Sinéad: This week, we're going to discuss a subject that's very important for cats and their humans to know about.

Siouxsie: Feline Immunodeficiency Virus, also known as FIV or "Kitty AIDS," is a viral disease that slowly destroys a cat's immune system and, like the AIDS that humans get, eventually causes death due to infections that overwhelm a cat's weakened immune system.

Thomas: We're talking about FIV this week because we've had a close call with it here at our house. Mama took one of our barn cats, Jim, to the vet last week for a pre-neutering checkup. While she was there, she had the vet do a blood test for feline leukemia and FIV, because even though Jim was almost three years old, he'd never been tested, and since he's been fighting with all of us, she wanted to make sure he wasn't sick.

Sinéad: Well, it turns out he was. Jim had FIV. And since he's bitten me (badly enough to give me an abscess on my paw!) and several of the other cats on the farm, we all have to be tested for FIV, too.

Siouxsie: So because FIV is hitting so close to home this week, we want to help the rest of you understand what FIV is, how it's transmitted, how it develops, and what you can expect if you have an FIV-positive cat. We'll also talk a bit about prevention and treatment options.

Thomas: First, let's talk about what FIV is. It's called a lentivirus (slow virus), and it's in the same family of retroviruses as the Feline Leukemia (FeLV) virus. The two viruses have different shapes, genetic structures, and proteins, though.

Sinéad: FIV viruses travel to a cat's lymph nodes, where they infect white blood cells called T-lymphocytes and reproduce inside those cells. T-lymphocytes are supposed to help fight infection, but with FIV infection they're transformed into virus factories instead, and so the cat's body can't fight off infections as well anymore.

Siouxsie: Infected cats may develop a slight fever or swelling of the lymph nodes at the beginning of the infection, but other than that, there may be no sign of any problems.

Sinéad: I had a fever and felt icky after Jim bit me. I hope it was just from the abscess and not because I got Kitty AIDS from him! We won't be able to tell for sure until after I have my blood test.

Siouxsie: I hope so, too, Sinéad. I mean, I do kind of, you know, love you and stuff .... and we'll talk more about the blood test later.

Thomas: Infected cats can appear normal and healthy for years. But eventually the cat's immune system is so diminished by the viral infection that it can't fight off common bacteria, fungi or viruses the cat is exposed to on a daily basis. At that time, infected cats start getting recurrent infections or chronic disease states that don't seem to respond well to medication.

Sinéad: Cats that develop FIV symptoms will often have problems like weight loss (and perhaps severe wasting or emaciation later in the disease process). Recurrent gum disease (gingivitis) and mouth infections (stomatitis) are also very common in cats suffering from FIV. Some cats also develop chronic respiratory infections and diarrhea. In unspayed females, FIV can cause spontaneous abortions and other reproductive problems.

Siouxsie: At this point you may be asking how FIV is spread. The most common way is through deep bite wounds, since the FIV virus is shed in a cat's saliva. Therefore, it stands to reason that the cats most at risk for getting FIV and giving it to others are roaming, fighting tomcats, like Jim the barn cat.

Thomas: Most of our references don't say that the virus is spread through sexual contact, but even so, given the reproductive problems of FIV-positive queens, we think it would be best to avoid sexual contact between FIV-infected cats and others ... particularly since part of the sex act between cats involves the male cat biting the female cat on the neck to hold her in place!

Sinéad: Ew! I'm glad I never got mated! It sounds terrible, with all this screaming and biting and barbed penises and everything! Ew, ew, eeeeew! I'm so glad Mama had Siouxsie and me spayed when we were kittens.

Siouxsie: Speaking of spaying, the best possible way to prevent cats from getting FIV is to have them spayed or neutered before they reach sexual maturity and begin manifesting adult behaviors -- roaming, fighting, and that sort of thing. Then, keep them inside or away from FIV-infected cats.

Thomas: There is an FIV vaccine available now, but there are still questions about how effective it is and whether it has any unintended side effects that might do more harm than good. Even the Cornell Feline Health Center says the vaccine doesn't protect all cats who get it, so preventing exposure to FIV is still the best thing to do.

Sinéad: Humans can't get FIV from an infected cat, so you don't have to worry if you're exposed to FIV. In the same way, cats can't get HIV from humans or bovine immunodeficiency virus (BIV) from cattle. The viruses are species-specific at this time.

Siouxsie: How is FIV detected? Your veterinarian can run a blood test on your kitty to detect the FIV and FeLV viruses. The blood test checks for the presence of antibodies to these viruses. It's worth the extra expense (Jim's FeLV/FIV blood test cost $39.50 US at our vet's office) for the peace of mind ... or the knowledge that you need to take special care of your cat's health.

Thomas: If you adopted your cat from a shelter, it will already have been tested; his or her adoption records should show the cat's FIV/FeLV status. Reputable breeders of purebred cats will also generally make sure all the animals they sell are free from any disease, including FeLV and FIV, and will provide health guarantees.

Sinéad: Some vets recommend that if your cat tests positive for FIV that they be retested using a blood test called the Western Blot, to make extra-double-sure that they do indeed have the virus. False positives are quite rare, but according to some of our sources, heavily vaccinated cats can sometimes show false positives on an FIV screening. Cats vaccinated with the FIV vaccine might also test false-positive. And sometimes cats born to FIV-positive mothers can show positive results for several months after birth, since the virus can be transmitted through nursing as well. Very few of these kittens will become infected, though.

Siouxsie: A negative test result means that antibodies to the FIV virus were not detected in the blood. However, according to some sources it can take up to 60 days after infection for an antibody response to manifest, so most vets recommend waiting until 1-2 months after the most recent exposure to an FIV-positive cat before testing. That's why Mama scheduled our blood tests for early January, even though Sinéad was bitten in mid-October.

Thomas: In end-stage FIV disease, a cat may test negative because its immune system is so compromised that it no longer produce detectable levels of antibodies.

Sinéad: So what do you do if you find out one of your cats is FIV-positive? First of all, don't panic! FIV is not a death sentence. As we said, FIV-positive cats can live long and happy lives, especially if they're well taken care of.

Siouxsie: First of all, keep your FIV-positive cat indoors, both to minimize the risk to other cats and to keep your cat from getting exposed to germs that might hurt his weakened immune system. Feed your cat a nutritionally complete and balanced diet; include vitamins and nutritional supplements under the guidance of your conventional and/or holistic veterinarian. Avoid feeding raw meat and poultry or unpasteurized milk, since these foods may contain bacteria or parasites your cat's body can't fight off. Schedule well-cat visits with your vet at least every six months, so that if an infection is brewing it can be caught early.

Thomas: Speaking of infections, people who life with FIV-positive cats need to be very vigilant about their cats' health. Even a slight sniffle could develop into a life-threatening respiratory infection in a cat with a compromised immune system, so stay right on top of these things and call your vet right away if your FIV+ cat shows any signs of illness.

Sinéad: Mama says that if any of us are FIV-positive, she's going to bring us to the holistic veterinarian here in town and work together with our regular vet, Doctor Sarah, and the holistic vet, to make sure that our bodies stay as strong and healthy as possible. We'd also have to go back to being indoor-only kitties, and that would be kind of sad.

Siouxsie: There are differences of opinion on whether or not FIV-positive cats should be vaccinated. Some vets say it's even more important for FIV-positive cats to be vaccinated because their immune systems need help in building responses to infectious diseases. Others, including many holistic veterinarians, say that vaccinations should be kept to a minimum (and preferably avoided entirely) because the vaccines may trigger an actual disease process in immune-compromised cats. If you have an FIV-positive cat, you're going to have to do your own research and talk to your veterinarian about this issue.

Thomas: Some veterinarians are treating FIV with drugs such as interferon and the human anti-AIDS drug AZT. For some cats this treatment program seems to work, and for some it doesn't. It may also be too costly for many of us to undertake, no matter how much we love our cats.

Sinéad: Any FIV-positive cat who is known to be highly aggressive, particularly if that cat is a biter, needs to be isolated from other cats if at all possible. If the cat is not neutered, it is possible that neutering would reduce the cat's aggressive behavior, but in order to see if any behavior changes happen, the cat would need to be kept indoors and away from other cats for 3-4 weeks after neutering. If this is not possible, or if it would have a seriously adverse effect on the cat's quality of life, then euthanasia should be considered. It's a heartbreaking decision to euthanize a cat at any time, particularly when that cat appears to be healthy. But if the FIV-positive cat is a high risk for spreading the disease and it cannot be contained for whatever reason, humans have a moral and ethical obligation to their and their neighbors' cats to prevent the spread of FIV.

Siouxsie: Whatever decisions you make about the care and management of your FIV-positive cat, the cat's quality of life and the "public health" of the cats in your home and your area are the top considerations. After learning the facts about FIV and a long discussion about Jim's behavior and quality of life, Mama's brother (who is officially Jim's human) made the decision to have him euthanized. He was an outdoor cat, who, although he was very friendly with people, was very aggressive with other cats. He had already bitten several other cats in the family, Mama's brother didn't have the lifestyle or ability to keep him indoors, and he believed (and we agree with him) that Jim would have been miserable living indoors only, all by himself.

Thomas: But not all FIV stories are sad! As we said, many FIV-positive cats live wonderful, long and healthy lives. As an example, we'd like to share with you a letter from our reader Sue, who has an FIV-positive cat who's quite alive and well at the age of 13:

We adopted Socks in December 2001 from our local Cat Protection League Rescue Team. His elderly owner had died leaving him homeless and they had trouble homing him because he was an older cat (aged between 9 and 11)

His health was fine but in the Summer of 2004, he started losing his tummy fur, became thin and restless. The vet diagnosed an overactive thyroid but at the same time found out that he was FIV positive. We made sure we had another blood test done, because FIV isn't very common at all here in the U.K. Unfortunately this confirmed he was positive and the vet felt that the virus would have been passed on to him many years earlier. We were particularly shocked because Socks is such a soft cat, avoiding trouble and never going beyond the garden, but as we hadn't had him from a kitten, we had to assume he wasn't always like that and must have received an infected bite when he was younger.

For the first month or so after diagnosis he displayed no symptoms and we focused on monitoring the thyroid problem and making sure he took the medication for that. But by Christmas 2004, he was obviously deteriorating and we began long courses of strong antibiotics to clear up recurring gum and mouth infections, sickness and poor appetite. This went on for around three months and he was very 'up and down' health-wise during that time, although he still seemed content and playful. In April 2005, the vet called me in to discuss some new treatment which might benefit Socks. This involved a concentrated course of treatment of Interferon and we had to take Socks to the vet for an injection every day for five days and once more after a month for a final booster injection. Within days Socks had improved greatly and now, six months later, he has shown no sign of secondary infection. Identifying and treating these secondary infections immediately is the key to keeping the cat well enough to live a good life.

If a cat is diagnosed FIV positive, then it doesn't necessarily mean the end, but there are so many factors to consider. Socks is a very 'soft' cat - he doesn't fight and apart from contact with our other non-FIV cat, doesn't get involved with other cats at all. We may not have kept him alive if his personality had been different and he was a risk to other animals, or if he couldn't bear not to wander around freely, or if the deterioration meant constant vet visits and resultant stress. I also strongly believe that if we treat him very kindly, give him lots of love and cuddles and plenty of treats that this boosts what little immune system he has left and he has responded extremely well to this so far. We also provide a very varied diet and replace his cat nip mouse regularly :) An owner must be prepared to watch the cat closely for any sign that there may be the start of a secondary infection and be aware that such an infection won't clear up by itself like it would in a normal healthy cat, because the immune system isn't there to cope with it.

As for Socks, he must be at least 13 years old now; living proof that FIV problems don't always manifest themselves in early life and even when they do, then it can be possible to manage and treat them to keep your pet well and happy.

Sinéad: And here's another story with a happy ending. Cat parent Tom Hapka shares his experience of treating an FIV+ cat with homeopathy and nutritional therapy at the Black Giraffe website.

Siouxsie: Much of the information in this article came from the Cornell Feline Health Center. The Animal Health Channel's article on FIV also contains a lot of good information about managing the care of FIV-positive cats.

Thomas: The book The Veterinarians' Guide to Natural Remedies for Cats - Safe and Effective Alternative Treatments and Healing Techniques from the Nation's Top Holistic Veterinarians by Martin Zucker (ISBN 0-609-80373-5) contains some good information that can be used to help in the management and care of FIV-positive cats. Also, some of the books in our Recommended Reading list have very good information on holistic care for cats with FIV or other chronic diseases.

Sinéad: If you have any information about treatment you've used on FIV-positive cats, we'd love to hear about it. If it turns out any of us are sick with FIV, Mama wants to know as much as possible about the options available to us to help us stay healthy.

Siouxsie: And one last bit of good news: Although our vet told us that no shelters in our area would take FIV-positive cats -- a fact that contributed to Mama's brother's decision about Jim's fate -- there are shelters in some cities that do take FIV-positive cats. Felines Inc. in Chicago and Annex Cat Rescue in Ontario, Canada, are two that Mama's online friends have told us about. We'd be glad to hear of more.

Got a question? Need some advice? E-mail us at advice@paws-and-effect.com. None of the material in this column is meant to be a substitute for regular veterinary care.