Infectious Disease - Feline Leukemia 2


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 Feline Leukemia - kittens 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 Feline Leukemia loss 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 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. Michal Last edited 04/20/04


Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...