stray tomcat and interferon revolt

So far I have rebelled against my vet on this. Monday I took a
stray tomcat that I am adopting to my vet for an examination,
neutering, and treatment of his ailments.

The vet wanted to wait to do the neutering until later. He
gave him an ear treatment, a deworming pill, a rabies
shot, a test for leukemia (positive), and two prescriptions. I
gave him a flea treatment, and have been giving the
prescribed antibiotics twice a day.

But I haven't started with the interferon, which I'm keeping
refrigerated. I saw on the internet that it has side effects
such that it will almost certainly make the cat sick. I
never had a chance to talk to the vet about quality of
life vs. length of life, but he did say that there is no cure
for leukemia.

Since the cat has a huge appetite, and plenty of energy,
and responds lovingly to petting, I think his quality of
life is good right now, and the look and feel of his skin
and fur are responding well to the antibiotics, which I
will continue for the prescribed 10 day period, twice a
day. Hopefully at the end of that time he will be in
good shape enough to be neutered.

Am I wrong to refuse to administer the interferon in this
case?

calvin wrote:
So far I have rebelled against my vet on this. Monday I took a
stray tomcat that I am adopting to my vet for an examination,
neutering, and treatment of his ailments.

The vet wanted to wait to do the neutering until later. He
gave him an ear treatment, a deworming pill, a rabies
shot, a test for leukemia (positive), and two prescriptions. I
gave him a flea treatment, and have been giving the
prescribed antibiotics twice a day.

But I haven't started with the interferon, which I'm keeping
refrigerated. I saw on the internet that it has side effects
such that it will almost certainly make the cat sick. I
never had a chance to talk to the vet about quality of
life vs. length of life, but he did say that there is no cure
for leukemia.

Since the cat has a huge appetite, and plenty of energy,
and responds lovingly to petting, I think his quality of
life is good right now, and the look and feel of his skin
and fur are responding well to the antibiotics, which I
will continue for the prescribed 10 day period, twice a
day. Hopefully at the end of that time he will be in
good shape enough to be neutered.

Am I wrong to refuse to administer the interferon in this
case?




check this out

Interferon may be prescribed by your veterinarian. Interferon is a
natural protein released by cells which have been invaded by viruses &
assist the immune response by inhibiting viral replication.

http://www.cat-world.com.au/FelineLeukemiaVirus.htm


You need to be prepared for a short life expectancy of around 4 years
depending on the health at diagnosis and of course the cat needs to be
kept indoors at all times - to protect it and other cats. The prospects
are not as good as FIV+ cats that can live healthy lives for around 10
years after diagnosis - not a vet but have had many cats and just lost
my 14 year old boy to FIV+ (brain tumour)

On Thu, 21 May 2009 16:46:03 -0700 (PDT), calvin
wrote:

So far I have rebelled against my vet on this. Monday I took a
stray tomcat that I am adopting to my vet for an examination,
neutering, and treatment of his ailments.

The vet wanted to wait to do the neutering until later. He
gave him an ear treatment, a deworming pill, a rabies
shot, a test for leukemia (positive), and two prescriptions. I
gave him a flea treatment, and have been giving the
prescribed antibiotics twice a day.

But I haven't started with the interferon, which I'm keeping
refrigerated. I saw on the internet that it has side effects
such that it will almost certainly make the cat sick. I
never had a chance to talk to the vet about quality of
life vs. length of life, but he did say that there is no cure
for leukemia.

Since the cat has a huge appetite, and plenty of energy,
and responds lovingly to petting, I think his quality of
life is good right now, and the look and feel of his skin
and fur are responding well to the antibiotics, which I
will continue for the prescribed 10 day period, twice a
day. Hopefully at the end of that time he will be in
good shape enough to be neutered.

Am I wrong to refuse to administer the interferon in this
case?

You won't be able to administer enough gamma interferon to a cat to make
a difference for this incurable viral infection.

The 'side effects' of gamma interferon can only be described a 'worse
than the disease'.

From wikipedia:

The most frequent adverse effects are flu-like symptoms: increased body
temperature, feeling ill, fatigue, headache, muscle pain, convulsion,
dizziness, hair thinning, and depression. Erythema, pain and hardness on
the spot of injection are also frequently observed. Interferon therapy
causes immunosuppression, in particular through neutropenia and can
result in some infections manifesting in unusual ways.[12]

All known adverse effects are usually reversible and disappear **within
a year** after the therapy has been finished. (Emphasis mine)

Yes, side effects can last a very, very long time.

Gamma interferon causes a high fever. The kind that makes the roots of
your hair hurt, and everything else, too.

The kind of fever that leaves you too weak to get out of bed to get
water. I have seen it happen, in a hospital setting.

A cat that experiences the 'side effects' of gamma interferon will stop
eating and drinking, and look for a place to go hide and die.

You cannot explain to a cat that it for it's own good.

The cat will only know that it's death is imminent.

I have seen gamma interferon used to treat patients, when I worked in a
large hospital, as part of a large clinical trial.

Not a single patient could complete the course of interferon, with all
of the clinical support a hospital could offer.

To be 'effective', interferon must be administered for approx. 6 months,
for most viral infections for which is has been approved for use in
humans.

In a large University veterinary hospital setting, if you had tens of
thousands of dollars to spend, you might prolong a cat with feleuk a few
years, at best.

The leukopenia (greatly decreased white blood cell count) will leave the
cat susceptible to secondary viral and bacterial infections.

Respiratory infections, usually progressing to pneumonia, are the most
common.

Your vet is nothing short of ...what's the word...let's be charitable,
and just say 'grossly incompetent', IMHO, to prescribe interferon to a
cat that presented to him with all of the ills you describe.

I believe you have made the right decision.

There is no way to know how long he will have a good quality of life.

You must keep him indoors, always.

You should avoid touching all other cats, for you could easily carry an
illness to him that he may not be able to fight off.

Because his immune system is weakened, even vaccines may not protect him
from common feline illnesses.

Feline distemper is always fatal. The virus that causes it can survive,
out of doors, on environmental surfaces, for as long as a year. Your cat
may not be immune.

If at all possible, your cat should only be allowed at closed, glassed
windows on the ground floor, lest another stray cat give him a virus or
infectious bacteria through a screen. He can be allowed at screened
windows on a second floor, as long as there is no ground access for an
outside cat to the second floor window.

All possible precautions must be taken to avoid exposing your cat to any
possible source of sickness.

Feed him the very best cat food you can possibly afford. There is a
world of difference between the cheaper cat food, and the 'premium' cat
foods available currently. Cat food has improved markedly in the past 20
years.

And, if I were you, I would get another vet. Like doctors, there are a
great many mediocre veterinarians in the world.

Your cat needs a GOOD vet, to keep him as healthy as possible.

I have only had cats for 27 years.

In that time I have used the services of a considerable number of
veterinarians.

I even worked for one, for awhile.

We parted ways over the issue of declawing cats.

He made a considerable percentage of his income by permanently
mutilating cats.

He did it cheaper than just about any other vet, in a very large city.

He did it by cutting corners, in every possible way. Using as little
anesthetic as possible, for example.

I couldn't stand suturing up those butchered cats' paws. He also refused
to provide, or even prescribe, pain medication. He said the cats 'didn't
need it'. That. was. the. final. straw.

It has been my experience that, in general, female veterinarians tend to
be much 'better' vets. They tend to be more compassionate and more
personally involved in the care of the pets they take care of.

Thank you for taking in this poor unfortunate sick cat, and giving him a
loving home. I hope you have many happy years together.

On May 22, 8:45*am, (Gandalf) wrote:
On Thu, 21 May 2009 16:46:03 -0700 (PDT), calvin
wrote:
So far I have rebelled against my vet on this. *Monday I took a
stray tomcat that I am adopting to my vet for an examination,
neutering, and treatment of his ailments.

The vet wanted to wait to do the neutering until later. *He
gave him an ear treatment, a deworming pill, a rabies
shot, a test for leukemia (positive), and two prescriptions. *I
gave him a flea treatment, and have been giving the
prescribed antibiotics twice a day.

But I haven't started with the interferon, which I'm keeping
refrigerated. *I saw on the internet that it has side effects
such that it will almost certainly make the cat sick. *I
never had a chance to talk to the vet about quality of
life vs. length of life, but he did say that there is no cure
for leukemia.

Since the cat has a huge appetite, and plenty of energy,
and responds lovingly to petting, I think his quality of
life is good right now, and the look and feel of his skin
and fur are responding well to the antibiotics, which I
will continue for the prescribed 10 day period, twice a
day. *Hopefully at the end of that time he will be in
good shape enough to be neutered.

Am I wrong to refuse to administer the interferon in this
case?

You won't be able to administer enough gamma interferon to a cat to make
a difference for this incurable viral infection.

The 'side effects' of gamma interferon can only be described a 'worse
than the disease'.

From wikipedia:

The most frequent adverse effects are flu-like symptoms: increased body
temperature, feeling ill, fatigue, headache, muscle pain, convulsion,
dizziness, hair thinning, and depression. Erythema, pain and hardness on
the spot of injection are also frequently observed. Interferon therapy
causes immunosuppression, in particular through neutropenia and can
result in some infections manifesting in unusual ways.[12]

All known adverse effects are usually reversible and disappear **within
a year** after the therapy has been finished. (Emphasis mine)

Yes, side effects can last a very, very long time.

Gamma interferon causes a high fever. The kind that makes the roots of
your hair hurt, and everything else, too.

The kind of fever that leaves you too weak to get out of bed to get
water. I have seen it happen, in a hospital setting.

A cat that experiences the 'side effects' of gamma interferon will stop
eating and drinking, and look for a place to go hide and die.

You cannot explain to a cat that it for it's own good.

The cat will only know that it's death is imminent.

I have seen gamma interferon used to treat patients, when I worked in a
large hospital, as part of a large clinical trial.

Not a single patient could complete the course of interferon, with all
of the clinical support a hospital could offer.

To be 'effective', interferon must be administered for approx. 6 months,
for most viral infections for which is has been approved for use in
humans.

In a large University veterinary hospital setting, if you had tens of
thousands of dollars to spend, you might prolong a cat with feleuk a few
years, at best.

The leukopenia (greatly decreased white blood cell count) will leave the
cat susceptible to secondary viral and bacterial infections.

Respiratory infections, usually progressing to pneumonia, are the most
common.

Your vet is nothing short of ...what's the word...let's be charitable,
and just say 'grossly incompetent', *IMHO, to prescribe interferon to a
cat that presented to him with all of the ills you describe.

I believe you have made the right decision.

There is no way to know how long he will have a good quality of life.

You must keep him indoors, always.

You should avoid touching all other cats, for you could easily carry an
illness to him that he may not be able to fight off.

Because his immune system is weakened, even vaccines may not protect him
from common feline illnesses.

Feline distemper is always fatal. The virus that causes it can survive,
out of doors, on environmental surfaces, for as long as a year. Your cat
may not be immune.

If at all possible, your cat should only be allowed at closed, glassed
windows on the ground floor, lest another stray cat give him a virus or
infectious bacteria through a screen. He can be allowed at screened
windows on a second floor, as long as there is no ground access for an
outside cat to the second floor window.

All possible precautions must be taken to avoid exposing your cat to any
possible source of sickness.

Feed him the very best cat food you can possibly afford. There is a
world of difference between the cheaper cat food, and the 'premium' cat
foods available currently. Cat food has improved markedly in the past 20
years.

And, if I were you, I would get another vet. Like doctors, there are a
great many mediocre veterinarians in the world.

Your cat needs a GOOD vet, to keep him as healthy as possible.

I have only had cats for 27 years.

In that time I have used the services of a considerable number of
veterinarians.

I even worked for one, for awhile.

We parted ways over the issue of declawing cats.

He made a considerable percentage of his income by permanently
mutilating cats.

He did it cheaper than just about any other vet, in a very large city.

He did it by cutting corners, in every possible way. Using as little
anesthetic as possible, for example.

I couldn't stand suturing up those butchered cats' paws. He also refused
to provide, or even prescribe, pain medication. He said the cats 'didn't
need it'. That. was. the. final. straw.

It has been my experience that, in general, female veterinarians tend to
be much 'better' vets. They tend to be more compassionate and more
personally involved in the care of the pets they take care of.

Thank you for taking in this poor unfortunate sick cat, and giving him a
loving home. I hope you have many happy years together.

Thanks to Netmask and Gandalf for the information
and advice. Since the cat is responding very well to
the antibiotics, and appears not to be suffering at all,
I'm assuming at this point that nothing needs to be done
as a result of the test for leukemia. For all I know it
was a false positive. I've always liked my vet very
much, but that could change if he reacts badly to my
refusal to administer interferon.

Seems like you were correct in questioning your vet's plan. Best of luck
with the little guy.

Barb

"calvin" wrote in message
...

Thanks to Netmask and Gandalf for the information
and advice.

That information you received from the latter was grossly incorrect and the
advice was even worse.



Since the cat is responding very well to
the antibiotics, and appears not to be suffering at all,
I'm assuming at this point that nothing needs to be done
as a result of the test for leukemia. For all I know it
was a false positive.

Which test? The in-office Snap test? or did your vet send a blood sample to
a lab for the IFA? A positive Snap result can mean the cat is is in process
of clearing the virus or in the process of developing a persistant FeLV
infection, or it could mean your cat is harboring the virus in some
**non-myeloid** part of the body. You need to have your cat's blood tested
with the IFA to know if your cat has a persistant infection.


I've always liked my vet very
much, but that could change if he reacts badly to my
refusal to administer interferon.

*Now's* the time to begin IFN therapy- while your cat is still asymptomatic
and the viral load is probably still low. Even low-dose (30 U every 24
hours) oral administration of rHuIFN-a can reduce clinical signs and improve
well-being in many infected cats. Given at this dose and route, IFN therapy
is safe, doesn't stimulate antibody production, is cheap, its easy to give,
and it might even prolong the asymptomatic period and possibly even your
cat's life.

Best of Luck,

Phil

On May 22, 11:46*pm, "Phil P." wrote:
"calvin" wrote:
Thanks to Netmask and Gandalf for the information
and advice.

That information you received from the latter was grossly incorrect and the
advice was even worse.

Since the cat is responding very well to
the antibiotics, and appears not to be suffering at all,
I'm assuming at this point that nothing needs to be done
as a result of the test for leukemia. *For all I know it
was a false positive.

Which test? The in-office Snap test? or did your vet send a blood sample to
a lab for the IFA? *A positive Snap result can mean the cat is is in process
of clearing the virus or in the process of developing a persistant FeLV
infection, or it could mean your cat is harboring the virus in some
**non-myeloid** part of the body. You need to have your cat's blood tested
with the IFA to know if your cat has a persistant infection.

*I've always liked my vet very
much, but that could change if he reacts badly to my
refusal to administer interferon.

*Now's* the time to begin IFN therapy- while your cat is still asymptomatic
and the viral load is probably still low. Even low-dose (30 U every 24
hours) oral administration of rHuIFN-a can reduce clinical signs and improve
well-being in many infected cats. Given at this dose and route, IFN therapy
is safe, doesn't stimulate antibody production, is cheap, its easy to give,
and it might even prolong the asymptomatic period and possibly even your
cat's life.

The vet didn't prescribe low dose. He prescribed the 7-days-on
followed by 7-days-off, and endlessly repeating procedure, which
is the high dose, and that (if what I read is true) will make the cat
sick continuously.

The leukemia test was done overnight, so I assume it was
what you call the Snap test. Why should I not just continue
with the antibiotics as prescribed, and then have the vet look
at the cat again? I see the cat up close and personal every
day, and he doesn't seem sick to me. His skin and fur
look and feel better to me, though they have a ways to go
before they look completely okay, he has a huge appetite, and
loves to be rubbed all over. If he was listless and not eating,
that would be different.

As long as the cat is improving, I don't see a need to rush
into anything that will make him sick. I can't do the low-dose
thing until the vet provides me with what is to be used.

"calvin" wrote in message
...
On May 22, 11:46 pm, "Phil P." wrote:
"calvin" wrote:
Thanks to Netmask and Gandalf for the information
and advice.

That information you received from the latter was grossly incorrect and
the
advice was even worse.

Since the cat is responding very well to
the antibiotics, and appears not to be suffering at all,
I'm assuming at this point that nothing needs to be done
as a result of the test for leukemia. For all I know it
was a false positive.

Which test? The in-office Snap test? or did your vet send a blood sample
to
a lab for the IFA? A positive Snap result can mean the cat is is in
process
of clearing the virus or in the process of developing a persistant FeLV
infection, or it could mean your cat is harboring the virus in some
**non-myeloid** part of the body. You need to have your cat's blood
tested
with the IFA to know if your cat has a persistant infection.

I've always liked my vet very
much, but that could change if he reacts badly to my
refusal to administer interferon.

*Now's* the time to begin IFN therapy- while your cat is still
asymptomatic
and the viral load is probably still low. Even low-dose (30 U every 24
hours) oral administration of rHuIFN-a can reduce clinical signs and
improve
well-being in many infected cats. Given at this dose and route, IFN
therapy
is safe, doesn't stimulate antibody production, is cheap, its easy to
give,
.. and it might even prolong the asymptomatic period and possibly even your
.. cat's life.

The vet didn't prescribe low dose. He prescribed the 7-days-on
followed by 7-days-off, and endlessly repeating procedure, which
is the high dose,


No. 7 on/7 off is the schedule for the *low-dose* treatment, i.e. 30
Units/q.d. PO.. The theory behind the 7 on/7 off protocol is so the cat
doesn't
develop antibodies to the rHuIFN-a. The high dose protocol is
administered *IM * for 5-7 weeks. How many units/day does the prescription
say?

What's the problem with administering IFN PO 7 on/7 off? Its no different
than if your cat had some other illness that required daily medication.

and that (if what I read is true) will make the cat
sick continuously


You've been misinformed or you misunderstood what you read. The 7 on/7 off
protocol doesn't make cats sick. I've treated literally dozens of FeLV+ cats
with higher doses PO and *never* had a problem. A few cats lived ~6 years
post diagnosis, other lived 3-5, and some cats extinguished the infection-
however, I can't say


The leukemia test was done overnight, so I assume it was
what you call the Snap test.

The Snap test takes only 10 minutes.


Why should I not just continue
with the antibiotics as prescribed, and then have the vet look
at the cat again?

I didn't say you stop the antibiotics. Definitely finish the full course of
antibiotics. But there is no reason why you shouldn't begin the IFN
therapy.


I see the cat up close and personal every
day, and he doesn't seem sick to me.


FeLV+ cats can remain asymptomatic for months to years- but they're still
sick. IFN therapy might prolong the period that your cat is asymptomatic.
IFN doesn't work in every cat- but it works in enough cats to justify using
it.




His skin and fur
look and feel better to me, though they have a ways to go
before they look completely okay, he has a huge appetite, and
loves to be rubbed all over. If he was listless and not eating,
that would be different.


You're not getting this, are you? The reason for beginning IFN therapy now
is so he might remain asymptomatic longer.


As long as the cat is improving, I don't see a need to rush
into anything that will make him sick.

7 on/7 off won't make him sick. I've treated enough cats with this protocol
to know what I'm talking about.


I can't do the low-dose
thing until the vet provides me with what is to be used.

Of course.

On May 23, 3:09*am, "Phil P." wrote:
"calvin" wrote:
On May 22, 11:46 pm, "Phil P." wrote:
"calvin" wrote:
Thanks to Netmask and Gandalf for the information
and advice.

That information you received from the latter was grossly incorrect and
and the
advice was even worse.

Since the cat is responding very well to
the antibiotics, and appears not to be suffering at all,
I'm assuming at this point that nothing needs to be done
as a result of the test for leukemia. For all I know it
was a false positive.

Which test? The in-office Snap test? or did your vet send a blood sample
to
a lab for the IFA? A positive Snap result can mean the cat is is in
process
of clearing the virus or in the process of developing a persistant FeLV
infection, or it could mean your cat is harboring the virus in some
**non-myeloid** part of the body. You need to have your cat's blood
tested
with the IFA to know if your cat has a persistant infection.

I've always liked my vet very
much, but that could change if he reacts badly to my
refusal to administer interferon.

*Now's* the time to begin IFN therapy- while your cat is still
asymptomatic
and the viral load is probably still low. Even low-dose (30 U every 24
hours) oral administration of rHuIFN-a can reduce clinical signs and
improve
well-being in many infected cats. Given at this dose and route, IFN
therapy
is safe, doesn't stimulate antibody production, is cheap, its easy to

give,
. and it might even prolong the asymptomatic period and possibly even your
. cat's life.

The vet didn't prescribe low dose. *He prescribed the 7-days-on
followed by 7-days-off, and endlessly repeating procedure, which

is the high dose,

No. 7 on/7 off is the schedule for the *low-dose* treatment, i.e. 30
Units/q.d. PO.. The theory behind the 7 on/7 off protocol is so the cat
doesn't
develop antibodies to the *rHuIFN-a. * The high dose protocol is
administered *IM * for 5-7 weeks. How many units/day does the prescription
say?

What's the problem with administering IFN PO 7 on/7 off? *Its no different
than if your cat had some other illness that required daily medication.

Because of what I read on the internet. It IS different from
another illness, because the vet said it is incurable; though
I'm not convinced that he has it. I want to know about
symptoms, not about a test result.

and that (if what I read is true) will make the cat
sick continuously

You've been misinformed or you misunderstood what you read. The 7 on/7 off
protocol doesn't make cats sick. I've treated literally dozens of FeLV+ cats
with higher doses PO and *never* had a problem. *A few cats lived ~6 years
post diagnosis, other lived 3-5, and some cats extinguished the infection-
however, I can't say

The leukemia test was done overnight, so I assume it was
what you call the Snap test.

The Snap test takes only 10 minutes.

Why should I not just continue

with the antibiotics as prescribed, and then have the vet look
at the cat again?

I didn't say you stop the antibiotics. Definitely finish the full course of
antibiotics. *But there is no reason why you shouldn't begin the IFN
therapy.

*I see the cat up close and personal every

day, and he doesn't seem sick to me.

FeLV+ cats can remain asymptomatic for months to years- but they're still
sick. IFN therapy might prolong the period that your cat is asymptomatic.
IFN doesn't work in every cat- but it works in enough cats to justify using
it.

*His skin and fur

look and feel better to me, though they have a ways to go
before they look completely okay, he has a huge appetite, and
loves to be rubbed all over. *If he was listless and not eating,
that would be different.

You're not getting this, are you? *The reason for beginning IFN therapy now
is so he might remain asymptomatic longer.

As long as the cat is improving, I don't see a need to rush
into anything that will make him sick.

7 on/7 off won't make him sick. I've treated enough cats with this protocol
to know what I'm talking about.

*I can't do the low-dose
thing until the vet provides me with what is to be used.

Of course.

Vet has already provided me with the 7-on/7-off
prescription and directions. Googling it shows
that it's the high dose. You call it the low dose.
Since I don't know whom to believe, I will continue
refusing to administer it.

I never said or implied that you were against
continuing with antibiotics. I merely asked why
I shouldn't just continue giving ONLY the
antibiotics, because I am AFRAID to give the
cat interferon, and the cat does not appear sick
to me, by my only indications of sick.

When I refer to the cat being sick or not, I mean only
that he feels bad or not. My only indications of feeling
bad are listlessness or lack of appetite. My only
indication of feeling good are showing affection and
purring when petted.

I'm told that what the cat has (based on some test, not
based on specific symptoms) is incurable leukemia.
If so, I would rather he live the rest of his days feeling
as good as possible, not feel bad and living longer.

I know we're not comunicating well. I'm not a vet. I
just have a horror of giving an animal something that
will make him feel bad, if all it is going to do is
prolong a life of feeling bad. I would rather he have
a good though shorter life.

After the 10 days of twice a day antibiotics are over,
I expect the cat to look and act great, based on the
improvement that I have seen already in his skin and
fur. The vet will see him after that period, and be
informed that I withheld the interferon. He can then
berate me all he likes, and we will take it from there.

Thank you for your advice.

Calvin, Why don't you listen to Phil? He probably knows more about this
than your vet.


---MIKE---
In the White Mountains of New Hampshire
(44° 15' N - Elevation 1580')