Management of FeLV and/or FIV – BarnCoop

Today, we shall check out the management of Felv and/or FIV.

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Identification of FeLV or FIV Status

All cats should be tested for FeLV and FIV infection.

This particularly important for cats in multiple-cat households, but is also important for cats in single-cat households, because either of these retroviral infections may impact a cat’s health status and long-term management.

Both FeLV and FIV infection cause immunosuppressive diseases, and although there are differences in the direct specific effects of each virus, most health problems in retrovirus-positive cats are due to secondary diseases caused by immunosuppression.

Although some older literature suggested that FeLV-infected cats live a maximum of 3 years after diagnosis, this appears to relate mainly to cats living in multiple-cat households in which FeLV is endemic.

With proper care, FeLV- and FIV-infected cats often live longer than this and , in fact, may die of causes unrelated to retroviral infection.

A decision to treat or euthanatize a cat should never me made solely on the basis of whether the cat has a retroviral infection.

Preventing Transmission of FeLV and FIV in Households

FeLV infection is primarily a concern for cats that are friendly with other cats, as close, intimate contact between cats is required for transmission.

This type of contact occurs among cats as a result of mutual grooming and sharing of food bowls, water bowls, and litter pans.

Transmission by biting can occur, but this is an infrequent mode of infection.

If an FeLV-positive cat is identified in a household, the best method of preventing spread to other cats in the household is to isolate the infected cat in a separate room and prevent the infected cat from interacting with its housemates.

There is strong, natural, age-related resistance to FeLV infection in adult cats.  Kittens less than a year of age are at a greater risk of infection than are adults.

If owners choose not to separate housemates, uninfected cats should be vaccinated against FeLV in an attempt to enhance their natural level of immunity.

However, it should be understood that FeLV vaccines do not necessarily protect all cats against FeLV infection.

FeLV can be transmitted vertically from an infected queen to her kittens in utero or via infected milk.

Infected queens should not be bred and should be spayed if their condition is sufficiently stable to permit them to undergo surgery.

FIV infection is primarily a concern for cats that are unfriendly with other cats, as the major mode of transmission is through bit wounds.

Generally, cats in households with stable social structures where housemates do not fight are at little risk for acquiring FIV infection.

However, separation of infected cats from uninfected housemates is recommended to eliminate the potential for FIV transmission.

Experimentally, FIV has been shown to be vertically transmitted by infected queens to their kittens.

Although this is apparently true only for a few specific strains of FIV, infected queens should not be bred and should be spayed if their condition is sufficiently stable to permit them to undergo surgery.

Routine Wellness Care for Infected Cats

Cats infected with FeLV, FIV, or both should be confined indoors to prevent spread to other cats in the neighborhood and exposure of affected cats to infectious agents carried by other animals.

As for all cats, good nutrition and husbandry are essential to maintaining good health in infected cats.  These cats should be fed a nutritionally balanced complete feline diet.

Raw meat and eggs and unpasteurized milk should be avoided, because the risk of food-borne bacterial and parasitic infections is greater in immunosuppressed individuals.

A program for routine control of gastrointestinal parasites, ectoparasites, and heartworms, where applicable, should be implemented.

Cats infected with FeLV and/or FIV should receive wellness visits at least semi-annually to promptly detect changes in their health status.

Veterinarians should obtain a detailed history to help identify problems requiring more intensive investigation and perform a thorough physical examination at each visit.

Special attention should be paid to the oral cavity, because dental and gum disease are common in affected cats.

Lymph nodes should be identified and carefully evaluated for changes in size and shape.

Ocular lesions are particularly common in FIV-infected cats, but all cats should receive a thorough examination of the anterior and posterior segments of the eye.

The skin should be examined closely for evidence of external parasitic infestations and fungal disease.

The body weight should be accurately measured and recorded, because weight loss is often the first sign of deterioration in a cat’s condition.

A complete blood count should be performed yearly for FIV-infected cats and at least semi-annually for FeLV-infected cats, because of the greater prevalence of virus-related hematologic disorders in FeLV-infected cats.

Serum biochemical analyses and urinalyses should be performed yearly; urine samples should be collected by means of cystocentesis so that bacterial cultures can be performed, if necessary.

Fecal examinations should be considered for cats with a history of possible exposure to internal parasites or with a history of gastrointestinal tract disease.

Vaccination programs to prevent common, serious infectious diseases should be maintained.

In general, vaccination programs for infected cats should be similar to those for uninfected cats.

Rabies vaccines should be given in accordance with state and local regulations.

Feline viral rhinotracheitis-calicivirus-panleukopenia vaccines should be given in accordance with the AAFP guidelines (ie, routine primary vaccination, followed by a booster vaccination 1 year later and every 3 years thereafter).

Some clinicians recommend that only killed virus vaccines be used infected cats.  However, there is little evidence that such cats are at increased risk of adverse effects with modified-live virus vaccines.

FeLV vaccines are of no benefit in and should not be given to FeLV-infected cats.  Other vaccines should be evaluated carefully before being administered.

Sexually, intact male and female cats should be neutered to reduce stress associated with estrus and mating behaviors.

Neutered animals are also less likely to roam outside the house or interact aggressively with their housemates.  Surgery is generally well tolerated by infected cats that are not showing any clinical signs of disease.

Perioperative antibiotic administration may be considered for cats undergoing dental procedures and invasive surgeries.

As stated previously, many cats infected with FeLV and/or FIV, particularly those infected with FIV, will live long lives.

There is no evidence from controlled studies to show that immunomodulator, alternative, or antiviral medications have any positive beneficial effects on the health or longevity of infected cats that do not have any clinical signs of disease.

Caring for Symptomatic FeLV- and FIV-Infected Cats

Most of the routine management principles described for asymptomatic cats apply to symptomatic ones.

It is essential to remember that illnesses in cats infected with FeLV and/or FIV are often secondary diseases acquired because of immunosuppression and not the direct effects of the retrovirus infection.

Prompt and accurate identification of secondary illnesses is essential to allow early therapeutic intervention and a successful outcome of treatment.

Therefore, more intensive diagnostic testing should proceed earlier in the course of illness for infected cats than might be recommended for uninfected cats.

Many cats infected with FeLV or FIV respond as well as their uninfected counterparts to appropriate medications and treatment strategies, although a longer or more aggressive course of treatment may be needed.

Owners should be forewarned and clinicians should not be discouraged if a response to treatment takes longer than expected.

As in the case of asymptomatic cats, corticosteroids and other immunosuppressive drugs should be administered only to those patients with a clear indication for their use.

Griseofulvin has been shown to cause bone marrow suppression in FIV-infected cats and should not be used.

There is no conclusive evidence from controlled studies to show that immunomodulator or alternative medications have any positive beneficial effects on the health or longevity of symptomatic infected cats.

Antiviral therapy, such as administration of AZT, has been shown to be beneficial in cats with stomatitis and seizure disorders.

To date, there is no treatment that has been shown to reverse well-established retrovirus infection in cats.

Diseases Associated with Retrovirus Infection