy cats is uncommon with appropriate supportive care. However, cats with concurrent FIV or FeLV infection face a much more guarded prognosis, as they may develop progressive disseminated disease despite treatment. Cats on immunosuppressive medications who develop poxvirus infection require careful management and may have worse outcomes. The extent of disease at presentation also influences prognosis, with cats having numerous lesions or systemic signs facing more uncertain outcomes than those with few localized lesions.

Long-term outlook for cats that recover from poxvirus infection is generally favorable. Most cats develop immunity following infection and are protected against reinfection for at least several years and possibly for life. Scarring or depigmentation may persist at sites of healed lesions, but this is primarily cosmetic. Rarely, cats may develop chronic skin changes in severely affected areas. Cats that experienced severe systemic disease should be monitored for any delayed complications. Behavioral changes are uncommon long-term, though some cats may show altered hunting behavior. Cats that recover should continue routine preventive care and wellness monitoring as normal. The risk of zoonotic transmission ends once all lesions have completely healed and no scabs remain.

Primary prevention of poxvirus infection in cats centers on reducing exposure to the virus through lifestyle modification. Keeping cats indoors eliminates the opportunity to hunt infected rodents, effectively preventing infection in areas where cowpox virus is endemic. For cats that must have outdoor access, supervising outdoor time and providing environmental enrichment indoors can reduce hunting behavior. In areas where poxvirus is known to be present in rodent populations, owners should be particularly vigilant about limiting unsupervised outdoor time. Rodent control measures around the home reduce prey availability but do not eliminate risk if cats have access to natural areas with wild rodent populations.

Environmental prevention measures complement lifestyle modifications in reducing poxvirus risk. Eliminating rodent access to the home through sealing entry points and removing food sources reduces the likelihood of cats encountering infected rodents near the residence. Outdoor cat enclosures or catios allow outdoor access while preventing hunting. Avoiding feeding cats outside, which can attract rodents, reduces potential contact opportunities. In multi-cat households where one cat is diagnosed with poxvirus infection, strict isolation prevents transmission to other cats, though cat-to-cat transmission is less common than acquisition from rodents. Thorough cleaning of areas contaminated with lesion material using appropriate disinfectants reduces environmental viral load.

Dietary factors do not directly prevent poxvirus infection but support overall immune health. Feeding a complete and balanced diet appropriate for the cat's life stage maintains optimal immune function. Adequate protein intake supports healthy skin and immune responses. Ensuring cats are not nutritionally deficient helps maintain robust defenses against viral infections if exposure occurs. Supplements such as omega-3 fatty acids may support skin health and immune function but do not provide specific protection against poxvirus. Maintaining ideal body weight through appropriate feeding helps overall health and immune competence.

Regular health maintenance through veterinary care supports the cat's ability to resist severe poxvirus disease if exposure occurs. Routine wellness examinations allow early detection of immunocompromising conditions that would worsen poxvirus outcomes. Testing for FIV and FeLV identifies cats at high risk for severe disease who should have their outdoor access more carefully restricted. Keeping cats current on core vaccinations maintains overall immune health. Prompt treatment of any illness helps prevent immune compromise. Cats receiving immunosuppressive medications for other conditions should have their outdoor access restricted to prevent poxvirus exposure during treatment periods.

Early intervention when exposure or infection is suspected improves outcomes. Owners in endemic areas should be educated about poxvirus risk and the appearance of early lesions. Any new skin lesion in a cat with outdoor access in endemic regions should prompt veterinary evaluation. Early diagnosis allows implementation of appropriate supportive care and isolation measures before extensive disease develops. Prompt diagnosis also enables early zoonotic counseling to protect human family members. If a cat is known to have caught a rodent, monitoring for skin lesions over the following weeks allows early detection of any resulting infection.

Daily management of a cat with active poxvirus infection requires commitment to nursing care, isolation, and hygiene practices. Affected cats should be confined to an easily cleaned area of the home, separate from other pets and with limited human access. Daily wound care involves gentle cleaning of lesions and application of prescribed topical treatments. Monitoring of lesion progression helps track recovery and identify any complications early. Ensuring adequate food and water intake may require offering highly palatable foods or hand-feeding if appetite is reduced. Medication administration follows veterinary instructions precisely. Environmental cleaning of the isolation area using appropriate disinfectants prevents viral persistence on surfaces.

Home environment modifications during active infection focus on infection control and comfort. The isolation area should have easily cleanable surfaces, with absorbent, disposable bedding that can be safely discarded. All food and water dishes, litter boxes, and other items used by the infected cat should be dedicated to that cat and disinfected regularly. Comfortable resting areas and environmental enrichment help reduce stress during the isolation period. Temperature control ensures the cat remains comfortable during recovery. Family members should minimize direct contact and wear gloves and wash hands thoroughly when care is required. Immunocompromised family members should avoid any contact with the infected cat.

Maintaining quality of life during poxvirus infection requires balancing necessary isolation with the cat's psychological needs. Interactive play through the enclosure barriers or with toys that can be disinfected provides mental stimulation. Speaking to the cat regularly maintains social bonds during isolation. Visual access to household activities through glass or screen barriers helps cats feel less isolated. Comfortable bedding and warm resting spots support physical comfort. Once lesions begin healing and the cat feels better, increased interaction following appropriate hygiene precautions supports emotional wellbeing. Most cats tolerate the temporary isolation well and resume normal activities enthusiastically once cleared.

Ongoing monitoring during active infection involves daily assessment of lesion status and overall health. Photographing lesions helps track changes over time. Signs of improvement include lesions progressing through crusting stages and beginning to heal, improved appetite and energy, and no new lesions appearing. Signs of concern requiring veterinary contact include appearance of new lesions, worsening of existing lesions, signs of secondary infection, declining appetite or energy, or any respiratory symptoms. Regular veterinary rechecks, typically weekly during active infection, allow professional assessment of recovery progress. Communication with the veterinarian about any changes ensures timely intervention if complications develop.

Caregiver support during management of a cat with poxvirus infection helps owners navigate this challenging period. Understanding that most cats recover fully provides reassurance during the weeks of nursing care required. Clear communication with the veterinarian about expected timeline and milestones helps owners know what to expect. Financial planning for ongoing veterinary care and supplies helps manage treatment costs. Resources about zoonotic risk help owners protect themselves and family members appropriately without excessive fear. For owners who are immunocompromised and cannot safely care for their infected cat, assistance from healthy family members or friends may be necessary. Veterinary staff can provide ongoing support and answer questions throughout the recovery period.

Poxvirus infection in cats does not show specific breed predilection and can affect cats of any breed or mixed heritage. The primary determinant of infection risk is lifestyle and exposure opportunity rather than breed characteristics. Cats with outdoor access in regions where cowpox virus is endemic in wild rodent populations face the highest risk regardless of breed. Breeds known for high prey drive and active hunting behavior may face somewhat elevated risk simply due to more frequent rodent contact, though any outdoor cat that hunts is at similar risk. Rural cats of any breed living in cowpox-endemic areas have higher exposure probability than urban cats.

Moderate risk factors relate more to individual immune status than breed. Breeds that may have higher rates of conditions requiring immunosuppressive treatment could face elevated risk for severe disease if infected. Any cat with FIV or FeLV infection, regardless of breed, is at increased risk for severe poxvirus disease. Purebred cats from lines with higher rates of inherited immunodeficiency would face worse outcomes if infected. Geriatric cats of all breeds may have age-related immune decline affecting disease severity. Conversely, young healthy outdoor cats of any breed are at risk for infection but typically experience milder disease with good outcomes.

Screening recommendations for poxvirus are exposure-based rather than breed-specific. Cats with outdoor access in endemic areas of Europe and western Asia should be monitored for suspicious skin lesions during routine examinations and owner observation. Testing for FIV and FeLV identifies cats at risk for severe disease who should have restricted outdoor access. Any cat with compatible skin lesions and appropriate exposure history should be tested for poxvirus infection. Breeding cats in endemic areas should be maintained with restricted outdoor access to prevent infection that could affect breeding programs. There is no carrier state that requires screening in healthy cats without lesions.

Poxvirus infection commonly co-occurs with immunosuppressive conditions that influence disease severity and outcome. Feline immunodeficiency virus infection significantly impacts poxvirus disease course, as FIV-positive cats are more likely to develop severe, disseminated, potentially fatal poxvirus infection. Feline leukemia virus similarly predisposes to severe disease through immune compromise. Cats receiving immunosuppressive medications for conditions such as inflammatory bowel disease, allergies, immune-mediated hemolytic anemia, or other diseases face elevated risk during treatment periods. Recognition and appropriate management of these concurrent conditions is essential when treating poxvirus infection and influences both treatment approach and prognosis discussions.

Several conditions present with similar clinical signs to poxvirus infection and must be differentiated through appropriate testing. Bacterial skin infections causing pustular lesions can resemble pox lesions, particularly in early stages. Cat fight abscesses and bite wounds may mimic primary pox lesions initially. Fungal infections including dermatophytosis, cryptococcosis, and sporotrichosis can produce nodular skin lesions. Eosinophilic granuloma complex creates varied skin lesions that may appear similar. Feline herpesvirus can cause ulcerative dermatitis that requires differentiation. Various skin tumors including squamous cell carcinoma may be considered in the differential diagnosis. Laboratory testing differentiates poxvirus infection from these other conditions.

Potential complications of poxvirus infection include secondary bacterial infections and systemic disease progression. Bacterial superinfection of skin lesions is common and requires antibiotic treatment. Severe cases may develop bacterial sepsis as a complication of extensive skin disease. Pulmonary involvement in immunocompromised cats can lead to fatal viral pneumonia. Rarely, ocular involvement may occur, causing keratitis or conjunctivitis. Zoonotic transmission to human caretakers represents an important public health complication, with human cowpox infection causing similar skin lesions and occasionally serious illness in immunocompromised individuals. Preventing complications through appropriate supportive care, hygiene measures, and monitoring helps optimize outcomes for both cats and their human families.