Лейкоз.

[skainag]

Решила поделиться своим опытом, подумала, что многим это будет полезно, поскольку когда мне нужна была хоть какая-то адекватная информация по лейкозу, я ее не нашла.

Сразу оговорюсь, я не врач, и все сказанное здесь - это информация от врача-вирусолога, с которым я общалась + личный трагический опыт.

У меня было 2 кошки. Одна из них 17 мая умерла (диагноз - лейкоз), вторая пока жива и я стараюсь надеяться на лучшее.

 

Не буду описывать всю трагическую историю, напишу основное, что должны знать владельцы котов, у которых обнаружили лейкоз.

1. НЕ лечите лейкоз у обычных ветеринаров или гомеопатов, идите к вирусологу //это из личного опыта.

2. Лечение котов с лейкозом НЕЛЬЗЯ начинать с иммуномодуляторов (ронколейкин, циклоферон и т.д.). Лейкоз вызывает аутоимунную реакцию в организме (по-простому - иммунитет начинает убивать здоровые клетки и ткани), иммуномодуляторы ее усиливают за счет повышения иммунитета. Ослабляют эту реакцию иммуносупрессоры. //инфо от вирусолога + личный опыт

3. Переливание крови - это крайняя мера, которую стоит делать только если все остальные варианты испробованы и не помогли. Если первое переливание не помогло, НЕ ДЕЛАЙТЕ ВТОРОЕ - оно гарантированно убьет вашу кошку за сутки, и поверьте, это будет очень тяжелая смерть. //личный опыт, подтвержденный вирусологом.

4. Просто для информации: у лейкоза нет стандартного сценария. У каждой кошки все проходит индивидуально. Выявлено порядка 8 форм лейкоза, каждая из которых имеет свои особенности. Из этих форм "необратимыми" являются следующие: лейкоз с неврологическими проявлениями (что-то похожее на рассеянный склероз у людей); лейкоз с гипертермической реакцией. Лейкоз с онкологическими проявлениями в редких случаях "обратим" (не "излечим", а именно "обратим" - то есть, есть шанс п, но как любая онкология тяжело лечится и шансов не слишком много. Разумеется, никаких гарантий успешности лечения нет, как нет и лекарства от лейкоза, но случаи //инфо от вирусолога

 

Я очень жалею, что узнала все это слишком поздно, и не сумела если не спасти, то хотя бы продлить жизнь своему животному.

Мне пытались помочь хорошие ветеринары, у меня нет к ним претензий, хотя они действовали по стандартной схеме и (как я сейчас понимаю) с моей кошкой просто ускорили процесс.

 

Вирусолога в Москве могу рекомендовать, также могу рассказать детали по течению болезни/курсу лечения моих кошек (кому интересно).

 

[ingrid007]

1. НЕ лечите лейкоз у обычных ветеринаров или гомеопатов, идите к вирусологу //это из личного опыта.

2. Лечение котов с лейкозом НЕЛЬЗЯ начинать с иммуномодуляторов (ронколейкин, циклоферон и т.д.). Лейкоз вызывает аутоимунную реакцию в организме (по-простому - иммунитет начинает убивать здоровые клетки и ткани), иммуномодуляторы ее усиливают за счет повышения иммунитета. Ослабляют эту реакцию иммуносупрессоры. //инфо от вирусолога + личный опыт

3. Переливание крови - это крайняя мера, которую стоит делать только если все остальные варианты испробованы и не помогли. Если первое переливание не помогло, НЕ ДЕЛАЙТЕ ВТОРОЕ - оно гарантированно убьет вашу кошку за сутки, и поверьте, это будет очень тяжелая смерть. //личный опыт, подтвержденный вирусологом.

4. Просто для информации: у лейкоза нет стандартного сценария. У каждой кошки все проходит индивидуально. Выявлено порядка 8 форм лейкоза, каждая из которых имеет свои особенности. Из этих форм "необратимыми" являются следующие: лейкоз с неврологическими проявлениями (что-то похожее на рассеянный склероз у людей); лейкоз с гипертермической реакцией. Лейкоз с онкологическими проявлениями в редких случаях "обратим" (не "излечим", а именно "обратим" - то есть, есть шанс п, но как любая онкология тяжело лечится и шансов не слишком много. Разумеется, никаких гарантий успешности лечения нет, как нет и лекарства от лейкоза, но случаи //инфо от вирусолога

1. Фуфло полное эти вирусологи, нужен просто грамотный врач. Назвавшиеся "вирусологами" три красавицы - они что, добились чего-то выдающегося в плане борьбы с вирусами или знают нечто, неизвестное простым терапевтов? Разводилово для обывателей, написанное автором яркая тому демонстрация.

2. Лейкоз стабилизирует определенный набор лекарств, в числе которых в обязательном порядке присутствует иммуномодулятор/стимулятордля поднятия иммунитета, чтобы организм имел силы сопротивляться вирусу. Какой - это индивидуально в зависимости от анализов крови и состояния животного, например, при низких лейкоцитах это будет ронколейкин. Исключение - лимфома, в этом случае иммунитет подавляется иммуносупрессорами и тогда это приговор животному, потому что лечение лимфомы и лейкоза диаметрально противоположно. Лимфома возникает у 70-80% лейкозников, это один из штаммов лейкемии, убивает именно лимфома.

3. Переливание крови для лейкозника штука бессмысленная.

4. Без комментариев, 50/50.

 

[ficus]

2. Лейкоз стабилизирует определенный набор лекарств, в числе которых в обязательном порядке присутствует иммуномодулятор/стимулятордля поднятия иммунитета, чтобы организм имел силы сопротивляться вирусу. Какой - это индивидуально в зависимости от анализов крови и состояния животного, например, при низких лейкоцитах это будет ронколейкин. Исключение - лимфома, в этом случае иммунитет подавляется иммуносупрессорами и тогда это приговор животному, потому что лечение лимфомы и лейкоза диаметрально противоположно. Лимфома возникает у 70-80% лейкозников, это один из штаммов лейкемии, убивает именно лимфома.

3. Переливание крови для лейкозника штука бессмысленная.

 

 

http://www.abcdcatsvets.org/feline-leukaemia-def/

Treatment

 

 

If FeLV-infected cats are sick, prompt and accurate diagnosis is important to allow early therapeutic intervention and successful treatment. Therefore, more intensive testing should be implemented earlier in the course of illness than in uninfected cats. Many cats with retrovirus infection respond well to appropriate medications although a longer or more aggressive course of therapy (e.g., antibiotics) may be needed than in retrovirus-negative cats. Corticosteroids, other immune-suppressive or bone marrow-suppressive drugs should generally be avoided, unless used as a treatment of FeLV-associated malignancies or immune-meditated disease.

 

 

 

Good veterinary care is important for FeLV-viraemic cats. Many may need fluid therapy. Some specific complications of FeLV infection may respond to treatment, such as secondary bacterial infections, especially with Mycoplasma haemofelis, which often responds to doxycycline. If stomatitis/gingivitis is present, corticosteroids should be considered to increase the food intake. Blood transfusions may be useful in anaemic cats and in the case of leukopenia, granulocyte colony-stimulating factor (G-CSF) can be considered (Fulton et al., 1991; EBM grade IV). Treatment regimes for lymphomas, particularly based on chemotherapeutic drugs, are now well established. Some cases of lymphoma respond well to chemotherapy, with remission expected in most cases, and some cats show no recurrence within two years. Chemotherapy of FeLV-positive lymphomas will not resolve the persistent viraemia and the outlook for such cats is not good (Ettinger, 2003).

 

Immune-modulators

 

 

 

There is little evidence from controlled studies to support the efficacy of immune modulators on the health or longevity of FeLV-infected cats.

Nevertheless, it has been suggested that some of these agents may benefit infected animals by restoring compromised immune function, thereby allowing the patient to control its viral burden and recover. Although uncontrolled studies have suggested dramatic clinical improvement (e.g., when using preparations known as ”paramunity inducers”), these effects were not observed in carefully controlled studies (Hartmann et al., 1998; EBM grade I).

 

 

 

Staphylococcus Protein A is a bacterial polypeptide purified from cell walls of Staphylococcus aureus Cowan I that acts as an immune modulator. In a placebo-controlled study, treatment of ill, client-owned FeLV-infected cats (with 10 g/kg, twice per week for up to ten weeks) did not cause a statistically significant difference in FeLV status. However, in the owners’ impression, the health of their pets had improved (McCaw et al., 2001).

 

 

 

 

Antivirals

 

 

 

The efficacy of antiviral drugs is limited, and many cause severe side effects (Hartmann, 2006). Only a few controlled studies have demonstrated some effect of a few drugs in FeLV-infected cats.

 

 

 

Feline interferon-ω inhibits FeLV replication in vitro. Treatment of FeLV-viraemic cats significantly improved their health and extended their survival time, but it did not resolve the viraemia (de Mari et al., 2004; EBM grade I). In a placebo-controlled field study, 48 FeLV-infected cats were treated with interferon-ω (106 IU/kg s.c. q24h on five consecutive days repeated three times with several weeks between treatments; de Mari et al., 2004). A statistically significant difference was found in the survival time of treated versus untreated cats. No viral parameters, however, were measured to support the assumption that interferon exerted an anti-FeLV effect rather than inhibited secondary infections.

 

 

 

An antiviral compound routinely used is 3’-azido-2’,3’-dideoxythymidine (AZT), a nucleoside analogue (thymidine derivative) that blocks retroviral reverse transcriptase. The drug effectively inhibits FeLV replication in vitro, and in vivo in experimental infections. It can reduce plasma virus load, improve the immunological and clinical status, increase the quality of life, and prolong life expectancy in FeLV-infected cats. It should be used at a dosage of 5 -10 mg/kg q12h per os or s.c.. Higher doses should be used carefully, as side effects (e.g. non-regenerative anaemia) can develop (Hartmann, 2005 EBM grade I).

 

 

 

The HIV integrase inhibitor Raltegravir was found to significantly inhibit FeLV in vitro (Cattori et al., 2011). The drug is tolerated very well by cats and within one week leads to a marked reduction in viral loads. However, this reduction is not sufficient for the immune system to control the viraemia, and treatment has to be continued over long periods in order to maintain low viral loads and prevent disease (Boesch et al., 2015; EBM grade III).

 

 

 

 

Vaccination

 

 

 

After several experimental vaccines had been described (Jarrett et al., 1975; Jarrett et al., 1974; Pedersen et al., 1979), the first FeLV vaccine used in veterinary practice was introduced in the USA in 1984. It was based on conventionally prepared FeLV antigens, and it protected cats from viraemia (Lewis et al., 1981). A number of FeLV vaccines are now available in Europe. Some used recombinant DNA technology, like the one consisting of the viral envelope glycoprotein as well as part of the transmembrane protein expressed in E. coli (Kensil et al., 1991); this was the first genetically engineered small animal vaccine.

 

 

 

The most recent product uses a canarypox virus vector that carries the genes for the envelope glycoprotein and the capsid protein (Tartaglia et al., 1993). After injection, there is a single round of replication by the vector poxvirus resulting in the expression of the inserted FeLV genes. In contrast to other cat vaccines, neutralising antibodies do not develop. The protective effect is achieved by stimulating cellular immunity which leads to rapid development of neutralising antibodies if vaccinated cats encounter field virus (Lehmann et al., 1991; Hofmann-Lehmann et al., 2006).

 

 

 

The differences between available FeLV vaccines are more significant than those for other feline infectious diseases – differences in performance, particularly efficacy of protection. Comparison of efficacy studies can be misleading because of differences in the protocols – such as the breed, route of challenge, challenge strain used and the criteria for defining protection (Sparkes, 2003; Torres et al., 2010). Different studies of the same vaccine sometimes led to divergent results. The first FeLV vaccine and some others, which are no longer on the market, have performed poorly, as found in independent efficacy studies with disappointing protection.

 

 

 

The European Pharmacopoeia defines the criteria for assessing the efficacy of protection. A common problem is the difficulty to infect healthy control cats with a single experimental challenge. The criteria include a minimum acceptable infectivity rate in controls to confirm that an acceptably strong challenge has been provided. Natural resistance to FeLV challenge is taken into account when calculating the level of protection, which is then expressed as the ”preventable fraction” (Scarlett & Pollock, 1991).

 

 

 

Some protocols have been based on a ”natural” FeLV challenge – by co-mingling viraemic with trial cats. These protocols are not in agreement with the European Pharmacopoeia, but they mimic the natural mode of virus transmission, which is generally based not on a single large exposure but on chronic exposure over a period of time. Cohabiting infected viraemic cats with vaccinated cats is regarded by clinical experts as a more realistic measure of protection that vaccines would provide in the field.

 

 

 

In many experiments it was shown that no FeLV vaccine provides complete (100 % efficacy) protection, nor does it prevent infection. Cats that overcome p27 antigenaemia without exception become provirus-positive in the blood, and also positive for viral RNA in plasma, although at very low levels when compared with persistently viraemic cats (Hofmann-Lehmann et al., 2007; EBM grade III). These experiments confirm that FeLV vaccination neither induces sterilising immunity nor does it protect from infection.

 

 

 

However, cats vaccinated with conventional, adjuvanted, whole inactivated virus vaccines did not show p27, viral RNA or DNA after a low-dose challenge with the subgroup A virus FeLV A/61E (Torres et al., 2010). Various factors may have played a role: the challenge virus was used at a very low dose (10,000 TCID50 injected once intraperitoneally), the assays used were less sensitive than those used by Hofmann-Lehmann et al. (2007), and the cats had a different genetic background. Testing for FeLV in internal organs would have resulted in observations as reported by Major et al. (2010). Thus, the proposition remains valid that vaccination against FeLV protects cats from disease but not from infection.

 

 

 

Long-term observation of vaccinated cats after experimental challenge indicates that low levels of RNA viraemia and of proviral DNA are not clinically significant, and these cats can be regarded as protected.

 

 

 

FeLV should generally be included in the routine vaccination programme for pet cats. Protection against a potentially life-threatening infection is justified, and the benefit for most cats considerably outweigh any risk of adverse effects. In situations where the probability of exposure to FeLV can be discounted, vaccination is not required. Geographical variations of the prevalence of FeLV may influence the decision. In some European countries FeLV has been almost eliminated, and there may be local variations in the prevalence within countries where the virus is still a significant health issue. The lifestyle of individual cats may also be a decision factor; if it can be assured that a cat will not be exposed to FeLV, vaccination is unnecessary. However, owners’ circumstances may change, and with them their cats’ lifestyle, particularly when moving house. This possibility should be considered especially in kittens presented for primary vaccination.

 

 

 

 

Primary vaccination

 

 

 

Vaccination should be carried out in all cats at risk of exposure. It is recommended that kittens be vaccinated at the age of 8 or 9 weeks and 12 weeks, together with the core vaccinations. (Brunner et al., 2006). Combination of different immunogens in one syringe is only legal when the company has registered it for that country, therefore the local veterinary regulations should be carefully consulted.

 

 

 

If its FeLV status is unknown, the cat should be tested for FeLV antigenaemia prior to vaccination in order to avoid ”vaccine failures”; these will be obvious when cats infected prior to vaccination develop FeLV-related clinical signs. If FeLV infection prior to vaccination is unlikely, testing may not be needed (e.g. kittens from a FeLV-negative queen and tomcat, which had no contact with other cats).

 

 

 

 

Booster vaccinations

 

 

 

Until recently, no data have been published to show that the immunity lasts longer than 1 year after primo-vaccination. Therefore, most vaccine producers recommend annual boosters. However, the demonstration that one FeLV vaccine provided immunity for at least 2 years (Jirjis et al., 2010; EBM grade II) suggests that his may also apply to other products. Combined with the lower susceptibility of adult cats to FeLV infection, the ABCD recommends that, in cats older than three years, a booster immunisation every two to three years is sufficient.

 

 

 

 

Control in specific situations

 

 

Multi-cat households

 

 

 

If a cat is diagnosed with FeLV in a multi-cat household, all of them should be tested. If indeed more positive cats are identified, the test and removal system should be implemented, which involves periodic testing and removal of the positive cats until all test negative. The best method of preventing spread of infection is to isolate the infected individuals and to prevent interaction with uninfected housemates. Although protection conferred by FeLV vaccines is good in most situations, the ABCD does not recommend reliance solely on vaccination to protect negative cats living together with FeLV positive cats.

 

 

 

 

Shelters

 

 

 

There are marked geographical differences in the prevalence of FeLV in rescued cats in Europe, which may influence policies of testing and vaccination. In some countries, like the UK, the prevalence is low, whilst in others it is noticeably higher, with regional differences within these countries.

 

 

 

 

 

Wherever possible, cats entering a shelter should be kept in quarantine for at least 3 weeks, if not (re)homed sooner. All incoming cats (at least in shelters that allow contact between cats after the quarantine period) should be screened for FeLV antigen and FIV antibody, ideally also for FeLV antibody (Boenzli et al., 2014). Antigen negative but antibody positive results suggest that the cat is not viraemic/antigenaemic, but may be latently infected. Therefore PCR for FeLV DNA should additionally be performed. If the PCR shows a high FeLV-DNA load, this cat should prudently be considered latently infected; those cats should best be placed in a home without other cats for several months. If only an FeLV antigen test is performed, cats testing negative should ideally be retested 6 weeks later (and kept in quarantine for this time period), as it may take 4-6 weeks after infection until the test turns positive.

 

 

 

After quarantine, FeLV-negative cats can be introduced into small groups of healthy cats. Vaccination may be considered.

 

 

 

FeLV antigen- and/or FIV antibody positive cats have to be kept separate, ideally housed individually, but may be housed together with other retrovirus-positive cats. FeLV-positive, healthy cats should be adopted out to adequate homes as soon as possible. It must be ensured that such cats do not pose any risk of infection to other cats. This may require positive cats to be re-homed to households where they will live in isolation or only with other infected cats.

 

 

 

The ABCD does not recommend euthanasia of healthy FeLV positive cats. However, if no adequate home can be found, if separation from the rest of the population is impossible, or if the cat is sick, euthanasia should be considered. Detailed recommendations are provided in the ABCD guidelines ”Prevention of infectious diseases in cat shelters” (Mцstl et al., 2013).

 

 

Breeding catteries

 

 

 

The prevalence of FeLV infection is now very low in pedigree breeding catteries in some European countries, largely as a result of routine testing and the removal of infected cats. It is recommended that routine testing is continued once or twice a year in such catteries. Contact should be limited to cats from establishments that implement a similar routine. If any cats are allowed access outside, with the opportunity of contact with neighbouring cats of uncertain FeLV status (discouraged for pedigree breeding cats), they should be vaccinated.

 

 

 

 

Vaccination of immunocompromised cats

 

 

 

The vaccination of FeLV-positive cats against FeLV is of no benefit.

 

In a long-term study where FIV-infected cats were experimentally vaccinated against FeLV infection, there was a clear benefit when compared with the non-vaccinated animals (Hofmann-Lehmann et al., 1995). Also under field conditions, FIV-seropositive cats should be vaccinated against FeLV infection (EBM grade III), but only if they are at risk (indoor-only FIV-positive cats should not be vaccinated). As the immune response in immunocompromised cats is decreased, more frequent boosters may be considered (in asymptomatic cats).

 

 

 

Acutely ill cats generally should not be vaccinated, but cats with a chronic illness such as renal disease, diabetes mellitus or hyperthyroidism should be vaccinated regularly, if they are at risk of infection.

 

 

 

Vaccination of cats receiving corticosteroids or other immunosuppressive drugs should be considered carefully. Depending on the dosage and duration of treatment, corticosteroids may suppress the immune response, particularly its cell-mediated arm. Concurrent use of corticosteroids at the time of vaccination should therefore be avoided.

[kisskina]

То, что по английски комментировать не буду, лень переводить.

Но как стабилизируются лейкозники с опред. формами ронколейкином знаю не понаслышке, а что там рахманинова думает мне до фонаря.

И ещё, есть такое понятие как носительство, когда вообще ничего стабилизировать не надо, но зверь может заболеть другим вирусом из быстрых, вот тогда я им циклоферончик и колола. И уж никто не выдал никаких аутоиммунных реакций. На всякий случай, зверь был не один и даже не два. Их четверо положительных было.

 

[ficus]

То, что по английски комментировать не буду, лень переводить.

 

Можете и через гугл транслейт перевести то, что выделено жирно и крупно, смысл поймете.

[kisskina]

Можете и через гугл транслейт перевести то, что выделено жирно и крупно, смысл поймете.

неохота, но смысл я поняла и без гугл переводчика. Мне бы всю статью в нормальном переводе.

[ficus]

Много руководств Европейского Совета по болезням кошек переводит доктор Васильев А.В., но именно это он еще не переводил.

http://www.veter96.ru/htmlpages/Show/zabol...ye-zabolevaniya