Feline Retroviruses and Oral Disease

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Sponsored by an educational grant from Feline Retroviruses ➔ and Oral Disease A clear association A new study demonstrates a correlation between feline oral health problems and retroviral infection. The IDEXX National Oral Disease and Retrovirus Prevalence study clearly illustrates that cats with oral disease have an increased risk of being retrovirus-positive.

The veterinary scientific literature has suggested a correlation between oral diseases and feline retroviral infections; however, for many years no large-population Key Points study had ever been conducted. ■ Cats with oral From its interaction with veterinar- disease are more ians, IDEXX suspected that feline than twice as likely oral disease patients were not to test positive for being appropriately considered retrovirus infection as high-risk for being retrovirus- as the general cat A feline odontoclastic resorption population. positive. So the company under- lesion (FORL). took a nationwide study to exam- ■ Knowing a cat’s ine this issue in greater detail. deficiency virus (FIV) infection retrovirus status has important before dental procedures. What’s implications for What the research more, retrovirus infection critical- dental care and means for veterinarians ly affects patients’ overall health, overall health. The study found a significant so testing this higher-risk popula- ■ All cats with oral correlation between feline retro- tion can provide valuable infor- disease should be virus infection and oral disease. mation regarding long-term care. tested for FIV and Based on these results, practition- To ensure cats’ safety, veterinar- FeLV infection. ers should begin to incorporate ians must answer the question of retrovirus testing into their oral whether their feline oral disease health protocols—specifically, patients are retrovirus-positive. testing cats for feline leukemia And the only way to find this out virus (FeLV) and feline immuno- is through retrovirus testing.

Common Feline Oral Diseases ■ Gingivitis: Gingival inflamma- Characterized by gingival labial or buccal surface near tion, edema, and bleeding recession, attachment loss, the cemento-enamel junction. on probing. and tooth mobility. ■ Stomatitis: Signs include ■ Periodontitis: Inflammation of ■ Feline odontoclastic resorp- glossitis, gingivitis, periodon- the periodontal ligament, alve- tion lesion (FORL): A tooth titis, dysphagia, weight loss, olar bone, and cementum. defect usually located at the and ptyalism. Oral Disease and Retrovirus Prevalence: A Study by IDEXX Purpose A study was conducted to determine Figure 1 the prevalence of retrovirus infection Oral Disease and Retrovirus Infection in feline oral disease patients. In a nationwide study, 14.2% of cats with oral disease tested positive for retrovirus infection: FIV infection, FeLV Methodology infection, or both.* Here’s a breakdown of FIV and FeLV ■ Private veterinary practitioners were infection rates compared with national prevalence.

recruited to test feline patients that 10.0% presented with oral disease. 9.0% ■ 8.0% The IDEXX SNAP FIV/FeLV Combo 7.9% Test was used to test this cat popula- 7.0% 7.4% tion from January 2006 through 6.0%

April 2006. 5.0%

■ Results were returned by fax 4.0% for analysis. 3.0% 3.4% 3.3% ■ Prevalence was calculated as the 2.0% percentage of positive test results 1.0% reported out of the population of 0.0% orally diseased cats tested. FIV FeLV FIV FeLV General population** Oral disease population Results *A dual retrovirus-positive test was counted once—i.e., an FIV- and FeLV- ■ A total of 8,982 orally diseased cats infected cat was considered one retrovirus-positive cat, not two. **Source: Levy JK, Crawford PC, Brien JL. Prevalence of FIV and FeLV in the were screened. Presenting cases United States, in Proceedings. 7th Int Feline Retrovirus Res Symp, 2004. included cats with gingivitis, stomatitis, plaque, calculus, periodontal disease, feline odontoclastic resorption Figure 2 lesions, and other oral diseases as Gingivitis, Stomatitis, and Retrovirus Infection defined by the practitioner. The study also examined the correlation between ■ Of 8,982 cats tested, 1,276 were retro- specific oral diseases and retrovirus infection. virus positive—a prevalence of 14.2% (Figure 1). Cats with gingivitis Cats with stomatitis ■ Of the 7,809 study cats with gingivitis, 1,113 were retrovirus-positive. Of the 1,954 with stomatitis, 467 were retrovirus-positive (Figure 2). Some cats had Retrovirus- Retrovirus- both gingivitis and stomatitis. positive: positive: 14.3% Discussion 23.9% Recent studies have reported the prevalence of FeLV nationwide as 3.3% and the prevalence of FIV as 3.4%.1 In the IDEXX study, the higher prevalence of retroviral infection in orally diseased cats indicates that almost one of every seven cats with oral disease has a retroviral infection. This study suggests that screening cats with oral disease for retroviral infection is important in under- standing the underlying cause of this clinical presentation.

1. Levy JK, Crawford PC, Brien JL. Prevalence of FIV and FeLV in the United States, in Proceedings. 7th Int Feline Retrovirus Res Symp, 2004. Viewpoint ➔ By Jan Bellows, DVM, DAVDC, DABVP The IDEXX Not only does a diagnosis help National Oral practitioners formulate the best Disease and treatment plan, it also allows Retrovirus them to communicate essential Prevalence information to clients about their study demon- pet’s prognosis. strates a corre- Dental procedures involve sali- lation between va and blood, and both FeLV and clinical signs FIV are transmitted through these of oral disease and positive retro- fluids. Dental instruments and virus status as determined by an endotracheal tubes should be in-house test. In the study, one- thoroughly cleaned and sterilized seventh of cats affected with gin- between uses, and disposable givitis and one-fourth of those prophy angles should be used with stomatitis to avoid cross-contamination. All cats with unknown were retrovirus- Perioperative antibiotic admin- positive. These istration may be appropriate for retroviral status presenting results have im- retrovirus-infected cats undergo- portant clinical ing dental procedures, while with oral disease should implications. corticosteroids should not be be tested for FeLV Illness in retro- used to manage stomatitis. Cats virus-infected with stomatitis and FIV may ben- and FIV infection. cats is often sec- efit from a short course (three ondary disease weeks) of zidovudine (5 mg/kg due to immunosuppression rather orally twice daily). However, this than a direct effect of retrovirus agent can cause bone marrow infection. Previous studies have suppression, particularly with shown that neither FeLV nor FIV long-term use, so complete blood causes gingivitis, stomatitis, or cell counts should be monitored feline oral resorption lesions.1 closely. Bovine lactoferrin (350 However, the IDEXX study mg applied topically or mixed implies that a significant number with milk or a small amount of of cats affected by retroviruses food) may also improve oral present to veterinarians with health in retrovirus-infected cats. clinical signs of oral disease. If a cat has oral disease, de- Interestingly, oral disease in peo- termining its retrovirus status ple has been cited as an early can help you make appropriate indicator of HIV infection. treatment decisions and improve One direct clinical implication the patient’s long-term quality of this study is that all cats with of life. I look forward to further unknown retroviral status present- research in this area. ing with oral disease should be 1. Harvey CE, Emily PP. Small Animal tested for FeLV and FIV infection. Dentistry. St. Louis, Mo: Mosby, 1993;151.