• Convincing Your Vet to Prescribe HIV Drugs Other Than Zidovudine (AZT)


  • Click here to open a Glossary of Terms in a separate window.

  • Most vets can be expected to be unwilling to prescribe or support use of human antiretroviral HIV drugs (ARVs) other than Zidovudine (AZT). The reason is simple. Among HIV drugs, only AZT is recognized as an approved veterinary therapy for FIV. Vets are disinclined to involve themselves with unapproved therapies, even if there is evidence that they are potentially helpful. The following suggestions may be helpful in gaining the cooperation of a vet who is at least moveable under any circumstances at all. It certainly doesn't hurt to be dealing with a vet with whom you have a relationship with some history behind it. But recognize that the initiative and ongoing impetus in the use of such drugs will likely have to come from an informed owner, not from his or her vet. Keep in mind, as well, that HIV antiretrovirals are expensive and are not a permanent solution, and for these reasons should be considered only for cats suffering significant effects of their FIV infection. For information on use of HIV antiretroviral drugs for FIV, see "Bud's Medications and Supplements."

  • Suggestion 1. Make yourself knowledgeable on the use of antiretroviral drugs in humans and cats in advance of any broaching of the subject. Nothing is more likely to fail in the securing of veterinary cooperation for any owner initiative to which the vet might not otherwise be inclined than ignorance. Vets are used to people with suggestions picked up casually from the internet or from the advice of others and have a well-practiced deaf ear. Like most professionals, they do not readily accede to the designs of nonprofessionals. They are also busy people and disinclined to take on time-consuming “projects.”

  • Suggestion 2. It's not unreasonable for a vet to think, Why should I stick my neck out for an unconventional therapy? Offer to sign a letter saying that you recognize that the therapy to be undertaken is not a recognized veterinary therapy and may involve elements of unknown risk; and that you do not hold the vet responsible for any negative outcomes directly associated with the therapy.

  • Suggestion 3. Do not expect a vet to have antiretroviral drugs on hand or to take the initiative in procuring them. The providers of their pharmaceuticals do not deal in these sorts of drugs. Offer to procure the drugs yourself and reduce them to appropriate dosages, asking only for a prescription and, if necessary, a phone call to the pharmacist with whom you are working. (Once division of human dosages have been made, two or even three separate drugs can usually be combined in one gelcap for convenience of administration. A compounding pharmacist cannot legally do this job for you.) A hospital pharmacy is a good place to access antiretroviral drugs, and it pays to ask to speak with the pharmacist and to get to know him or her.

  • Suggestion 4. Commit to writing a formal proposal of what specific therapy you wish to have considered, why you expect it to be safe and effective, and how precisely you intend to carry it out. Not only is a written document impressive, but it will put your thinking in a more ordered, persuasive form than you would be able to muster orally. It also gives the vet something to “look over” if he or she want to “think about it” for a bit.

  • Suggestion 5. Arm yourself with available research demonstrating the safety and effectiveness of whatever drugs you decide on in cats, as well as documented clinical instances in which they have been used safely and effectively by people who have secured veterinary cooperation. You can supply URLs, but having hard copies in hand is probably preferable. Companies who make specific drugs may be willing to forward information and/or full-text copies of animal research.

    • Bibliography of Relevant Research and Clinical Use

  • Research sources below may be listed multiple times if a given study involved more than one drug. On-line records of private owner use are preceded by three asterisks (***). The Reports page of this site contains an Index of Medications which can be used to locate case histories of cats given some of the drugs listed below. The Poose website contains the owner’s account of information published in the study by Huebner et al, although they do not agree in all particulars. However, it is no longer a free site and is in German.

  • Tenofovir (TDF, formerly PMPA)
  • --Hoover EA, Myles MH, Ebner JP, Black RJ, Bischofberger N. Efficacy of 9-(2-phosphonylmethoxypropyl) adenine for therapy of acute feline immunodeficiency virus infection. Eleventh International Conference on Antiviral Research. Antiviral Res. 1998 Mar; 37: A57 (abstract no. 60).
  • http://gateway.nlm.nih.gov/MeetingAbstracts/102236584.html
  •  --Huebner J, Klein D, Muller E, Vahlenkamp TW, Langbein I. Long-Term Combined Anti-Retroviral Therapy (CART) in Feline Immunodeficiency Virus Infected Cat: A Case Report. 2004. ACVIM Abstracts, No. 171.
  • http://www.laboklin.de/pdf/en/publications/jvim_huebner_2004.pdf
  • ***J Kehler, Bud's FIV Therapy
  • ***M Menz, Poose, Hope for Animals. http://websitewiki.de/Poose.de (In German)

  • Abacavir (ABC)
  • --Savarino A, Pistello M, Zabogli E, Mancini F, D’Ostilio D, Taglia F, Ciccozzi M, Ciervo A and Bendinelli M. Cats with Feline Immunodeficiency Virus (FIV) as an Animal Model for Studying Lentiviral Persistence during Antiretroviral Treatment. Third International Workshop on HIV Persistence during Therapy (2007), Abstract 3.
  • --Savarino A, Pistello M, D'Ostilio D, Zabogli E, Taglia F, Mancini F, Ferro S, Matteucci D, De Luca L, Barreca ML, Ciervo, Chimirri A, Ciccozzi M and Bendinelli M. Human immunodeficiency virus integrase inhibitors efficiently suppress feline immunodeficiency virus replication in vitro and provide a rationale to redesign antiretroviral treatment for feline AIDS. Retrovirology 2007, 4:79
  • http://www.retrovirology.com/content/4/1/79
  • --Bisset LR, Lutz H, Böni J, Hofmann-Lehmann R, Lüthy R, Schüpbach J. Combined effect of zidovudine (ZDV), lamivudine (3TC) and abacavir (ABC) antiretroviral therapy in suppressing in vitro FIV replication. Antiviral Res. 2002 Jan;53(1):35-45.
  • http://www.ncbi.nlm.nih.gov/pubmed/11684314
  • ***J Kehler, Bud's FIV Therapy
  • ***M Menz, Poose, Hope for Animals. http://websitewiki.de/Poose.de (In German)

  • Emtricitabine (FTC)
  • --Huebner J,. Klein D, Muller E, Vahlenkamp TW, Langbein I. Long-Term Combined Anti-Retroviral Therapy (CART) in Feline Immunodeficiency Virus Infected Cat: A Case Report. 2004 ACVIM Abstracts, No. 171.
  • http://www.laboklin.de/pdf/en/publications/jvim_huebner_2004.pdf
  • ***J Kehler, Bud's FIV Therapy
  • ***M Menz, Poose, Hope for Animals. http://websitewiki.de/Poose.de (In German)

  • Lamivudine (3TC)
  • --Bisset LR, Lutz H, Böni J, Hofmann-Lehmann R, Lüthy R, Schüpbach J. Combined effect of zidovudine (ZDV), lamivudine (3TC) and abacavir (ABC) antiretroviral therapy in suppressing in vitro FIV replication. Antiviral Res. 2002 Jan;53(1):35-45.
  • http://www.ncbi.nlm.nih.gov/pubmed/11684314
  • --Arai M, Earl DD, Yamamoto JK. Is AZT/3TC therapy effective against FIV infection or immunopathogenesis? Vet Immunol Immunopathol. 2002 Mar;85(3-4):189-204.
  • http://www.ncbi.nlm.nih.gov/pubmed/11943320
  • ***J Kehler, Bud's FIV Therapy
  • ***M Menz, Poose, Hope for Animals. http://websitewiki.de/Poose.de (In German)

  • Didanosine (ddI)
  • --Gobert JM, Remington KM, Zhu YQ, and North TW. Multiple-drug-resistant mutants of feline immunodeficiency virus selected with 2',3'-dideoxyinosine alone and in combination with 3'-azido-3'-deoxythymidine. Antimicrob Agents Chemother. 1994 April; 38(4): 861–864.
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC284556/
  • --Zhu Y, Antony JM, Martinez JA, Glerum DM, Brussee V, Hoke A, Zochodne D, Power C. Didanosine causes sensory neuropathy in an HIV/AIDS animal model: impaired mitochondrial and neurotrophic factor gene expression. Brain. 2007 Aug;130(Pt 8):2011-23.
  • http://brain.oxfordjournals.org/content/130/8/2011.long
  • --Zhu Y,Vergote D, Pardo C, Noorbakhsh F,. McArthur JC, Hollenberg MD,. Overall CM, and Christopher Power C. CXCR3 activation by lentivirus infection suppresses neuronal autophagy: neuroprotective effects of antiretroviral therapy. FASEB J. 2009 September; 23(9): 2928–2941.
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796902/
  • ***J Finlow, FIV Treatment (ebook, no longer on-line. Contact me for a copy)

  • Tipranavir
  • --Norelli S, El Daker S, D'Ostilio D, Mele F, Mancini F, Taglia F, Ruggieri A, Ciccozzi M, Cauda R, Ciervo A, Barreca ML, Pistello M, Bendinelli M, Savarino A.. Response of feline immunodeficiency virus (FIV) to tipranavir may provide new clues for development of broad-based inhibitors of retroviral proteases acting on drug-resistant HIV-1. Curr HIV Res. 2008 Jun;6(4):306-17.
  • http://www.ncbi.nlm.nih.gov/pubmed/18691029

  • Raltegravir and L-870,810 (Raltegravir relative)
  • --Savarino A, Pistello M, Zabogli E, Mancini F, D’Ostilio D, Taglia F, Ciccozzi M, Ciervo A and Bendinelli M. Cats with Feline Immunodeficiency Virus (FIV) as an Animal Model for Studying Lentiviral Persistence during Antiretroviral Treatment. Third International Workshop on HIV Persistence during Therapy (2007), Abstract 3.
  • --Savarino A, Pistello M, D'Ostilio D, Zabogli E, Taglia F, Mancini F, Ferro S, Matteucci D, De Luca L, Barreca ML, Ciervo A, Chimirri A, Ciccozzi M and Bendinelli M. Human immunodeficiency virus integrase inhibitors efficiently suppress feline immunodeficiency virus replication in vitro and provide a rationale to redesign antiretroviral treatment for feline AIDS. Retrovirology 2007, 4:79.
  • http://www.retrovirology.com/content/4/1/79
  • --Cattori V, Weibel B, Lutz H. Inhibition of Feline leukemia virus replication by the integrase inhibitor Raltegravir. Vet Microbiol. 2011 Aug 26;152(1-2):165-8.
  • http://www.ncbi.nlm.nih.gov/pubmed/21570781

  • [Page Top]

    • Back to >>>Bud's Outcomes>>>