My beautiful dumb cat has FIV and FeLV and is very sick.
April 24, 2019 12:53 AM   Subscribe

Just back from the vet. He's lost 25% of his weight in 4 weeks and has an elevated white blood count and anaemia. No mouth ulcers. He eats just a few mouthfuls of his favourite canned food and is very lethargic. I want to know what to expect if he doesn't improve (acute), and what practical things I can do to help him.

The vet has put him on two antibiotics and support meds, and will see him in 2 weeks, earlier if he worsens. She won't give a prognosis beyond he is still alert and has a chance of recovery maybe. She said if he does recover from this infection, any future infection will be as dangerous. He likely picked it up when he went outside exploring (no more!) and fought a stray.

(Mandatory cat picture)

His liver and kidney functions are good, and his fever is very mild. He is peeing and pooping fine when he does. His fur is okay.

I have two more cats at home, so I'm taking them in for tests this week. They don't groom with him as he is/was the Big Alpha and I can separate their bowls and keep him in my bedroom pretty easily. They all have their own 'territory' in the apartment and only come together when it's food or petting time.

I've read what I could find on Google and Google Scholar on FIV and FeLV, and my immediate questions are:

1) Definitely no cross-grooming hair brushes right? He gets his own cat brush now?

2) I think a cat toothbrush would enrage him and hurt me far more than any potential dental health benefits - is there something else I can do towards preventing mouth ulcers? He only has v. mild gingivitis right now.

3) The vet was firm on no FeLV vaccines for the other two cats. She says the negative side effects outweigh any benefits. I found conflicting notes on this - is it about the risk of increased infection or something else?

4) Should I insist on re-testing for FeLV and FIV for my sick cat? It was an in-house test, Feline Combo, plus a full blood work up and the usual chemical for liver and kidneys. I sort of feel like given the weight loss and white cell count, it's highly likely to be accurate, but also the false positives?

5) What is the acute stage of both of these diseases combined? The vet is great but because she's both good and affordable, she's crazy busy so it was a two hour wait for a 15 minute consult. I can't go back to her or call with questions. She was very clear that he is not in the infected and okay stage but in the very sick acute stage. She said he could recover or he might not, and we would have to wait and see over the next week or two.

6) What can I do to make him more comfortable? Is he going to need privacy, warmth, darkness...?

7) And what can I do to get him to eat more? More frequent tiny meals? Hand feeding him? Variety? He was the greediest kitty until he got sick so I'm at a loss.
posted by dorothyisunderwood to Pets & Animals (13 answers total) 2 users marked this as a favorite
I don't have experience with FeLV but my cat had FIV and died from a secondary infection last week - probably a small cold- because he couldn't fight it off due to FIV. He was only 1.5 years old. However my cat also had severe IBS that often is concurrent with FIV which made it hard to keep hydrated so yours may stand a better chance. Once my cat stopped wanting to eat he began to lose weight quickly. Even though an appetite stimulant was prescribed he still didn't have the will to eat more than a handful or so daily. He got thinner and thinner (down to under 5 pounds) and weaker and weaker. He was still in good spirits and didn't appear to be in any pain but we had to put him down because the vet advised he wasn't capable of getting better and would be in the suffering zone soon. If your cat stops caring about grooming himself and gets down to 5 pounds where organ failure can begin to occur you will probably have to say goodbye. The best thing you can do for him is keep his weight up. Ask for appetite stimulant maybe? And plenty of water. Iv drip if needed for hydration. To keep him comfy give him something soft to lay on you don't mind getting dirty like an old towel as he will probably get too weak to jump up on the bed with you anymore and he will have trouble keeping his bottom clean as he gets sicker. Spend time with him. Soothe him with your voice. Some cats go into hiding when sick while others like mine start to follow you around more. Maybe keep him out of rooms where there are any tiny crawlspaces to hide in thst you wouldn't be able to get him out from.
posted by TestamentToGrace at 5:56 AM on April 24, 2019 [2 favorites]

Can't speak to these conditions exactly, but I lost my oldest cat not long ago, and when her appetite started to go at the end I think she got a small-but-noticeable quality of life boost from going to feeding a small amount of canned food 3x as often as previously. Inconvenient, but it was worth trying.
posted by Sequence at 6:13 AM on April 24, 2019

When our cat, Rupert, was battling through a really bad bout of peritonitus, his vet recommended that we have a feeding tube installed so we could keep his weight up and ensure adequate hydration. We balked, thinking that it would be terribly uncomfortable for him, but were convinced that cats actually tolerate it really well. So we went for it.

The feeding tube went into his neck and then ran down his esophagus such that the food/water was deposited atop the sphincter at the entrance to his stomach, which would then open automatically in response to that stimulation. The feeding tube and stoma (really just an opening) were protected by a collar that wrapped it around his neck in a sleeve with a velcro-closing. We were instructed on how to make slurries of high calorie food in a blender (actually we used a coffee grinder), fill an hypodermic-style injector with it, screw the injector onto the end of the feeding tube, and then slowly depress the plunger. Same went for water. He tolerated it really well and started to understand that it made him feel better and waited patiently during the routine. At first, it was tiny amounts of food every two hours, but as he improved it became more food less often. As a bonus, we delivered his many medications this way which meant that he received their full benefit (he's terrible at taking pills or accepting squirts in him mouth) and it was easier to track his nutrition so his docs could compare it to his weight changes.

The feeding tube period lasted about a month and we credit it with his recovery. As he improved, he started eating his favorite dry food again and the tube did not interfere. Before the tube, we had tried to tempt Rupert to eat with all of his favorite foods... and we ruined most of them for him, as he started associating them with feeling bad, I guess. I regret that.

TL;DR - If he's doing better vis-a-vis the infection but still losing weight or getting dehydrated, don't reject the idea of a feeding tube out of hand. Sending positive vibes to your kitty!
posted by carmicha at 7:07 AM on April 24, 2019 [5 favorites]

I'm so sorry this is going on. If you can get them, McDonalds' chicken mcnuggets are like crack for many cats and I've seen very ill cats come out from hiding places just to eat them. Bonus, they increase thirst so the cat will drink more water.
posted by yes I said yes I will Yes at 8:35 AM on April 24, 2019

If dehydration is a concern, the vet should be able to show you how to give saline solution at home through a needle in the scruff between his shoulders. This worked great for getting a sick kitty of my acquaintance feeling better enough to eat more. Bonus: kitty associated handling with feeling better and got a bit more snuggly afterwards.

Sending warm wishes to you and your handsome catpanion.
posted by momus_window at 9:35 AM on April 24, 2019 [1 favorite]

[caveat: not a vet]

I volunteer with a cat rescue group and if we get a cat with FeLV we have it put down unless we can find someone with no cats to foster (or if the cat is sick, hospice foster). This is due to the risk of infecting other cats. If your kitty recovers that doesn't mean he won't keep shedding the virus, so you may have to keep him in the bedroom indefinitely.

Yes, do not cross-groom with the hair brush. Keep everything as separated as much as possible. Their own bowls even, even if you're washing them.

You could re-test for FeLV if he recovers to see if he's cleared the virus, but I agree with you that it's unlikely to be a false positive if he's showing signs of illness.

Teeth cleaning is great for gingivitis, but requires putting a cat under. Vets will generally not do this if the cat is sick.

There are good recommendations on getting your cat to eat here. Browse the rest of the site too--there's a good deal of it that's helpful for dealing with sick cats in general, not just CRF kitties.

I'm so sorry this is happening. I hope that good boy feels better!
posted by Anonymous at 10:04 AM on April 24, 2019

Re vaccinations: Vaccinating your cat is info supplied by the PDSA, who are a long-established animal charity in the UK. Scroll down the page linked and there is also a section on why owners should get their pets vaccinated, which looks at some of the pros and cons of doing so.

I must confess to being surprised that a vet would recommend against getting your other cats vaccinated. As anecdata, we have had a number of cats over the last 20+ years, always had them vaccinated against all the nasties including FeLV and never had any side effects or issues associated with injections over that time.

Wishing you and your beautiful cat strength and peace.
posted by Martha My Dear Prudence at 10:05 AM on April 24, 2019 [1 favorite]

I am so sorry that you and your beautiful cat are going through this. I don't have any experience with FIV or FeLV, but I do have experience with an aging cat who lost her appetite. A vet friend suggested I try giving her meat-flavored baby food. It got her eating again, so it might be worth a try for your guy.
posted by fiery.hogue at 1:16 PM on April 24, 2019

Shredded cooked chicken is another thing to try.
posted by y2karl at 2:26 PM on April 24, 2019 [1 favorite]

We have an FIV+ cat and were advised not to vaccinate the other cat in the household (just as another data point).
posted by slidell at 2:39 PM on April 24, 2019 [1 favorite]

One of the reasons I've heard for not doing the FeLV and FIV vaccine is that once you vaccinate a cat, they will then always test positive for FeLV or FIV. For your other cats, this means you would not in the future be able to test them to see if they have it. Another concern is if say, your (vaccinated) cat runs out the front door, and ends up in the shelter, the shelter will test them for FeLV and FIV, and your cats would now test positive. Of course, IANAVet, but this is just what I've heard as a layperson who cares a lot about her kitty.
posted by litera scripta manet at 9:18 PM on April 24, 2019

Response by poster: I would favourite everything. He perked up almost immediately on the antibiotics and has begun noisily demanding food 4-5 times a day now, including kibble. He is up to two small cans a day today! We have had a conversation about pills and agreed that he will swallow them before his meal and in return he will not tear out my throat thanks to a tea towel jacket.

He isn't interested at all in human food at the moment, but I will try chicken nuggets, sausage and bacon tomorrow in tiny pieces.

He snuck out this morning to yowl at the neighbours after a month indoors, so the next thing is to get him a noisy bell collar so he is forced to be an indoor cat and a sign to remind everyone in the house to check for his shadow by the door.

I know he will not live as long as he should have, but he was rescued from the streets as an adult and he's clearly enjoying his time now, sleeping belly-up and purring on the couch and making the dog hide under the table by flexing his claws in her face pointedly. The time left is good enough.
posted by dorothyisunderwood at 12:56 AM on April 27, 2019

Response by poster: He started losing weight two weeks ago sharply, and is now refusing food and water. I've been spoon feeding him water a few times a day and carrying him to the litter box. I've scheduled an at-home euthanasia for tomorrow because although he's quiet and napping, he is in pain and can't bear to be touched or move much.

For future askers, this Quality of Life for pets calculator was helpful in figuring out how rapidly he was worsening.

Mostly I just sit next to him and tell him what a beautiful and wonderful cat he is, and he seems to like that.
posted by dorothyisunderwood at 10:38 PM on May 13, 2019 [1 favorite]

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