Feline Leukemia Treatments

Feline Leukemia Treatments

vetinfo.com

Question: Dr Richards, our cat has feline leukemia. She was a stray with kittens when we found her, she was probably less than a year old. It has been almost 3 years since we found here, but she is now starting to really show the effects of the leukemia. She is listless, lost much weight, and at times losing the ability to control her back legs (she has fallen off tables). She started to show last week, I tried giving some herbs, echinacea, and she looked like she was doing better by the end of the week, she was moving around and eating food. I took her to the veterinarian on Saturday, he gave her a shot of antiobiotic and took xrays and blood from her. After that she was worse off, listless, and not eating again. The doctor said that the leukemia was effecting her kidneys and liver, both were smaller than normal. Since Satuday, she finally started to eat a little again, the doctor suggested kitten food for her anemia. He suggested blood transfusion, but said that it was costly and would really only have little effect and she would relapse shortly after that. He said he would merely be taking my money. I have read of alternative treatments immunoregulin, interferon, staphylococcus protein A, etc. Is there any treatment that actually has shown some level of effectiveness. There is an article by Blakeslee (Adoptive immunotherapy of feline leukemia virus infection using autologous lymph node lymphocytes) that actually looks like they had some results. In postings you talk of clearing the virus, is this possible? At this point is she too far gone? When I asked the vet if she was in too much pain, should I put her to sleep, he would not give me an answer, other than do what I think is best, but he wasn't giving me any decent alternatives.

Greg

Answer: Greg-

It probably is true that the prognosis for your cat is poor at this point. It is also true that the recommended therapies for the situation you find yourself making decisions about are likely to fail in the majority of cases, despite spending money on them. As long as you understand that, the decision making is yours. If you think that you would like to spend money on therapies that are highly likely to be unsuccessful, that is your decision. If you are convinced that your cat has not given up on life and would want aggressive therapy (of course this is a guess), that is your decision to make, too.

To the best of my knowledge there is no treatment that has been shown to be consistently effective in more than one scientific study in eliminating the FeLV antigen from the bloodstream. The paper by Blakeslee does look promising and I hope that it will lead to a better treatment. I suspect that at the current time you would have to travel to Ohio State University in order to have this treatment, but I am not sure of that.

From a practitioner's standpoint, there are several things that I would consider at this point.

The first is treatment for the possibility of haemobartonellosis. This is a blood parasite that is sometimes a complicating factor in FeLV. It is responsive to doxycycline (10mg/kg of body weight once a day). Testing for this parasite is a good idea, too -- but sometimes it is more practical just to treat for it.

The second thing is prednisone therapy. When euthanasia is the alternative, the use of prednisone makes a lot of sense. While it doesn't help all cats it sometimes makes a big difference in an individual cat. If this has not been done, it may be time to think about it.

Interferon is used by a lot of vets and there are lots of anecdotal reports of success with it. I have some person doubts since we never seemed to have much luck with it --- but sometimes that is just bad luck.

I think that blood transfusions do help some cats. I can remember a couple of cats that I was pretty sure would die within a few days that lived for some time after a blood transfusion. Unfortunately, this is not the usual case. Your vet is probably right that it is grasping at straws. But again, that decision is yours to make.

Appetite stimulants such as diazepam, oxazepam and cyproheptadine may be helpful in cats that aren't willing to eat. A lot of cats in our practice will eat Hill's a/d diet when they won't eat much else. I can't figure that out since the stuff doesn't look too appealing to me, but I'm not a cat.

I am not well versed in alternative care because I really like the idea of scientific testing of treatments I intend to use but the sources that I have access to suggest that echinacea, astragalus and ganoderma mushrooms might be beneficial. Practitioners into accupuncture say they see benefits from treatment in this manner in feline leukemia cases, too.

I did not have time to recheck the site for the information on clearing the virus. I am hoping I didn't state that I knew a way to do that because I don't. There are cats that are able to clear the virus from their circulation and suppress it for life --- but they do that on their own, not because of something I do for them.

You do have to do what you think is best. As time goes on you may decide that euthanasia is the best alternative. Until you are sure, these are the alternatives that I am aware of that may be beneficial. I hope that they are helpful for your cat.

Mike Richards, DVM 4/13/2000

Feline Leukemia therapies

Q: Dr. Richards, Last week our cats were diagnosed with feline leukemia, one is acute and the other is still dominant, this is interesting as we have had them since they were 6 and 10 weeks old, they are house cats and have had their leukemia shots since we were told to begin them. They are both 91/2 years old. Rufus the acutely ill one RBCs were 10 we decided to give him a transfusion and the Vet started him on 17mg. of prednisone initially, reduced to 10 and now 5 mg. Since his transfusion and with prednisone he is eating and up moving around acting almost like a kitten again. At this time he has no infection, only anemia.

My question is: do you recommend the Alpha Interferon injections, how much and how often? In reading on the internet I have noticed some of the complimentary therapies, of Kassaic Tea, or the aloe vera juice, mixed with DHEA precursor called Wild Yam Extract and Vitamin C with DMG, do you recommend either of these if so how much and how often. Thank you in advance for any assistance

Cathie

A: Cathie-

I can not give much advice on the treatments you have asked about as I don't use any of them currently. There are veterinarians who really think interferon helps but not a lot of evidence to support that view. There are probably proponents among veterinarians of the other therapies you asked about but I have not seen much discussion of them and can not help at all with that.

There is still a lot to be learned about feline leukemia but it seems to be more and more evident that it can be a very long term latent resident in the bone marrow or central nervous system and that other diseases or treatments that cause immune suppression can stir up long dormant feline leukemia virus infections. It is a good idea to look for something that might have allowed the leukemia virus to resurface such as another disorder that might affect the immune system (liver disease, feline immunodeficiency virus, chronic corticosteroid use, cancer, etc.).

I wish I could help more.

Mike Richards, DVM

Feline Leukemia virus - treating infections

Q: Hi, I have a cat named Casper, who had a sister named Patty, who passed away Feb, 13, 1997. They came from a litter of 5 ophans.(Mother ran away or got ran over 1 day after birth. But our friend did the untaking of stepping in a nurturing them to young kittyhood. Anyway, all 4 have passed away. Patty was just 3 years old. They were born on Halloween,1993. And when Patty became VERY sick, we did not know till after her death, that a sister had feline leuk. We never had Patty tested for this,but had taken her in when we noticed her belly rising constantly, like a hiccup, to breathe. The vet said she had respitory virus, which he tried to treat. She would not eat, just lay around alot. She was getting weaker, she was already a slender cat. So her not eating did not help matters. We took her back to the vet, and kept her there for 1 week, until we were at our limit as too how much to invest $$ in her if the end result was futile anyway. And there was no improvement anyway, She was on a I v. to keep her going. It wasn't long at all after we brought her home and tried to force feed her, which was hard to do, and she fought it as well. To make a long story short, It only went on for 3 more days, and the night before we basically spent an extra few minutes w.her before going to bed, And i guess we knew it was our good-byes to her. It was sssoooo sad, i am about to cry just writing this and it's been over a year. But Casper got tested immediately after this and she is + but were told she is in remission. She's fatter, and more a happy, seemimgly healthy cat. She is my Baby......... But this past week April 17, 1998. She has done ALOT of laying around, no interest really in playing, or eating. I told my daughter that she felt really warm, and took her temp. I read in a cat care book that normal temp is 101.6 and her's was 104.2. The vet prescribed and antibiotic (what, i don't know) It's a tiny yellow pill.....And she has not eaten still very much at all. She drinks more water than anything, and some catsip milk. My daughter wanted to try a more enticing food, such as Fancy Feast, which we did, she ate some off her finger, but still nothing realitively enough. Casper, seems bright-eyed, and walks from place to place around the house, but just to lay around in a different spot. She vomits after every pill, my husband gives her. Just once, but a small amount, like the size of a silver dollar. I checked fever again today it was down to 102.7. This was the 5th day for her medicine. She goes #1 in the pan, and small # 2's, but because she hardly eats i can see why. Is this the going the way of her sister, or do you feel that she'll get over this hurdle and get better, or do you feel that we can expect things only to get worse??????

If you can recommend any thing please let me know..........Thank you for caring about people's kitty's.She is such a sweet kitty, and all our family would miss her terribly.

A: Casper's mom-

I am hoping that Casper is doing OK at this time. When a cat is persistently positive for feline leukemia virus it is necessary to treat any infections or problems that arise pretty aggressively in order to prolong life as long as possible. Antibiotic therapy should be used when appropriate for secondary infections. Some vets feel that using interferon is helpful in improving the overall quality of life for cats infected with feline leukemia. It is worth trying since it seems to be very safe. You might want to ask your vet about this.

Cats that can not clear the leukemia virus from their blood stream do not live as long as cats who are infected but can clear the virus from their blood stream. In many cases continuously positive cats only have two to three year lifespans, which is consistent with the rest of Casper's litter's history.

I hope that you and Casper are able to beat the odds with good nursing care and aggressive therapy when necessary.

Mike Richards, DVM

Feline Leukemia Virus Treatment

Q: My 2yr. male cat, Basil, just tested + today when I took him to be neutered and have his shots updated. The vet says he is otherwise healthy; the virus is currently dormant. I also have a 1yr. female who shares the same litter box and food bowl but has not been tested yet since I just found out today. I understand she also runs a high risk of being + but she is also currently healthy. They are indoor/outdoor cats in a v. rural area. My Veterinarian mentioned the possibility of immunotherapy and that it was 75% effective in young cats in general. So far, he is having a 66% success rate in his personal practice but has only treated cats younger than Basil. I still had my cat given his other vaccinations (rabies..) and had him neutered anyway. I love my pets, want to keep them healthy!! I have several q's. ** What is the most effective treatment for + cats like my 2 yr. old healthy male? ** What is the most likely prognosis for my + cat with treatment? ** If my female is -, will the vaccination protect her from being infected by Basil? ** If both are + and have immunotherapy, can one cause the other to have a "relapse" if only one is cured? ** If immunotherapy is successful, can they then be vaccinated to prevent reinfection? Your response will be greatly appreciated!!!!

A: To the best of my knowledge there is not a scientifically proven method of clearing the feline leukemia virus from infected cats using immunotherapy. That may not be what you Vet is referring to by "success" in treatment, though. We have a number of cats who live reasonably long and healthy lives despite infection with feline leukemia virus. I count the treatment of them as successful, despite the fact that in the end they may die from complications of the disease. This may also be what your Veterinarian is referring to. If he is referring to actually clearing the virus from these cats, he is aware of a treatment I am unaware of, or else he is somehow adding up the natural cases of resistance, cases of sequestration of the virus in areas that result in subsequent negative tests and other complicating factors of testing and coming up with a higher clearance rate than is actually happening. There have been conflicting studies on a couple of therapies for feline leukemia virus using Staph protein A (one claimed benefit, one didn't), Immunoregulin (at this point, I think that the studies overwhelmingly support no success in treatment) and interferon. There have been good anecdotal reports of the helpfulness of interferon in treatment of cats ill with this disease but no reports of it actually clearing the virus under controlled conditions, at least to the best of my knowledge. We generally try to use good supportive care -- good quality diet, reduction of as much stress as possible, early aggressive treatment of any illness and keeping the cats indoors (both for their benefit and the benefit of cats they might expose to the virus). Many cats live reasonably normal lives for quite some time despite infection with this virus under these conditions. The vaccines are about 85% effective in preventing infection with feline leukemia virus. It would be worthwhile to vaccinate your female cat if she will remain exposed to your male cat and she is negative on testing. I hate to disagree with you vet and I really do hope that he knows something I don't in this case. Good luck with this.

Mike Richards, DVM