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Genetic Linkage

My Cat Has AIDS (Part 1)

Artie, our second FIV+ cat. (Credit: Dr. Wendy Josephs)
Juice was an impulse buy.

It was early July 2003, and we were headed to the mall for a gift for Carly, about to turn 15. We parked near a bus equipped as an animal shelter.

Inside, kitten-filled cages lined the walls, except for one, which had a large, orange and white cat stuffed into it. Carly made a beeline for him and the attendant hoisted him out and handed him over. I reminded Carly that we already had 5 felines, but we knew he’d be left behind as the kittens were adopted.

FIV CAT #!
The shelter had named him Juice, and his owner had just gone to a nursing home. On the drive home, in the rearview mirror I saw Juice pop his head up from the box, swiveling like a periscope. We already knew he was one-of-a-kind.

Our house is on a dead end, with an acre of woods and several ways in and out. Juice, given sudden freedom, bolted. Our three daughters were home for the summer, and we plastered the neighborhood with signs and searched everywhere. After two weeks, we held a family meeting in the living room to discuss strategy – and Juice sauntered past.

Cats do that.

While AWOL, Juice fell into the company of two feral cats, who bit or scratched him, transmitting FIV: feline immunodeficiency virus. After the winter, I discovered the remains of the feral cats, flattened bones bearing matted hair, like macerated mummies, at the back of our shed.

The following summer, during a visit to middle daughter Sarah in Savannah, Carly called.

“Juice may have AIDS!” she wailed.

Carly and our eldest, Heather, had taken Juice for a routine physical, and the vet had picked up on persistent ear mites and swollen, bleeding gums. She took blood to test for FIV antibodies.

DISCOVERY IN A CALIFORNIA CATTERY
Finding FIV occurred against a backdrop of full-blown AIDS panic, especially in the Bay area of California. “The medical insights on AIDS ran the gamut from depressing to dismal,” wrote Randy Shilts of the situation in 1985, in And The Band Played On. With nearly a million people in the U.S. infected, researchers were beginning to realize that the incubation period exceeded five years. The numbers, they knew, would explode.

Also in 1985, Niels Pedersen, DVM, PhD and Janet Yamamoto, PhD, and colleagues from the University of California, Davis heard about “a peculiar outbreak of disease” at a cattery in Petaluma, an hour’s drive from San Francisco. The facility housed 43 strays, some feral, in five pens. None had feline leukemia virus (FeLV).

From 1968 until 1982, all residents of the cattery had been healthy. Then pen D welcomed a newcomer, a kitten named Cy, who developed diarrhea, a drippy nose, and conjunctivitis. At age two, she miscarried. By her third year, Cy was skeletal and compulsively moved her mouth and tongue. Her gums bled and her teeth fell out. “Several blood transfusions were of temporary benefit but ultimately the emaciation, chronic infections, and anemia worsened and the cat died,” wrote the researchers.

By 1986, 8 more cats died in much the same way, all from Pen D. The syndrome started with gum and ear infections, which was why our vet was so alarmed at the otherwise robust Juice. A few cats were discovered dead, after seeming well the night before. One poor fellow was “found depressed and hypothermic with terminal hysteria and rage.”

The apparent immune breakdown spread. Kittens intentionally exposed to blood from sick cats got sick. The researchers isolated novel virus from two sick kittens, cultured the virus, gave it to other kittens, observed these kittens get sick and isolated the virus from them. Koch’s postulates fulfilled.

DIAGNOSIS: CAT AIDS
We didn’t really expect Juice to have FIV, but he did.

Carly participated in the annual HIV/AIDS walk in Albany the September after his diagnosis, taking her place among others honoring their loved ones, and contributed her chalk drawing of a cat with Juice’s information.

Meanwhile, we didn’t do what we were supposed to do.

We didn’t keep Juice or our other cats indoors.

We didn’t test our other cats. And if we had, and they had been positive, we wouldn’t have
vaccinated
them. Vaccinated pets who’d wandered into shelters had been euthanized because the antibody response to vaccine is indistinguishable from that to infection, even before symptoms arise. Our vet mentioned the vaccine, halfheartedly.

What was the point of all this intervention? Our crew stayed among themselves, were too mellow to bite or scratch, and if we kept them indoors, where I write, I’d go insane. But this was a very anti-science situation for me, advising against a test that would identify disease before symptoms arose (like genetic tests), and refusing to vaccinate.

For the next year, Juice was healthy. Then sores appeared, everywhere, and wouldn’t heal. He oozed blood and pus to the point that his coat bore pink patches; he flung phlegm. His hair fell out in clumps and he scratched constantly. If he could have read the Science paper, he’d have recognized his “chronic severe pustular dermatitis” and “extremely thin, rough hair coat.” He apparently missed the part about weight loss.

Years passed. Gradually Juice’s skin cleared up and his glossy coat regrew. But then he began drooling and his mouth swelled hideously, deforming his face. He started sneezing and dripping, fortunately only from his front end.

Yet Juice never became depressed like the original cattery cats – quite the opposite. He’s charmingly sociable. And so “juice” as a verb entered the family lexicon.

“You haven’t truly been welcomed into the Lewis home until you’ve been juiced,” explains Heather, referring to the phenomenon of Juice detonating at close range, hurling multicolored mucus. He’d famously do this at parties, where he’d plop himself on any available human and settle in until the next eruption.

In the fall of 2011, Juice became gravely ill with a systemic infection that rendered him unresponsive. Antibiotics saved him. Last spring the vet removed many rotting teeth. In days Juice perked up, his face deflating to normal proportions as he happily gummed the hard food, refusing the wet goop the vet had suggested.

Today Juice is enjoying his fifth or so life. He’s slowed down. Capturing him for a vet visit used to require a three-person battle plan, but now he doesn’t even awaken as I drop him into the once-dreaded cat box. He still drips. A shot of antibiotics in the tush every 2 months keeps the serious infections away. At his last check-up, he’d gained weight – he’s a very solid 20 pounds.

AN IMMUNODEFICIENCY VIRUS BY ANY OTHER NAME
Naming viruses is tricky, both for scientific reasons and because human egos can get in the way. The name must have meaning, to distinguish the types of viruses in any particular species.

Cats get lots of retroviruses, which have RNA as their genetic material: the very common FeLV, feline sarcoma virus, endogenous type C onconavirus, feline syncytium-forming virus. HIV and FIV belong to a subtype called lentivirus, which means “slow virus” – incubation time is typically years. In contrast, distemper can start just two days after exposure.

The UC Davis researchers first named the new virus “feline T-lymphotropic lentivirus” (FTLV), because dubbing it FIV without further experiments would be “presumptuous.” Given the timing of the mid 1980s, I suspect they wished to avoid the embarrassing turf war over who discovered HIV: was it Robert Gallo or Luc Montagnier?

HIV’s first name was HTLV, for human T lymphotropic virus, due to initial misclassification. AIDS, too, had another name: GRID, for “gay-related immune deficiency,” circa 1981. That vanished with the discovery of the disease in other groups.

FIV resembles HIV, shares some of its genes, but has a small, cone-like protrusion. Cats can’t transmit FIV to humans, nor can humans give HIV to cats. But FIV is more similar to HIV than are lentiviruses from goats, sheep, and horses to each other. Conquering AIDS may come from unraveling lentivirus evolution.

Just as HIV likely evolved from simian immunodeficiency virus (SIV), FIV originated from a lentivirus seen today in lions And other cats: pumas (aka mountain lions or cougars), cheetahs, and panthers. Chimps and lions live with their lentiviruses, in health.

FIV CAT #2
With Juice constantly sneezing, snuffling, and snoring, it was clear that we couldn’t add any kittens to the family roster. I was sad.

Then one day last March, I wandered into a pet store hosting an adoption clinic. I gazed at the homeless felines, especially a beautiful fellow who looked like he was wearing a Tuxedo.

“Are you interested in adopting a cat?” asked a cat lady.

“Yes, but I can’t.”

“Are you allergic?”

“No. But I have a cat with FIV. So I can’t get a healthy cat.”

The lady launched into a lecture in defense of FIV cats, but remembering Juice’s recent brush with death by infection, I wasn’t convinced. Then she said something I hadn’t thought of.

“That cat there. The Tuxedo. He’s FIV positive. Take him!” And she handed me a piece of paper.

“In a million years, I never expected to see my face on an adoption flyer!” read the announcement, beneath a photo of Artie. His owner was dying of cancer, and could no longer care for him, so the Animal Support Project brought him to a cat adoption clinic in the pet store in Albany sponsored by Orange Street Cats. No one knew how he’d become infected.

But we couldn’t just waltz in and take Artie. We had to go home and download an extensive contract more detailed than the college application Common Form. And then ensued a several-week investigation that would put the FBI to shame. Finally, when we passed the cat police qualifications, a cat social worker conducted a home visit.

We’d recently lost a brother-sister pair to very old age, which was in our favor. When the cat social worker sat at our dining room table and started shuffling papers, the remaining 3 Lewis cats jumped up to investigate. Juice rubbed his perpetually runny nose on the visitor, as we recited the genealogy of all our cats, tortoises, assorted rodents and lagomorphs, and hedgehog.

The social worker then asked a series of questions.

“If the new cat peed on the floor, what would you do?”

Clean it up.

“If the cat vomited on your bed, what would you do?”

Change the sheets.

“If the cat seems upset, what would you do?”

Talk to him.

We passed.

Two weeks later, the nice cat lady delivered Artie, and a huge contraption that unfolded into a cage. We set it up in my office.

We’d gotten our other cats in varied places: a sorority house at Indiana University (cat #1, Angie, white Persian). A poison-ivy-infested cornfield that landed Larry in the ER (cat #2, Sydney, American shorthair). A petrified forest in Saratoga (cat #4, Bullwinkle, long-haired grey). We’d never put a cat in a cage.

Yet according to the detailed instructions, Artie was to stay in prison, with his blankie, for a week. Then we were to let him out for short periods, and gradually work up to freedom.

The first morning in my office, Artie stared at me from behind bars. I sprung him. He spent the first week biting my feet as he followed me everywhere, then began to explore. Jelly taught him how to drink from faucets, and with astonishing speed, Artie was absorbed into the continuum of Lewis catdom.

Artie remains healthy. A few days ago we walked into the pet store to a chorus of “Artie’s parents!” I signed up for more FIV cats.

So is this blog just as an excuse to post cat photos? No, I could’ve done that on Facebook. But the fact that Juice and Artie will likely live normal lifespans, with manageable symptoms, makes me wonder why this isn’t true for many people with HIV/AIDS. I’m also intrigued by what we can learn from the problems that the FIV vaccine has encountered. I’ll address these in another post.

This blog was originally published January 24 at http://blogs.plos.org/dnascience/2013/01/24/my-cat-has-aids. All cats gave permission to release their medical information.
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