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Feline Leukemia Virus Infection 331

Advanced or Confirmatory Testing Treatment of FeLV-infected cats with recurrent of age. Progressive FeLV infection can be
• No gold standard available infections: detected from birth onward by antigen
VetBooks.ir positive antigen tests. (e.g., long-term antibiotics after culture and • Even progressive FeLV infection is not Diseases and Disorders
• Intensive treatment of recurring infections
testing.
• PCR can be used to confirm results of
a reason for euthanasia because the cats
sensitivity)
TREATMENT
• Treatment trial with immunomodulators
6
(e.g., feline interferon-omega 1 × 10 IU/ can live several years with a good quality
of life. However, the diagnosis has certain
Treatment Overview kg SQ once weekly). implications.
Lifestyle management is the cornerstone of ○ Strict indoor-only lifestyle
treatment and prevention. Indoor-only life- Nutrition/Diet ○ More intense veterinary care
style is highly recommended, reducing risk of No raw meat, milk, or eggs to avoid secondary ○ Vaccination programs to prevent common
secondary infections. In progressively infected infections through food-borne pathogens serious infectious diseases should be main-
cats with no clinical signs, no other treatment tained; revaccination on a more frequent
is required. Supportive care includes compre- Behavior/Exercise basis (e.g., q 6 months) is recommended
hensive treatment of secondary infections, Strict indoor-only lifestyle is important life- given these cats’ immunoincompetence.
treatment of neoplasia, blood transfusion, prolonging advice to reduce exposure of the
and other therapy as needed. When overt FeLV-infected cat to other infections and to Prevention
clinical signs are present, antiviral treatment prevent transmission of FeLV to other cats. • Vaccination against FeLV is efficacious in cats
(e.g., feline interferon-omega, azidothymidine at risk for exposure to the virus, but level
[AZT]) might be beneficial. Drug Interactions of protection is not sufficient in cats with
Avoid immunosuppressive or myelosuppressive very high infectious pressure (e.g., naive cat
Acute General Treatment drugs whenever possible. living with FeLV-shedding cats).
Intensive treatment should be given for • FeLV vaccine can be associated with develop-
recognized disorders, such as antibiotic Possible Complications ment of injection-site sarcomas in cats (p.
therapy for secondary bacterial infections or Reversible nonregenerative anemia is an adverse 550). Only cats at risk should be vaccinated
blood transfusion for life-threatening anemia effect of AZT. (e.g., not cats that live entirely indoors). Vac-
(p. 1169). cinate against FeLV distally in the hindlimb
Recommended Monitoring or tail to allow amputation for removal of
Chronic Treatment • Regular monitoring for evidence of secondary injection-site sarcomas if they occur. Vaccines
• If no clinical signs are present, no treatment infectious diseases, neoplasia, or progression without adjuvants should be used.
is necessary. Strict indoor-only lifestyle and of infection • Cats used for blood donation should be
good preventative health care (e.g., parasite • Recheck veterinary visits with CBC every 6 screened by PCR as well as ELISA.
control, vaccinations) are recommended. months
• If clinical signs are present Technician Tips
○ Identify any underlying diseases. FeLV PROGNOSIS & OUTCOME • The FeLV status of every cat should be
alone might not be responsible for the known.
clinical signs (e.g., secondary infections • Abortive infection: excellent prognosis; cats • FeLV is infective only for minutes outside
might be present). are protected lifelong and do not develop the cat and is susceptible to all disinfectants,
○ Underlying diseases should be treated clinical signs. including common soap. Simple precautions
aggressively (e.g., bactericidal antimicrobi- • Regressive infection: good prognosis; cats and routine cleaning procedures prevent
als for bacterial infection). rarely develop clinical signs (due to lym- transmission in the hospital.
Treatment of FeLV-infected cats with phoma or myelosuppression) or reactivate • House FeLV-infected cats in individual
lymphoma: their infection (≈10 % of cats). animal cages and never in an infectious
• Chemotherapy (p. 607) • Progressive infection: good to fair prognosis disease ward with cats with contagious
• Owners should be informed about more if recognized before the onset of clinical signs diseases (e.g., upper respiratory infections).
guarded prognosis. and with good veterinary care
Treatment of FeLV-infected cats with anemia: ○ Historic findings for a median life span Client Education
• Blood transfusions recommended if anemia of 3 years are likely outdated. Nowadays • Every cat should be tested for FeLV; a
is severe (p. 1169). normal longevity is possible, although progressively FeLV-infected cat can live for
• Treatment trial with erythropoietin (100 IU/ FeLV-associated syndromes require treat- many years as an indoor pet with regular
kg SQ q 48h) ment. veterinary care.
• If no effect, consider glucocorticoid treatment ○ Prognosis for cats that develop leukemia • Importance of neutering cats should be
(anemia in FeLV-infected cats can have an or myelosuppression is guarded to poor. emphasized.
immune-mediated origin, and some cats Cats with FeLV-associated lymphoma still
respond to immunosuppressive therapy). can experience remission and an improved SUGGESTED READING
Treatment of FeLV-infected cats with neurologic quality of life with chemotherapy. Hartmann K, et al: Feline leukemia virus infection.
signs: ○ Cats with severe myelosuppression (e.g., In Ettinger SJ, et al, editors: Textbook of veterinary
• First identify and then treat any underly- anemia) sometimes respond to therapy. internal medicine, ed 8, St. Louis, 2017, Elsevier,
ing diseases (e.g., lymphoma) causing the pp 978-983.
neurologic signs. PEARLS & CONSIDERATIONS AUTHOR: Katrin Hartmann, Dr.med.vet., Dr.habil.,
• If no underlying disease is identified (and the DECVIM
neurologic signs are assumed to be caused Comments EDITOR: Joseph Taboada, DVM, DACVIM
by FeLV directly), treat with AZT 5 mg/kg • The FeLV status of all cats should be known,
PO q 12h. and every cat should be tested independent

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