Management of Feline Immunodeficiency Virus (FIV)
FIV management should focus on supportive care, prevention of opportunistic infections, and monitoring immune function, as there is currently no definitive cure for FIV infection in cats.
Diagnosis and Initial Assessment
- Confirm diagnosis using Western blot (gold standard) when in-practice ELISA tests are positive, especially in low-prevalence populations 1
- Assess baseline immune status with complete blood count to identify cytopenias
- Evaluate for secondary infections or complications (oral examination, lymph node assessment)
Treatment Approaches
Antiviral Therapy
While no officially approved antiviral drugs exist for FIV treatment, several experimental options have been studied:
(R)-9-(2-phosphonylmethoxypropyl)-2,6-diaminopurine ((R)-PMPDAP): Has shown improvement in clinical scores and reduction in viral load in naturally infected cats, though side effects may include mild hematological abnormalities 2
Combination antiretroviral therapy (cART): Recent research using dolutegravir, tenofovir, and emtricitabine showed improved blood parameters in experimentally infected cats 3
Zidovudine (AZT) and Lamivudine (3TC): Long-term therapy may lead to development of resistance mutations, limiting efficacy over time 4
Management of Secondary Infections
- Regular veterinary health checks to monitor for opportunistic infections 1
- Prompt treatment of secondary bacterial, fungal, or parasitic infections
- Dental care for management of gingivostomatitis, a common complication
Prevention of Opportunistic Infections
- Keep FIV-infected cats indoors to prevent exposure to pathogens
- Implement flea control to reduce risk of Bartonella infection 5
- Maintain good hygiene practices, especially after handling infected cats 5
- Consider appropriate vaccinations based on individual risk assessment
Supportive Care
- Nutritional support with high-quality diet
- Maintain hydration
- Treat specific clinical manifestations (gingivostomatitis, rhinitis, etc.)
- Monitor weight and body condition regularly
Prevention of FIV Transmission
- Neuter infected cats to reduce fighting behavior and virus transmission 1
- House FIV-infected cats in individual cages when hospitalized 1
- Maintain strict hygiene with needles and surgical instruments used on FIV-positive cats 1
- Avoid adoption of cats younger than 1 year to reduce risk of acquiring an infected cat 5
Special Considerations
For Immunocompromised Humans
- HIV-infected persons should consider potential risks of cat ownership, particularly with FIV-infected cats 5
- HIV-infected individuals should:
Monitoring
- Regular assessment of immune status (if possible)
- Monitor for clinical signs of disease progression
- Evaluate response to any implemented treatments
Prognosis
FIV-infected cats may live as long as uninfected cats with appropriate management 1. The disease typically progresses slowly, with cats remaining clinically normal for several years before developing signs of immunodeficiency 6.
Common Pitfalls to Avoid
- Euthanasia based solely on a positive FIV test is not recommended 1
- Avoid using human antiretroviral drugs without veterinary supervision due to potential serious adverse effects 2
- Don't neglect dental care, as oral disease is a common complication
- Remember that FIV is not transmissible to humans, unlike some other zoonotic infections 1