Dear Most Esteemed and Knowledgeable Kitties:
I am disabled and a Vietnam veteran and my cat, my best and only friend, has FIV and stomatitis. One vet says he can be helped and one vet says to put him to sleep. Can anyone help me keep my friend with me?
Siouxsie: First of all, J, we want to say we know how hard it is to face losing your friend to this chronic and progressive disease. Mama’s first cat companion had FIV, so she has tremendous compassion for what you’re experiencing.
Thomas: Because of the stomatitis diagnosis, it sounds like your cat is in the third stage of FIV infection.
Dahlia: FIV infection has three stages. The first stage happens shortly after the cat is infected. Sometimes this stage has no symptoms, but some cats develop a fever and other signs of acute illness.
Siouxsie: In the second stage of the disease, the cat has no symptoms at all. This stage can last for many years.
Thomas: In the third stage, an FIV-positive cat’s immune system weakens considerably and he becomes highly susceptible to opportunistic bacterial, viral, or fungal infections. These infections may improve with a round of antibiotics but then resurface when the antibiotics are discontinued.
Dahlia: Stomatitis, infection and inflammation of the mucous membranes in the mouth, is a very common condition in third-stage FIV-positive cats.
Siouxsie: Although it is possible to manage FIV, there is, as yet, no cure for the illness.
Thomas: The American Association of Feline Practitioners’ (AAFP) 2008 guidelines for management of retrovirus infections (FIV and Feline Leukemia) publication lays out a few options. It’s written in “doctor-ese,” of course, but here are a few things we pulled out and translated into English.
Dahlia: Some drugs that have been used to treat AIDS in humans have improved immune system function in FIV-positive cats. AZT is one of these, but it tends to have some serious toxic side effects in cats. Alpha-interferon (natural human interferon alpha) has improved survival rates in FIV-positive cats, too, because it stimulates the production of certain types of immune system cells and doesn’t seem to cause as many harmful side effects as AZT.
Siouxsie: Most treatment for FIV-positive cats revolves around managing the opportunistic infections that arise as a result of the cat’s compromised immune system — antibiotic and antifungal medications, for example.
Thomas: The AAFP guidelines recommend avoiding steroid treatment because these drugs can further weaken the immune system. For cats with stomatitis, for example, they recommend removal of all the teeth rather than continuous use of steroids to reduce the swelling.
Dahlia: Griseofulvin, a systematic antifungal drug, is also not recommended for use in FIV-positive cats because it destroys neutrophils. Neutrophils are a type of white blood cell, and since white blood cells are the primary line of defense in the immune system, you don’t want to mess with those.
Siouxsie: Another thing you’ll need to watch very carefully, J, is your cat’s appetite. Cats in third-stage FIV often start to lose their appetites or have gastrointestinal symptoms like diarrhea, and your cat needs his food and fluids to stay as healthy as possible.
Thomas: Some people have added Omega-3 and Omega-6 fatty acids and vitamin supplements to their FIV-positive cats’ diets. There has been little scientific research on the effectiveness of vitamin and fatty acid supplements, but anecdotal evidence suggests that using such supplements with your vet’s guidance is not going to do any harm.
Dahlia: We’re very sad to tell you this, but we think it’s important for you to know. Most of the materials we’ve read (and Mama’s experience with her own FIV-positive cat) indicate that most cats in the third stage of FIV don’t live much longer than a year, even with treatment.
Siouxsie: So, J, there are treatments that can help your cat to live longer. They may be quite costly, so you need to be prepared for that. But there’s no reason why even third-stage FIV needs to be an immediate death sentence.
Thomas: All this does, of course, depend on your cat’s current state of health and the strength of his immune system. We recommend you go with the “it’s possible to manage this illness” attitude, but be prepared for the financial and emotional cost.
Dahlia: You’ll still need to be vigilant and observe your cat with a loving — if breaking — heart and allow him the mercy of letting him go when he’s ready. As long as you’re able to be honest with yourself about whether or not your cat has a decent quality of life and observe with your heart, you’ll know when he’s tired of fighting.
Siouxsie: In the meantime, enjoy each day with your cat friend, and be present with him. Although your friend’s passing is inevitable, and it would be even if he didn’t have FIV, please try not to worry about when that day will come.
Thomas: Some people try to cope with an impending loss by shutting down their hearts. Try not to emotionally distance yourself from your cat because he needs your love now more than ever. Allow yourself to relish his company and give yourself the opportunity to come to terms with the loss.
Dahlia: There are online support groups for caretakers of FIV-positive cats. One forum we found was the Yahoo Group FIVCats. Joining such a group may help you feel less alone in your quest to give your cat the best possible quality of life. These groups often have forums and lists of resources for coping with grief and loss, too.
Siouxsie: We wish you and your cat the best of luck, J.
Sniff sniff. Very true about keeping an open heart. I made the mistake once of closing my hart at a critical time like that and I regret it. I think my cat friend would have made my life so much richer if I had kept my heart open.
Cats also have a different relationship with death than we do. If you can stay calm with love and acceptance it will help your cat a great deal. They only think there is something wrong when we do. Death for them is a peaceful and natural transition. Of course you will be sad and go through grieving and my heart goes out to you. Enjoy your dear friend.
Sorry about your cat being FIV+. Please, do NOT put him to sleep. In fact, I would stop going to the vet who recommended putting your cat to sleep. You are blessed with the love and companionship of a very special cat. My cat is also FIV+ and I sponsor several FIV+ cats at a no-kill shelter. If you talk to anyone who is familiar with cat rescue he/she will tell you that FIV+ cats are the most affectionate and wonderful animals in the world. It is as if they know their time on earth is limited so they decide to love everything and everyone with all their hearts.
When we adopted our cat and found out he had FIV+ I started to do a lot of research on FIV. The conclusion I came to was that the best defense against FIV virus is a strong immune system. Give your FIV+ cat the most nutritious food you can find/afford. My FIV+ cat is on a raw diet with free-range and organic meats. Give your cat supplements to boost and maintain a strong immune system. Standard Process Veterinary Formula has a product called Feline Immune System Support. It is recommended by numerous holistic vets. Also give your cat Probiotic. It helps with his/her digestive, and also immune system.
My FIV+ cat has been healthy and happy for 5 years. In fact, he is probably one of the healthiest cat I’ve known. All his vets (he has 3) say that he will be around for quite a while.
Be vigilant about any symptom your cat is showing. Be thankful that you are chosen by this amazing animal as his family and best friend until the day he decides it’s time to go. It is an honor, really.
I recently lost my beloved Francis, an FIV+ angel. I put him to sleep when it was clear to me that he had reached the limits of the disease. He too had stomatitis. He lived with it for years. About two years ago, the vet said Francis had less than a year to live, based partially on his stomatitis. About a year and a half later, Francis started suffering from horrible neuological problems. When medicine could no longer keep him pain free, I had to make the decision. I wanted to keep him alive so badly. But I realized, with my vet’s guidance, that at that point of the disease, there was a lot more pain ahead with little to no quality of life. I never thought I could euthanize my little baby, but ending his horrible pain became more important than my need to have him with me physically.
Keep in mind that this is a decision you have to be certain about. There is no turning back after euthanasia. If a vet is offering a reasonable pain management plan for the stomatitis, I would go with it. After all, Francis did enjoy a certain quality of life with the stomatitis until his neurological problems surfaced. Good luck to you and your little friend. I know your pain. My thoughts are with you at this difficult time.
Given the dates of the replies, I’m not sure if you are even “in the market” for additional commentary, but I can tell you that if your cat’s only problem is gingivostomatitis — and if there is nothing in its bloodwork (very high or very low WBC, low RBC) to suggest late stage disease, there is absolutely much that can be done to help your cat. You are welcome to consult my webpage on gingivostomatitis (www.fivtherapy.com/gingivostomatitis.htm) or to join the FIV group that I sponsor (http://pets.groups.yahoo.com/group/fiv-healthscience/). I’m only sorry I didn’t stumble upon your site sooner. Understand that cats without FIV also suffer from stomatitis. FIV predisposes toward the disease and can also make it more difficult to treat. But stomatitis alone does not mean that a cat is dying or even approaching death. The accepted staging of FIV infection is borrowed from HIV medicine and is not always a good fit.
After losing my own cat to FIV, I had done a lot of research on finding ways to extend the lives of cats when they get infected. My cat first showed signs of illness in 2002 when we took him to the vet and he tested positive. After given some anti-biotics for the secondary infections, he recovered and lived 3 more years. He probably would have lived longer if I knew now what I knew then. There are herbal supplements called transfer factors that increase sensitivity and response to viruses, bacterias, etc.. I really believe in this supplement and I take it myself. Since being on it I have never gotten sick so I know that it works. It can get a little expensive, but it is definentely worth it. I thought I’d pass this knowledge and hope that it helps anyone looking for an answer. Here is a website with some info on it. http://www.shirleys-wellness-cafe.com/tf/s/pets.htm.