23Rd Annual Feline Symposium

Bellwether Magazine Volume 1 Number 47 Summer 2000 Article 7 Summer 2000 23rd Annual Feline Symposium Joan Capuzzi University of Pennsylvania Follow this and additional works at: https://repository.upenn.edu/bellwether Recommended Citation Capuzzi, Joan (2000) "23rd Annual Feline Symposium," Bellwether Magazine: Vol. 1 : No. 47 , Article 7. Available at: https://repository.upenn.edu/bellwether/vol1/iss47/7 This paper is posted at ScholarlyCommons. https://repository.upenn.edu/bellwether/vol1/iss47/7 For more information, please contact [email protected]. Symposia for Breeders & Owners Feline he Twenty-Third Annual The donor cat is brought into the surgical possible poor owner compliance. Feline Symposium was held area 30-45 minute prior to the recipient. Among all the cats receiving renal on March 25, 2000 at VHUP. Once the donor vessels and ureter have transplantation at VHUP, the postopera- T been prepared for a nephrectomy, the tive complications that were treated suc- The event was well attended and recipient is brought into surgery and pre- cessfully included renal infarction, sad- supported by Sheba® and Mrs. pared to receive the kidney. The renal dle thrombus, seizures, bladder atony Robert V. Clark, Jr. and Mrs. Edith vessels are anastomosed (end-to-side) to and associated ureteral obstruction, and M. Young. Mr. Richard Gebhardt the recipient’s aorta and caudal vena fever of unknown origin. again narrated the Parade of cava. A ventral midline cystotomy is then Renal transplantation is a revolution- Breeds. Following are summaries done, and the ureteral mucosa is attached ary development in feline medicine. of the presentations. to the bladder mucosa. One of the native When tethered to careful case selection, kidneys is biopsied and a gastrostomy postoperative intensive care, and early Update on the Renal tube placed. The incisions are closed and recognition of complications, renal trans- the recipient is taken to the intensive plantation can restore quality—and quan- Transplant Program care for close monitoring. The donor tity—of life to cats in renal failure. recovers in the regular fluid ward. idney transplantation is the freshest “The key to success with these approach used to combat the most K patients is intensive post-operation man- pervasive—and perhaps deadliest—dis- FELV and FIV— agement to try to prevent complications,” ease in geriatric cats: renal failure. Dr. Dr. Aronson said. “Furthermore, she Lillian Aronson, assistant professor of Differences and added, the owner needs to realize that surgery at VHUP, discussed the method- this is a commitment for the life of the Similarities ology and potential complications of cat.” This commitment includes continu- renal transplantation, and data from the eline leukemia virus (FeLV) and al immunosuppressive therapy and regu- first two years of the program at VHUP. Ffeline immunodeficiency virus (FIV) lar visits to the referring veterinarian for VHUP’s renal transplantation pro- cause immunodeficiency syndromes that bloodwork and evaluation. gram began in early 1998. Since then, 30 can greatly impact the quality of life of Dr. Aronson cited some statistics cats (25 domestic shorthairs and five our cats. Dr. Lesley King, associate pro- regarding postsurgical outcome in kidney purebred cats) diagnosed with end-stage fessor of critical care at the School, transplant patients at VHUP. Nineteen of renal failure have received kidney trans- explained the differences and similarities the 30 cats that have received kidney plants here. The causes of renal failure in between FeLV and FIV. transplants at VHUP are currently alive these cases included chronic interstitial Three subfamilies of retroviruses are and thriving; sixteen of these are over nephritis (50%), nephroliths and/or important in domestic cats: the one year post-transplant. Complications ureteroliths of kidneys/ureters (20%) spumaviruses, which typically do not in the surviving cats include three cases polycystic kidney disease (7%) and cause disease; the oncornaviruses—like of diabetes, possibly associated with unknown in 6 cats. FeLV—which potentially cause immuno- chronic immunosuppressive therapy, and Careful patient selection is crucial to a suppression and cancer; and the one case of a parathyroid gland tumor; successful medical outcome of renal lentiviruses—or “slow” viruses—such as the tumor has been removed and the cat transplantation, Dr. Aronson explained. FIV, which cause immunosuppression. is doing well. Kidney recipients must be healthy; pre- The latter two viruses are quite patho- Of the cats that are no longer alive, operative tests include routine blood- genic in cats. three died in the perioperative period work, FELV/FIV test, serum T4, urinaly- “The viruses FeLV and FIV certainly prior to discharge—one from a possible sis and urine culture, chest/abdominal cause some of the most serious health coagulopathy, one from hypotension radiographs, echocardiography and problems that we see in cats today,” Dr. associated with a hemoabdomen, and the abdominal ultrasound. King said. third from pancreatitis and pleural effu- Prior to surgery, recipient cats are Both viruses consist of a RNA core, sion. Seven cats died following dis- given a protein-restricted diet, phosphate which is surrounded by structural charge—two from calcium oxalate stone binders, blood transfusions to correct any formation in the new kidney (14 month anemias, and intravenous fluids. and two years, post operatively), three Immunosuppression, which reduces the from infection secondary to immunosup- likelihood of organ rejection, is accom- pressive therapy, two cats with system plished by the administration of toxoplasmosis infection four months and cyclosporine and prednisone, started two six months post-op, one cat from an days prior to surgery. infection of her peg tube site, one from The surgeries on the donor and recipi- ureteral obstruction secondary to scar tis- ent cats are performed simultaneously. sue formation at the graft site, and one of 6 Symposia for Breeders & Owners Feline proteins and protected by a lipoprotein to small quantities of virus, viral antibod- are also prone to respiratory and intesti- envelope. This envelope consists of anti- ies against the gp70 antigen are formed, nal tract disease and skin lesions. gens, such as the gp70 molecule in the infection is eliminated, and lifetime FeLV is diagnosed by antigen tests case of FeLV, which enable the virus to immunity develops (42 percent of (ELISA or IFA), and positive results are attach to and infect the host cells. exposed cats). If the inoculum is large or obtained only when the virus is actively “Cats’ cells have specially designed the cat is immunosuppressed, the virus replicating. Negative results to these tests receptors on their surfaces to link into spreads hematogenously to other sites, therefore occur in cats with latent infec- this virus,” Dr. King explained. “The two particularly the intestines and the bone tions. False positives may occur with have evolved together over probably marrow (28 percent of exposed cats). ELISA testing, and should be confirmed thousands of years.” These cats, 85 percent of which die with- with IFA. A third test, polymerase chain Once the FeLV or FIV viruses attach in 3.5 years of diagnosis, are capable of reaction (PCR), can theoretically detect to cell membrane receptors, they pene- transmitting the virus to other cats. Alter- virus in latently infected cats that are trate the target cell and shed this enve- natively, in about 30% of cats the virus negative on ELISA and IFA. Positive lope. Using the enzyme reverse tran- dies out and is eliminated from the cat, results may also be seen during the acute scriptase, a DNA copy of the viral RNA but the cat does not develop an immune phase of FeLV infection; if this scenario is made. A provirus is then formed and response and is susceptible to re-infec- is suspected, these cats should be retest- integrated into the cat cell DNA. Follow- tion in the future. In a small percentage ed two to three months later. ing integration, most cat cells then repli- of exposed cats, latent infections can In the case of FIV, antibodies may not cate the virus. occur in which the virus is present in the be present until six weeks after infection, Both fragile viruses, FeLV and FIV cat but not replicating. Latent infections but then the cat will remain positive for are readily inactivated by heat, desicca- can potentially revert to viremia and dis- life. The ELISA test is highly sensitive tion and light. They are not transmitted ease if the cat becomes stressed. for FIV antibodies, and the Western blot by transient contact with other cats or In the case of FIV—the feline coun- test is thought to be the definitive test. with fomites, such as cages or brushes. terpart to human immunodeficiency virus There are no “cures” for FeLV or FIV. Hence, owners need not delay before (HIV)—the host is infected for life. Fol- However, immunomodulator therapies introducing a new cat into a household lowing inoculation, a fever, enlarged and reverse transcriptase inhibitors (i.e., formerly occupied by an infected cat. lymph nodes and a transient drop in the AZT) may be used to manage infection FeLV is present in high concentration white blood cell count occur about four or delay the spread of the virus. in the saliva and respiratory secretions of weeks after infection. These low-grade For both viruses, prevention is key, infected cats. Transmission requires pro- signs may persist for several months, Dr. King said. This involves preventing longed, intimate, moist contact between after which time the cat appears normal, cats from roaming free and, in the case cats, such as occurs when cats groom even though the virus is still replicating of FeLV, vaccinating. Dr. King also rec- each other. In single-cat households in its system. Eventually these cats ommended a stepwise program for where there is no known exposure to the develop immune deficiency, after which removal of FeLV from catteries: Test all virus, infection incidence is less than one mean survival time is an estimated two cats for FeLV.

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