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Feeding Tubes

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In comparison to people, feeding tubes in animals are not routinely used in terminal cases to prolong life. They are used to help an animal get over a temporary problem and return to good health.

Most species of animal can go many days without eating. This is not true for cats, especially when they are sick. Several days of not eating (anorexia) can have serious consequences in cats and lead to failure of important organs like the liver.

In addition to cats we use feeding tubes in our practice for turtles and tortoises that are not eating.

Causes of Lack of appetite

Internal organ diseases like hepatic lipidosis, infections, FeLV, and fevers, along with anatomical problems like a broken jaw can all prevent a cat from taking in adequate nutrition. In addition, all of these diseases increase caloric needs for healing to occur, so a lack of appetite in a diseased cat is an important problem to address.

The yellow discoloration to this cats gums is called icterus, more commonly know as jaundice. In this specific case the icterus is caused by liver disease because this cat has hepatic lipidosis. Feeding tubes are commonly used in these cats because they have stopped eating.


Short Term Treatment Options

Several options are available to give adequate nutrition to cats that are not eating. Many times they begin eating after we rehydrate them with intravenous fluids, especially if they have kidney disease. Sometimes we also need to assist feed them with special foods that are easy to administer and digest. Some cats will even start eating after we give them valium intravenously. Cats that have sugar diabetes (diabetes mellitus) might begin eating after we control their blood sugar level with insulin. Cats that are in pain from serious injury like a broken jaw might start eating when we give them pain medication.

This liquid diet called Clinicare is often used to provide both fluid and nutrition on a short term basis. It can be given orally or through a tube.

Another food used to provide short term nutrition is called A/D. It is also used for long term nutritional support in some cases. It can also be given orally by just putting it in your pets mouth. It can also be given through a tube when some water is added to it.


Medium Term Treatment Options

A nasogastric tube is an option that sometimes works well for several days. This tube is passed through the nostrils and into the esophagus. It is taped and sutured in place. It has the advantage of easy placement and maintenance. The main problem is that the small diameter of the tube that is used only allows a liquid diet (CliniCare). To give an adequate amount of calories on a long term basis with this liquid diet would mean giving a volume of liquid that is far too much for the digestive system to handle, and the cat will usually vomit.

Another medium term treatment option is tube feeding. In this technique we fill a syringe with A/D and attach a small rubber feeding tube to the end. We gently pass this tube into your pets esophagus and give it the full amount of food that is in the tube. It has the advantage of using a food source (A/D) that is more solid than a liquid diet (CliniCare), so your pet receives more of its needed calories. It also has the advantage of minimal discomfort since no tube is left in for long periods of time. Some cats will begin eating on their own after only 1 or 2 feedings with this technique.

Long Term Treatment Options

  • PEG Tube

    A very effective solution to long term feeding is a PEG tube. PEG stands for Percutaneous EndoGastric. It consists of a tube that passes from the inside of the stomach, through the abdominal body wall to the outside. It allows the long term use of food that will give adequate nutrition. Its first disadvantage is difficult placement. It is usually put in with a special instrument like an endoscope, or is placed surgically during an exploratory surgery of the abdomen. Both methods require general anesthesia. In addition, a further disadvantage is the potential for infection in the abdomen at the site the tube passes out of the stomach.

    In this picture you can visualize the PEG tube that is exiting from the stomach after an exploratory surgery.

  • Esophagotomy Tube

    In terms of ease of placement, cost, and effectiveness, one of the best options for long term feeding is an esophagotomy tube. It does not require specialized equipment or exploratory surgery, and can usually be placed with sedation only. Serious complications are rare, and usually consist of regurgitation of food if too much is given too rapidly, especially in the first few days of feeding. This problem tends to go away by itself.

    The esophagotomy tube passes from the left side of the neck into the far end of the esophagus. The tube is measured to ensure that the proper length is passed, and that the tube does not go into the stomach. This picture shows the measurement of the tube.

    This is the appearance of the tube immediately after insertion and suturing to the skin.

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    When it is bandaged only the tip where you will insert the food is visible.

    An x-ray reveals the path of the tube. The arrows on top outline the tube that is outside of the neck and under the bandage and along the back. The arrows on the bottom are the feeding tube as it passes inside the esophagus from left to right. As planned, it goes partway down the esophagus and does not enter the stomach. The white structure just below and to the right of the tube in the esophagus is the heart. The tube never touches the heart because it stays in the esophagus.

    Here is another view. Click on it for larger size.

    tuberad

Feeding Technique

A food that is routinely fed through a feeding tube for long term maintenance is called A/D. We have a handout that gives you detailed information on this food. We will let you know how much to give and if we want any supplements added. You usually need to add a little water to it to so that it can flow through the feeding tube.

If a PEG tube has been put in then the food you administer goes directly into the stomach. When food is given through the esophagotomy tube it partially fills the esophagus temporarily until it flows into the stomach. In both cases give the feeding mixture slowly and usually at room temperature or slightly warmed.

You will be feeding several times per day throughout the day. After the feeding you need to flush the tube with a small amount of warm water. If it becomes clogged in spite of flushing, place a small amount of cola or papaya juice in the tube until it dissolves the clotted food.

One of our nurses will give you detailed instruction in how to use one of these tubes before your pet leaves the hospital. If you have any difficulty with this tube we are here to help you, so please let us know if you need assistance after you return home. We would like to check your pet and the tube on a weekly basis until it is removed.

The amount of time the feeding tube stays in varies from weeks to months. Only when your pet is eating well and putting on weight will we remove it. An added advantage to the esophagotomy tube over the PEG tube is the ease of removal. On occasion the PEG tube can cause an intestinal blockage when removed because the tip of the tub remains in the stomach after removal and must pass through the intestines to be eliminated.

The overwhelming majority of cats respond positively to long term tube feeding. If your pet consistently vomits then we will put it on some medication to minimize this usually temporary problem.

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Feline Radiographs (X-rays)

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Radiographs-FelinePleuralEffusion

The first series of radiographs are before we had our digital radiography. If you click on some of them they will increase in size.

Cat that was shot in the neck with a pellet

Radiographs-FelinePellet

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Wires in a fractured mandible (lower jaw)

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Foreign body in the stomach

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Bone plate for fractured radius

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This cat has fluid in the thorax. Compare it to the  normal chest rad below

Radiographs-FelinePleuralEffusionLabeledRadiographs-FelinePleuralEffusion

 Radiographs-FelinePleuralEffusion

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Abdominal Hernia

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Pets that roam outdoors are prone to numerous traumatic injuries. Fighting with other animals, and getting hit by a car, are some of the more common ones. This page shows a surgical procedure to correct an abdominal hernia in a cat named Sundance that was hit by a car.

In this case the hernia was caused by a blow to the abdomen by the car. The blow was strong enough to tear a large hole in the abdominal muscles that surround the abdomen. The small intestine went through this hole and was trapped between the muscle and the underside of the skin. This needs to be corrected because the blood supply to the intestines can be compromised while entrapped in this abnormal location. This will cause a segment of the intestines to die with subsequent loss of life as a possible outcome.

This page has graphic surgery pictures. At the end of this page are autopsy (correctly called necropsy in animals) pictures that are also graphic in nature.

Diagnosis with Radiography

Our physical exam gave us an indication there was a hernia when we palpated the abdomen. To help us confirm the diagnosis we took a radiograph. Radiographs are taken for numerous reasons on every pet that is hit by a car. These pets can have trauma to the chest, broken ribs, herniation of abdominal contents into the chest, and ruptured internal organs like the urinary bladder. The radiograph helps us determine if any of these problems exist. In this case, the radiograph helped verify that Sundance had an abdominal hernia. He also had a fractured pelvis which would heal on its own if he was confined and rested for one month.

In addition to an abdominal hernia, which you will learn more about soon, animals that are hit by cars also can get a diaphragmatic hernia. In this hernia, the abdominal organs like liver or stomach have literally torn through the diaphragm (muscle of respiration) and are sitting in the chest. Needless to say, these are serious injuries. We will show you pictures of this at the end of this page. Lets look at how we make a diagnosis of a diaphragmatic hernia with radiographs.

 The arrows are pointing to a normal diaphragm. The lungs are the dark areas. Use them for comparison to the abnormal radiograph that follows.

This is the radiograph appearance of a cat with a diaphragmatic hernia. Several abnormalities are apparent:

The windpipe is pushed upwards to the top of the chest

The lungs are not black throughout the whole chest

The diaphgram is not visualized at the bottom

The heart seems huge because the liver and stomach are pushing up against it from below

A different case with a diaphragmatic hernia. It just looks like a big and round heart, but it has a diaphragmatic hernia like above.

This dog has 2 fractured ribs at the arrows. Can you see them?

This view of the same chest might help a little. The fractures could easily be missed in the above view, verifying how important it is to take 2 views.

This is a radiograph of cat with a fractured pelvis that is more severe than the one Sundance has. Do you see the fracture on both sides?

Presentation

Sundance was presented to us with a history of being gone for 5 days and lethargy. Most cats that are hit by a car are in a state of shock and can die if not treated with intravenous fluids. Sundance is lucky he survived being hit by a car without any shock therapy.

Our exam revealed a swollen and bruised area just under the skin in the right inguinal area, which made us suspicious of a hernia. Bruising is very common in such small animals that have been hit by a car, so it does not necessarily mean there is an abdominal hernia.

Surgery

Any pet that has been traumatized so severely that it has a hernia has an added anesthetic risk. We take special precautions to minimize this risk.

Surgery-Monitor

We keep a close tab on important physiologic parameters for all of our surgeries. Monitors like this give us an early warning of an impending problem.

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Once our surgeon has scrubbed up and is in a sterile gown, gloves, and mask, the surgery begins

In most hernias we make an incision directly over the hernia and proceed to make the repair. In this case, the hernia area had extensive swelling due to the fact that it had been present for several days before we saw Sundance. Also, the herniated area was near the area where we routinely make an incision to enter the abdomen for an ovariohysterectomy (spay). In this case it was decided to make an incision directly in the center of the body like a spay surgery, and repair the hernia through this incision.

The following section contains graphic surgical pictures of the actual hernia repair we performed on Sundance.

Lets get our orientation before we show surgery pictures. Our patient is on her back, with her head towards the top, and the abdomen clipped of hair. Our patient is already under anesthesia.

The white arrow shows the area of the hernia on the inside of the right rear leg. This is called the inguinal area. It is difficult to visualize the swelling from this view.

This second arrow in the middle of the body shows the location of our incision into the abdomen

The incision directly in the middle of the body was much longer than our typical spay incision. You can see our surgeon starting the incision.

We dissect through the tissue under the skin (called the subcutaneous tissue) until we encounter the rectus sheath, an area where the abdominal muscles come together. This area is very tough, and is used to hold the abdominal muscles together when we suture our patient back together.

The rectus sheath can be seen here as the large white glistening area between Dr. P’s finger. A horizontal incision is made directly through this layer in order to enter the abdomen and find the hernia.

The tear in the abdominal muscles was 4 inches long. It can be visualized here as the horizontal opening towards the bottom of this picture, just under Dr. P’s finger. A large segment of the small intestines was found caught in this hole, and was gently removed just prior to this picture.

Intestines do not belong in this area, and are easily damaged when trapped in an opening this size, especially for 5 days in this case. In this picture Dr. P is carefully checking them to make sure their blood supply in intact.

Here is a different case showing the bruising and compromised blood supply that can occur when the intestines are trapped

Intestines are not the only organ that can be bruised during abdominal trauma or a hernia. The kidney on the left has been traumatized as evidenced by the severe bruising when compare to the other kidney.

A special suture is used to sew the herniated muscle opening shut. It will provide the strength needed to hold the muscle together until healing is complete. Eventually the suture will dissolve.

You can view the partial closure of the opening in this picture as Dr. P sutures the muscle from right to left in the picture.

The muscle closure is now complete. The hernia was so large that additional sutures were placed over this layer for added strength.

The intestines were not the only abdominal organ trapped in the hole in the muscle. The omentum is tissue that naturally resides in the abdomen. When an abdominal organ is traumatized, as the intestines were in Sundance’s case, the omentum migrates to this area and covers the injured tissue to help in the repair process.

In this picture our surgeon is trimming off a piece of omental tissue that is discolored at the tip

It is important to check all the abdominal organs for injury. After the unhealthy omental tissue seen above was trimmed, Dr. P methodically went through all the abdominal organs and checked for injury.

Here he has exposed the urinary bladder and is looking for any signs of problem

Sundance had no other abdominal organ trauma, so his rectus sheath and skin were sutured back together.

Here is the 7 inch incision in his abdomen after it has been sutured closed. These sutures will be removed in 7-10 days.

At this point in the procedure Sundance was given a pain injection and monitored carefully by our nursing team. He went home the next day and eventually made a full recovery. He was lucky this time, and certainly used up more than one of his nine lives!

Necropsy Photos

To give you a better understanding of anatomy we have some photos taken at necropsy of a diaphragmatic hernia on a pet that did not make it.

 

This thin, fan shaped, and very strong muscle is the diaphragm. The front side of this muscle is facing the abdomen. On the right side of this muscle is the thorax (chest). You can see the reddish colored liver at the bottom of the picture.

This one has been torn at the bottom

This liver has gone through a torn diaphragm and is now in the thorax. The vertical white line on the left is where the diaphragm was. To the left of this white line is the abdomen, where the liver normal resides. To the right of this line is the thorax, which now contains the liver, when it should not.

When you pull the liver away you can see the heart and lungs

When abdominal organs are in the thorax they take up space and prevent the lungs from expanding. The lungs might also be bruised, called pulmonary contusion.

The darker areas of these lung lobes have pulmonary contusion

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Stomatitis (Lymphocytic/plasmacytic)

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This disease goes by several names. Some of them are faucitis and infectious stomatits. The primary symptom noticed by most people is a cat that is no longer eating well (anorexia). In some cases, there will be weight loss, drooling, a poor haircoat, halitosis (bad breath), bloody oral discharge, or a pet that seems ill in general.

Some cats are also painful around the mouth, and resist being petted there, and might even cry out in pain. We have even seen cats with severely inflamed mouths that have no symptoms at all. The problem was discovered during a routine exam. This is rare, and this cat will probably show symptoms in the near future.

Symptoms of this disease might come and go, but as time goes on the symptoms become more apparent and consistent. This again stresses the need for routine physical exams on all pets to catch problems while they are still treatable or curable.

Diagnosis

A diagnosis is made by one of our veterinarians when you bring in your pet for an exam. During the oral part of the exam our doctor will notice inflammation of the gums and tissue in the oral cavity.

This is an example of the seriously inflamed mouth that occurs in this disease. This cat is under anesthesia and we are preparing to biopsy the roof of the mouth prior to treatment. This cat is so painful we can only do this exam under anesthesia. You can see the anesthetic breathing tube at the bottom left of the picture.

There are a multitude of other diseases the mimic lymphocytic/plasamcytic gingivitis:

After our oral exam we do a basic diagnostic workup. This includes a blood panelviral teststhyroid levels, and dental radiographs.

Dental radiography can be an important part of the diagnosis and the treatment

normalrad

The roots in this first radiograph are normal

badtoothrad1circle

The circle shows the problem with the roots of this tooth. There is loss of bone around the tooth.

A definitive (positive) diagnosis is made by taking a biopsy of the tissue and sending it to a veterinary pathologist. This step is important because other diseases, especially cancer called squamous cell carcinoma, can mimic this one.

Cause

  • Kidney failure causing uremia
  • Foreign bodies from plant material
  • Viruses
  • Allergic responses

It is usually caused by a specific reaction in the immune system (called immune-mediated), similar to, but not exactly like, allergies. This abnormal response is secondary to even a small amount of plaque on the teeth. For some reason a cats immune system over reacts to this plaque and the inflammation starts. This emphasizes the need for early and thorough dental care.

Like many diseases, there are numerous factors working together.  These factors  include viruses, bacteria, genetics, stress, nutrition, and hormone diseases.

It is sometimes associated with the Feline Leukemia virus (FeLV), and more commonly associated with the Feline Immunodeficiency virus (FIV). We can easily test for these diseases with our in-hospital laboratory. Fortunately, due to vaccines, we rarely see FeLV any more.

More specifically, it is the inflammation in the gums, not an infection, that causes this problem. The inflammation is caused by plasma cells and lymphoctyes (hence the name in the title of this page) that infiltrate the gums. It is the immune system that gets this whole process going. Why, we do not know.

It is at this point, called a neck lesion in the cat, that gets the process started. The slight redness and inflammation  does not seem like much at this point in time, which is why most people ignore the problem at this stage.

This problem rapidly progresses unless the teeth are professionally cleaned and routine dental hygiene is instituted at home. Now the stage is set for the severe inflammation seen in the first picture on this page.

Treatment

This problem is one of the most frustrating diseases for veterinarians and owners, not to mention the poor cats that have this problem. Some cats respond to treatment, others do not. Some cats are effectively treated with a specific modaltily, while other cats treated with that same type of treament might not respond at all. Prevention is particularly important in this disease due to the difficulty in controlling it once it occurs.

Plaque control is paramount in treatment. This means your cat’s teeth need to be professionally cleaned as the plaque builds up. In our hospital we perform non-anesthetic dentals (also called NAD) to start the process of dental hygiene long before the gums become significantly inflamed like the two prior pictures. For most cats cleaning the teeth this way every 6 months can prevent the problem.

In between these cleanings the teeth need to be brushed. This is difficult to near impossible to accomplish once the gums become inflamed. It emphasizes the importance of preventing this problem with good dental hygiene before any symptoms appear.

Our dental page has comprehensive information on how we professional clean pets’ teeth.

You will read about and hear of numerous treatments for this problem. In most cases they only give temporary relief, if that, and cats continue to suffer. The most consistent and effective treatment for this problem is removal of the teeth. Unfortunately people commonly wait too long thinking medical therapy will cure the problem.

There are several different therapies, that have been used by themselves or in combination, to treat this disease. The medical therapies eventually do not work well, and removal of the teeth is needed in almost every case.

1. Laser Surgery

In very select cases our laser machine has been used to help cats with this serious problem. The results are not always beneficial. It removes the inflamed tissue and makes the mouth much less painful. Sometimes several treatments are performed in order to gently remove just the layers of tissue that are inflamed. After tooth removal the laser can sometimes be beneficial to help with the gums that are still inflamed.

Click here to learn more about our laser in general and to see how it is used in many surgeries.

2. Antibiotics

Antibiotics can give immediate relief until the best course of action is decided. For most people we choose liquid antibiotics due to their ease of administration in cats, not to mention cats whose mouths are in pain. To help ease administration only a small amount of antibiotic is needed. One of our technicians will demonstrate the proper method of administration.

We chose antibiotics that are safe and specific for the type of bacteria that are adding to the problem. They are given for one to two weeks initially, and are refilled as needed. They will be used periodically during the course of this disease as the problem flares up in the future. We will sometimes vary them for greater effectiveness. Unfortunately, they do not effect a cure, and only help us bide time. Their long term use can also cause resistance.

3. Cortisone

Prior to our new and more effective treatment modalities, cortisone, in the form of DepoMedrol injections, was used to control the inflammation. It was helpful because it helped decrease the inflammation for up to a month, and when used with antibiotics, helped these cats feel better and start eating again.

It never cured the problem, and eventually required higher doses to achieve its desired effect. In many cases, it no longer worked at all. Even though cats are very tolerant of cortisone compared to people, high and prolonged levels cortisone can cause  problems, so this form of therapy is no longer recommended.

4. Homeopathy

Anecdotal evidence suggests some cats do well with homeopathic remedies, although this is far from being proven or a standard treatment for this disease. This treatment modality is used in select cases by one of our doctors. You can learn more about it by following this link on homeopathy.

5. Tooth Removal

Even though it seems extreme, in most cases we recommend removing all of the teeth. It might be more effective when used earlier in the course of the disease, which is why we frown upon long term use of oral antibiotics and DepoMedrol. These medications are delaying the inevitable, add to the cost, and increase chances of side effects to the medication. Removing all of the teeth cures the problem in the majority of cases. Those that are not cured show a significant improvement, making the surgery well worth it.  Your cat does not need teeth to eat, even hard food.

 Removing these teeth is a tedious process due to the number of teeth involved, the small size of these teeth, and the inflammation around the teeth.

Long Term Care

Every ill pet benefits from proper nutrition and husbandry. There are some specific Prescription Diet foods that are fed to keep your pets weight up and give it the strength to fight this problem.  We also use Standard Process vitamin supplementation successfully. Ask your doctor if one of them is appropriate for your situation.

In a chronic disease like Lymphoplasmocytic gingivitis it can be frustrating to give proper medication and care on a long term basis. It is important to understand that this disease is not cured with medical therapy alone, it is only controlled. It is important that you make your pet’s care a high priority and give medication as prescribed. It is also important to bring your cat in for an exam at least every 6 months, and even more often in some situations.

Always let us know if you are having difficulty giving medication or following our recommendations. We have extensive experience in diseases of animals, and can help you with your unique situation. Never hesitate to call us with questions, or bring your pet in for an exam if you think it is having a problem or are unsure of what to do because we are all part of your pet’s health care team

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Feline Immunodeficiency Virus (FIV)

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The Feline Immunodeficiency Virus, also known as FIV, was discovered in California in 1986. It is transmitted from cat to cat primarily by bites and scratches, as the virus is shed in the saliva. Intimate contact through grooming, sharing food etc., does not spread the virus. This disease is found worldwide. Prevalence varies from 2.5% up to 47%, and depends on the country.

FIV is closely associated with FeLV– you should learn about both diseases if you have a cat.

FIV preferentially infects white blood cells (WBC’s) which are an essential part of a cat’s immune system. The virus disables or destroys the white blood cells, and leaves its host susceptible to infections. Once a cat is infected with FIV it is infected for life, and can transmit the virus if it bites another cat.

We monitor white blood cells (WBC’s) in our routine blood panel. You can see a normal WBC of 10,400 at the top of this CBC (Complete Blood Count).

The prevalence of this disease has decreased significantly since it was first diagnosed. This is due to increased awareness and testing.

Even though this virus acts similar to the AIDS virus in people, humans are not infected with FIV.

Cause

FIV is caused by a retrovirus called the lentivirus. It is similar to the retrovirus that causes FeLV in cats, and causes similar symptoms, particularly supression of the immune system. It is also similar to the human AIDS virus, and is sometimes referred to as cat AIDS. There is no evidence that people can get AIDS from a cat that has FIV.

Only a small percent of cats in the U.S. are infected with this virus. One of the most prevalent methods of transmission is bite wounds in fighting cats, especially roaming males. Kittens can possibly pick up the virus in the uterus and while nursing, although most infections are in adult cats.

This virus is easily killed by routine detergents and disinfectants.

Stages

FIV has three clinical stages. The initial acute stage occurs approximately four to six weeks after infection. It may manifest as, but is not limited to, a fever, swollen lymph nodes, a low white cell count or any combination of the above. Most cats survive this phase without treatment. Most cat owners do not even know this has occurred since symptoms are minimal and cats are experts at hiding illness.

The second phase is a period of relative normalcy lasting months to years. The timetable depends on a host of factors like nutrition, stress, parasite load, and each cat’s immune system. Since all of this is occurring internally, most owners still do not notice any problems with their cat.

The third stage of the infection results from a progressive destruction of the white blood cells and dysfunction of the immune system. This leads to the vast array of different symptoms seen, and is when owners typically first bring in a sick cat for an exam.

Symptoms

A variety of clinical syndromes may develop, waxing and waning for years or months until the cat succumbs. The most frequent finding is a chronic oral infection of the gums, cheeks or tongue. This infection is known as stomatitis.

When a cat is presented with gums that look like this it might have this virus and should be tested to know for certain

Sometimes it is dental disease, and not FeLV, that causes the gums to be inflamed. In this case, this is Grade II periodontal disease.

Cats may also acquire upper respiratory, eye, ear, or skin infections. Some cats may also show vague signs such as lethargy, fever, diarrhea, poor haircoat,weight loss or inappetance and a certain percentage may develop cancer. Diseases of internal organs like the liverkidneys, brain, lung, GI tract, and eyes are also associated with FIV due to its immunosuppressive nature.

Diagnosis

We diagnose FIV the same way we diagnose every disease, using a thorough approach.

The approach to testing for FIV is similar to that of FeLV, and follows the recommendations of the American Association of Feline Practitioners and Academy of Feline Medicine advisory Panel. Their testing recommendations are as follows:

  • The FIV status of every cat should be known
  • This test should be repeated at least 60 days later when introducing a new cat into your household, while limiting exposure to other cats.
  • Yearly testing should be performed on every cat that goes outdoors or has exposure to an FIV positive cat
  • Every sick cat should be tested, regardles of previous test results
  • Every cat should be tested prior to entering a new household, whether or not they have other cats
  • When test results are negative but a recent exposure is possible (ex.-a cat that fights and has wounds). These cats should be tested at least 60 days after the last potential exposure to allow time for the cat’s immune system to develop antibodies and show up as a positive test.

Our routine feline blood panel checks for FIV every time. This is very important due to the variable nature of the immune system and the constant monitoring needed in this disease.

Our in-house test kit that checks for the FeLV also checks for the FIV virus. It is a screening test for antibodies to the virus. If it comes back positive then a confirmation test called the Western Blot test is needed to verify the diagnosis. On occasion false positives can occur, so this verification test is important.

Kittens up to 12 weeks of age, that have circulating FIV antibodies from nursing their mothers, might also test positive. They will return to a negative state several months later, so they should be retested at 60 day intervals to make sure.

A cat that tests negative, but is exposed to an FIV positive cat, should be retested in 8 weeks.

A cat that tests positive might be a carrier, and not show any symptoms of this disease for many years, if at all.

If the test comes back negative there is minimal chance a cat has FIV. Since it takes 2-3 months (at least) for antibodies to show up in the bloodstream once a cat gets infected by a bite wound, theoretically it is possible that this is going on when a cat is tested negative. Also, in the later stages of the disease, when cats are actually showing severe symptoms, the test can be negative. This is because the immune system is so depleted at this point that it can not make adequate antibodies to fight the disease, hence there are no antibodies circulating in the bloodstream for the test to detect.

The 2 blue dots indicate a positive FIV test on our in-house test

This same cat was postive on its Western Blot test to confirm that is has FIV. Notice the age of this cat on the top line of the form.

PCR (Polymerase Chain Reaction) test can be helpful because it tests for viral DNA, and is not dependent on antibodies from the immunes system, which can vary. In spite of this, there can be false positives and negatives, so more information and standardization among laboratories is needed before this test will be used routinely.

Treatment

There is no medication that will kill this virus. Treatment is aimed at keeping the immune system as strong as possible and utilizing medication as needed. Fortunately, the disease progresses slowly, and cats can remain healthy for several years,sometimea a lifetime,  after being positively diagnoses. Do not euthanize a healthy household cat that lives by itself just because it has FIV.

FIV positive cats that are not showing any of the associated signs of illness should be examined every 6 months at least. Routine blood panels, worm checks, and urine samples should also be performed every 6 months to monitor for changes that should be treated.

Treatment of FIV revolves around the organ or organs that are most affected. This means we routinely will use antibiotics and immune simulators. Your doctor will let you know if this applies to your cat. Gum and mouth infections are treated by keeping the teeth clean and the use of oral antibiotics. As with any disease, good nutrition, routine preventive medical care, along with plenty of TLC, are mandatory for a good quality of life. There is no evidence that shows treating cats that are positive for the FIV test, but are not yet showing symptoms, is of any benefit on the health or longevity of these cats.

Since this disease suppresses the immune system in a manner similar to FeLV, therapy is similar. You can find this therapy in the FeLV page. The same caveats apply to both diseases in the use of these medications. Treatment times for both FIV and FeLV cats tends to be longer than cats that don’t have these viruses. In addition, the use of human AIDS medications have potential to help, but they have greater side effects and are considered experimental. also, their cost precludes their use in most budgets.

These cats are also susceptible to food borne bacterial and parasitic diseases due to their immunosuppression, so do not feed them raw or unpasteurized foods.

All FIV positive cats should be kept indoors to prevent transmission to other cats.

An FIV positive cat should be checked for internal parasites (worms) at least every 6 months. These worms weaken the immune system, which is the last thing we need in this case.

Prevention

This virus will not survive long in the environment. Still, keeping your cats environment clean, and routinely using bleach to disinfect feeding bowls etc., makes sense.

Only introduce new kittens into your household if they are healthy, free of internal or external parasites, and are current on their vaccines. The best method of preventing FIV (this also applies to the FeLV) is to prevent exposure in the first place. FIV control is aimed at preventing exposure. It is best to keep cats indoors, neuter male cats to reduce fighting and avoid introducing stray cats into a household without prior FIV testing. Also, one should segregate FIV positive cats from uninfected cats.

A vaccine was developed years ago, but it was rarely used. A major disadvantage to the vaccine is the fact that a cat that gets the vaccine will test positive on routine FIV testing for at least one year. Any cat given an FIV should be identified by a collar or microchip.

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