Changes

In the sick FIV-positive cat, treatment is aimed at symptomatic and supportive care and management of the secondary infections present. Because these animals are immunosuppressed, their response to antibiotic therapy is often much slower and less successful^{2, 5}. Therefore, much longer courses of antimicrobials are often required in FIV positve cats compared to normal animals. Higher doses may also be neccessary^{4, 5}. Antibiotics used should be broad spectrum, with activity against anaerobic bacteria. Combinations including metronidazole or clindamycin are therefore good choices⁵. In inflammatory conditions, such as gingivitis/stomatitis, careful use of anti-inflammatory doses of corticosteroids in combination with antibiosis may be effective in reducing the severity of disease^{2, 4, 5, 6}. Topical steroids may be used in uveitis. Tooth extraction and scale and polishing can also help in the control of gingivitis. Dietary modifications may need to be made, for example in the face of renal disease or diarrhoea⁵, and appetite stimulants such as cyproheptidine can be useful in anorexic cats. Cats should not be fed raw meat and should be discouraged from hunting due to the increased risk of ''Toxoplasma gondii'' infection². Griseofulvin is contraindicated in FIV-positive individuals because it can cause a severe neutropenia that can enhance the establishement of secondary infections⁵.

In the sick FIV-positive cat, treatment is aimed at symptomatic and supportive care and management of the secondary infections present. Because these animals are immunosuppressed, their response to antibiotic therapy is often much slower and less successful^{2, 5}. Therefore, much longer courses of antimicrobials are often required in FIV positve cats compared to normal animals. Higher doses may also be neccessary^{4, 5}. Antibiotics used should be broad spectrum, with activity against anaerobic bacteria. Combinations including metronidazole or clindamycin are therefore good choices⁵. In inflammatory conditions, such as gingivitis/stomatitis, careful use of anti-inflammatory doses of corticosteroids in combination with antibiosis may be effective in reducing the severity of disease^{2, 4, 5, 6}. Topical steroids may be used in uveitis. Tooth extraction and scale and polishing can also help in the control of gingivitis. Dietary modifications may need to be made, for example in the face of renal disease or diarrhoea⁵, and appetite stimulants such as cyproheptidine can be useful in anorexic cats. Cats should not be fed raw meat and should be discouraged from hunting due to the increased risk of ''Toxoplasma gondii'' infection². Griseofulvin is contraindicated in FIV-positive individuals because it can cause a severe neutropenia that can enhance the establishement of secondary infections⁵.

Preventive strategies should also be implemented in the FIV-infected animal in order to protect the cat from potentially life-threatening infections. This is particularly important as FIV positive animals are often refractory to treatment when secondary infections arise. Vaccination, particularly against herpesvirus,

Preventative strategies should also be implemented in the FIV-infected animal in order to protect the cat from acquiring potentially life-threatening infections. This is particularly important as FIV positive animals are often refractory to treatment when secondary infections arise. Ideally, affected cats should be kept indoors to minimise exposure to potential pathogens⁴. Routine vaccination against herpesvirus, calicivirus and panleukopenia and possibly feline leukaemia virus is recommended², and killed vaccines should be favoured as there is a small risk of the attenuated strains in modified live vaccines causing disease in the immunosuppressed patient^{2, 5}. It may also be advisable to administer an extra booster before introducing the cat to a high risk environment, such as a cattery or in hospitalisation if the cat has not received one in the last six months². Treatment against worms and fleas should be kept up to daye, particularly to minimise the risk of transmission of ''H  

calicivirus and panleukopenia, is recommended and it

may be worthwhile considering the use of killed vaccines,

where available, to minimise the potential risk of

an attenuated virus strain causing disease in an immunosuppressed

patient. Vaccine boosters should be given

according to manufacturers' instructions and, in any cats

moving to a high risk situation such as a veterinary hospital

or cattery, it may be advisable to give an additional

booster unless the cat has received one in the previous

six months. Vaccination for feline leukaemia virus

should be considered according to the risk of exposure

to this virus. Flea treatment is advisable to minimise the

risk of H felis transmission. Routine worm treatment is

Agents such as the reverse transcriptase inhibitor AZT

Agents such as the reverse transcriptase inhibitor AZT