I'm so sorry to hear that Jake is sick again. I'd take him to the vet again and like others have said it may not be a URI. My cat Sky gets these type of symptoms every year and I had to take him to the vet the other day. He's now on antihistamines for allergies and is doing well on it so far. Jake may also have a bacterial infection. I hope he'll get well soon. He sure is a cutie pie. Good luck.