Page 1073 - Cote clinical veterinary advisor dogs and cats 4th

530.e4 Immunodeficiency Syndromes, Cat

• Specific testing for other infectious diseases FeLV (oral formulation would be used in they are > 4 months old and have some
natural resistance to FeLV.
as needed (e.g., serologic titers, bacterial practice). Anemia can result from long-term • FIV test result for kittens can be positive from
VetBooks.ir • Bone marrow aspirate and biopsy if cytope- • Plerixafor decreased FIV viral load but did maternal antibody. Kittens testing positive
use of AZT.
culture and susceptibility for purulent/septic
processes)
not improve clinical signs in a trial of six
should be retested after 5 months of age.
nias are present or abnormal cells are noted
in peripheral blood cats. Young kittens are rarely actually infected
with FIV.
• Tests of CD4 counts do not correlate well Behavior/Exercise • FIV, FeLV vaccinations are needed only for
with immune function. Not all cats with Immunodeficient cats should be kept indoors, outdoor cats or those with exposure to other
low CD4 T cell counts develop infections. away from other cats. cats, as in multi-cat households.
• Compared with a normal cat, microscopic • Neutered males are less likely to fight with
examination of the shaft of a hair plucked Drug Interactions other cats, reducing the risk of retroviral
from a cat with Chédiak-Higashi syndrome Avoid corticosteroids or other immunosuppres- infection.
reveals large, clumped melanin granules. sive drugs unless absolutely needed. They may • Cats with hereditary disorders should not
increase the risk of infections. be bred.
TREATMENT
Possible Complications Technician Tips
Treatment Overview • Inability to eradicate some infections • Wash hands thoroughly before and after
• FeLV/FIV–associated immunodeficiency • Bone marrow failure, myelodysplasia, or handling cats carrying retroviruses.
○ Maintain good nutrition and husbandry, hematopoietic malignancy, especially from • Because most soaps and disinfectants kill
including core vaccinations. FeLV retroviruses, infected cats may be housed
○ Keep infected cats indoors for their own in the same room as other cats; clean cages
protection as well as to protect other cats. Recommended Monitoring thoroughly after they leave.
○ Treat any secondary infections early and Monitor weight because weight loss is often
aggressively. an early sign of complications. Also monitor Client Education
• Chédiak-Higashi–associated immunodeficiency: appetite and activity. Once or twice yearly, • Keep cats indoors. Avoid raw meat diets.
○ Treat secondary infections as they arise; CBCs may identify a problem, but healthy Test new cats before allowing contact with
prophylactic treatment in cases of surgery FeLV-infected cats generally have normal counts currently owned cats.
or trauma (bleeding) except for lymphopenia. • For multi-cat households with endemic
FeLV infection, isolate or remove positive
Acute General Treatment PROGNOSIS & OUTCOME cats, vaccinate the rest, and do not bring
• Find and treat any secondary infections in new cats. Retest negative cats 3 months
quickly and thoroughly. • Previous studies showing a 50% mortality later.
• Use supportive care and nutritional support for FeLV infection in 2 years and 80% in 3 • Virus is spread by carrier cats and does not
as needed. years were done with multi-cat households in survive in the environment.
• No value in FeLV/FIV vaccines for infected which the risks of secondary infections were
cats, but other routine vaccines are safe and high. For a single indoor cat, the prognosis SUGGESTED READING
should be given. is guarded but much better than such data Hartmann K: Feline leukemia virus infection. In
indicate. Greene CE, editor: Infectious diseases of the dog
Chronic Treatment • Many FIV-positive cats can survive for many and cat, ed 4, St. Louis, 2012, Elsevier, pp 108-135.
• No drug has proven efficacy in eliminat- years without developing signs of illness if
ing feline retroviruses. Drugs used to treat they are kept indoors. ADDITIONAL SUGGESTED
humans with HIV are less effective and more READING
toxic for cats. PEARLS & CONSIDERATIONS Sellon RK, et al: Feline immunodeficiency virus
• Anecdotal benefit has been reported for oral infection. In Greene CE, editor: Infectious diseases
human interferon-alpha (IFN-alpha), Propi- Comments of the dog and cat, ed 4, St. Louis, 2012, Elsevier,
onibacterium acnes, acemannan, Staphylococcus • Although FeLV and FIV cause immunosup- pp 136-149.
protein A, and PMEA (adefovir), but none pression, most secondary infections can be
of these has been effective in decreasing viral treated successfully. RELATED CLIENT EDUCATION
replication or prolonging survival in limited • Keeping these cats indoors and separated SHEETS
controlled clinical trials. from ill or young cats (especially cats with
• IFN-omega improved clinical signs and signs of respiratory disease, skin disease, Feline Immunodeficiency Virus Infection
1-year survival for some cats, but another or diarrhea) can protect them from many Feline Leukemia Virus Infection
study of FIV infection showed no benefit. infections.
• Azidothymidine (AZT) at a dose of 5- AUTHOR: Susan M. Cotter, DVM, DACVIM
10 mg/kg SQ or PO q 12h has inhibited Prevention EDITOR: Jonathan E. Fogle, DVM, PhD, DACVIM
viral replication and improved some clinical • FeLV: test kittens at 8 weeks. If negative and
signs and immune function in some cats from a high-risk environment, repeat in 4
infected with FIV, but it is less effective for weeks. Isolate FeLV-negative kittens until

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