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.

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 ''Haemobartonella felis''.

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 date, particularly to minimise the risk of transmission of ''Haemobartonella felis''.

Some antiviral agents have been shown to give improvement in FIV-infected cats². Zidovudine is the mot effective of these⁵ but can induce bone marrow toxicity and so patients' haematological profile should be closely monitored^{2, 4, 5}. Immnunomodulatory products such as feline interferon omega also show some efficact<sup>5</suP>. Bodyweight, haematocrit and neutrophil count improve with administration of oil of evening primrose², particularly in asympotmatically or mildly affected FIV-positive cats.

Some antiviral agents have been shown to give improvement in FIV-infected cats². Zidovudine is the mot effective of these⁵ but can induce bone marrow toxicity and so patients' haematological profile should be closely monitored^{2, 4, 5}. Immnunomodulatory products such as feline interferon omega also show some efficacy<sup>5</suP>. Bodyweight, haematocrit and neutrophil count improve with administration of oil of evening primrose², particularly in asympotmatically or mildly affected FIV-positive cats.

==Control==

==Control==