Cats in the Cradle

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Living with the FIV+ Cat

In the past, cats who tested positive for FIV were routinely euthanized since it was believed that they'd automatically pass the virus to any other cat they encountered.  Unfortunately, that thinking still abounds, and FIV positive cats are rarely given a chance to be adopted.  The following information will hopefully shed more light on this disease and its transmission and will allow people to re-think having an FIV positive cat in their household. - Editor

Management of Feline Immunodeficiency Virus

Feline Immunodeficiency Virus, a lentivirus identified in 1987, induces and immune deficiency similar to that caused by HIV.  Cats can be infected for up to 10 years without obvious symptoms although most will test positive on commercially available antibody tests.  Eventually, their immune system becomes compromised leading tow wasting, opportunistic infection, and various secondary diseases.  Because of this long period of generally good health, most cats are over 10 years old by the time they are exhibiting signs of FAIDS (the feline term for AIDS).

FIV and HIV also share similar routes of transmission; mother to offspring, blood to blood (sharing of needles in humans or transfusions in both species), and traumatic wounds such as bites.  Sexual transmission does not appear to be a major route of infection in cats.  Like HIV, FIV does not transmit through casual contact.  Mutual grooming, sharing of food and water dishes, sharing of litter boxes and sleeping with one another do not lead to the spread of this disease.

The goal in managing FIV-infected cats is to minimize the number of new cases of FIV.

Mother to kitten transmission is substantial with rates of 30-50% of kittens infected while still in the uterus.  Because of the significant chance of FIV-infected mothers producing at least some FIV-infected kittens, spay/abort is recommended for mothers who can still safely handle the surgery.  If a FIV-infected mother has a litter of kittens, it is recommended to allow her to nurse the litter even though an additional 15% of kittens may be infected through the milk.  Maternal antibodies are also almost entirely transferred to the kitten through ingestion of colostrum within the first 24 hours.  This colostrum also contains FIV antibodies which then interferes with accurate testing of the kittens.  It can take up to 16 weeks for kittens to clear this maternal FIV antibody leading to false positive tests on kittens tested at younger ages.

Management of the FIV-infected cat

Euthanasia of the FIV-infected kitten or cat is not recommended since it can be expected to have a long (up to 10 years) symptom-free period and is of no significant risk to other cats within the household.  These kittens or cats should, however, only be adopted out to responsible owners willing to spay/castrate and keep them indoors.

When testing cats in the feral neuter-release program, it is important to look at the big picture.  These cats are being returned to the outdoors and are likely to engage in conflicts with any cat encroaching on their territory.  Since bites are know to be an efficient means of transmission of FIV, no cat testing positive for FIV should be released.  If they are too feral to be a house pet, unfortunately the most responsible option is humane euthanasia. 

Treatment of the exposed or FIV-infected pet

Prevention of transmission of FIV has been documented with AZT (Zidovudine) and PMEA (9-(2 phosphonoyl-methoxyethyl) adenine), with administration preferable within 24 hours of exposure.  They may also be useful in minimizing transmission from mother to kitten when given during pregnancy.  Unfortunately, availability of AZT and PMEA in veterinary practices is very limited and many exposures occur without the knowledge of the owner. 
Once a pet has been diagnosed as FIV-infected, it should be examined carefully for any complicating diseases.  This should include a complete blood count, a blood smear for Hemobartonella, a biochemical profile, and a fecal.  Any conditions identified should be treated aggressively.  Vaccinations for common infectious diseases with inactivated vaccines are highly recommended. 

Treatment of the sick FIV-infected pet

Common immune diseases associated with FIV infection include: lymphocytic-plasmocytic stomatitis (red-raised sore gums), polyarthritis, and thrombocytopenia (clotting abnormality). These conditions are all responsive to corticosteroid therapy.

Good nutrition is essential and should include high quality food, a vitamin supplement (any commercially available multivitamin),, and appetite stimulants if necessary (diazepam, oxazepam, and cyproheptadine). 

AZT and PEMA may be indicated to help reduce clinical signs, but toxicity is a potential problem (anemia, weight loss). Immunotherapeutic agents such as IFN alpha and acemannan has been shown to reduce clinical signs in some patients, although controlled studies to prove their efficacy are lacking.

There is, unfortunately, no therapy available to reverse infection.

Written by Lynne O'Neil, D.V.M., who dedicated over five years to FIV/FeLV research at Colorado State University in Fort Collins, CO, with Dr. Edward Hoover, one of the doctors credited with producing the first effective FeLV vaccine.

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