Vet Advice: FeLV, Neutering & Second Opinions
November 10, 2015 5:05 PM Subscribe
Our vet doesn't want to neuter our four-month-old kittens due to their weak positive FeLV status. We feel the importance of neutering now outweigh the risks and have found a vet willing to neuter them both next week. Can we continue seeing the old vet after the operation or should we find a new practice?
We adopted kittens about a month and a half ago from the local SPCA via a pet shop that was fostering them. Their surprise positives would have been enough reason for us to return them to the pet shelter but we already loved them and figured we'd try our best. They're both healthy indoor cats and there's a chance they may get better. The local low-cost neuter/spay clinic is aware of their status and is still willing to neuter because they also feel the benefits outweigh the risks. They apparently frequently neuter FeLV cats. Their main concern is not the slight possibility of the cats not surviving anesthesia (our vet's worry) but rather making sure they stay separate from other cats there to avoid potential infection.
I think the other vet practice is wonderful but this is a sticking point. They have been helpful in trying to determine the urination issue (they believe it's health-related and not due to behavior.) However, nothing has solved it and we are ready to just accept the status quo rather than continue to put our cat through (more) expensive tests or treatments that may not work. I feel they're not trying to overcharge us but merely caring and thorough. I'm willing to do a lot to support pets but I have to draw the line at spending thousands of dollars.
I'd be happy to continue seeing them due to their level of care and expertise. However, I'm determined about neutering and is going to happen. We have an appointment for more shots and a check-up the week after neutering. I know returning would be awkward but would it be bad? If this were a human doctor, I'd find a new physician. However, these are cats, not people, and I feel these rules might be a bit different?
We adopted kittens about a month and a half ago from the local SPCA via a pet shop that was fostering them. Their surprise positives would have been enough reason for us to return them to the pet shelter but we already loved them and figured we'd try our best. They're both healthy indoor cats and there's a chance they may get better. The local low-cost neuter/spay clinic is aware of their status and is still willing to neuter because they also feel the benefits outweigh the risks. They apparently frequently neuter FeLV cats. Their main concern is not the slight possibility of the cats not surviving anesthesia (our vet's worry) but rather making sure they stay separate from other cats there to avoid potential infection.
I think the other vet practice is wonderful but this is a sticking point. They have been helpful in trying to determine the urination issue (they believe it's health-related and not due to behavior.) However, nothing has solved it and we are ready to just accept the status quo rather than continue to put our cat through (more) expensive tests or treatments that may not work. I feel they're not trying to overcharge us but merely caring and thorough. I'm willing to do a lot to support pets but I have to draw the line at spending thousands of dollars.
I'd be happy to continue seeing them due to their level of care and expertise. However, I'm determined about neutering and is going to happen. We have an appointment for more shots and a check-up the week after neutering. I know returning would be awkward but would it be bad? If this were a human doctor, I'd find a new physician. However, these are cats, not people, and I feel these rules might be a bit different?
I have a cat that pees on the couch, any couch, only in a specific spot. If she can get to that spot. It's such a bummer.
Your urine issue sounds like a behavior and you will have to be vigilant.
Your vet doesn't sound great. I don't think they pinpointed the urination issue. Plus, they don't seem to want your cats there. I think they are doing you a favor and you should find a new vet.
posted by jbenben at 5:13 PM on November 10, 2015 [1 favorite]
Your urine issue sounds like a behavior and you will have to be vigilant.
Your vet doesn't sound great. I don't think they pinpointed the urination issue. Plus, they don't seem to want your cats there. I think they are doing you a favor and you should find a new vet.
posted by jbenben at 5:13 PM on November 10, 2015 [1 favorite]
It sucks to feel judged by a vet. I think you should do what makes you feel comfortable. Back in the late 80s I had a weak positive FeLV cat that I adopted when she was five weeks old (her mother had been hit by a car). I didn't know she was FeLV positive before I adopted her, and I had her spayed. I managed to keep her alive and mostly healthy for 11 years. I understand your vet's concern, but I would think they'd be more concerned at the possibility of creating additional FeLV kittens.
On the urination issue: my roommate adopted a kitten from the same place at the same time, but a different litter, and that kitten peed on only soft things. We had to rehome her as a barn cat, to be honest. I hope you have luck solving it. Because we had to get rid of the couch...
posted by clone boulevard at 5:16 PM on November 10, 2015 [2 favorites]
On the urination issue: my roommate adopted a kitten from the same place at the same time, but a different litter, and that kitten peed on only soft things. We had to rehome her as a barn cat, to be honest. I hope you have luck solving it. Because we had to get rid of the couch...
posted by clone boulevard at 5:16 PM on November 10, 2015 [2 favorites]
Most kittens with "weak positive" combo test results will test negative when retested at 6 months. In years of fostering kittens, I've had several kittens with positive combo tests, and none of them ever retested positive at 6 months. A lot of kittens from feral mothers will test positive from as a result of maternal antibodies. They are normally not considered completely free of maternal antibodies until six months (it's probably sooner than that, but there's a safety margin).
I'm curious as to why you are so anxious to have them spayed or neutered at 4 months? It's definitely NOT too early for males, and I always have my fosters snipped between 4 and 5 months. Any later than that and you risk adolescence and all the attendant negative behaviors like spraying. It is also considered to be better to spay females before their first heat, as it does reduce some cancer risk factors. Having said those things, it's not necessarily bad to wait until they are six months old and have been retested.
If it were me, I would have any male kittens done immediately. They usually don't even anesthetize them because it's such a small incision with no stitches. The risk factor is really minimal. If there are females, there's really not much harm in waiting until six months. If you're lucky, they'll be late bloomers and you won't have to go through that first heat.
Either way, I don't really understand your vet's concern about transmission of FELV. Are there are other cats in your household? If so, yeah, they should be separated, and I'm not sure how the speutering makes a difference. If he's concerned about transmission to other cats in his practice, then he I would question his expertise about FELV transmission. As long as your kittens aren't caged or housed with any other cats there isn't going to be any chance of transmission.
posted by ereshkigal45 at 9:18 PM on November 10, 2015
I'm curious as to why you are so anxious to have them spayed or neutered at 4 months? It's definitely NOT too early for males, and I always have my fosters snipped between 4 and 5 months. Any later than that and you risk adolescence and all the attendant negative behaviors like spraying. It is also considered to be better to spay females before their first heat, as it does reduce some cancer risk factors. Having said those things, it's not necessarily bad to wait until they are six months old and have been retested.
If it were me, I would have any male kittens done immediately. They usually don't even anesthetize them because it's such a small incision with no stitches. The risk factor is really minimal. If there are females, there's really not much harm in waiting until six months. If you're lucky, they'll be late bloomers and you won't have to go through that first heat.
Either way, I don't really understand your vet's concern about transmission of FELV. Are there are other cats in your household? If so, yeah, they should be separated, and I'm not sure how the speutering makes a difference. If he's concerned about transmission to other cats in his practice, then he I would question his expertise about FELV transmission. As long as your kittens aren't caged or housed with any other cats there isn't going to be any chance of transmission.
posted by ereshkigal45 at 9:18 PM on November 10, 2015
Even ignoring their declining to perform this service for you, it is perfectly normal to go to the low-cost clinic for spay/neuter and then go right back to your regular vet for ongoing care, if that's what you want to do. Happens all the time, and will barely rate a second thought by your vet. I do want to speak to this concern a bit, too:
I feel they're not trying to overcharge us but merely caring and thorough. I'm willing to do a lot to support pets but I have to draw the line at spending thousands of dollars.
A good vet has an ethical responsibility to present their clients with recommendations for the highest and best level of care available. A good vet also understands that not every client will consent to that level of care for any number of reasons (cost, convenience, best interest of the pet, etc). Don't feel bad for a minute about not automatically agreeing to all of their recommendations, and if they try and make you feel bad about it, they are not a good vet.
posted by Rock Steady at 9:52 PM on November 10, 2015 [1 favorite]
I feel they're not trying to overcharge us but merely caring and thorough. I'm willing to do a lot to support pets but I have to draw the line at spending thousands of dollars.
A good vet has an ethical responsibility to present their clients with recommendations for the highest and best level of care available. A good vet also understands that not every client will consent to that level of care for any number of reasons (cost, convenience, best interest of the pet, etc). Don't feel bad for a minute about not automatically agreeing to all of their recommendations, and if they try and make you feel bad about it, they are not a good vet.
posted by Rock Steady at 9:52 PM on November 10, 2015 [1 favorite]
A lot of kittens from feral mothers will test positive from as a result of maternal antibodies.
The most commonly used clinical test for FeLV is an ELISA from Idexx that tests for the presence of the FeLV virus or its antigens, not an antibody. Confirmation can be obtained by detecting the virus in the blood using PCR.
Cats that test positive for FeLV can convert to 'negative' status by developing an effective immune response that controls the viral infection. In those cases, there is no antigen in the blood for the test to detect.
There is no cure for FeLV.
Your vet might be hesitant to perform surgery on your kittens because FeLV suppresses the immune system, making opportunistic infections more likely. Also, it can affect the bone marrow, resulting in low red blood cells (anemia) or low platelets.
So a cat that has a suppressed immune system, fewer red blood cells to carry oxygen, and fewer platelets to clot is a riskier surgical candidate.
The low-cost spay and neuter clinic may not be hesitant to perform the surgery because they frequently never see their surgical patients after they are discharged. These patients may have had complications related to being FeLV positive of which they are unaware. On the other hand, your regular veterinarian probably sees their patients after surgery, and for years to come and may be more aware of the post-surgical risks.
One of my colleague's only feline neuter complication arose because an immunosuppressed FeLV positive cat developed a nasty infection at his surgical site and was euthanized.
posted by Seppaku at 4:37 PM on November 11, 2015 [1 favorite]
The most commonly used clinical test for FeLV is an ELISA from Idexx that tests for the presence of the FeLV virus or its antigens, not an antibody. Confirmation can be obtained by detecting the virus in the blood using PCR.
Cats that test positive for FeLV can convert to 'negative' status by developing an effective immune response that controls the viral infection. In those cases, there is no antigen in the blood for the test to detect.
There is no cure for FeLV.
Your vet might be hesitant to perform surgery on your kittens because FeLV suppresses the immune system, making opportunistic infections more likely. Also, it can affect the bone marrow, resulting in low red blood cells (anemia) or low platelets.
So a cat that has a suppressed immune system, fewer red blood cells to carry oxygen, and fewer platelets to clot is a riskier surgical candidate.
The low-cost spay and neuter clinic may not be hesitant to perform the surgery because they frequently never see their surgical patients after they are discharged. These patients may have had complications related to being FeLV positive of which they are unaware. On the other hand, your regular veterinarian probably sees their patients after surgery, and for years to come and may be more aware of the post-surgical risks.
One of my colleague's only feline neuter complication arose because an immunosuppressed FeLV positive cat developed a nasty infection at his surgical site and was euthanized.
posted by Seppaku at 4:37 PM on November 11, 2015 [1 favorite]
I feel they're not trying to overcharge us but merely caring and thorough.
I think that they are trying to be cautious about your kittens because they know the risks as I outlined above. If they simply wanted your money, they would perform the surgery without considering the overall well-being of your pets.
posted by Seppaku at 4:46 PM on November 11, 2015 [1 favorite]
I think that they are trying to be cautious about your kittens because they know the risks as I outlined above. If they simply wanted your money, they would perform the surgery without considering the overall well-being of your pets.
posted by Seppaku at 4:46 PM on November 11, 2015 [1 favorite]
your vet's concern about transmission of FELV
OP's vet isn't concerned about FeLV transmission, the low-cost clinic is.
Because FeLV lives only minutes outside the host and is susceptible to all disinfectants, including common soap, simple precautions and routine cleaning procedures will prevent transmission in the hospital. But FeLV-infected cats should not be placed in an “infectious disease ward” with cats with contagious diseases (e.g., upper respiratory infections).
I suspect that many cats that are serviced at low-cost spay/neuter clinics have upper respiratory infections.
making sure they stay separate from other cats there to avoid potential infection
They do need to be prevented from exchanging bodily fluids with other cats. But since your cats live indoors without any other cats, they are not likely to infect others, so I am not as concerned as your low-cost clinic is.
The local low-cost neuter/spay clinic is aware of their status and is still willing to neuter because they also feel the benefits outweigh the risks.
From the perspective of a low-cost spay/neuter clinic, any intact cat is a potential nidus of additional cats, and if FeLV positive, of FeLV positive cats. They are focused on reducing pet overpopulation by providing cheap gonadectomies. It is a completely different mindset held by healthcare providers whose focus is on herd health, not on individual health. That is not to say that they don't care about your cats, it is just a radically different world than a general practitioner.
posted by Seppaku at 5:20 PM on November 11, 2015 [1 favorite]
OP's vet isn't concerned about FeLV transmission, the low-cost clinic is.
Because FeLV lives only minutes outside the host and is susceptible to all disinfectants, including common soap, simple precautions and routine cleaning procedures will prevent transmission in the hospital. But FeLV-infected cats should not be placed in an “infectious disease ward” with cats with contagious diseases (e.g., upper respiratory infections).
I suspect that many cats that are serviced at low-cost spay/neuter clinics have upper respiratory infections.
making sure they stay separate from other cats there to avoid potential infection
They do need to be prevented from exchanging bodily fluids with other cats. But since your cats live indoors without any other cats, they are not likely to infect others, so I am not as concerned as your low-cost clinic is.
The local low-cost neuter/spay clinic is aware of their status and is still willing to neuter because they also feel the benefits outweigh the risks.
From the perspective of a low-cost spay/neuter clinic, any intact cat is a potential nidus of additional cats, and if FeLV positive, of FeLV positive cats. They are focused on reducing pet overpopulation by providing cheap gonadectomies. It is a completely different mindset held by healthcare providers whose focus is on herd health, not on individual health. That is not to say that they don't care about your cats, it is just a radically different world than a general practitioner.
posted by Seppaku at 5:20 PM on November 11, 2015 [1 favorite]
Response by poster: Thank you all for taking the time to share your experience, expertise, and understanding! It had been a difficult situation but everything feels much more resolved now. Our kittens were neutered this past Thursday and seem to be doing well. We also got them microchipped, vaccinated, and the like so we should be set for awhile. In fact, we've decided to cancel the upcoming vet appointment and see how things go.
FWIW, there have been no accidents in over a month, although we've also removed the tempting fabrics from the environment; we're going to try again with the fabrics soon as we're hoping the neutering could help.
posted by smorgasbord at 12:30 PM on November 21, 2015
FWIW, there have been no accidents in over a month, although we've also removed the tempting fabrics from the environment; we're going to try again with the fabrics soon as we're hoping the neutering could help.
posted by smorgasbord at 12:30 PM on November 21, 2015
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posted by smorgasbord at 5:09 PM on November 10, 2015