Forticlient and Citrix Receiver

I am having performance problems with Citrix receiver when running forticlient real-time AV protection.  The symptoms I see are mouse & Keyboard become very slow to respond in the citrix session.  When trying to type, there will be a lag in the keystrokes showing up that could be ip to 1 second.  Mouse performance is similarly lagging.  If I disable the real-time protection, keyboard and mouse response become normal and responsive again.  I am currently running Forticlient version 5.4.0 but have seen this as far back as 5.2.3.  I am running citrix receiver version 4.3 but have seen the issue with several other versions as well.

One thing I have tried that has worked in the past was to make a folder exclusion for the location that the citrix receiver is installed.  That is no longer working.

I have also tried deleting the cache.dat file in C:\Program Files (x86)\Fortinet\FortiClient.  That seems to work for a period of time, but the problem always returns after a period of time.

Any insight or suggestions would be greatly appreciated.