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Boli Pisici an 5 Curs FelV Si FIV

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    Dr. Drago s Cobzariu

    Sef Lucrar i, FMV Bucuretie-mail:dragoscobzar iu@gmai l .com

    2014

    mailto:[email protected]:[email protected]
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    Leucemia Infectioasa si Imunodeficienta Felina

    DR. Dragos Cobzariu DVM PhD

    Infectious Diseases

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    FeLV si FIV IntroducereFeline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are

    among the most common infectious diseases of cats. Risk factors forinfection include male gender, adulthood, and outdoor access, whereas indoorlifestyle and sterilization are associated with reduced infection rates.26

    The retroviral status of all cats should be known. Cats may requireretrovirus testing at different times in their lives. Here are some generalprinciples for retrovirus testing:

    A cat with a confirmed-positive test result should be diagnosed ashaving a retroviral infection not clinical disease. Diseases in cats infected

    with FeLV or FIV may not necessarily be the result of the retrovirus infection.Cats infected with FeLV or FIV may live for many years.

    A decision for euthanasia should never be made solely on the basis ofwhether or not the cat is infected. No test is 100% accurate at all times under allconditions. All test results should be interpreted along with the patients healthand prior likelihood of infection.

    All positives should be confirmed by another test method.While they can be life-threatening viruses, proper management can

    give infected cats longer, healthier lives.

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    FeLV(Eng.-Ro.)Feline leukaemia virus (FeLV) is a retrovirus, which may inducedepression of the immune system, anaemia and/ or lymphoma

    ( anemie,imunosupresie,limfom) It affects cats worldwide. The prevalence of infection in Europe islow(5%), although it may exceed 20% in some regions fromEast Europe ( prevalenta 5-20% datorita lipsei de informare aproprietarului si a vaccinarii, comertului cu animale fara acunoaste provenienta acestora, si lipsei metodelor de testare)

    Over the past 25 years, the prevalence of FeLV infection hasdropped in US (datorita actiunilor sustinute de informare-profilaxie si datorita testelor si vaccinurilor), thanks to reliablediagnostic tests and vaccines.

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    ETIOLOGIE

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    ETIOLOGIE

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    Retrovirusurile sunt specifice fiecarei specii . Acest lucru nseamn ca unretrovirus felin, FIV va infecta numai pisicile, un retrovirus uman, HIV va

    infecta numai omul.Retrovirusurile sunt alctuite din ARN. n gazd, ARN-ul este transcris nADN i ncorporat n ADN-ul celulelor gazdei.

    Retrovirusurilor sunt fragile, fiind uor inactivate de lumina ultravioleta,caldura, detergenti, i uscare.

    ETIOLOGIE

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    Particularitati structurale virusul FeLV Cats with transient viremia

    may develop persistent bonemarrow infection-Fast tests used spleen, lymph node or small intestine

    Peyers patches and timus developpersistent infection

    neutralizing antibodies clear blod viremia Once marrow infected, remain latent infection for years ( 3-4

    years)

    Latent infection can be present even thoughserological tests are negative blood and bone marrow are negative for virus by

    Imunofluorescence, ELISA or viral culture, but viral genom can befound.

    FeLV defective viruses that transduce cellular oncogenes PCRused to find them

    LTRGAG

    LTRPOL

    oncogene

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    EPIDEMIOLOGIE Transmission of infection occurs through viral shedding (saliva,

    faeces,nasal secretions, milk) by FeLV infected cats.(transmitereavirusurilor se realizeaza prin secretii, excretii, lapte, bolurile de apa simancare custile de transport, litierele venite in contact cu pisicileinfectate.Transmission between cats occurs mainly through friendlycontacts(mutual grooming), but also through biting. (transmiterea sepoate face doar prin contact, muscatura, zgarietura)

    In large groups of cats: ( distributia viremiei) 30-40% will develop persistent viraemia, 30-40% show transient viraemia and 20-30% seroconvert; a minority(IgM IgG) (~5%) shows antigenaemia in the absence of viraemia

    In viraemic queens, pregnancy usually results in embryonic death,

    stillbirth or viraemic, fading kittens(mortalitate embrionara, pisoineviabili)Young kittens are especially susceptible to FeLV infection.

    With age, cats become increasingly resistant( receptivitatea maxima oau pisoii mici in primele saptamani de viata)

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    Clinic suspicionam FeLV?

    Most common(frecvent) signs of persistent FeLV viraemia are: Anemia(mainly non-regenerative) Anemie

    Imunosupresion (predisposition to other infections) Imunosupresie

    Limfoma(thymic, alimentary, multicentric or atypical)Limfom

    Most persistently viraemic cats die within two to three years

    Less common(atipic): Immune-mediated disease (haemolytic anaemia,

    glomerulonephritis, polyarthritis) Boli autoimune

    Chronic enteritis (crypt necrosis) Enterite cronice

    Reproductive disorders (foetal resorption, abortion,neonatal death and fading kittens) Probleme Reproductive

    Peripheral neuropathies (anisocoria, mydriasis, Horners syndrome,abnormal vocalisation, hyperesthesia, paresis, paralysis)

    Neuropatii SN periferic

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    Patogeneza si Diagnostic

    Replication in tonsils

    Replication in draining lymph

    node

    Bone marrow Thymus Peyers patches

    Protective Immune Response Inadequate Immune Response

    Recovery LatencyViremia

    ELISA +

    Fast TestsELISA +

    IFA +

    PCR on Bone Marrow

    Infection by oral routeInfection by bite

    envelope(ENV)

    nucleocapsidp27 (GAG)

    genome (2 copies)

    RNA dep. DNA pol(POL)

    p15e

    gp70

    http://www.youtube.com/watch?feature=player_detailpage&v=B0AxdX4n_gI

    http://www.youtube.com/watch?v=B0AxdX4n_gI

    http://localhost/var/www/apps/conversion/tmp/scratch_3/CURS%20AN5http://localhost/var/www/apps/conversion/tmp/scratch_3/CURS%20AN5http://www.youtube.com/watch?v=B0AxdX4n_gIhttp://www.youtube.com/watch?v=B0AxdX4n_gIhttp://localhost/var/www/apps/conversion/tmp/scratch_3/CURS%20AN5
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    DIAGNOSTICUL FeLV

    Soluble-antigen tests are preferred for initial screening.These include:

    Immunochromatographic FAST tests: Agrolabo FeLV IC

    Agrolabo FeLV/FIV IC

    ELISA: Agrolabo FeLV ELISA Ab Anti GP70

    Agrolabo FeLV ELISA antigenic

    While screening tests detect the presence of free antigen inthe circulating blood, the IFA tests for the presence ofantigen within infected white blood cells and platelets.

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    Managmentul FeLV Supportive therapy (including fluid therapy if required) and good nursing care Secondary infections should be treated promptly

    Feline interferon omega may reduce clinical signs and extend the survival time

    AZT (azidothymidine) may be used, but side effects may occur

    Blood transfusions may prolong survival (Agrolabo RapidVet-H feline)

    Asymptomatic FeLV + cats may live many years and end up dying of anunrelated cause FeLV + cats need special care to avoid infections

    FeLV infected cats should remain indoors and receive a regular clinical

    check-up (every 6 months) (Carantina)

    Corticosteroids, other immune-suppressive or bone marrow-suppressive

    drugs should be avoided (Atentie! Imunosupresori corticosteroizi)

    The virus does not survive for long outside the host and is readily destroyed

    by disinfectants, soap, heating and drying (Rezista putin in mediu)

    However, the virus may survive in faeces; it remains viable if kept moist

    at room temperature

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    Imunoprofilaxia

    All cats of uncertain FeLV status should be testedprior to vaccination (Se recomanda testarea tuturorpisicilor inainte de vaccinare, folosind testele rapide )

    All healthy cats with a potential risk of exposure(outdoor access, FeLV endemic area) should be vaccinatedagainst FeLV

    Kittens should be vaccinated at 8 to 9 weeks of age, with a

    second vaccination at 12 weeks, followed by a booster oneyear later (Vaccinarea se face la varsta de 8-9 saptamani, curapel la 12 saptamani, apoi la un an)

    Inactivated vaccines are recommended

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    Concluzii1.All cats of uncertain FeLV status should

    be tested prior to vaccination!

    La achizitionarea unei pisici solicitatitestarea ei cu:

    Teste rapide-Imunofluorescenta-PCR

    pentru ai stabili statusul:

    - Libera de FeLV

    -Viremica

    -Provirus integrat

    2. Most persistently viraemic

    cats die within 3 to 4 years!

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    3.Anaemia in a cat with persistentFeLV infection

    4.Alimentary lymphoma associated

    with FeLV-clinical enteric sindrom

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    6.Primary visible signs of an FeLV

    infected cat

    chronic stomatitis gingivitis

    non-healing skin lesions

    respiratory infections Haemobartonella felis

    skin Ringworms-Microsporum, Tricophiton (Agrolabo - Dermakit)

    5.Thymic lymphoma filling thethoraxof an FeLV infected cat

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    Prezentare de caz StinkyStinky's chronic problems

    Stinky, a 4 year old neutered male, was presented to the clinicin August 1992. He had been depressed and anorexic and for theprevious two days he had diarrhea with lots of mucous. Owner hadnoticed a wound on the right side of his abdomen.

    We examine Stinky and find:Depressed, T= 39.5o, Pulse =144, yellow mucous membranes. Wound on right lateralabdomen with palpable firm tract going ventrally. Oral cavity- large red plaque with small

    white plaques under tongue - some ocular discharge - 8% dehydrated. When placing IVcatheter cat went into cardiac arrest - revived with external cardiac massage. Positivepressure ventilation, IV epinephrine, bicarbonate, dexamethasone - later given mannitol IV.CBC: Neutropenia with left shift and 2+ toxic change. PCV 0.24 - non regenerative SADB(small animal data-base): bilirubin 40. 2+ icteric serum UA (urinalysis): strong positive forbilirubin +2 blood 1+ bilirubin crystllauria SG 1.068.

    Stinky's rescords show:

    Stinky had a long history of chronic infections and problems that are summarized below:Normal until 1990, except:Chronic non-parasitic otitis externa overweight - 8kg, Began losing weight in mid-1990.Developed suspicious number of abscesses and infected scratches after skirmishes with

    other catsworkup shows :whitish grey plaques bilaterally in ear-canal - biopsies non-diagnostic noradiographic evidence of otitis media... otitis resolved after antibiotic treatment

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    Stinky's rescords show:Spring 1991: Hair coat shows marked thinning,presumably pruritic as cat is constantly grooming.Skin and hair samples show evidence ofdermatophytosis

    Culture on dermatophyte medium Dermakit-heavy growth of Trichophyton equinum and anotherobscure dermatophyte that is not normally pathogenictreated with oral ketoconazole resolved in 2 weeks, hair coat improved.

    Fall 1991: Upper respiratory tract problems but no etiological agent couldbe identified

    Spring 1991: Alopecia and pruritus returned. URT problems still there.alopecia treated with oral vitamin E

    You decide to see if Stinky's chronic problems are related to FeLV infection.

    What should you do?

    What samples do you need to take? What does the tests determine? What do the results mean?

    Stinky's test show that he is FeLV ELISA-FastKit: positive, FeLV PCR:positive

    What is you opinion?!

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    Prezentare caz Emily-4luni

    Emily was a 4 month old female Siamese. She was apparently healthy until theprevious day when she was caught under the leg of a recliner chair. She hashad difficulty breathing since then. A physical examination showed that Emilyhad trouble breathing - Inspirational effort, marked pleural effusion present.Her chest showed more than normal resistance to compression.Radiological findings:There is a medium to large volume of pleural fluid with associated lung

    collapse. The mediastinum is abnormally dense. The heart is difficult to assess.Progress exam. No.1 - There is an increased volume of pleural f luid with furtherlung collapseProgress exam No 2 - Again there is an increase in pleural fluid indicatingactive fluid formation or hemorrhage, as the case may be.Reassessment of the abdomen indicates an almost certain cranial mediastinalmass as seen in the dorsoventral view.Radiologist's note:This latter diagnosis, although unsuspected in the context of the proposedtrauma, was confirmed on the basis of the palpable mass in the mediastinum.the reason for the rapid fluid formation is uncertain. Possibly, trauma mightcause hemorrhage in a mass or a mass may erode regional vasculature toproduce such blood tinged fluid as it is removed from this cat's thorax onrepeated occasions.

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    Necropsy reportGross necropsy: Ventral mediastinal area contains a nodular, grey-

    white mass-- approximately 3 X 3 X 6 cm in size. Both right and leftlung lobes appear atelectatic and there is a 2 cm tear in the posteriormediastinum. A single sub lumbar lymph node is visibly enlarged.HistopathologySections of mediastinal mass contain a uniform population oflymphoblast like cells. These cells have roughly circular nuclei, somehave prominent nucleoli and most have minimal cytoplasm that has illdefined margins. There are scattered foci of necrotic cells andhemorrhage. Similar cells have replaced the sub lumbar lymph nodethat was sectioned and are also present in sinusoids and portal areas ofthe liver.Immunohistochemistry

    A section of the liver shows cells that stain with anti GAG antibody aswell as antibody against CD3.

    How would you interpret the results of the immunohistochemistry? Was the tumor induced by a feline retrovirus? How did a young 4 month old kitten develop rapidlygrowing retrovirus induced tumor?

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    Feline immunodeficiency virus- FIV

    First isolated in 1986, (FIV) is a retrovirus-lentivirusclosely related to HIV. Most felids are susceptible to FIV,

    but humans are not.

    FIV is endemic in domestic cat populations worldwide

    (4 subtypes A and B are most common in Europe)

    Seroprevalence of FIV varies greatly between regions

    Sick adult cats, male cats and free-roaming cats are

    most likelyto be infected FIV loses infectivity quickly outside the host and is

    susceptible to all disinfectants including common soap

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    Infectia cu FIV

    Most FIV infections are acquired by bites (fights,mating) from persistently infected cats. The risk oftransmission is low in households with socially well-

    adapted cats (Transmiterea frecvent prin muscaturi) Transmission from mother to kittens may occur,

    especially if the queen is undergoing an acuteinfection (Transmiterea de la mama la pui frecventeinfectii acute)

    FIV infected cats are persistently infected in spite oftheir ability to mount antibody and cell-mediatedimmune responses

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    Patogeneza infectiei cu FIV

    Bite(virus shed in saliva)

    Virus infects B-cells,T-cells and macrophages

    B-cell proliferation

    (Swollen Lymph nodes)

    Reversed CD4:CD8 ratiosImmunodeficiency

    (Opportunistic infections, B-cell Lymphomas)

    Variable

    time

    Inapparentinmost cats

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    Clinic suspicionam FIV?Infection has a long latent or asymptomatic phase. Infected catsgenerally remain free of clinical signs for several years, and somecats never develop disease. (Perioada de latenta lunga.Semnele clinice pot lipsi ani de zile sau pe tot timpul vietii)Clinical signs are not caused by FIV, but are the consequence ofimmunodeficiency(CD4+/CD8+ decreased ratio)

    Typical manifestations are: Acute phase

    May last a few days to few weeks (cateva zile cateva saptamani) Fever and malaise may go unnoticed (febra)

    Acute enteritis (diarrhea), stomatitis, dermatitis, conjunctivitis,respiratory tract disease (enterite, stomatite, dermatite,conjunctivite, inflamatii ale tractusului respirator)

    Generalized lymph node enlargement common (marirea in volum alimfonodurilor)

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    Clinic suspicionam FIV?

    Asymptomatic phase

    Follows acute phaseAppear clinically healthyMay last for years

    Use to say would become ill within 5 years

    Now know that many FIV + cats can live normallives for much longer

    FIV is not a death sentence

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    Clinic

    suspicionam FIV? Terminal phase

    - No good predictor of when this phase will occur- Characterized by opportunistic infections, neoplasia or other

    syndromes such as wasting (infectii oportuniste, neoplasm) bacterial, fungal, and protozoal (Toxoplasmosis, Ringworms)

    infections common treatment is directed at the secondary condition

    - Chronic gingivostomatitis (stomatita cronica)- Lymphadenopathy (limfadenopatie)

    - Renal failure associated with immune-mediatedglomerulonephritis (glomerulonefrita autoimuna)

    - Chronic rhinitis and - weight loss (rinita cronica, pierdere ingreutate)

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    Examenele de laborator

    paraclinice-suspiciune? None are specific for FIV but

    Acute phase Neutropenia, lymphopenia

    Resolves as progresses to asymptomatic phase CBC and chem panel normal during asymptomatic phaseClinically ill cats may have

    anemia, neutropenia, lymphopenia (seen in 1/3 1/2 of cats), thrombocytopenia

    Cytopenias may reflect secondary disease or may besuppression of bone marrow precursors by the FIVinfection

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    DIAGNOSTICUL FIVFIV produces a persistent, life-long infection, so detection of

    antibodies in peripheral blood has been judged sufficient forroutine diagnostic screening (screening epidemiologic) ifthe cat has not been previously vaccinated against FIV and hasnot acquired FIV antibodies in colostrum.21, 22

    ELISA and other immunochromatographic tests are thepreferred screening tests:

    Agrolabo FIV ELISA antibody

    Agrolabo FIV IC

    Agrolabo FeLV/FIV IC

    Confirmation of positive screening tests should include adifferent method or at least an antibody test from a different

    manufacturer.23, 24,22

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    DIAGNOSTICUL FIVVaccination of cats against FIV induces anti-FIV antibodies . These

    antibodies persist for at least one year and can be transferred incolostrum to kittens.

    Discriminant ELISA was reported by Dr. Levy and co-workers fromthe University of Florida, can differentiate between antibodiesproduced after FIV vaccination and antibodies produced after FIV

    infection.While polymerase chain reaction (PCR) assays may help distinguishcats infected with FIV from cats vaccinated against FIV, one studyfound marked variability in diagnostic accuracy among commerciallaboratories.

    Positive in-practice ELISA test results obtained in a low-prevalenceor low-risk population should always be confirmed by a laboratoryWestern blot or IFAare the gold standard laboratory test for FIV

    serology

    PCR-based assays (for proviral DNA) are variable in performance and

    may even be inferior to serological tests

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    Diagnostic-rezultate fals pozitive!

    Want to confirm diagnosis with IFA CYF or WesternImmunoblot antibody testing in asymptomatic cats

    IFA same accuracy of ELISA but may decrease

    technical error by sending to lab Western blot considered gold standard for

    confirming a positive

    Kittens from FIV infected queens may test seropositivedue to persisting maternal antibodies, and should beretested at 16 weeks of age. Exceptionally, kittens mayremain seropositive until 6 months of age

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    Diagnostic-rezultate fals negative!

    False negatives occur due to: Anergic stage of disease (terminal phase)

    Early infection and lack of seroconversion

    Lack of seroconversion due to immunosuppression orseroconversion occurs later in disease (up to 6 months

    reported) *Most cats seroconvert within 2-4 weeks post-exposure but

    may take up to 8 weeks

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    Managmentul Bolii

    Cats should never be euthanised only on the basis of an FIVpositive test result, cats may live as long as uninfected cats.

    Neutering is recommended to reduce aggression and decrease

    biting incidents FIV infected cats should receive regular (6 monthly) veterinaryhealth checks including routine biochemistry, haematology and

    weight monitoring Prompt and accurate diagnosis of any secondary illness is essential

    FIV infected cats can be housed in the same ward as otherpatients, but should be kept in individual cages separate fromcats with contagious conditions

    In rescue shelters, cats should be housed individually to avoidcrossinfection

    (at the very least, FIV positive cats should be segregated)

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    Managmentul Bolii

    Feline interferon omega may reduce clinical signs andextend the survival time (interferon)

    AZT (azidothymidine) may be used, but side effects may

    occur Surgery is well-tolerated by asymptomatic FIV infectedcats, but perioperative antibiotic treatment should be usedin all cases (obligatoriu antibiotic post-operator)

    Care must be taken to avoid iatrogenic virus

    transmission (e.g. by thorough decontamination ofsurgical instruments that have been used on seropositivecats)

    Avoid use of Griseofulvin for dermatophyte infections(increased susceptibility to neutropenia)

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    Vaccinarea In Europe at present there is no FIV vaccine

    commercially available

    Vaccination against routine pathogens can be

    considered for healthy seropositive cats but is notrecommended for sick, FIV infected cats Fel-O-Vax FIV (Fort Dodge)

    new vaccine available on the market minimal side effects

    Efficacy quoted to be 82% but heavily disputed Protects against Subtype A and D of FIV

    Subtype B FIV probably more common

    Vaccine titer and infectious titer not distinguishable on ELISA orWestern blot testing and will make diagnosis of the disease verydifficult !!

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    Concluzii1.FIV positive cats (like this one) may live

    as long as uninfected cats

    2.Chronic infections may arise

    due to FIV Infection

    3. Cats should never be euthanised

    on the basis of an FIV positive

    test alone

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    4.Chronic infections may arise

    due to FIV Infection gingivitis,

    stomatitis, otic infections

    5.Weight loss and haemorrhagicenteritis in an FIV positive cat

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    FeLV Algoritmul de Diagnostic

    All positive results should be confirmed, especially asymptomatic andlow-risk cats. Re-test immediately with IFA/ELISA Negative screening test results are highly reliable. However, if results are

    negative but recent infection cannot be ruled out, testing should be repeateda minimum of30 days after the last potential exposure (Supraveghereepidemiologica 3 testari la un interval de 30 de zile efectuate pe un numarcat mai mare de animlae preferabil toate animalele din efectiv)

    Discordant results may be due to the stage of infection, the variability ofhost responses or technical problems with testing. It is not usually possibleto determine the true FeLV infection status of cats with persistentlydiscordant test results.

    Antigen Test Negative results for either FeLV or FIV are much more reliable because of the

    low prevalence of infection in most cat populations. No test is 100% accurate all the time, under all conditions. In cat populations

    with a low prevalence, for example less than 0.5%, more than half of the catsthat test positive are likely to be uninfected.26

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    FIV Algoritmul de Diagnostic Cats vaccinated with a whole-virus vaccine will test antibody-positive. Re-test with another

    antibody test. Negative screening test results are highly reliable. However, if results are negative but recent

    infection cannot be ruled out, testing should be repeated a minimum of 60 days after the lastpotential exposure. (Necesitatea repetarii testului dupa 60 de zile)

    Antibody Test If positive after kitten reaches 6 months old, consider FIV-infected and continue appropriate

    management program. (Anticorpii maternali persista in organism maximum 6 luni de zile)

    May also consider utilizing alternative test methods such as culture or PCR where available. If negative at any interval, consider free of infection and begin wellness program. Kittens may be tested for FeLV and FIV at any age. Most kittens test negative, indicating no

    infection. Antibody tests for FIV can detect antibodies passed in colostrum from an infected orvaccinated mother, which can be mistaken for infection in the kitten.

    FeLV vaccinations will NOT induce positive test results. FIV vaccinations WILL induce positive test results.

    M l C il P i i

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    Managmentul Cazurilor Pozitive

    Sanatoase Clinic

    Examinations should be performed at least twice a year and at each visit:

    Update medical history. Monitor for any signs of weight loss. Perform a thorough physical exam; pay close attention to lymph nodes,

    eyes and oral cavity. Perform a complete blood count, biochemical analysis, urinalysis, and

    fecal examination at least once a year. FeLV cats may need a complete

    blood count twice a year. Spay or neuter intact cats. Control internal and external parasites. Vaccinate as lifestyle indicates. Most retrovirus-infected cats mount

    adequate immune responses when vaccinated, and there is no need tomodify standard vaccination intervals.28

    There is controversy about the use of inactivated versus modified-live

    vaccines. Current recommendations are to use inactivated vaccineproducts due to the theoretical risk of a modified-live product regainingits pathogenicity in cats with compromised immune systems.

    Infected queens should not be bred and should be spayed if theircondition is sufficiently stable to permit them to undergo surgery.

    M l C il P i i

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    Managmentul Cazurilor Pozitive

    Clinic manifeste

    Prompt and accurate diagnosis is essential to allow early therapeuticintervention and a successful treatment outcome. Therefore, intensivediagnostic testing should proceed early in the course of illness forinfected cats.

    Many cats infected with FeLV or FIV respond as well as their uninfectedcounterparts to appropriate medications and treatment

    strategies,although a longer or more aggressive course of treatmentmay be needed. Few attempts have been made to evaluate anti-viral drugs,

    immunomodulators, or alternative therapies in large controlled studiesof naturally infected cats. To date, no treatment has been shown toreverse well-established retrovirus infection in cats.

    Clients with a healthy or ill retrovirus positive cat may be frightened bythe initial diagnosis. It is important to alleviate these fears when appropriate and offer

    encouraging advice on the proper care and management of the cat.

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    LIMITAREA TRANSMITERII FeLV-FIV

    In the veterinary PracticeRetroviruses are unstable outside their host animals and can be quickly

    inactivated by detergents and routine disinfectants.1317Simple precautions and routine cleaning procedureswill prevent transmission

    of these agents in veterinary hospitals.As a guide:

    All infected patients should be housed in individual cages and not inisolation/contagious wards where they may be exposed to infectious agents.

    Staff shouldwash their hands between patients and after cleaning cages.Because FeLV and FIV can be transmitted in blood transfusions, donors

    should be tested prior to donating.A real-time PCR test for FeLV is alsorecommended for blood donors as proviral elements in seronegative cats with

    regressive FeLV infection may cause infection in transfusion recipients.Dental and surgical instruments, endotracheal tubes and other itemspotentially contaminated with body f luids should be thoroughly cleaned andsterilized between uses.

    Fluid lines, multi-dose medication containers and food can becomecontaminated with body f luids (especially blood or saliva) and should not be sharedamong patients.

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    LIMITAREA TRANSMITERII FeLV-FIV

    Limiting transmissionAt home

    Confine Infected cats should be confined indoors so they do not pose arisk of infection to other cats and so they are protected against infectioushazards in the environment.Isolate The best method of preventing spread to other cats in thehousehold is to isolate the infected cat from interacting with its

    housemates. Isolation to a separate room is recommended, but a simplescreen or chain-link barrier is adequate. Generally, FIV transmission is lowin households with stable social structures where housemates do not fight,but FeLV can still be transmitted via friendly interactions.Dont Introduce If separation is not possible, no new cats should beintroduced in the household to reduce the risk of territorial aggression.

    If owners choose not to separate retrovirus-infected housemates from theirother cats, the uninfected cats should be consideredfor vaccination.Vaccinated cats should be isolated from infected cats for at least twomonths after the vaccine series is completed.

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    LIMITAREA TRANSMITERII FeLV-FIVPrevention of FeLV and FIV transmission in Shelters and Catteries

    Control recommendations: As for pet cats, it is ideal for all cats in shelters and catteries to be tested for FeLV and FIV. Testing at admission is optional for singly-housed cats in shelters, but all cats in breeding catteries should be

    tested. Testing is highly recommended for group-housed cats. If not performed prior to adoption, testingshould be recommended to the new owner before exposure to other cats.

    Testing should be repeated 60 days after the initial test and annuallyfor cats kept in long-term grouphousing.

    Each cat should be individually tested. Testing representative kittens in a litter or colony and extrapolatingresults to other cats in the group is unreliable. Procedures such as pooling multiple samples for use in a single

    test reduce test sensitivity and should not be performed. Both foster families and adopters should have their own resident cats tested prior to fostering or adopting a

    new cat. FeLV vaccination is optional for singly housed cats. Cats should test negative prior to vaccination. FeLV

    vaccination is highly recommended for all cats housed in groups and for both foster cats and permanentresidents in foster homes.

    In catteries that follow testing guidelines and maintain retrovirus-negative status, vaccination against FeLVand FIV is not necessary.

    Vaccination is not 100% effective and should never be used in place of a test and segregate program. In contrast to the case for feline panleukopenia, herpesvirus and calicivirus vaccines, the value of a single FeLVvaccine for feral cats has not been determined. Therefore, FeLV vaccination is not recommended for feral cattrap-neuter-return programs if program resources are needed for higher priorities.

    FIV vaccination is not recommended for use in shelters or feral cats. Strict adherence to universal precautions is required to prevent iatrogenic transmission of retroviruses in the

    shelter environment via contaminated equipment and secretions.

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    You dont have to consider it a death sentence. First of all, youd dowell to have the animal retested after about three months, sincethe original test may have yielded a false positive.

    Secondly, some FeLV-infected cats develop an effective immuneresponse, which controls the viral infection and results in atransient viremia instead of a persistent viremia.

    In these cats, subsequent FeLVtests will show that the cat nolonger has virus in its blood.

    Finally, while there is no complete cure for FeLVor FIV infection,newer treatments and supportive care can often result in several

    years of relatively good health.

    Epilog!

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    Va Multumesc !


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