Feline immunodeficiency virus (FIV) vaccination is quite controversial due to the interference of vaccinating with diagnostic
testing. Like FeLV, FIV is a retrovirus and causes immunosuppression. FIV is spread primarily though bite wounds making cats
that are born of negative mothers, live indoors and never fight at low risk. Conversely, cats of questionable ancestry, that
roam outdoors and participate in neighborhood feline brawls, are at high risk of infection. Careful consideration needs to
be given to FIV vaccination protocols dictated in preventive medicine programs. Veterinarians need to examine the degree of
cross protection achieved by a bivalent vaccine against a virus with at least five subtypes or clades. The available vaccine
(Fort Dodge) contains subtypes A and D, while the most prevalent subtype in the United States is subtype B. Currently available
antibody tests (IDEXX SNAP, Western Blot) do not distinguish between a truly infected cat and a vaccinated one. PCR testing
and virus isolation are not readily available to most practitioners and are quite costly for the client. With this in mind,
the AAFP still advocates testing/isolation as the best means of preventing FIV. Still, vaccination of FIV negative cats living
with FIV positive cats in an unstable social structure or cats living outdoors who fight frequently may be potential candidates
for vaccination. Veterinarians must carefully weigh the benefit of vaccinating such an at risk cat against the future testing
complications. Amid the controversy, one preventive medicine point is clear - all cats should be tested for FIV.
Other less frequently used vaccines may be included in basic hospital preventive medicine protocols depending on the incidence
of disease in a particular practice. For example, vaccines for Microsporum canis, Bordetella bronchiseptica, Giardia lamblia,
Chlamydia psittaci and Feline infectious peritonitis are available, but not routinely recommended for all cats. Infrequent
usage of these vaccines can be attributed to one or more of the following factors: lack of vaccine efficacy, low incidence
of disease, minimal severity of symptoms and ease of treatment. Veterinarians need to decide how important these vaccines
are to the health of cats in their practice and may prefer to emphasize the core vaccines in clinic programs rather than these
less frequently administered vaccines.
We must also consider the risk of vaccine-induced feline sarcoma. While some consider injection site sarcoma a significant
problem, others are not impressed by the incidence. Nevertheless, over-vaccination is not something we aspire to and sticking
to the important diseases and their related vaccines in preventive medicine protocols makes the program easier to master.
We can add vaccines or increase frequency of administration as necessary on an individual case basis.
When it comes to feline parasites, staff education is again an essential element to a successful preventive medicine plan
because receptionists sell most of the parasite control products. There are a myriad of parasites that thrive both in and
on cats and an equal number of products to eliminate or prevent them. Veterinarians should be well informed of the most prevalent
parasites in their practice area and include stringent preventive measures for those particular pests. In order to develop
a good parasite control program, it is also necessary to be familiar with the major commercial medications on the market and
their spectrum of activity.
Certain internal parasites prefer particular environments and climates; therefore, routine deworming of kittens as part of
a preventive medicine program varies with locale. Regardless of practice locale, we should be aware of the Centers for Disease
Control and Prevention (CDC) guidelines when establishing parasite treatment protocols. The CDC suggests routine de-worming
of both kittens and their mothers when the kittens are 3 weeks of age. Kittens should be treated with oral parasiticides again
at two-week intervals until 9 weeks of age. These guidelines not only protect the kitten, but also focus on the potential
for zoonotic infection.
After treating kittens and cats for intestinal parasites, we want to keep them parasite-free with good parasite prevention
protocols. The available medications on the market determine the content of our preventive programs. There are currently easy-to-use
medications for hookworm and roundworm prevention in cats. Monthly oral preparations (Feline Heartgard®) prevent heartworms
as well as intestinal parasites. In addition to internal parasite control and heartworm prevention, the topical preparation
(Feline Revolution®) treats ear mites and controls fleas. Other topical parasite preparations (Advantage, Frontline®) only
address flea control, so clients need to understand the significant difference between topical feline products.
The abundance of parasiticides on the market is a blessing and a curse - a blessing because clients have so many from which
to choose, but a curse because they are often confused by the number of products and choose the wrong one. A strong parasite
control portion of a feline medicine program can guide clients in determining the best parasite protection for their cats.
Preventive medicine programs should include routine diagnostics to allow early detection of health problems. As stated before,
the AAFP recommends routine testing for FIV/FeLV. The in house test kit available (SNAP® combo by IDEXX) makes testing for
FIV and FeLV easy to do during annual examinations. Regardless of age, cats benefit from routine retrovirus testing and regular
fecal exams, but additional tests should be considered routine as cats age. A senior care program is an important part of
a good preventive medicine plan for cats. Senior care programs should be implemented in cats older than 7 years of age, regardless
of health status, and should include a CBC, chemistry panel, urinalysis and thyroid function tests. If clinic preventive medicine
programs are instituted correctly, the number of senior cats in the practice should increase as should the practice income.