Feline Infectious Peritonitis

1
Feline Infectious Peritonitis

• Feline Infectious Peritonitis (FIP) is a
  progressive, almost always fatal, viral disease
  of domestic cats. It affects some exotic cats,
  with the cheetah being particularly susceptible.
  It does not affect non-feline species, such as
  dogs.

Navies 2011
2
Etiology or Cause

• Field strains of feline coronavirus vary in their
  ability to induce FIP. Some isolates cause FIP
  (feline infectious peritonitis virus FIPVothers
  cause more localized GI disease)
• Mutations from feline enteric coronavirus to FIPV
  occur.
• FIP is thought to result from a mutation of the
  virus within the body, combined with the response
  of the immune system, leading to inflammation in
  various organ systems.
• FIPV and canine coronavirus are very closely
  related antigenically and may have crossed
  between hosts.
• Feline coronaviruses are fairly stable in the
  environment and, once dry, can survive for 4-6
  wk. They are enveloped viruses and are destroyed
  by most household disinfectants, particularly
  household bleach at a 132 dilution.

3
History

• FIP was first described as early as 1963 and even
  today it is not fully understood how this disease
  develops and spreads.

4
History of disease

• This is the pathogenesis of the Feline Infectious
  Peritonitis. The video shows how the infection
  of monocytes by the feline Coronavirus leads to
  the development of the clinical signs of feline
  infectious peritonitis. This is still not well
  undestood
• Because it was derived from the Coronavirus,
  history on the disease was vague, as well as any
  dates on when FIP originated.

5
Signalment

• FIP primarily affects cats under 1 years of age
• Low prevalence 5-10 of cats
• Cats housed in dense populations
• Cats under stress
• A genetic predisposition may also exist.
  (Purebred cats such as Birmans, Abyssinians and
  Himalayans, among others, may also be at
  increased risk. Kittens with littermates or
  mothers definitively diagnosed with FIP are also
  at higher risk.)

6
Transmission

• Primarily FECAL ORAL ROUTE Ingestion of the
  virus aerosol is also possible.
• Close contact with an infected cat or infected
  saliva or feces
• Because Cats shed viral particles in their feces,
  sharing litter boxes and mutual grooming are
  important sources of transmission
• Cats living in multiple cat households are at
  greater risks of contracting feline coronavirus
  and developing FIP because of sharing multiple
  strains of the virus and stress-associated
  immunosuppression.
• Contaminated food or water dishes, bedding, and
  personal clothing may also serve as sources of
  infection.

7
Clinical signs

• Wet (more common 75)
• Ascites
• Fluid wave
• Pleural
• effusion
• Anorexia
• Depression
• Weight loss
• dehydration
• /- fever

• Dry form
• Fever of unknown origin
• Anorexia
• Depression
• Weight loss
• Ocular lesion
• Neurologic signs
• Enlarged kidneys (uncommon)

8
Diagnostic Tests Expected Results

• There is no simple diagnostic test. The ELISA,
  IFA, and virus-neutralization tests detect the
  presence of coronavirus antibodies in a cat, but
  these tests cannot differentiate between the
  various strains of feline coronavirus.
• The only way to definitively diagnose FIP is by
  biopsy, or examination of tissues at autopsy.
• Evaluation of the cat's history, presenting
  symptoms, examination of fluid if it is present,
  and the results of supporting laboratory tests
  including a positive coronavirus antibody titer.

9
Diagnostic Tests

• The fluid has been described as straw-colored
• / clear yellow and is usually viscous It
  usually
• has a relatively low cellular content that is
• pyogranulomatous (macrophages and neutrophils
• usually no toxic changes in the latter)
• lt 20,000 nucleated cells/microliter
• Protein rich gt 3.5 microliter
• Albumin Globulin lt 0.81

10
Recommended Treatment

• There is no known treatment that can cure FIP
  once clinical signs arise. Treatment with
  anti-inflammatory and immunosuppressive drugs,
  along with supportive care, can make the cat more
  comfortable.
• In some cats, therapy may extend survival time
  by several months. Treatment is best advised in
  cats that are in good physical condition, are
  still eating, have no neurologic signs, and that
  do not have concurrent FeLV-induced malignancy or
  bone marrow suppression.
• Treatment is directed toward controlling the
  immune-mediated vasculitis and reducing viral
  load. The most effective treatments are
  combinations of prednisolone and
  cyclophosphamide. Supportive therapy for FIP is
  important and includes broad-spectrum
  antibiotics, adequate nutrition and fluid intake,
  and high doses of ascorbic acid. The use of low
  doses of aspirin because they can be useful as an
  anti-inflammatory.
• The Rivalta test is used in order to
  differentiate a transudate from an exudate1. A
  test tube is filled with distilled water and
  acetic acid is added. To this mixture one drop of
  the effusion to be tested is added. If the drop
  dissipates, the test is negative, indicating a
  transudate. If the drop precipitate, the test is
  positive, indicating an exudate

11
Recommended Treatment

• There is no cure for FIP. As with all terminal
  illnesses, the basic course of action is to
  provide supportive care. A combination of
  corticosteroids, immunosuppressive drugs,
  antibiotics, good dietary maintenance and proper
  fluid intake. It may relieve discomfort.

12
Prognosis

• The likelihood of survival is very poor for cats
  who are clinically diagnosed with FIP ( 1 11/2
  year)
• With a 95 mortality rate, euthanasia is normally
  the most appropriate course of action.

13
Pathologic Lesions of Disease

• In classic FIP, there is diffuse peritonitis or
  pleuritis (or both) characterized grossly by
  variable amounts of viscous abdominal or thoracic
  fluid, deposition of gray-white exudate, and
  disseminated necrotic plaques on the visceral
  and parietal peritoneum or pleura.
• Fibrinous adhesions (scar tissue), particularly
  between the liver and diaphragm and between loops
  of bowel, can develop in protracted cases.
• Lesions in the CNS affect the brain and spinal
  cord and can cause several types of masses.

14
Pathological Lesions

• The lesions are primarily extraserosal.
  Characterized by granulomatous inflammation in a
  variety of organs but principally affect the
  kidneys, visceral lymph nodes, lungs,liver, eyes,
  and leptomeninges.

15
Prevention Client Education

• An intranasal MLV vaccine to prevent FIP is
  available (but has shown very little
  effectiveness)
• Reducing exposure to the disease such as
• Disposing of Feces Properly
• Early Weaning
• Isolation of Cats that Test Positive for
  Coronavirus Antibodies
• Isolation and Testing of Cats after Shows
• Proper Sanitation/Cleaning with Disinfectants
• Immunization Against Other Feline Viruses.

16
Prevention and client education

• Please see text book pg 231

17
REFERENCES

• "Client Education - Feline Infectious
  Peritonitis." Sheepshead Bay Veterinary Group.
  Web. 10 Mar. 2011. lthttp//www.sbvet.net/ClientEdu
  cation_FIP.htmlgt.
• "Feline Infectious Peritonitis (FIP) in Cats
  Kittens." Pet Health Care Dog and Cat Behavior
  Information by Veterinarians. Web. 10 Mar. 2011.
  lthttp//www.peteducation.com/article.cfm?c1
  2134aid212gt.
• Team, The Petside. "Peritonitis, Infectious
  (Feline) Diagnose Dog Cat Health Problems,
  Pet Health Information." Petside.com Pet Health
  Information, Dog Cat Breeds, Pet News. Web. 10
  Mar. 2011. lthttp//www.petside.com/health/petvet/p
  eritonitis-infectious-feline.phpgt.
• Brown MA, Troyer JL, Pecon-Slattery J, Roelke ME,
  O'Brien SJ. Genetics and pathogenesis of feline
  infectious peritonitis virus. Emerg Infect Dis.
  2009 Sep. lthttp//www.cdc.gov/EID/content/15/9/14
  45.htmgt.
• "Genetics and Pathogenesis of Feline Infectious
  Peritonitis Virus CDC EID." Centers for Disease
  Control and Prevention. Web. 11 Mar. 2011.
  lthttp//www.cdc.gov/EID/content/15/9/1445.htmgt.
• "Merck Veterinary Manual." The Merck Veterinary
  Manual. Web. 11 Mar. 2011. lthttp//www.merckvetman
  ual.com/mvm/index.jsp?cfilehtm/bc/56900.htmword
  FIPgt.
• "YouTube - Pathogenesis of Feline Infectious
  Peritonitis (FIP) - the Infection of the
  Monocyte." YouTube - Broadcast Yourself. Web. 11
  Mar. 2011. lthttp//www.youtube.com/watch?v6RyI2LI
  9R9Qgt.