Update on Chiana and Her Treatment Plan

I posted this in the FeLV Warriors Group to share an update on Chiana's progress and treatment.

Viral Load and Weight Data

Date	Viral Load	Weight (Vet)	Weight (Home)
10/8/24	17.10 x 106 = 17,100,000	13.3 lbs	13.2 lbs
12/20/24	45.91 x 106 = 45,910,000	13.6 lbs	13.4 lbs

Switch to Dolutegravir

On 12/21/24, we started her on dolutegravir (50 mg/day). We plan to retest her during the first week of February and will also conduct a CBC test to monitor any effects on her organs.

Why We Changed Drugs

We have two theories about why raltegravir stopped working:

1. Possible drug resistance.
2. Underdosing: Chiana, at 14 lbs, should have been on 400 mg/day, but we were giving her 200 mg/day due to:
• Cost: The drug is expensive!
• Physical limitations: The dosage size is significant and hard for her to swallow twice daily.

Husband's Theories on Dolutegravir

Positives:

• There was one study on dolutegravir with cats, though it focused on FIV. As with raltegravir, the drug didn’t work for FIV but may work for FeLV.
• For humans:
• The pill is smaller and taken once daily.
• Dosage is less than raltegravir.

Our Theories:

The dolutegravir study on cats used 2.5 mg/kg/day. My husband believes this is too low. Using the raltegravir dosage as a reference, we calculated a starting dosage of 7.87 mg/kg/day. With her weight of 6.35 kg, that comes to 50 mg/day. We'll see how this works when we get her test results in February.

Has anyone used dolutegravir at such a high dosage for a cat? If so, do you have any results to share?

Current Status

Chiana has been on dolutegravir for over a week. My husband finds it easier to give her the medication once daily (in 4 smaller pieces), and she’s less stressed about it. So far, she hasn’t shown any side effects.

Final Note

Please let me know if you have any questions about Chiana’s treatment plan. We’ll share updates in 2025 as we learn more!