Month: January 2024

What You Need to Know About Cats With FeLV and FIV

Posted on by felinepurrspective_u3q4o6
Gus and Miso were outdoor cats from the same neighborhood. They are FIV+.

Feline Leukemia (FeLV) and Feline Immunodeficiency Virus (FIV) are among the most common causes of infectious diseases in cats. FeLV can lead to cancer, anemia, and immunosuppression.   FIV primarily suppresses the cat’s immune system (Reference 1).

Cats with FeLV and FIV have played a role in human medicine. The discovery of FeLV pointed to the role of viruses in causing cancer.  FIV has given us insights into its human counterpart, HIV.

what you need to know about cats with Felv and fiv

Feline leukemia virus (felv)

FeLV was discovered in 1964, when attention was drawn to a multi-cat household with multiple cases of lymphoma. The FeLV virus was found in the cats’ tumors.  Once testing procedures were developed in the 1970’s, FeLV was found to be a major cause of disease in owned cats (Reference 2).

FeLV is very infectious. It is passed from cat-to-cat by bodily fluids (Reference 1).

  • Infected mother cats shed the virus in their milk and pass it on to their kittens.
  • The virus can be found in the saliva, urine and feces of infected cats and can be transmitted by sharing food bowls and litter boxes.
  • Cats can also be infected by being bitten by an infected cat.

 

 three stages of FeLV infection (Reference 1).

abortive infection

cat on cat tree
Indoor only cats are not likely to have contact with FeLV infected cats.

The cat is able to mount an immune response, killing the virus, and has a lifelong immunity to the virus. These cats will test negative for FeLV but have antibodies to FeLV.

regressive infection

The cat mounts an immune response but does not eliminate the virus. He will become ill with fever, swollen lymph glands, anemia and low white blood cell count. Once recovered, he will be asymptomatic and have antibodies to FeLV but may still have detectable virus in his blood. These cats do not shed the virus in saliva, urine and feces. There is a low chance that the virus may reactivate.

progressive infection

If the cat’s immunity is compromised in some way, her immune response will not be enough to kill the virus. It will spread to the bone marrow and then to the mucous membranes and glandular tissue.  The virus is then shed in saliva, urine and feces. Cats with this stage of infection will succumb to cancer or complications of diseases that are usually not fatal.

feline immunodeficieny virus (FIV)

FIV is not as contagious as FeLV.  Routes of transmission are (Reference 1):

  • Bite wounds that introduce saliva with virus and FIV-infected white blood cells into the wound
  • Transmission from queens to kittens is uncommon
  • Transmission is uncommon among cats living in households where the cats do not fight
  • Unlike humans, sexual transmission is unusual

initial infection with FIV

Fighting cats
FIV is transmitted by cat bites often acquired during cat fights.

The cat is ill with fever, swollen lymph glands, and a low white blood cell count.

immune response

The cat’s immune system produces FIV antibodies.  The antibodies suppress the amount of circulating virus, lowering the total amount of virus in the infected cat’s blood.

asymptomatic phase

The asymptomatic phase that follows the immune response can last many years, although progressive dysfunction of the immune system can occur. As a result of this deterioration of the immune system,
FIV cats are prone to chronic and recurrent infections.

Cats with FIV are 5 x more likely to get cancer than uninfected cats.  However, many FIV+ cats live as long as non-infected cats (Reference 1).

identifying cats with felv and fiv

Identifying and segregating infected cats will help reduce the numbers of cats with FeLV and FIV. The development of Point-of-Care (POC) tests allows the status of cats to be checked when at the veterinary clinic. FeLV vaccines are available to protect uninfected cats.

Screening for FeLV and FIV is recommended (Reference 1) :

  • when the cat is first acquired
  • prior to vaccination for FeLV
  • following exposure to infected cats
  • when the cat has clinical signs of illness, eg. dental disease

 

What is the testing like?

Most POC tests require a few drops of blood from the patient. Results are usually available in 10 minutes. Most test kits  include tests for both FeLV and FIV.

Test Results (Reference 1)

Negative Results

  • Negative tests are generally reliable
  • A retest  of a negative result is recommended in 30 days (FeLV) or 60 days (FIV) if there is high risk of recent exposure – for example, a cat bite acquired in a cat fight
  • Cats with regressive FeLV infection have low levels of antigen which may not be detected by some tests and the cat will test negative

Positive Results

Because a positive result will involve lifestyle changes, repeat testing is recommended at a reference lab to rule out a “false positive”.

FeLV

  • Cats that initially test positive can transition to a regressive infection pattern within 16 weeks of infection.

FIV

  • Kittens that nurse on FIV mothers may test positive on a POC test
  • Most kittens will test negative once they stop nursing and the maternal antibodies have waned
  • Kittens that test positive after 6 months are likely to be FIV+
  • Cats vaccinated with FIV vaccines may test positive

vaccines for  cats with felv and fiv

FeLV

Vaccines have been developed for FeLV and give cats protection against progressive infections (Reference 1).

Vaccination is particularly recommended for kittens as they are more susceptible to progressive infection than adult cats.

  • Kittens can receive their first vaccine when they are 8 weeks or older.
  • This first shot is followed by a second dose 3-4 weeks later.
  • A booster vaccination is recommended 1 year after the second shot.
  • The vaccine may be discontinued for adult cats that are not at risk of interacting with an infected cat (eg. indoor-only)

FIV

FIV vaccination has been discontinued in the US and Canada due to the low protective rate of the vaccine. However, FIV vaccines are still available in other countries, such as Japan, Australia and New Zealand. Cats vaccinated with FIV vaccine may test positive on a POC test (Reference 1).

FeLV and FIV are viruses that together affect 9% of the cat population in North America. These viruses suppress the cat’s immune system making him more susceptible to infections, cancer, and other diseases. POC tests are available to identify cats with FeLV and FIV, allowing cat owners to take steps to protect uninfected cats by vaccination or husbandry. The next post will address caring for virus infected cats and giving them the best of their nine lives.

references

  1. Little S, Levy J, Hartmann K, et al. 2020 AAFP Feline Retrovirus Testing and Management Guidelines. Journal of Feline Medicine and Surgery. 2020;22(1):5-30. doi:10.1177/1098612X19895940
  2. Pedersen N, Synopsis of Feline leukemia virus infection and its relationship to feline infectious peritonitis. May 21,2021. https://ccah.vetmed.ucdavis.edu/sites/g/files/dgvnsk4586/files/inline-files/.  Viewed January 2024.

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Strategies for Managing Hairballs in Cats

Posted on by felinepurrspective_u3q4o6
Canned food spread on a textured silicone mat can give your cat the enjoyment of licking without ingesting fur.

As you are en route to the bathroom during the night, your foot contacts something tubular and mushy – another hairball! I have lived with over a dozen cats – some I have shaved to reduce the hairball menace; others I have dutifully given the hairball gels, which promise to lubricate the cat’s GI (gastrointestinal) tract to help the hairball pass. But, are hairballs normal, part of something you have to put up with when owning a cat?

Hairballs are rare to non-existent in feral cats and zoo cats. Why do our domestic cats get hairballs? Hair that is ingested during normal grooming activities passes out the intestines in the stool. On average, a short‐haired cat loses about 28 g of hair per kg of body weight each year. Two‐thirds of this hair consumed while grooming is found in the stool (Reference 1). The more the cat grooms herself, the more hair she consumes. Couple this with slower gastric emptying, hair can accumulate in the stomach, forming a hairball.  Here are the “why’s” and “how’s” of managing hairballs in cats.

managing hairballs in cats

If a hairball becomes too large to pass through the GI tract, the cat usually expels the hairball by vomiting. However, if vomiting is not successful, we risk (Reference 2)

  • intestinal obstruction
  • obstruction of the esophagus
  • hair lodging in the nasopharynx (top part of the throat throat just behind the nose) causing sneezing, retching, and nasal discharge

How Common Are Hairballs in Cats? (Reference 2)

  • 73% of cats have never had a hairball
  • 17% cats bring up a hairball once a year
  • 10% bring up two or more hairballs in a year
  • Long-haired cats are twice as likely to vomit hairballs than short-haired cats

When Do We See (or Step on) Hairballs?

  • Flea infestations can lead to increased grooming
  • GI motility is decreased due to food intolerance or gastrointestinal disease
  • The cat is “over-grooming” due to anxiety

What to Do About Hairballs

Chronic gastrointestinal disease, pain, and/or stress can change how fast hair and food move through the GI tract. Your first stop should be your veterinarian’s office. Appropriate management of GI disease can significantly reduce hairball vomiting (Reference 2). Your vet will consider dietary therapy and run diagnostics to detect GI disease.

Diet and Hairballs

Diet may be helpful in managing hairballs in cats. Studies have found that diets containing moderate levels of fiber (11-15% total dietary fiber) can minimize hairball formation, particularly in long-haired cats. Fiber aids in increasing the amount of hair passed out in the stool (Reference 1).

Hairball diets also have larger sized kibbles. Radiographic studies have linked larger kibbles with hairballs exiting the stomach and passing out in the feces (References 1, 2).

Consider feeding more canned food.  Canned food passes through the GI tract more quickly (about 4 hours) compared to dry kibble (14-16 hours) (Reference 2).

The following strategies may help reduce the amount of hair ingested and promote GI motility (Reference 2).

  • daily grooming to reduce loose hair
  • shaving long-haired cats
  • monthly flea prevention
  • increase gastric emptying by feeding frequent small meals rather than large meals
  • use petroleum-based laxatives to lubricate the intestinal tract easing the passage of hairballs
  • prokinetic drugs (metoclopramide, cisapride, ranitidine) promote GI motility

hairballs in cats: environmental modification

The GI tract is very responsive to psychological stress.  Stress, chronic GI disease, and pain are factors that can affect how fast ingesta are processed by the GI system (Reference 3).

Domestic cats spend 25-30% of their waking hours grooming; those kept solely indoors may spend even more time at this task. Grooming may increase when the cat is stressed or bored.

Enironmental modification gives us a way to reallocate the cat’s time budget – giving him/her other activities to do, in addition to grooming. It also helps us reduce the stress perceived by the cat. In addition to providing the requirements for a healthy feline environment, the following strategies can affect the feline time budget.

  • feeding frequent small meals (may also help with gastric emptying)
  • incorporating species specific behaviors in feeding strategies (Why Meal Feed Your Cat)
  • providing outdoor access in an enclosure or on a harness and leash
  • regular interactive play time
  • establish a routine; allow the cat control over his environment by knowing what will happen and when

Grooming is a self-soothing behavior. The use of lick mats (textured silicone mats that you spread food on) can take advantage of the satisfaction cats find in licking without hair ingestion.

Although hairballs may seem to be a nuisance behavior, frequent vomiting of hair balls is NOT normal and can be an indicator of underlying GI disease or stress. A visit to your vet can diagnose medical problems; implementing environmental modification can reduce stress that affects how much cats groom and how fast hair moves through the GI tract.

references

  1. Weber M, Sams L, Feugier A, Michel S, Biourge V. Influence of the dietary fibre levels on faecal hair excretion after 14 days in short and long-haired domestic cats. Vet Med Sci. 2015 Jul 7;1(1):30-37. doi: 10.1002/vms3.6. PMID: 29067172; PMCID: PMC5645811.
  2. Cannon M. Hairballs in cats: a normal nuisance or a sign that something is wrong? J Feline Med Surg. 2013 Jan;15(1):21-9. doi: 10.1177/1098612X12470342. PMID: 23254238.
  3. Rudinsky, Adam https://www.youtube.com/live/CkZsUYhswGk?si=dauNUIjuEBGtSvIx October 4, 2022: YouTube Live: Chronic Vomiting Cats: What Can We Do? Viewed 1-17-24

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Treating Pandora Syndrome in Cats: the Environment

Posted on by felinepurrspective_u3q4o6
An elevated perch allows this cat a good vantage point to survey her surroundings for other cats and people.

Pandora Syndrome refers to cats suffering from multiple medical ailments that do not resolve with appropriate medical treatment. Instead, the symptoms are chronic, waxing and waning in response to environmental stressors. These cats also share a history of traumatic experiences and exhibit an abnormal stress response, partly due to epigenetic changes resulting from the stressful events in their lives (Reference 1).

Pandora syndrome is an “anxiopathy” – a condition resulting from chronic activation of the central stress response system (Reference 1).

Treating Pandora syndrome in cats: the environment

Careful modification of the Pandora cat’s environment (in additional to medical therapies) can reduce the severity and frequency of the cat’s symptoms (Reference 1). One of the first studies to demonstrate the efficacy of MEMO (Multimodal Environmental Modification) studied the response of 46 cats with Lower Urinary Tract Symptoms (LUTS) to MEMO. Cat owners were asked to reduce environmental and social stressors using the following suggestions (Reference 2):

  • avoid punishing the cat
  • change to canned food
  • change to unscented, clumping litter
  • improve litter box management
  • provide climbing structures, viewing and resting perches
  • provide audio/visual stimulation when the owner was gone
  • increase interaction with the cat
  • identify and resolve conflict in multi-cat homes

The most commonly followed MEMO suggestions were:

  • increasing the amount of time interacting with the cat
  • changing to a canned diet
  • adding another litter box

During the 10 months of follow-up, no signs of LUTS were observed in 70-75% of the cats. Owners also reported reduction in fearfulness, nervousness, respiratory signs, aggressiveness, and lower intestinal tract signs (Reference 2).

Treating Pandora Syndrome in cats: MEMO

Environmental modification for the Pandora cat needs to:

  1. increase the security of the environment
  2. allow the cat to feel in control of his environment

Treating Pandora syndrome in cats: choosing the memo that suits the cat

The basic blueprint for cats’ environmental needs can be  found at https://catfriendly.com/cat-friendly-homes/what-your-cat-needs-to-feel-secure/.  Treating Pandora syndrome in cats will be most successful when MEMO is tailored to the individual cat.  Here is some additional information to consider once the basic environmental needs are satisfied.

The Fearful, Nervous Cat that Prefers to Stay Alone

For these cats, MEMO will focus on providing safe places and positive, predictable interactions with humans.

  • make plenty of hiding places available – these can be the top shelves of closets or boxes in the bottom of closets
  • increase the number of “vantage points” through the use of shelves, perches and cat trees (Reference 3)
  • increase the security of the floor space: minimize wide open spaces by positioning furniture to create places where cats can rest and hide (Reference 3)
  • use baby gates to limit the access of potential stressors such as dogs or small children to the cat’s area (Reference 3)
  • allow the cat to choose to interact with humans (https://www.felinepurrspective.com/touch-not-the-cat-interacting-with-cats/)

Treating Pandora Syndrome in Cats in the Multi-cat home

In a multi-cat house, Pandora cats may show aggression or become ill when threatened. Successful MEMO requires identifying the social groups of cats in the house and ensuring that plenty of resources are spread throughout the house. Be prepared to intercept aggression when necessary (https://www.felinepurrspective.com/managing-aggression-in-the-multi-cat-home/) – keep the peace!

Separation Anxiety

Some Pandora cats were orphans or abandoned. These cats may exhibit some separation anxiety due to a strong attachment to the owner. For example, some of these cats follow the owners around like a dog (Reference 1). MEMO can be adapted for these cats.

  1. Encourage Kitty to spend “alone time” in an enriched room or space (don’t force – maybe coax her into the room with some treats). Enrichment can be elevated perches near windows, a play tunnel with toys in it, food puzzles with snacks. Cats have a great sense of hearing and many like music – choose music designed for cats when you are not there.
  2. Establish a routine – help your cat to have control of his environment by knowing what is going happen and when it will happen (https://www.felinepurrspective.com/routines-help-cats-reduce-stress-and-anxiety/).

Many cats cope with environments that are not optimal. However, Pandora cats have suffered traumatic events in their lives resulting in epigenetic changes. These cats exhibit an abnormal response to environmental stress. Consequently, they do not cope as well as other cats with changes in their environment and develop chronic illnesses. MEMO allows these cats to feel safer and more in control of their environments, reducing their stress, and, in turn, reducing the frequency and severity of their symptoms.

references

  1. C.A. Buffington DVM, PhD, DACVN.  Pandora Syndrome in Cats: Diagnosis and Treatment; Today’s Veterinary Practice. August 10, 2018, Issue: September/October 2018. viewed on 1/06/24 https://todaysveterinarypractice.com/urology-renal-medicine/pandora-syndrome-in-cats/
  2. Buffington CAT, Westropp JL, Chew DJ, Bolus RR. Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis. Journal of Feline Medicine and Surgery. 2006;8(4):261-268. doi:10.1016/j.jfms.2006.02.002
  3. Ellis SL. Environmental Enrichment: Practical Strategies for Improving Feline Welfare. Journal of Feline Medicine and Surgery. 2009;11(11):901-912. doi:10.1016/j.jfms.2009.09.011

 

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Diagnosing Pandora Syndrome in Cats

Posted on by felinepurrspective_u3q4o6
Some of the Signs that May Indicate Pandora Syndrome

The term “Pandora syndrome” was coined by Tony Buffington of Ohio State University to describe cats with chronic clinical symptoms suffering from health issues involving multiple organ systems. Buffington initially studied a group of 200 cats that had “incurable” urinary tract symptoms (bloody urine, difficulty urinating, urinating outside the box, and urinating small amounts). These cats had other health issues in addition to the urinary tract disease.  Curiously enough, the cats’ symptoms resolved after living in an enriched environment (Reference 1).

Early studies linked the urinary symptoms to diets containing too much magnesium, causing formation of urinary stones. However, dietary changes did not resolve the cats’ urinary issues and they continued to suffer from bloody urine, difficulty urinating, urinating outside the box, and urinating small amounts, frequently in the absence of stones (Reference 1).

diagnosing Pandora Syndrome in cats

What “Pandora Cats” have in common (Reference 2):

  • history of traumatic experiences such as abandonment, orphaning, infection
  • having more than one disease at once
  • clinical symptoms that wax and wane in response to changes in the environment

More About Pandora syndrome in cats

Genetic makeup and traumatic events are thought to contribute to Pandora syndrome in cats. Our genomes (cats and humans) contains the DNA that makes us unique. DNA is made up of 4 building blocks that can be assembled in different orders. The sequence of the DNA building blocks in a gene provides the code for a particular trait such as eye or hair color (Reference 3).

However, there is more to growth and development than just genes that code for a particular trait. The science of epigenetics studies modifications to our DNA that don’t change the order of the DNA building blocks. The epigenome refers to chemical compounds that are attached to your DNA. Exposure to pollutants, what you eat, and stress are some things that can result in certain molecules attaching to your DNA and turning particular genes on or off. This is why genetically identical twins may have different skills, health, or behavior (Reference 3).

The epigenome is reset when the genome is passed on from parents to their offspring at conception. Maternal stress during pregnancy, traumatic events such as abandonment, orphaning, and infection can subsequently affect the epigenome. While many cats recover from these things, others may develop chronic illnesses or behavioral abnormalities (Reference 2).

Pandora cats are inherently “sensitive” cats who have difficulty coping with challenges presented by their environment.  They have a heightened stress response that increases the likelihood of them becoming ill.

Why the name “Pandora” syndrome?
Pandora is a figure from Greek mythology. She was a human woman made by the gods from clay.  She was endowed with many attributes, such as beauty, charm, cleverness, and curiosity. Before sending her to earth, the gods gave her a box, that she was told NEVER to open. Pandora’s curiosity got the best of her one day and she opened the box, releasing evils to plague mankind – disease, violence, greed, old age, death… However, all was not lost. Hope was also in the box to help people survive and cope with the evils in the world.

Like Pandora’s box, “Pandora cats” have multiple problems (“evils”).

diagnosing pandora syndrome in cats

A diagnosis of Pandora Syndrome is a diagnosis of exclusion – the symptoms may respond to medical therapies but then recur. Diagnostic procedures do not reveal a root cause. Diagnosis requires an extensive review of the cat’s life history, medical history and home environment. Some sample questions are below. (A more complete history form can be found in the supplementary materials of Reference 2).

Life History

  • where did the cat come from? from a shelter? was he/she a stray? an orphan?
  • are other cats/pets in the house?
  • how many people in the house?
  • indoor only? outdoor access?
  • is your cat fearful? friendly?

Medical History

  • vomiting? diarrhea? coughing? sneezing?
  • using litter box?
  • history of medical problems- e.g. allergies, heart problems?

Environmental Resources

  • safe and secure resting places?
  • multiple, separated litter boxes, feeding stations, water bowls?
  • can the cat interact with people and other pets on his/her own terms?

treating pandora syndrome in cats

Pandora syndrome is treated with medical therapies and MEMO (multimodal environmental modification).   MEMO aims to reduce the cat’s perception of threat and increase his/her perception of control of his/her environment. There is no cure for Pandora syndrome but medical therapies and MEMO can reduce the cat’s clinical signs and increase the time between episodes of symptoms (Reference 1).

The goal of MEMO is to create an OPTIMAL environment for the individual cat.  This will be the subject of the next post.

references

  1. C.A. Buffington DVM, PhD, DACVN.  Pandora Syndrome in Cats: Diagnosis and Treatment; Today’s Veterinary Practice. August 10, 2018, Issue: September/October 2018. viewed on 1/06/24 https://todaysveterinarypractice.com/urology-renal-medicine/pandora-syndrome-in-cats/
  2. Tony Buffington CA, Westropp JL, Chew DJ. From FUS to Pandora syndrome: Where are we, how did we get here, and where to now? Journal of Feline Medicine and Surgery. 2014;16(5):385-394. doi:10.1177/1098612X14530212
  3. National Human Genome Research Institute; Epigenomics fact sheet 8/16/20. Viewed on 1/6/24. https://www.genome.gov/about-genomics/fact-sheets/Epigenomics-Fact-Sheet.

 

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