FIV in a Three-Year-Old Cat
Yesterday I had the sweetest little patient. She was perhaps a Turkish Angora, pure white with blue eyes. Super friendly, which maybe had to do with the fact that she was not spayed. She presented with a non-healing wound on the side of her face. The owner was concerned that she had an immunodeficiency preventing her from healing. However, the owner had also used peroxide on the wound, used Benadryl cream and now was using coconut oil on it. We started the discussion of re-homing her as she is in a multi-cat household. But the owner has had her for over a year and she is not aggressive with her other cats. Prior to doing anything else, let’s do a snap test for viral diseases. As mentioned in a previous post, the snap test shows whether a cat has exposure to the Feline Immunodeficiency Virus (FIV) and active infection of Feline Leukemia Virus (FeLV). Exposure means that the cat’s body has amounted an immune response to the virus in their body by producing antibodies. While active infection is looking for the antigen or viral particles, which says virus is present in the body. Why is the distinction important? Presence of antibodies does not mean that the cat is sick. FIV is the cat equivalent of HIV, and many people nowadays in the western world have found management of their condition. These cats can live happy and healthy lives. These cats are best kept in a single cat household or with other FIV positive cats, for the just in case they happen to get into a fight with one of the other cats. They should also be kept 100% indoors, for several reasons. This is to prevent spread of the virus to other outdoor cats, but also the outside world is full of other problems. They are more likely to pick up intestinal parasites, external parasites like fleas and ticks, as well as injuries from running around. But I have seen healthy FIV positive cats living into their teens. Yesterday just happened to be a day where I was both the tech and the doctor. I don’t usually get to do tech duties, so I had to pull out the instructions for the snap test. I collected a small sample of blood via venipuncture to the medial saphenous, and put it into an EDTA or purple top tube. I made a blood smear with this blood and left the sample while I was waiting for 30 minutes for the test solution to come to room temperature. Sure enough, she tested positive for FIV. I discussed with the owner that the wound will heal with proper treatment. It’s not that she had zero immune system. Not a word of euthanasia came up for this otherwise young and healthy cat. She should be spayed however, that would be important for more reasons than one. We clipped the fur around the cat’s wound on her face, which was very superficial, scrubbed it with chlorhexidine wound flush, and fitted her with a cone to prevent her from scratching the scab open. I put a small amount of betamethasone and fusidic acid gel on it, and planned to send her home with this. Here’s a look at some impression smears from the wound and a few photos of her blood smear. The first two show some dark gram stained round organisms that are suspicious of cocci, skin bacteria that would likely be normal skin flora now allowed to cause infection. The below slide shows inflammatory cells. This would be the cat’s immune system cleaning up the mess. The next few slides are inflammatory cells in the peripheral system, just proof that she has an immune system. Since this cat is an otherwise healthy young cat, I would not euthanize her. Just as HIV is not a death sentence for people, FIV status is not a death sentence for cats. As mentioned, minimizing exposure to infections is important in maintaining health for this little kitty.