CPD ACCREDITED ARTICLE
calicivirus and panleukopenia virus) and possibly
vaccinated more frequently (for example, every six
months) based on an individual cat’s risk assessment
and lifestyle 4 . There is controversy surrounding the use
of inactivated, modified-live or recombinant vaccines.
Some researchers and clinicians suspect an increased
risk for the development of injection-site sarcomas
with the use of adjuvant killed vaccines 16 , and others
are concerned that modified-live vaccine viruses may
regain their pathogenicity in immunocompromised
cats1 7,18 .
Managing clinically ill FeLV-positive cats
Early therapeutic intervention is key to a successful
treatment outcome in FeLV-infected cats that
display clinical signs. First, the clinician should
determine whether the illness is directly associated
with FeLV infection (for example, lymphoma or
anemia) or a secondary disease associated with
immune dysfunction (opportunistic infection or oral
inflammatory disease). Intensive diagnostic testing
should occur earlier during a diagnostic workup as
opposed to a “wait-and-see” approach. Most FeLV-
infected cats respond well to appropriate medications
and treatment strategies, but they may require a
longer or more aggressive course of treatment and
need to be more closely monitored during recovery.
While several antiviral drugs, immunomodulators
and alternative therapies have been investigated for
efficacy in FeLV treatment, most have been shown
to be ineffective or only marginally beneficial 19,20 . To
date, no treatment has been shown to reverse or cure
FeLV infection in cats.
Educating owners of FeLV-infected cats
Initial diagnosis may illicit quite a bit of anxiety in an
owner. To alleviate this anxiety, it’s helpful to educate
the owner about FeLV infection aetiology, its clinical
effects, and how proper home management and
veterinary care can provide the best health and quality
of life for the cat. Remember the old adage that
people often fear what they don’t understand. Be sure
to empower owners regarding management of the
cat at home and have them view the veterinary clinic
as a source for medical and management advice. In
addition, alert owners to the 10 common feline signs
of illness 21 :
1. Inappropriate elimination (urination, defaecation
or both)
2. Changes in social interaction
3. Changes in activity level
4. Changes in sleeping habits
5. Changes in food and water consumption,
changes in chewing and eating habits
6. Unexpected weight loss or gain
7. Malodorous breath
8. Changes in sleeping habits
9. Changes in vocalisation
10. Signs of stress (hiding, withdrawal, changes in
appetite, decreased grooming, decreased social
interaction, more awake time and so on).
If owners observe any of these signs, or if they notice
other behavioural changes and aren’t sure if they’re
important, they should contact the veterinary clinic for
advice.
The best situation for an FeLV-infected cat is to live
in an indoor-only environment and be the only cat in
the household 10 . A nutritionally balanced diet is also
essential. Cats are obligate carnivores and evolved
from a desert environment; thus they thrive on high-
quality (animal-based) protein (more than 45% by dry
matter), low-carbohydrate, moderately low-fat and
high-moisture diets 22 .
Canned cat foods are ideal because they have high
water content. It’s possible to transition cats that prefer
dry food to a canned food diet, but this should be done
cautiously. Remember that many cats would rather
starve to death than eat unfamiliar foods or foods they
don’t like. It’s better to have a cat eat than not eat, so
if dry foods must be fed, then research dry foods with
a good nutrient profile. Raw diets should be avoided
in FeLV-infected cats because of the increased risk of
foodborne bacterial and parasitic diseases.
Although it’s preferable for FeLV-infected cats to
live in single-cat households, thereby avoiding viral
transmissio n to cat housemates and preventing
high-risk behavior such as cat fights, this isn’t always
possible. If they’re to be part of a multicat household,
then separation of FeLV-infected cats is ideal. If an
owner is unwilling to separate the FeLV-infected cat
from non-infected cats, then the non-infected cats
should be adequately FeLV-vaccinated. Warn owners
that vaccination does not guarantee 100% protection,
especially in high-exposure environments.
No new cats should be added to the household
because this would disrupt the social structure and
possibly increase the risk of cat fights and bites.
Since FeLV is primarily transmitted by close contact
(both friendly and aggressive) and the sharing of food
bowls, water bowls and litterboxes, it’s unlikely that an
owner will create an environment completely void of
FeLV infectious virions. However, providing separate
feeding stations for infected and non-infected cats
may help decrease the degree of exposure.
FeLV is also labile outside of the host, remains
infectious for only minutes in the environment and
is readily inactivated with soap and disinfectants, so
frequent cleaning of litterboxes and other potential
fomites with soap and disinfectant may decrease viral
load. FeLV is not zoonotic.
Recommendations in this article are based on 2008 American Associa-
tion of Feline Practitioners (AAFP) Feline Retrovirus Guidelines but also
include some updated material and perspectives 10 . The AAFP Feline
Retrovirus Guidelines are presently in the process of being updated 23 .
Issue 02 | MAY 2018 | 7