"Lub-Dub... Lub-Dub... Lub-Dub..." Can you hear that? "Lub-Dub... Lub-Dub... Lub-Dub..."
Anyone within a mile of me would have heard this sound on May 28th, 2014... the sound of my heart pounding so loudly that I thought it would come right out of my chest.
Last week I was ready to announce the closure of Heart'nsoul after receiving news that completely ruined me. For days I was physically ill due to the stress this caused me and mentally I was ready to have a breakdown. I couldn't even look at my cats and kittens without tears filling my eyes! This whole ordeal has made me over $1000 poorer, which in the grand scheme of things is so minuscule compared to everything else.
However, it turns out that things didn't go quite as I had expected them to and I got to thinking "why on earth would I be put through this pure and utter hell for nothing?". I realized in the end that this was another lesson, another experience, that I have the ability to share with others. By sharing this maybe I will prevent someone out there from suffering the same way I did and more importantly, hopefully fewer cats will be euthanized.
Before I start, I would like to say that TODAY was a day for celebration. It marks the day that I can once again sleep without nightmares and wake up without running to the bathroom. Today my mind will no longer be occupied with the negative and worrisome thoughts that it's been filled with for over a week. TODAY I can BREATHE finally and ENJOY my cats and kittens without the thoughts of their fate consuming me. TODAY was the day that I received news that ALL I HAVE GONE THROUGH the last week and a half was due to TWO FALSE POSITIVE TESTS.
You can bet that before I even decided to write this I made sure to have PROOF that each and every one of my cats is HEALTHY. Proof in the form of not only photos but also printed documents from the veterinarians office. As sad as it sounds, I know there are many breeders out there who like to spread rumors and all I can say is "People are going to talk no matter what you do, so you might as well give them something to talk about."
On Wednesday May 28th, 2014, three of my kittens had their first check-up. They were declared healthy and received their first vaccines. Because I intended to keep one of these kittens, I asked for my vet to perform the ELISA (enzyme-linked immunosorbent assay) SNAP FIV/FeLV COMBO. Ten minutes later I received news that completely shocked me; my kitten received a faint FeLV positive on the test. I wondered how this was even possible given the fact I test each and every cat that enters my cattery. I told my vet that the test had to be wrong and asked that the litter mate to this kitten was tested as well. My heart was pounding so loudly that I thought it would come right out of my chest and those 10 minutes literally felt like a lifetime. And sadly, the result was also a faint positive. I had to leave my vets office to take a breather and to stop myself from being sick. It didn't make sense but I was under the impression that any coloring in the FIV or FeLV spot within the 10 minute time frame was accurate because the virus MUST be present in order for the spot to develop color. I immediately brought the mom to these kittens in and had the ELISA SNAP FIV/FeLV COMBO done and she came back NEGATIVE. However, this didn't ease my worry because I still felt that my kittens had to be positive to receive any kind of positive result on the ELISA SNAP FIV/FeLV COMBO. I opted to send one of the kittens blood away to Antech Diagnostics for the IFA (indirect immunofluorescent antibody assay) test to confirm.
I contacted the last two people that adopted my cats and asked that they test them ASAP for FeLV. Both were very understanding (thankfully, because I was a real mess!) AND immediately tested the cats who thankfully BOTH came back NEGATIVE.
As I was waiting for the IFA results to come back (which would take 2-5 days) I contacted Dr. Niels Pedersen (world-renowned expert on feline infectious diseases and director of the UC Davis Center for Companion Animal Health). I had done a great deal of research on my own, none of which came even close to providing me with the reassurance and hope that Dr. Pedersen did.
Lets go over a few things here about FeLV and the testing available before I finish my story.
Feline Leukemia (FeLV), a retrovirus, causes a decline in your cats health over time. It is the most common cause of cancer in cats and may cause a number of blood disorders as well as immune deficiency which reduces the cats ability to protect itself against other infections.
It is spread from cat to cat through prolonged intimate contact or in utero from infected queens to their fetuses. In one of the articles Dr. Pedersen sent to me, 'Common Infectious Diseases in Multi-Cat Environments', Dr. Pedersen writes that, and I quote "... in-utero infection results in fetal or neonatal death in 80% of infected queens, 20% of kittens born to FeLV-infected mothers may carry the infection into later life". He also writes that, and I quote "Horizontal spread of FeLV infection requires prolonged intimate contact between cats. The reasons for this are the low stability of the virus in nature, the relatively large dose of virus required to infect by the oral route, and age resistance. Prolonged intimate exposure allows virus spread by mutual grooming and sharing of litter pans. A simple wire partition between cats is sufficient to prevent cross-infections if there is no physical contact between cats and their excretions. Bite wounds are an efficient mode of transmission because a large amount of virus can be injected directly into the body. Infection can also be spread via blood transfusions and reuse of dirty instruments for sequential surgeries".
I was concerned that there may be a slight possibility that one of my rescue cats could have had FeLV and maybe that was how my kittens were infected. I expressed this concern to Dr. Pedersen and he went on to say, and I quote " The only way you can get FeLV into your cattery is if you bring in an infected cat, often from the outdoors, and let it live with your cats for a period of time (often weeks or months)." All of the cats I have ever rescued have been FIV/FeLV tested before entering my home and NEVER have they EVER stepped foot into my cattery. So, the possibility that one of my rescue cats spread the virus to my kittens was highly unlikely.
Again, I was trying to figure out HOW two of my kittens could possibly be infected. In one of the emails Dr. Pedersen told me, and I quote "for a kitten to be truly positive, the mother must also be positive, or at the least other cats in the same environment." Well, I knew that the mother was negative AND these kittens never had any "prolonged intimate contact" with any other cats. So it really was a mystery as to how these kittens were apparently POSITIVE for FeLV.
In Dr. Pedersen's article ' Common Infectious Diseases in Multi-Cat Environments" he mentions, and I quote "Resistance to FeLV infection increases with age. Following infection 70-100% of neonates become persistently viremic for life. Kittens 8-12 weeks of age are much more resistant, and only 30-50% become persistently viremic following exposure. Less than 10-20% of adolescent or adult cats become persistently viremic and then only after exposure lasting as long as 1.5 years."
Dr. Pedersen goes on to write, and I quote "Feline leukemia virus has 2 main clinical stages. The initial stage occurs 2-6 weeks following infection and corresponds to the appearance of virus in the blood, saliva, urine and feces for the first time. This state of the disease is manifested by varying degrees in severity of fever, malaise, generalized lymphadenopathy, leukopenia, thrombocytopenia and anemia. These signs usually persist for 1-16 weeks before all clinical abnormalities disappear.
...Cats that survive the initial stage of infection make a real (true) or apparent (false) recovery. True recovery is manifested by disappearance of the virus from the blood, and eventually from other tissues as well. Cats that make an apparent or false recovery appear outwardly normal but remain persistently viremic for life. As a rule, cats that show either mild or in apparent signs during the initial stage of infection are usually among those that make a true recovery. The more severe the clinical signs are during the initial stage of infection, the more likely the cat will become persistently infected.
Cats that make a true recovery following initial infection usually suffer none of the long term complications associated with FeLV infection. There is one exception however. Completed recovered cats still suffer a higher incidence of lymphoid tumors than cats that never were infected. This increased incidence is much less than in persistently viremic cats."
Now lets talk a little about the tests available to detect FeLV.
The test that most veterinarians recommend and use first is called ELISA (enzyme-linked immunosorbent assay). This test can be performed in your veterinarians office and it detects both transient and persistent viremia.
The IFA (indirect immunofluorescent antibody assay) if often used as a confirmatory test and must be sent out to a diagnostic laboratory. It detects persistent viremia only, which means that if your cat comes back as "positive" he is most likely infected for life. This test is thought to be about 99% accurate in detecting persistent viremia.
Idexx offers an In House version (FeLV Antigen ELISA) of the ELISA. This test is done by sending the serum from the whole blood to Idexx for testing. It does not distinguish between transient and persistent viremia and results are more accurate than the ELISA FIV/FeLV SNAP COMBO.
And, lastly, a PCR test can be done and this is likely the most sensitive test for the diagnosis of FeLV because it can actually detect the presence of viral DNA that has been incorporated into the cat’s own genome.
I felt this was important to share, in particular for breeders. In one of the emails Dr. Pedersen sent me he said, and I quote " ... The first thing to do is to find out about the history of other cats in the catteries, test results of parents, other cats, and litter mates, etc. If the test results do not fit you should retest before jumping to any conclusions."
Now it gets interesting because we are going to talk about WHY you cannot rely on ONE (OR EVEN TWO) positive ELISA SNAP FIV/FeLV COMBO test results and WHY it is of the utmost importance that if you receive a positive on this test that you RETEST by IFA, In House Feline Antigen ELISA or PCR BEFORE YOU EVEN CONSIDER EUTHANIZING!
Lets face it, most veterinarians will automatically euthanize if a cat or kitten receives a positive FeLV result on the ELISA SNAP FIV/FeLV COMBO. And in the last week and a half I think that many people involved (veterinarians, techs, assistants, breeders, friends, etc) have been heartsick knowing how many cats and kittens could have been euthanized for absolutely NO REASON.
I cannot recall which veterinarian told me this, but apparently Idexx admitted that there is only about a 3% chance that you will receive a false negative result (97% accurate) BUT a 15-20% chance that you will receive a false positive (80-85% accurate) on the ELISA SNAP FIV/FeLV COMBO.
In two different emails Dr. Pedersen told me, and I quote "It is highly unlikely for a young kitten to be positive, because if they were infected it would have been from the queen and if the queen were infected, the kittens would have very likely been resorbed, aborted, or faded shortly after birth. People have been warned about problems with increased false positives in young kittens and the use of badly hemolyzed serum/plasma and whole blood. ... ... The fact that the positives were weak should also have been a tip-off, because true positives in kittens are usually very strong. In a statistical sense, when the incidence of true FeLV infection is extremely low, the chances of a test being falsely positive is greater than the chances that it is a true positive."
And oddly enough I took a TNR Workshop last Saturday and in the workbook that we received, this is what it says "... the ELISA test for FeLV is sensitive and prone to false positives from mishandling. A classic example is when the result is labeled a "weak positive". There is no such thing. Either the antigen is present in the blood or it's not. A "weak positive" finding almost always indicates some type of testing error."
When I told Dr. Pedersen that I felt it was just too odd that BOTH of my kittens would test faintly positive and that it must be a TRUE positive result, he told me, and I quote " ... the reason why two sibling kittens should test positive is that both are likely to contain the same non-specific substances in their blood that would cause such a reaction, they were both tested with the same test kit at the same time, and the same person is conducting and reading the test."
The IFA came back on my kitten and the results were NEGATIVE! However, due to the fact that the IFA only detects persistent viremia and there was a slight possibility that my kittens may have still be in the transient stage, I opted to send the serum away to have the In House Feline Antigen ELISA done as well. About two days later I received news that the In House Feline Antigen ELISA was also NEGATIVE!
Dr. Pedersen warned me that, and I quote "... if you test a whole bunch of healthy non-FeLV infected cats, you will run the risk of getting a false positive and starting the whole cycle all over again." BUT... I had to be 100% sure that my cats were all FeLV negative (even though I test each and every one when they enter my cattery). In the last week I have tested ALL of my cats using the ELISA SNAP FIV/FeLV COMBO using ONLY serum (and NOT whole blood!). And each and every single cat came back NEGATIVE! I am BEYOND relieved and so incredibly happy! The cats and kittens who's fate I did not know just a week ago are healthy and FeLV NEGATIVE! The original faint positive FeLV results on the two kittens were definitely FALSE POSITIVES like Dr. Pedersen felt they would be.
As I sit here and celebrate I can't help but feel sad all at the same time. SAD that SO MANY kittens and cats have been euthanized after a positive result when there was a real possibility that they may not have even been positive for FeLV at all. AND, to make matters even worse, even if the test was a true positive, there is still a chance that the kitten/cat may BEAT the virus and become NEGATIVE. That is why it's recommended that any positive cat be RETESTED a minimum of 30 days later to see if the virus is still present OR that the blood is sent to a reputable lab for the IFA to determine whether the cat is positive.
I can't stress enough how important it is to ALWAYS RETEST using IFA, PCR or In House Feline Antigen ELISA when you receive a positive on the ELISA FIV/FeLV SNAP COMBO. In particular if you tested kittens, used whole blood or received a faint positive on the test. If possible I personally recommend that serum is used any time you test using the ELISA FIV/FeLV SNAP COMBO. And be sure that the instructions are followed to a "T".
SNAP FIV/FeLV COMBO Test Package Insert LINK
Common Infectious Diseases of Multi-Cat Environments (Chapter 4) - Read Starting at PG 210
Dr. Niels Pedersen
I want to send out a HUGE thank you to Dr. Niels Pedersen for sharing his knowledge and for providing a super paranoid and incredibly sad human being with some reassurance.
And thank you to the veterinarians, technicians and assistants who have helped me through this ordeal and offered me support!
Lastly, thank you to my family and friends for letting me vent and cry and for putting up with me the last few weeks while I have gone through a few not so nice situations.