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Feline leukemia transmission and false positive test results
Feleuk tests and exposure to positive kitten
Feline leukemia, feral cats and euthanasia
FELV care and lifestyle changes
Sequestered FeLV
High CPK levels and FeLV
FeLV - love and support helps
Feline Leukemia
Feline Leukemia
FeLV related problems
Adding another FeLV positive cat
Feline Leukemia
Feline Leukemia diet
FeLV positive kitten
FeLV
Feline Leukemia Kitten
FeLV transmission
FeLV survival
Feline leukemia and children
Feline Leukemia and bladder infections
Feline Leukemia and Kittens
Feleuk and fluid in chest
Feline leukemia loss
Feline Leukemia - Kitten
Feline Leukemia/ Behavioral changesalso see Euthanasia
also see Feline Leukemia Test
also see Feline Leukemia Treatments
also see Feline leukemia Medication
also see Living Arrangement Problems
also see FIP - Feline Infectious Peritonitis
also see FIV - Feline Immunodeficiency Virus
also see Infectious Disease
also see Vaccine related Problems
also see Zoonotic Disease
Feline leukemia transmission and false positive testQuestion: Two years ago I found a young female cat on the farm where I was
living. It took 3 months of daily feeding her before she would let me
close enough to pat her. By that time, of course, she was pregnant.
I brought her into my house where, six weeks later, she had 3 kittens (2
males, 1 female). Mom and her children have never been outside since
mom moved it. When the kittens were 7 months old, I had them all
"fixed" and get all their shots. However, this year at their 1st
annual checkup, we discovered the males did not get the Fel-Luk test or
vaccination. So the vet did the test and both tested negative. Ivory
got his vaccination, but Freckles had a slight fever and had not been
feeling well for a few weeks (loss of appetite, weight and coloring),
so the Dr gave him some antibiotics and said he'd get all his shots in
two weeks. Later that afternoon, the Dr called to tell me that a recheck
of Freckles' test showed a very slight positive, so he would need to be
rechecked on his follow up visit in two weeks. This week Freckles had
his follow up visit, and they did just the Fel-Luk test (not the combo
test previously done) and again he showed a very slight positive. The
Dr also said he feels something in his stomach/intestinal area and has
put him on 1cc of Interferon daily. I've been reading all I can find
on Fel-Luke and Freckles does show symptoms, although after the
antibiotics kicked in, he began eating again and has regained 1/4 lb during the
two weeks.My question is this. Can an indoor cat get Fel-Luk when its mother
and siblings have all tested negative?Thank you for your time and assistance.
Hazel
Answer: Hazel-
It would be pretty unusual for a cat that was only exposed to its
mother, who has tested feline leukemia negative, and then kept inside away from
exposure to other cat to come up positive for feline leukemia. However,
it is not impossible for this to happen. Feline leukemia is difficult to
totally rule out because the virus can live sequestered in the bone
marrow or central nervous system but not be present in the blood stream in
some patients. When this happens, blood tests are negative but the cat still
has the virus. If there is a stressful event in its life the virus may
re-emerge. If the kitten's mother was an inapparent carrier of the
virus but did have a period of viremia during the pregnancy it is conceivable
that the kittens could have been infected while she was pregnant or
when she was nursing them. This is not a highly likely scenario, it is just
a remote possibility.I think that it would be best to try to confirm the results of this
test by using a different testing technology. The best way to do this would be
to send out an IFA (immunofluorescent assay) test to a reference lab. If
this test was positive then it would be very likely to be a true positive.
The in-office tests for feline leukemia virus are very accurate but still
have a very big chance of being wrong in a situation in which they are being
used as a screening test for cats that appear healthy. In this
scenario, due to the overwhelming chance that the cat will actually be healthy,
false positive tests are actually more common than true positive tests. This
was discussed in this issue of the VetInfo Digest. I am hoping that Freckles will be in the majority of cats who have a false positive test in this scenario.Mike Richards, DVM
8/2/2001
Feline leukemia test results and exposer to positive kitten
Question: Dear Dr. Mike,
I have a question regarding my felv positive kitten. This is long but I feel I need to explain alot of things. First I'll try to give you some history. I'm a vet tech and I've been working at a vet's office for about 5 years. We sometimes take in stray kittens and cats and find them homes. We would always test the adult cats for felv but we never tested the kittens. The vet didn't think it was likely the kittens would have felv and plus the added expense of testing them and so he didn't think it was necessary to test
kittens for felv. Well this year we've all learned our lessen. A kitten we adopted out last year came back this year very very sick and we tested it for felv and it was positive and it was euthanized. It was an inside cat. Two of the kittens we had this year went to a Vet Tech school and were going to find homes through there. I had tested them both for felv before they left because I knew they'd be put to sleep immediately if they had it and I didn't want that to happen. Both kittens tested negative with the Idexx Snap test when I tested them. Three days after I tested them and they were at the vet school
they were retested with the wells test and one tested a very faint positive. That one did have a URI. They tested him the next day again with the wells test and it was a weak positive and they put him to sleep. They wouldn't give the kitten back to me like I wanted so I could do an IFA test. I was very mad at them cause I tested him as negative and I know the wells test isn't very accurate. The other kitten they had they retested 2 weeks later and he tested positive on the wells, they tested him again on the wells and it was neg and then they tested him with the Snap test and it was neg so they found him a home. Because of all that we felv tested all the kittens we had left at the vet. One tested a very faint positive on the Snap test. It was a kitten I had bottle raised since it was 2 or 3 days old. We did have a kitten I caught in the woods outback of the vet that was very skinny but I got it back to good health and I didn't get a chance to test him before he got adopted and I"m thinking maybe this one had it but I don't know for sure. I'm saying that because I just don't know from who this virus came from. We do vaccinate the kittens for felv at the 3rd round and most of the kittens we had at the time we tested them had had 2 felv vaccs. Maybe the baby kitten I raised had had it all it's life but my opinion was
that if he had it since he was born it would have been a strong positive but I don't really know. This kitten is now 6 months old and is doing perfectly fine. I've retested him with the Snap test 3 times and he's been a very faint positive each time. I recently sent out an IFA Felv and he was positive. I always have my bottle raised kittens with me until they find homes and so I had the one that eventually tested positive (Tiger) and one other one which was a calico. I got them on the same day and they were both about 2 or 3 days old and they were raised together. The calico has not been tested as far as I know.
She got adopted 2 months before I tested the Tiger. Anyway I had the kittens at home with me when we weren't open at the vet. All of them. I have a 1 to 2 year old cat that loves to play but my other cats won't play with him and he loves to play with the kittens. His name is Spooky. Spooky has been around Tiger since Tiger was able to play. I have kept Tiger. No other kittens are here. I did separate Tiger and Spooky for awhile but Tiger didn't like not having a playmate and Spooky didn't like being separated with my other cats and my other cats didn't like Spooky with him because Spooky terrorized them. So neither Tiger nor Spooky were real happy with the situation and I don't want to put Tiger to sleep because he's my little baby and he's not sick. Spooky had been vaccinated for Felv and I tested him about 2 months ago and he was negative and I revaccinated him for Felv. I have now decided to let Spooky and Tiger be together again because at least they are both happy and I don't want Spooky to get Felv but I don't want either cat to be unhappy either so I have let them be together again and they are very happy now. Sorry it took so long to get to my questions but how likely is it that
Spooky will get Felv from this kitten (Tiger). Tiger tested a very faint positive and he acts perfectly healthy, he was just neutered 1 week ago and had no problems with the anesthetic. Does having a faint positive result mean Tiger could live longer than strong positives? Also how often can I vaccinate Spooky for felv to improve the chances that he won't get felv. I understand he still could with the vaccine but my vet said that I could vaccinate him every 6 months if I wanted but I didn't know if that would do any good or if it would be harmful or if I could vaccinate him more often or what. Spooky is
about 1 1/2 to 2 years old and like I said before he did test negative 2 months ago and he was tested last December when I got him too and was neg. Basically I am just wondering what the usual outcome is of very faint positive felv results, how likely it will be for Spooky to get felv with felv vacc's, and how often can I vaccinate Spooky for felv. Again I'm sorry for the long message.Dawn
Answer: Dawn-
I don't think that it matters whether the ELISA FeLV (feline leukemia virus) test is a faint positive or strong positive, just whether it is a true positive or false positive. In this case, I suspect that a false positive test is unlikely but it would be a good idea to do an IFA test. If it is positive, the chance of the result being a false positive is very low.
Although adult cats can be infected with FeLV, it is hard to infect an adult cat with feline leukemia virus. It usually takes immunosuppression for some reason, such as the use of corticosteroids, concurrent feline immunodeficiency virus infection or severe illness to overcome the natural resistance to this virus which most adult cats have. I think that once yearly vaccination with feline leukemia virus vaccine is probably more than adequate. Due to the link between feline leukemia vaccination and the vaccine associated sarcomas, I really think that the risk of vaccinating too frequently outweighs the risk of infection with the virus in an adult cat. Spooky is unlikely to become infected but remember that the possibility exists if he has to go on corticosteroids or becomes stressed or ill -- in which case it would be best to separate him until he no longer needs the medication or until he is well again.
You do have to be concerned about exposing kittens to Tiger. Kittens less than 4 months of age are most susceptible to FeLV. After reaching 14 months or so of age, natural resistance has usually become strong enough that most cats will not develop FeLV even if exposed to a cat carrying the virus on a regular basis. Keep the kittens physically separated from Tiger to ensure that they do not develop the disease. It would also be a good idea to consider testing any cats that may have come into contact with the kittens you have been raising because it seems somewhat likely that you have a carrier cat they have been exposed to. Kittens can get FeLV virus from their mother, both in the
uterus and through infected milk. It is not unusual for entire litters of kittens to gradually test positive over time when they come from an infected mother, so if a littermate of a kitten tests positive it is important to consider the kitten to be potentially infected with the feline leukemia virus.Cats which test persistently positive for FeLV virus usually have shorter lifespans than cats that can clear the virus from their bloodstream and test negative after having a positive test at an earlier time. It could be reassuring to do an IFA test and see if it is positive as well, since there definitely are false positives on ELISA FeLV tests.
Hope this helps some.
Mike Richards, DVM
11/6/2000
Feline Leukemia and feral cats and Euthanasia
Question: Dear Dr. Richards,
I currently volunteer with an organization called Kittico Cat Rescue in
Dallas, Texas.
About 75% of our work is with the Trap/Neuter/Return program for ferals.
Occasionally we will have the need to relocate ferals and we have been
fortunate enough to find a feral sanctuary nearby that we can take them to.
My problem is this. Recently I have been trapping cats at Lone Star Park
which is a horse track in Grand Prairie, Texas. There were 3 adult
females, 1male and a litter of kittens. I trapped the first female approximately 1
month ago. She was one of the cats from the momma cat's first litter and
she is about 1 year old. We had her spayed and vaccinated and took her to the
sanctuary. She's doing great. She has a good appetite and she seems quite
healthy. Yesterday, I trapped this cat's sister and took her to be spayed.
Only this time, the sanctuary asked that the cat be tested for FeLV/FIV.
She came back FeLV+. I have read alot of info on feline leukemia and I guess
that I just need some reassurance as to what to do. I know that when I worked
for a veterinary practice our protocol was euthanasia for domestics but I have
never dealt with the feral situation before. What are the chances that this
cat might shed the virus or is that even possible? And when I trap the rest
of the cats should we test on a case by case basis? I know how contagious
this disease is and I have seen cats suffer with it. I just feel
differently in this situation. They were living at a horse racing facility and they
were an isolated colony with no new outside cats coming into the group in
about a year. They were well fed and had shelter at the facility but management
decided that they were a nuisance and must go. If they could stay at the
track they would not have to be euthanized after we altered them. All of
this is coming from my heart and I guess that I need your medical input to help
make this decision easier. Should these cats be euthanized in your opinion?Any input would be greatly appreciated,
Apryl
Answer: Apryl-
Feline leukemia virus (FeLV) is contagious between cats. At the present
time, the feeling is that cats are susceptible to this virus when they are
less than a year of age and become very resistant to it after this age. If
there is something that compromises the immune system, such as feline
immunodeficiency virus, older cats may become susceptible to the virus.
Enough stress can probably also make a cat's immune system weak enough to
allow infection, which is a conceivable problem in a cat that is fending
for itself.My current thinking on FeLV is that there is no reason to euthanize a
housecat that lives alone, or lives with other adult cats that it has been
with or some time, as long as it is understood that the cat will probably
need more medical care than the average cat.The situation is a lot different for an outdoor cat, though. In this
circumstance there is a much better chance of the cat passing on the virus
to a susceptible kitten or young cat. I think that it is unfair to the
general cat population to release cats known to be infected with FeLV
virus. Unless a home can be found for these cats in which there is no
contact between the colony, I believe that euthanasia is appropriate in
this situation. It is hard to be put in the position of having to make this
decision but releasing the cat could lead to more than one death among
other feral cats.Mike Richards, DVM
6/28/2000
FELV care and lifestyle changes
Question: Dear Dr. Richards:
I have a cat named "Baby" and he is a domestic short hair with black and
white color. My husband and I found him in front of our apartment about 2
years ago. I think he cannot be more than 2.5-3 years old. He does not like
to be hold or carried, so we have never had a chance to take him to the
vet. Besides, we had never had a pet before, so we did not know exactly
what we had to do. But he has been a very healthy and active cat and never
been sick or injured. He likes to stay outside and comes back home to sleep.Last week, both my husband and I had to go on a school field trip for 5
days. We left a window partly opened so that Baby could come in and get
out. We left him with enough foods and water for 5 days. When we came back
from the trip on 04/04/2000, we found him inside the apartment with a big
open wound in his chest. We took him to the Animal Emergency Hospital at
once. The doctor said he had been in a fight. The wound was 5" long and
deep into the muscles. He had a surgery and also got neutered while he was
sedated. The doctor also took a blood test and the result showed Feline
Leukemia positive. We were heartbroken. We were told to keep him indoors
for life.We took him home that night and took care of him very well. Baby slept
through all day all night and seems to be getting a lot better. He eats
almost as usual. He is very picky about foods and eats nothing but boiled
fish (frozen pollock fillets) and gravy from Fancy Feast sliced beef feast.
But just this morning, he really wanted to go outside and was begging us to
open the door. We could not stand watching, so we let him out thinking that
we could stay close to him and put him back inside after a few minutes. But
he run away so quickly. We could not believe that he has that much
strength. I know that he will come back home this evening as he always did
before. But I worry about him so much since he has the injury.Baby has been in the same neighborhood with same friends since I think he
was born. He was little when we found him soon after we moved into our
current apartment in July 1998. His friend are all outdoors cats and they
all also probably have FELV since baby has it. No one seems to be sick and
they all are strong and active. Baby has never been sick too. My questions
are ..........- Is it okay for Baby to live the way he has been before since he and his
friend have been together for a long time?- What steps I should take to take care of Baby for his FELV? Should I take
him to the vet and get treatments now or wait until the symptoms develop?- Should I take another test to see if the first one was right? If so, when
and what kind of test I should do it? The first one was blood test.- Can he be still be immune even if he is FELV positive?
- Can I get him other vaccinations?
- He is strong and healthy even with the injury. Can you tell from the
information I give you that he will live long?- I do not care about how much it will cost to get FELV treatments for him.
Can you give me information about vets who do this kind of treatments in
Austin, Texas area?I apologize for long message, but I thought you should get enough
information to help me. Please reply me as soon as possible so that I can
do whatever necessary for Baby. The nurse from the Emergency Hospital said
there is no treatment for FELV, but from your web I want to believe that
there is. I love Baby so much and he is the most important part of my life.
Please help me to save Baby. Thank you very much for your time.Sincerely,
ThandarAnswer: Thandar-
I will try to answer all your questions. If I miss one, or you have a hard
time interpreting something, please feel free to write again.- Is it okay for Baby to live the way he has been before since he and his
friend have been together for a long time?It is unlikely that Baby will infect his friend, if he has not done so
already. However, if he is fighting with other cats, which is likely with
this injury, he could potentially infect another cat. This is why your vet
recommended keeping him indoors.- What steps I should take to take care of Baby for his FELV? Should I take
him to the vet and get treatments now or wait until the symptoms develop?There are no specific treatments that are effective, that I know of, for
the feline leukemia virus, itself. When cats have FeLV, though, they are
more susceptible to other infections. For this reason, it is necessary to
be very vigilant about taking him to the vet at the first sign of illness
and treating any illnesses found aggressively. Keep him on a good quality
cat food and make sure he is eating every day. Keeping secondary illnesses
under control really helps to keep these guys comfortable and to prolong
their lifespan.- Should I take another test to see if the first one was right? If so, when
and what kind of test I should do it? The first one was blood test.Most veterinary offices test for FeLV using blood tests using a technique
known as an Enzyme-Linked Immunosorbent Assay or ELISA test. These tests
are very sensitive, meaning they can detect a very small amount of the
leukemia virus antigen. However, they do have some false positives, so it
is reasonable to recheck the test. We usually try to use a different
manufacturer's test but I am not sure that really matters. Then if the
second ELISA test is still positive and there is any reason to doubt the
diagnosis we will send blood for an immunofluorescent antibody (IFA)
test. This test is less sensitive but if it is positive it is very likely
that there is circulating feline leukemia virus in the bloodstream.Cats who can not clear the FeLV virus from their bloodstream are carriers
of the disease and these cats also have a less favorable prognosis, with an
average lifespan of two to five years after infection (varies in different
studies). However, much of the time cats with this illness appear to feel
well and act like they are not bothered by the disease.- Can he be still be immune even if he is FELV positive?
No. If he is positive on two tests more than three weeks apart and/or
postive on both ELISA and IFA tests, he is very very likely to really have
the virus.- Can I get him other vaccinations?
Yes. There is no reason to skip other vaccinations in a feline leukemia
positive cat that I am aware of, especially since they may be more
susceptible to the illnesses the vaccine protects against. I would think it
really important to get at least the rabies vaccination, since he is
getting bitten by someone.- He is strong and healthy even with the injury. Can you tell from the
information I give you that he will live long?It is not possible to predict the lifespan of a cat infected with FeLV with
any precision. The longest lifespan in our practice was for a cat who
tested positive on at least four tests from the time he was two until the
time he was eleven. He died from lymphoma, a cancer associated with FeLV
infection, when he was just short of twelve years old. We have seen cats
who appeared to be fine on routine visits who had severe complications of
FeLV within weeks. This is just not something that can be predicted with
accuracy.- I do not care about how much it will cost to get FELV treatments for him.
Can you give me information about vets who do this kind of treatments in
Austin, Texas area?Some veterinarians do think that using interferon helps in controlling the
secondary problems associated with feline leukemia virus infection. It is
probably best to wait until a secondary problem is present to use this
therapy since some cats become sensitized to the interferon and then it is
not effective for future use. There are vets that use interferon
continuously. I have seen this recommendation on the Veterinary Information
Network from Dr. Alice Wolf, who is associated with the veterinary college
at Texas A&M. Dr Wolf is one of the leading authorities on infectious
diseases in cats, so if you don't mind making a trip to see her, you do
have an expert on this disease in your state, at least.Baby's current wound should heal fine even with his new excursion. If you
watch him closely and provide a good quality environment for him it is
likely he could live a good quality life for several years. There is no way
to guarantee on that, but he may live longer, too.Mike Richards, DVM
4/10/2000
Q: Dear Dr. Richards,
I have 2 cats, Truffaut and Fellini. They are both around 11 years old and I have
had them since they were kittens.
Both were tested (blood test) for Feline Leukemia when I first got them and
they tested negative. As they are indoor cats who do not come into contact
with any other cats, I didn't have them vaccinated.Now, 11 years later, Truffaut has been diagnosed with Feline Leukemia. We
took him in for a blood test because he'd been losing weight and had a few
scratches that weren't healing. A blood test showed VERY low white blood
cell count and low red blood cell count as well. But the blood test was negative
for Feline Leukemia. Then they gave him a bone marrow aspiration and found
the leukemia virus hidden there.Fellini has tested negative for leukemia and we are now having him
vaccinated.I have a few questions -- one is I don't understand how Truffaut could have
caught this. I live in Manhattan in an apartment and he never goes outside.
He only has contact with Fellini. My vet thinks he was born with it or
caught it from his mother (I adopted him from the ASPCA when he was
5 weeks old.)
But how could he have lived with this virus for over 11 years?Second, more important question.... What can I do for Truffaut?? We've been
giving him predisone for a few weeks and his white blood cell count dropped
even further (from 2000 to 1600 I think). He is also on Baytril. He's
acting fine and eating well but the vets are concerned about the low WBC. Is there
anything else I can do to help my poor critter?Sorry for the long-winded mail but I'm trying to research this. I've already
been through over 2 years of fighting CRF with Fellini and he gets daily
sub-q injections... and now I find Truffaut diagnosed with this nightmare.Any advice is GREATLY appreciated.
Best wishes,
Jacqueline
A: Jacqueline-
At the present time feline leukemia virus infection is more confusing than
it was in the past (and it has always been confusing). There is a strong
possibility that most cats that are infected with this virus have lifelong
infections. This is not what we thought occurred even a few years ago. Cats
who test negative on blood tests do not have the virus in their bloodstream
but it is likely to be sequestered in the bone marrow or in the central
nervous system. As long as it stays sequestered it usually doesn't cause
much problem. In a small number of cats it seems that FeLV virus
sequestered in the bone marrow can cause the bone marrow to quit producing
red and/or white blood cells, though. This may be happening in your cat.
Immunosuppression is usually attempted in these cases but I do not know how
well it works.I worry when white blood cell counts are less than 3000 and the WBC is
considered to be critically low when it is below 1000 so there is some
cause for worry. It is a good sign that Fellini feels good. I hope that he
has continued to feel well and that things are improving now.Mike Richards, DVM
7/1/99
Q: Hello Dr. Mike,
I wondering if you could answer a few questions for me?
I recently got the results back from a blood panel on my 5 year old FeLV
positive cat. My vet was not concerned about the CPK level. He said
that he had seen levels this high before and that it could be related to
the leukemia, or may not have any significance. The analysis was
repeated at the lab for verification and the CPK was 6,962 IU/L as
opposed to the reference range of 88 - 382. Is it common to have
reading this high, and have you seen any correlations between high CPK
levels and FeLV or any other disease?
My second question is more of a dilemma. Since I rescue cats in my
neighborhood, I have had a sample of many veterinarians in my San Jose,
California area. The problem is that it took me years to find a
veterinarian that I really liked, and I am now leaving the area of my
primary veterinarian. I am moving to the Las Vegas, Nevada area, and am
in search of a referral. My primary vet does not know any one in that
area and I was wondering if you have a colleague or can recommend
someone in that area. Any suggestions?Thanks for your help,
Marc
A: Marc-
High CPK (creatinine phosphokinase) levels in cats occur for several
reasons. There are numerous reports of high CPK levels in the absence of
any identifiable disease, too. That may be because of diseases that are
hard to find or there may be some problem associated with CPK that we just
don't know about.The identified causes of CPK rises in cats are muscle damage, anorexia (not
eating), inflammatory bowel disease and pancreatitis (possibly due to
intestinal muscle damage, possibly due to not eating associated with these
diseases), cardiomyopathy (again due to muscle damage), thromboembolisms
(also probably due to muscle damage it causes in rear legs) and a genetic
disorder in a research colony of cats with dystrophin deficiency. The CPK
value can get into the hundreds of thousands and is commonly in the
thousands just from not eating, apparently. This makes it a little hard to
figure out how significant a rise in level is.It is still worth looking for any cause of muscle damage, checking for
heart murmurs, making sure your cat is eating OK and thinking about
pancreatitis. The TLI (trypsin immunoreactivity like) serum levels may be
high with pancreatitis and somewhere I think I have read about an increase
in pancreatitis in cats with FeLV, so that is another thing you could check
out. Monitoring weight over the next month or so would be a good idea, too.As with all testing, lab errors sometimes occur, too. It might not be a bad
idea to recheck the CPK level just to see if it remains high.One of my classmates, Roger Paulsen, was in Las Vegas. I can't say that I
really know how good a vet he is but he was a very nice person -- one of
the nicest in my class. I'm not sure if he is still there and I don't know
anyone else. I wish I could help with this one, but unfortunately, I can't.Mike Richards, DVM
4/8/99
Q: Dear Dr. Richards,
We just found out my daughters cat has fel v. She (Adrina) is 13 and her
cat is 10. She is alittle upset but being I volunteer at a local hospice she is
very understanding about quality of life and not quantity.
We are treating the respiratory infection for now going to take one day at a
time. We will let the illness take is own path and make her comfortable as
long as we can. She is heavy and still has a great appetite.
Any advise for my daughter you would like to share? I'm alittle
concerned as she was a foster child before she was adopted and was considered autistic.
She has opened up through the years and a lot has to do with her cat. She
also started playing the violin 3 years ago and plays wonderfully. The cat
hates it though. She wants to spend as much time as possible with her "friend " while she
can.
Thank you
GingerMy daughters name is Adrina, the cat is Stripes
A: Ginger-
I wish that I could give you some meaningful advice but it just isn't
possible. Ten is a little old for an initial diagnosis of feline leukemia
and you didn't say what prompted the diagnosis (what sort of illness is the
current problem). However, many cats with feline leukemia can be helped
with aggressive therapy directed at whatever secondary problems develop,
such as secondary infections, loss of appetite, kidney or liver disease,
etc. Keep working with your veterinarian to address the problems that
develop and encourage Adrina to provide love and support for Stripes. It
really does seem to help.Mike Richards, DVM
2/26/98
Q: Dear doctor,
Please HELP! Our cat-cookie-has been with us for about 4 months ( he is
about 7 months old). We took him to the vet today for a spay and we
found out that he has Feline Leukemia. The local vet says it is acute.
We have been away for the last two weeks and when we picked her up
yesterday, the changes were significant. He has lost weight, he is not
eating and he seems very tired and lethargic. The vets tech pointed out
extremely white gums and indicated he was anemic.They seemed pretty nonchalant about the whole process and immediately
wanted to put him to sleep. This cat is my nine year old's very best
friend. I can not do this without being certain that I have done
everything I can to help. The doctor has intimated that our cat will
not live more than a few weeks. I can not believe that in this day and
age that there is not a thing I can do for this cat.I have receive antibiotics to be given to her BID. Predisone tablets
once daily and special A & D cat food with a syringe. I am willing to
force feed him if I have to and if it will help.PLEASE write back as soon as possible if you can give me any advice. I
am doing the right thing? Do it sound hopeless? I realize that there
is only so much you can do from afar, but is there anything I can do to
prolong his life WITHOUT pain and suffering (or at least minimal
suffering). Is it typical for cats to die as early as 7 months from
this disease?THANK YOU so much
Paula
A: Paula-
It is not unusual to see young cats who are severely ill due to feline
leukemia virus infection. Supportive care is all that can be done.
Antibiotics to prevent secondary infections and prednisone to suppress the
white blood cells are the most common treatments. Anemia may need to be
corrected with blood transfusions and other supportive care may also be
necessary. There is not always a positive response to treatment even with
aggressive care. I hope that your cat did respond and is doing better by
now. It is not unusual for veterinarians to be discouraged about treating
for feline leukemia virus when there are severe clinical signs. It is hard
to recommend intensive and costly treatment in the face of an illness that
is often non-responsive. But your wishes are the most important part of the
equation and if you wish to try your vet should, and almost certain will,
respect that wish.Mike Richards, DVM
2/16/99
Q: What are the symptoms of feline leukemia? My cat is an inside cat and
has been since the day I found her 6 yrs ago. At that time she was
tested and had all her shots. I have not taken her back to the vet since
because she never, ever, goes outside. Lately, (last 2 wks) she has been
throwing up after she eats, and she occasionally sneezes. Could it be
Feline leukemia or do cats get the flu or colds?
Thank you for any advise.
VickieA: Vickie-
In general, almost any clinical sign of illness can be related to feline leukemia virus
so it is a concern in any ill cat. Vomiting is not the most common sign and your cat's
history is not highly suggestive of this disease but it would be best to have your
cat checked by your vet to find out what is going on.Mike Richards, DVM
2/16/99
Q: Dear Dr. Mike
My husband and I have had Elmo since he was a small kittem (3 weeks)
His mother was killed and we had to hand feed him. Anyway he tested
positive for FeLV from the very beginning. The docter said it was a
faint positive and he might "fight it off" We had him tested again 2
months later and again the vet said that it was a faint positive. I
have some questions related to this. He is now 1yr 1/2 old and is very
aggressive ( i.e biting , pouncing) and is skiddish around strangers. Is
this related to FeLV or being weaned so early? Also would it be OK for
us to someday get a dog? we have always wanted to adopt a Greyhound and
would like some suggestions concerning this. Finally what symptoms
should I look for to see if he is developing an illness related to FeLV?Thank you so much for your time and answers!!
Elmo's mom
A: Shannon-
It might be worthwhile to consider testing Elmo with a different test
method but it is probably likely that he is persistently infected with
FeLV. He poses no risk to a dog and a dog poses no real risk to him except
perhaps by increasing the stress level in his life.It is not unusual for cats who are weaned early to be overly aggressive
while playing, so that is the more likely problem with that behavior. It is
often possible to teach cats limits to biting/playing behavior even later
in life so you might want to ask your vet to help with suggestions for this
( I think we have some on our web site, too).FeLV can cause lots of symptoms. The best approach is to take Elmo to your
vet as soon as you notice any difference in his behavior, eating habits or
anything that makes you think he might be ill. Early aggressive treatment
of problems secondary to FeLV helps to prolong a cat's life that has feline
leukemia virus better than anything else.Mike Richards, DVM
1/99
Adding another FeLV positive cat
Q: We currently have a male cat that is about 3 years old. He was a stray that
we took in about a year ago, He tested positive twice for feline leukemia.
We would like to get him a playmate (another cat). I understand that if we
are to get another cat, we should get another one that has also tested
positive. My concern is that so far Indy has had no medical problems, and
is in perfect health. So I assume his virus is currently latent. If we
were to get another cat, that may not be latent or may develop medical
problems sooner, are we putting Indy's health at risk. Is there any
possibility of an active carrier with active disease making Indy's disease
become active sooner than it would otherwise? I don't want to get another
feline positive cat if the contact could increase Indy's medical risks.
Sincerely,Brenda
A: Brenda-
If your cat is still positive for feline leukemia (which he probably is if
he tested positive twice) then it is unlikely that his status will be
affected by the addition of another cat, unless he finds that situation
stressful, or the new cat carries another disease he has not been exposed
to or if there are fights that lead to injury and bacterial infection.
Since those things are possible it is a good idea to weigh the decision to
add a new cat carefully. Do quarantine the new cat so that any transient
illnesses that might be stirred up by the stress of a new home pass before
the cats are introduced. Many people do adopt new feline leukemia positive
cats in this sort of circumstance quite successfully.Mike Richards, DVM
1/99
Q: My cat was diagnosed with Leukemia. What type of diet she should be on?
Are there any foods that are best for her to eat? Thank You
Lara
A: Lara-
At present the best recommendation that I can make is to feed her a high
quality diet to ensure that she is getting adequate energy from the diet.
Canned food is probably a little better in this instance than dry food
because it tends to have more fat and less carbohydrate (at least I think
that is the case), which is actually probably better for a pet with cancer.
Recently Hill's came out with a prescription diet for dogs with some types
of cancer but I don't think there was a cat version of this diet. Iams also
has a diet formulated for helping cancer patients but I do not know if they
have a cat version, either.Mike Richards, DVM
Q: I just acquired a kitten (Winston) who tested positive for FeLV. I was
heartbroken-as were my two children. The person we got Winston from had
the brother as well. The brother tested positive "with a trace". We
decided to take the brother in as well, because the women who took the
cats in had an older cat that she didn't want to expose to the disease.
Here are my questions:1) Can I provide some sort of vitamins for my kittens to help keep them
as healthy as possible? Currently they show no symptoms, and if I can
do anything to keep them that way, as long as it's not outrageously
expensive, I'd like to do it. What is Interferon?2) My vet never suggested to have Winston (or his brother) re-tested.
I was never told what type of test was given to him, never given any
options on treatments, never really provided with any sort of
information. Should I ask to have them both tested again?And finally, as mentioned above, I have two children (7 and 9) who adore
the kittens. I have explained to them that the kittens have this virus,
and that they may not live a very long time. They seem to have accepted
this (after a bit of crying), but want the kittens around as long as
they are healthy. Do the kittens pose any risk to my kids? The vet
said "no" but I did read with much concern the same question about the
British study that talked about increased risk of leukemia with children
that had cats. Are there indeed studies on families that have FeLV+
kittens with kids? And are indeed the kids fine? I think I need some
reassurance here.Thank you so much!
Carolyn
A: Dear Carolyn-
I think that you should have the kittens retested. If the second test comes
back negative there is a very good chance that the kittens will live much
longer than if the second test is positive. Since I have delayed in
responding to this question it has been long enough to retest them at any
time. If the second test is positive the average lifespan is shorter but
can still be of good quality for several years.I do not know if any vitamin preparations are helpful in extending
longevity. It is a good idea to be sure that vitamin requirements are met
but most good quality cat foods do meet the minimum requirements.Interferon is an immune system modulator that some vets believe is helpful
in prolong the quality and/or quantity of life in cats infected with feline
leukemia virus. I do not have an opinion either way on this but it seems to
be pretty safe.There have been a number of studies which have shown no relationship
between feline leukemia infection in cats in a household and leukemia or
lymphoma cancers in humans. There have apparently been two reviews of the
infection rate in infants or young children which showed a higher rate of
leukemia in households with a feline leukemia positive cats, one of which
was from Britain. I am not familiar with these studies but they are
mentioned in Dr. Scherding's book "The Cat, Diseases and Clinical
Management". It is my impression that the consensus of opinion among
oncologists is that this link is very tenuous or that it doesn't really
exist. I would personally feel comfortable having a feline leukemia
positive cat in my household but everyone has different levels of comfort
or tolerance for risk and you have to do what seems right to you. If I can
find these studies I will try to post an abstract online.Mike Richards, DVM
Q: Hi Dr Mike,
I have a few questions, mostly related to FeLV:
I have a cat that tested FeLV positive, a few months later I had her
retested and she tested negative. The first test was sent to the lab
(they said they tested it twice at the lab). When I had her retested,
she had an IFA test (which was sent to the lab) and an in-house elisa
test -- both were negative. Someone told me that if a cat tests
positive (excluding false positives) and then later tests negative, the
cat doesn't really seroconvert, it just sequesters the virus in the bone
marrow and it can resurface if the immune system is later compromised.
Is this true???I have a FeLV positive male cat that was forming acidic crystals and
stones in his bladder. About two years ago he was on a cat food made by
Flint River Ranch (a high quality oven baked kibble that is made from
human grade meat). He was on this food for a few years and was also
receiving sodium ascorbate. We discontinued the sodium ascorbate, but
he was still straining when he urinated. I tried to find other diets
without acidifiers, but they all seemed to have DL -Methionine. I
switched to Eukanuba chicken and rice and he stopped straining. About a
month later I tried the Flint River Ranch diet again. About a week or
so later, he started to strain again. He has been on the Eukanuba for
the last two years without any problems. I still feed Flint River Ranch
to my other cats and have had no problems with them. Is there any
connection between acidic crystal formation and FeLV?
I have other concerns about the use of these diets. I am pleased with
both diets, although both diets are high in protein and fat. I was told
that the high protein and fat content would "blow out their kidneys at
an early age". I was also told by someone else that it is not the the
protein or fat content that is damaging, but the source of the fat or
protein. So, if the source of protein and fat is from "real" meat, is
it okay to have a high fat and protein content??Thanks,
Marc
A: Marc-
I don't think that anyone knows the answer to your first question at the
present time. For a long time veterinarians assumed that cats had three
outcomes from the initial infection with feline leukemia.
1) they died from the initial infection
2) they became carriers of the disease until they became ill from it and died
3) they became immune.
Recently it was proven that cats could sequester the virus in their bone marrow
or central nervous system, keeping it suppressed indefinitely, perhaps lifelong.
In the event of a serious illness or immunosuppression for other reasons such as
corticosteroid administration, some of these cats lose the ability to
suppress the virus and it becomes an active problem again. The question is
this: do any cats become immune or are there only cats who are infected but
suppressing the virus effectively in this group? My guess is that there are
many more cats suppressing the virus than there are cats who are able to
become immune. So it would be worthwhile to test your kitten anytime that
there is a serious illness, unfortunately.I am confused by your second question and this confusion is actually the
reason for the delay in responding to your inquiry. This is what confuses
me: acidic urine is associated with the production of calcium oxalate
stones in cats but the treatment you are describing actually sounds like
the treatment for struvite crystals which occur more commonly under natural
conditions and which are treated by acidifying the diet and restricting
magnesium.Sodium ascorbate is Vitamin C or at least closely related to it.
Administration of Vitamin C will acidify the urine, but not usually
efficiently enough to help a whole lot with struvite crystals. It would
almost certainly encourage the production of calcium oxalate crystals. D-l
methionine is commonly added to cat foods to acidify the urine in an effort
to cause urinary acidification. It works pretty well for this. Most cat
foods strive for a neutral pH or slight acidification. I have no idea what
effect the Flint River Ranch food has on urine pH. Eukanuba is supposed to
slightly acidify the urine. Given this, I would tend to think that your cat
has struvite crystals and that urinary acidification is helpful rather than
harmful. If I am wrong and these were calcium oxalate crystals, then it
would be better to try to find a food that causes a more neutral pH. Hill's
makes a food specifically for cats with calcium oxalate stone problems and
other "ordinary" foods produce neutral urine.I do not know of an association between feline leukemia virus infection and
feline lower urinary tract disorders but one is possible.High fat diets are not particularly harmful in cats unless they are
overfed, leading to weight gain. The same is true for high protein diets. I
do not know of any benefit to feeding high fat or higher than needed
protein levels, though.If you have the same confused feeling about the acidic urinary crystals as
I have it may be a good idea to discuss this with your vet and try to
figure out whether there has been a miscommunication or if these were in
fact calcium oxalate crystals.Mike Richards, DVM
Q: Dr. Richards,
I don' t know where to start --- my kitten, who is almost three months old was diagnosed with FeLV three days ago. My husband and I had just gotten her and were taking her in for her initial vet exam. We do not know if she got it from her mother or from another cat she was with. We are so confused and keep getting conflicting information. We do not want
to put her down - she is healthy at this time. We feel so helpless though. I guess my first question is this -a) as a kitten with it, is it possible for her to be healthy? It seems to me that a kittens immune system would already be weaker than an adults cats and therefore it be at a disadvantage with this virus.
b) have there been any cases where a kitten (whether getting it from another cat or in the womb) has been able to pass this virus out of their system?I know that there are no simple answers - I'm just scared for our kitten and want to keep her healthy as long as possible --- (do you recommend vitamins? or foods with vitamins (I don't want to stress her out by making her take pills at this time...) I don't think we are alone in our crusade and our desire to keep her around.
These are just the beginning questions - tons more are swarming around. Thank you so much for reading and responding to this. Please let me know where I can turn for info. -- It's scary being ignorant.
Many thanks - Sean and KarlaA: S-
Some kittens are able to clear the virus from their system. Others are able
to suppress it sufficiently that they are not affected by the virus and do
not transmit it to other cats. The exact percentage of cats able to do one
of these two things is not known exactly but it probably is at least 30%
and may be as high as 50% or more of infected kittens.Kittens that remain positive for the virus on two or more tests done at 3
to 6 week intervals are likely to remain positive. These kittens often have
several years of relatively normal life and then develop problems
associated with the feline leukemia infection. In some cases there is severe
illness early in the infection, though. These kittens are also potentially
infective to other cats and need to be kept isolated from other cats who
are not also positive for the feline leukemia virus. As long as this is
possible I see no reason not to try to provide a good life for a cat
infected with the feline leukemia virus.You are correct in the assumption that kittens are at a disadvantage when
infected with this virus. Feline leukemia virus infects kittens much more
readily than it does adult cats. Most cats that are infected with this
virus probably were infected as kittens. Even so, there are a number of
kittens who can suppress the virus.I hope that your kitten is one of the lucky ones. If not, you can still
provide her with a good quality of life, potentially for several years. It
means being responsible for her and not allowing her to have contact with
cats or kittens who might become infected but that usually isn't too
difficult to accomplish.Mike Richards, DVM
3/99
Q: Dear Dr. Richards,
My name is Veronica A and yesterday my cat was diagnosed with FeLV. I
found this cat in the woods about 3 weeks ago, and was told the cat was about 5 months old. My cat, Oliver is scheduled for a retest in October. I also have 2 other cats in my home, but my question is, is it safe to have Oliver living in my home upstairs, while I have my other 2 cats living downstairs and outdoors? Is there still a chance that my 2 other cats can still get infected? Should I wait for the retest before making any
decisions? Please let me know what you think. I would really appreciate it.Thank You , Veronica
A: Veronica-
Feline leukemia virus is transmitted by contact with bodily fluids from one
cat to another. The virus does not live more than a few seconds in the
environment, so it is generally considered to be safe to keep a cat with
feline leukemia if it can be kept physically separated from other cats in
the household. In addition, feline leukemia virus is most easily transmitted
from an infected cat to a kitten and natural immunity to the virus appears
to be pretty strong in adult cats. Since you have an inside/outside cat I
am presuming that the other cats are also vaccinated against this disease,
making it less likely that they would be infected as well. With all of
these things going for your downstairs cats I really think it is probably
safe to keep Charlie upstairs and separate from them without worrying too
much about the other cats contracting feline leukemia virus.It is a good idea to retest, after at least a three to six week interval,
whenever a cat tests positive for feline leukemia virus. Many cats can
either free themselves of the virus or suppress it sufficiently that they
do not pose a threat to other cats. In either case, the test should be
negative on the second test. If the cat continues to test positive on two
tests this far apart if may be a good idea to test using another testing
method or to assume that the cat is infected and capable of transmitting the
virus, in which case it should be kept separate from other cats.Hope this turns out well on the second test.
Mike Richards, DVM
Q: Hi, I'm a vet tech and I have a cat that is almost 2 years old. She has been positive since she was a kitten. She isn't really showing any signs of the virus and never has. Just a runny eye and she had swollen glands that we treated with pred. when she was about 4 months old, which never reoccurred.
What I'd like to know is if there are a lot of positive kittens that have done as well as mine or if she is an exception. I've had her on interferon since she tested positive. At first I also had her on vitamins (she was malnourished). Thank you for any information you can give.
Vicki
A: Dear Vicki
I am only aware of one study that reported lifespan expectations for cats infected with feline leukemia virus and persistently viremic (continuously test positive). In the study, reported by Dr. Susan Cotter in the November 1991 issue of the Journal of the AVMA, most cats died within two years but about 20% of the cats lived three or more years. In our practice we had one cat who tested positive at 2, 4, 7 and 11 years of age and lived a fairly normal life until he was eleven. I can't remember another cat that did nearly that well, though. I think that cats who live alone or with one other cat do better than cats in larger households, probably just because they are less exposed to other diseases and less stressed.
Cats who can not clear the feline leukemia virus (FeLV) from their bloodstream need to be carefully monitored. If they show signs of illness they should be treated promptly and aggressively. It is not a good idea to adopt a "wait and see" attitude about any illness in an FeLV positive cat. Ensure that your cat has a good quality diet. Checking the mucosal color (gum color, conjunctival color) on a regular basis and occasionally having bloodwork drawn to ensure that anemia is not a problem may be a good idea. Interferon is used by many veterinarians and most feel that it helps. I do not think that the scientific literature adequately proves that interferon use is helpful, though. It does appear to be very safe and I see no reason not to try it.
An FeLV positive cat should be kept indoors. The virus infects kittens much more effectively than adult cats. You should not bring a kitten home to live with this cat. For some people this is very hard but it is important.
I hope your cat continues to do well.
Mike Richards, DVM
Q: I have friend with cat with feline leukemia....her vet said there was an increased incidence of leukemia in children where cats with this disease were around? is this true???? never heard of it and can't imagine it lives long enough to cause problems in humans... Thanks, BMan
A: BMan-
There was an exchange in the letters to the editor (I think that is where it occurred) section of a veterinary journal in which this claim was made. It was apparently based on a British study in which children with leukemia were studied for factors that might have contributed to their disease. Children with cats were more likely to have leukemia in that study but to the best of my knowledge (I have only seen reference to this in a textbook, not the article) there was no mention of this being from feline leukemia virus. Many other studies have been done since this one and none have shown any evidence that feline leukemia virus can cause leukemia or lymphoma in humans. I truly believe that this information is simply incorrect.
Mike Richards, DVM
Feline Leukemia and Bladder Infections
Q: My cat Raul tested positive about 1 month ago. He has a pale mouth and nose, has lost weight,and has cut down on eating. I noticed a odor coming from our basement that smelt like cat urine. Yesterday I actually saw him going bathroom right in front of me in the basement. I don't no how long this has been going on but I think it is fairly recent. Is this because of the leukemia or what?is there any thing to do to make him quit. I would appreciate it greatly if you could answer this question. If not thanks for taking time to read it.
A: Mel-Cats with feline leukemia often have an increased susceptibility to bladder infections (actually to many infections). It would be best to be sure that this was not leading to the behavioral changes. Cats with feline leukemia also often have behavioral changes that do not always seem to have a specific physical cause. In some cases they may be too weak to make it to a litterpan in a location such as the second story of a house or even into a litterpan with high sides. If there is an suspicion this is the case it is definitely a problem you need to discuss with your vet. Lastly, cats with feline leukemia can have physical and behavioral problems totally unrelated to the feline leukemia. If this seems to be the case the standard advice for litterpan problems found in our cat information area would apply.
The pale color to his mouth is not a good sign. I hope that he has regained some color since you wrote.
Mike Richards, DVM
Q: We got a kitten two weeks ago. We also have an 11 year old cat with health problems. We were just told that the litter has tested positive for Feline Leukemia. We are testing both cats. What do we do if the kitten was born with it? Is is true it could never get sick? Is the probability high that the older cat will contract it? Help, I'm devastated. Linda
A: Linda- It is pretty confusing to deal with feline leukemia in litters of young kittens. It is entirely possible for only part of the litter or even one kitten to be infected and the rest of the litter unaffected. Some kittens (or cats) who are infected with feline leukemia will develop immunity to the virus and will not ever become ill from it. Probably about 30% of the time this happens. Some kittens will be able to sequester the virus in the bone marrow or central nervous system where it will not cause harm until some future stress occurs and causes the immune system to fail in its suppression of the virus. This is usually considered to be a latent infection.
Some cats can tolerate the virus but can not suppress it. These cats have virus in their bloodstream constantly. They are carriers of the disease because they are infectious to other cats. Finally, some cats die from the initial infection. This wouldn't be too confusing except for one thing. There is no easy way that I know of to tell the difference between a cat who becomes immune and one who is latently infected. So it is very hard to be sure that future problems won't crop up if a kitten tests positive for the virus and then later tests negative. If this is what happens, the risk to your older cat is minimized but a small risk would remain due to the possibility for activation of the latent infection. It would be best to keep the kitten and your older cat separated until you can ascertain if the kitten is has circulating virus antigen (is POSITIVE for feline leukemia virus). If this is the case, continuing to keep them separate is a good idea. If the kitten tests NEGATIVE for the virus then the decision to let them play with each other and live together is easier -- but you should still discuss vaccinating your older cat with your vet and you should be willing to retest the kitten if it shows signs of illness.
Mike Richards, DVM
Feline leukemia - Part 2
Q: Thanks for replying. The kitten did test positive. We had to return it to the animal shelter because we did not want to risk infecting the older cat. As it turns out the older cat may have cancer. She is going in for exploratory surgery. If she has cancer, we will get the kitten back from the shelter. One other question; one of the other kittens from the same litter (who has also tested positive) is at the shelter. We were thinking of taking both kittens home if my older cat is terminal. Figured they could live together without much risk. Is it safe to have both kittens (who are both positive) live together?
A: Linda- I see no reason not to adopt both kittens as long as you are prepared to deal with the feline leukemia. With aggressive care for illnesses and a good quality of life, many cats can live a long time with feline leukemia but almost all have a shortened life span. That is OK as long as you are prepared.
Mike Richards, DVM
Feline Leukemia and fluid in chest
Q: Dr.Mike, I just found your page, I've enjoyed reading the letters from other people. My husband and I lost Muffin a week before x-mas 1996 due to feline-luke or so the vet said.? We found muffin seven yrs ago in the woods along with her two brothers. I Raised them on a bottle. Muffin was the only one we kept, after a litter of kittens we found out that she was felin-luke pos. we had her spayed, loved and cared for her after that. Through out the years she would develop upper respiratory infections. I would take her to the doctor get medicine for her until the next time (about every two years). We moved back to S.C in Oct.1996 she adapted well to the move. It was a usual thing for her to hide that would tell it was time to go to the doctor. On dec.16 We made a trip to the vet (a new vet to us) he checked her over found weezing in the chest and some congestion gave us a bottle of amoxill and sent us home two days later she was no better I called this vet back they said don't worry give the medicine a chance to work I knew better than that so I call another vet. I was told to bring her in right a way (I explained her past medical condition) needless to say her chest was so full of fluid that they could not see her heart on x-ray she died the next day.I realize that she was going to die one day probably from feline-luke. Please correct me if I'm wrong but I feel that the first doctor (keep in mind that I told him of her past history) was negligent. I think my best friend could have been there again if this was the beginning of a long draw out stage of suffering for her then it was best that she pass a way quietly. To this day I still have not gotten a straight answer to my question did she die from the leukemia? I have so many questions about this disease and never finding any good answers. I have three cats left they lived with muff for two yrs and everyone has tested negative so far. Thank you for your time I hope this gets to you and you will consider an answer for me. Sincerely , Terri from S.C
A: Terri- Feline leukemia virus is one of the more common causes of fluid accumulation in the chest of cats. This can be chylothorax (accumulation of white blood cells) or other effusions. In general the presence of fluid in the chest in combination with the history of feline leukemia is a poor prognostic sign. Many times a secondary tumor in the chest, associated with the feline leukemia, is causing the fluid accumulation. In this case radiation therapy or chemotherapy for the tumor (it is important to make sure there is a tumor) may provide short term relief but the prognosis for survival long term is still pretty grim -- probably about 3 or 4 months. While I suspect that Muffin would not have benefited for very long from a more aggressive approach to the initial treatment I tend to agree that your vet probably should have taken your concerns more seriously. I try not to fall into this trap in my practice but it is easy to put people off on bad days. I am glad you believed strongly enough in your convictions to seek help from another vet. I appreciate it when a client tells me I am not listening adequately to their concerns and gives me the opportunity to respond again to their concerns, too. If you are sincere your vet will probably respond to this approach as well if it is necessary to express your concerns again in the future.
Mike Richards, DVM
Q: My dear cat "White Cat" passed away on June 5, 1997. I am confused about what his diagnosis was and wondered if you could help. White Cat had been leukemia positive for approx. 3-1/2 years, but was very healthy and never showed symptoms. On May 29, I took him to a vet on emergency call, as he had stopped eating for a day and a half, was lethargic, and was not acting his usual self. I noticed his gums and ears were very white. The vet ran a PCV and found it to be 11%. He said he was extremely anemic, with red blood count at 97. He gave him a blood transfusion, some fluids, and a shot of immuno-reglin and sent him home. The next day, he spiked a fever of 105.1, so I took him back to the vet. They stated it may be a transfusion reaction. The fever came down quickly with fluids and a shot of Dexamethasone. I took him back home. The next day, he continued to not eat and then began having difficulty breathing. I took him to my regular vet who stated he needed aggressive treatment. His PCV was at 14%, a chest x-ray showed fluid around the heart and lung area. She treated for three days with Dexamethasone, and antibiotics. White Cat continued to not eat and breathing was not normal. Blood tests showed he was auto-glutenating fiercely. After 3 days of treatment, the auto-glutenating slowed down and PCV was at 17%. However, the cat would not eat, and when force fed, would vomit. I took him home to see if less stress would help the situation. He remained at home for two days, with no improvement. I then noticed his ears were turning blue, and at that point I took him to be euthanized. The vet stated he was throwing blood clots and had very little oxygen. Can you help me understand if all of this was from the leukemia? Could the transfusion have caused this? Would any other treatment have helped or was this the leukemia causing him to crash? I just need to know that all the right things were done for him so that I can find some peace about the situation. Thank you. Teresa
A: Teresa- I think that the signs are probably all from the leukemia based on the information in your note. Feline leukemia virus often causes profound anemia so that would be a very typical problem. It often occurs years after cats are infected so that is not unusual, either. Blood transfusion reactions in cats do occur but they usually occur during or very shortly after the transfusion as cats seem to react quickly to administration of inappropriate blood types. Fortunately, most cats in this country (perhaps as high as 98%) are type A so reactions do not occur frequently. Some cat breeds (especially British Shorthairs) have a high rate of Type B blood so purebred cat owners need to be more careful about transfusions.
I am sorry hear about White Cat. It sounds like both vets were working hard to deal with the problem. Sometimes we just aren't able to make a difference no matter how hard we try.
Mike Richards, DVM
Feline Leukemia / Behavioral Changes:
Q: Puddy is 3 years and 5 months. She was diagnosed feleuk when she was 8 months old. Until now she has been very healthy. For the past 3 weeks her behavior has changed. She doesn't sleep with me anymore. She pooed on the carpet in front of her litter box, she stopped sitting in the sun , etc. For the past 3 days she hasn't eaten much either. I went to a vet yesterday and was told that her red cell count is down to 15%. She also has a mass around her mid abdomen (i can't feel it myself, but the doctor did) and it seemed to hurt at the exam. After an x-ray, the dr. assumed it was a tumor on her small intestine. (not 100% sure). She is afraid the tumor might cause an obstruction. How do i know for sure...it is very risky to operate on her at this time. I have consulted an homeopath, and will try to get her some immuno regulin. Is there something else i can do? I don`t want her to suffer, it is hard to judge when enough is enough. I just find that most vet`s attitudes about Feleuk are very negative even when the cat is not sick. Statistics are easily reinforced with such attitudes. I appreciate you taking the time to read this long story.
ps: Puddy is my best friend.
A: Puddy sounds very lucky to have you. I think that more and more vets are realizing that in many circumstances cats with feline leukemia can live comfortably a fairly long time.
The development of tumors is a very serious complication of feline leukemia, though. Some veterinarians feel that chemotherapy is a reasonable option when tumors arise. I have not had a client recently who was interested in pursuing that option and can not comment on its effectiveness.
Prednisone therapy usually will help with the anemia and can help prolong the comfortable lifespan, even with tumors. I have seen variable reports on interferon and can not remember seeing anything on Immuno-regulin (Rx) but that doesn't mean there isn't supporting information for its use. I definitely don't see all studies -- there are a number of journals.
I wish you and Puddy the best of luck with this.
Mike Richards, DVM
There is an excellent site called Chloe's Web that offers support as well as links to research and other Feline Leukemia resources. http://www.felineleukemia.com
Michal
Last edited 04/20/04