Hello, my name is Dr. Kara and I have over 20 years of experience as a veterinarian.
I am so sorry to hear that Barney has been diagnosed as FIV positive.
FIV positive cats often have painful secondary bacterial infection and ulcers in the mouth. We cannot cure these lesions but we can make them more comfortable by controlling the infections with a thorough dental cleaning to reduce the bacteria population, oral antibiotics, and oral rinses like CET rinse to decrease bacteria in the mouth. I also recommend pain medication such as buprenorphine.
These are temporary control measures but they are worth trying if you are not ready to euthanize him yet.
I also recommend a complete blood count and biochemistry panel to look for underlying organ failure. FIV cats will often have kidney failure at a young age which leads to mouth ulcers, a poor appetite and anemia. We can help control the symptoms of kidney failure with specialized diets, acid reducers such as Pepcid ac (famotidine), fluid therapy, and other medications based upon whether he has secondary high phosphorus levels or high blood pressure.
In the meantime I do recommend fluid therapy now so he doesn't become dehydrated, an appetite stimulant such as Mirtazapine or Cyproheptadine and feeding soft, easy to eat canned foods.
Best of luck with Barney, please let me know if you have any further questions.
thank you for your reply is the buprenorphine used in uk his gums are very pale hes still passing urine can the vets refuse to treat him as she said she didnt think he would live a week we dont want to lose him please help
Buprenorphine is a very common pain medication that is easily absorbed across the gums. I would be very surprised if it isn't used in your cat's veterinary clinic. Subutex is one trade name that is listed as available in the UK.
Even if he is passing urine his kidneys may be failing. Only when there is no functional kidney left will they completely stop producing urine and those cats will pass away fairly quickly due to the toxins building up in their body. Cats that have kidneys that are failing often drink and urinate more to try and flush out the excess toxins that the kidneys aren't able to do as efficiently as usual. If his gums are very pale then that may indicate anemia and I would be very suspicious of kidney failure.
I cannot say if your veterinarian will refuse to treat him or not. If they do refuse perhaps a second opinion is in order to take him to another veterinarian that is willing to try.
Sometimes they are at a point however that no matter what we do we cannot keep them comfortable and we lose them, or treating them is inhumane in that we cannot give them their deserved, good quality of life. I know that it is hard to face losing him as he has been a wonderful companion but you must put his enjoyment and quality of life first. I know that you love him very much and do not want him miserable.