FeLV treatment options

Re: FeLV treatment options

Martin Atkinson — Mon, 08 Nov 2010 16:35:50 GMT

[quote user="Richard Fox"]

Cheers for that Martin, sorry wasn't trying to be critial.

FeLV infection causes immune mediated destruction of erythroid pre-cursers or induce myelodysplasia (again a lack of blast cells) as well as other problems so EPO as you say is possibly less likely to be effective (if there are less blast cells/precursors) than immunomodulatory therapy?. EPO is still recommended in FeLV infection? Especially as you say its cheap?

However I do feel bone marrow examination is still important to distinguish the types of underlying marrow problem with regards to response of treatment.

[/quote]

I didn't think for one moment you were being critical Richard, just expressing a point of view. I use EPO quite frequently in anaemia of CKD in cats and occasionally for the odd idiopathic case or to speed up recovery from an anaemia of know cause being treated/corrected by other means. I've not used or felt there was a benefit for EPO in FeLV anaemia but then irregardless of my enthusiam and tales of succes I'm still only talking about a handul of cases. Certainly there is much more profound recovery in CKD anaemic cats with EPO than with anabolics alone. I usually give old cats a shot of B12 as well just in case there's a pernicious anaemia.

Re: FeLV treatment options

Richard Fox — Mon, 08 Nov 2010 13:19:57 GMT

Cheers for that Martin, sorry wasn't trying to be critial.

However I do feel bone marrow examination is still important to distinguish the types of underlying marrow problem with regards to response of treatment.

Re: FeLV treatment options

Martin Atkinson — Mon, 08 Nov 2010 12:41:22 GMT

[quote user="Richard Fox"]

Is Virbagen useful in terminal stages of FeLV infection? The data sheet says not for use in terminal stages - would this cat not be regarded as in terminal stages? Have you has good responce to Virbagen with cats with profound anaemia in your experience. That was why I was wondering about the use of anabolics to try and stimulate haematopoiesis as EPO etc would be rather expensive? (sorry questions but I gain a lot from vets experiences esp. when other vets phone me up for advice regarding prognosis ).

[/quote]

Depends how terminal it is - if its moribund then I guess its not worth the effort but the cats I had success with had PCVs in the order of 12-15%, were lethargic and anorexic, and the response was dramatic - PCV back to normal in 2 weeks with huge improvement in demeanour to the extent of being clinically normal before that. I would guess that EPO probably wouldn't help if the bone marrow is suppressed because of the FeLV so the interferon will work better. However that said, for cats EPO is not that expensive anyway, Eprex from my local pharmacy ordered via Janssen is £35 (inc VAT) for 5x1000iu, given the dose is ~ 300iu for a small cat and I titrate the dose so I can use the syringe three times.

Re: FeLV treatment options

Hannah Wynne Richards — Mon, 08 Nov 2010 10:59:45 GMT

The real problem is that money is an issue !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Wynne

Re: FeLV treatment options

HMC — Mon, 08 Nov 2010 10:51:58 GMT

[quote user="Rebecca Benge"]She lives in a multicat household with her elderly owners, the status of the other cats are unknown, and it is unlikely they can completely seperate this cat from the others.[/quote]

At a CPD evening a few years ago I was told that FIV/FeLV cats did not need to be separated from others in the household as long as it was a stable household ie do not introduce a new kitten who could trigger fights. I can't remember the thoughts behind sharing drinking bowls though...

Re: FeLV treatment options

Richard Fox — Fri, 05 Nov 2010 09:53:36 GMT

Re: FeLV treatment options

Simon Neuhoff — Fri, 05 Nov 2010 09:14:43 GMT

This is a good example of how variable experiences can be between vets. As another example I've worked with vets who don't "believe" in chemotherapy -at all! They have had some failures and now don't offer it or discourage clients from pursuing it. My wife locummed for a vet who euthanased all diabetics on the basis that they couldn't be controlled....... She didn't go back to that practice needless to say!

Re: FeLV treatment options

Martin Atkinson — Fri, 05 Nov 2010 09:00:31 GMT

[quote user="Simon Neuhoff"]

Interesting. I have tried Virbagen in cats for FELV and FIP and to date have had such poor results that I had given up on it (for those applications). Perhaps I should try it again....

[/quote]

It doesn't work in all cases - I would say I've had about 60% success in FeLV and FIV cases so maybe you just got a disproportionate number of non-responders. I've not tried it in FIP but reports suggest it doesn't work as well as in the retroviruses probably because the immunology of FCoV/FIP is so complex. If the client can afford it and it's a PTS case otherwise then its got to be worth a shot, if it works it is dramatic. You have to always wonder if its working as a true anti-viral drug or as an immunomodulator though.

Re: FeLV treatment options

Simon Neuhoff — Thu, 04 Nov 2010 20:34:50 GMT

[quote user="Martin Atkinson"]

Give Virbagen Omega at 1mega unit per kg daily for 5 days. Repeat HCT after 14 days if not improved it isn't going to, if it has improved repeat interferon and then repeat periodic sets of 5 days of injections in response to falling HCT levels. I've had cats that have improved clinically and become non-anaemic for up to 6 months between sets and lived a total of 18 months beyond when they would otherwise have been PTS. If the owner cant afford Virbagen at 1MU/kg, lower doses may still work.

[/quote]

Interesting. I have tried Virbagen in cats for FELV and FIP and to date have had such poor results that I had given up on it (for those applications). Perhaps I should try it again....

Re: FeLV treatment options

Martin Atkinson — Thu, 04 Nov 2010 19:37:35 GMT

Re: FeLV treatment options

Richard Fox — Thu, 04 Nov 2010 12:59:23 GMT

Problem is we are assuming the FeLV infection is causing the anaemia? I expect it is but also consider myelofibrosis/myelodysplastic syndromes (idiopathic). Ideally a marrow sample (cytology and biopsy) would be useful to ID what is going wrong but that maybe too expensive? From the sounds of it your up against if if the owner is not too keen to give medication. With that level of anaemia the prognosis would seem very poor if there is no sign of regeneration and there is a leukopaenia. FeLV causes erthyroid hypoplasia and a non-regen anaemia and neutropaenia - I would think anabolic steroids may be of benefit to the cat ?