- fecal-oronasal - highly infectious - shed in feces (also saliva, resp. Excretions, urine)

- asymptomatic or brief mild upper resp. Tract signs - self-limiting diarrhea, vomiting

- clinical IMMUNE-MEDIATED syndrome - induced by infection with FCoV (may involve viral mutation) - can be systemic or affect single organ - pathogenicity enhanced by FeLV > FIV

- prevalence about 1% - most common in young cats w/ hx of multi-cat env - purebreds, males have higher risk

- fever unresponsive to abx - rapid wt. loss - icterus and/or yellow plasma - anorexia, depression - body cavity effusions - abd. Mass - neuro signs

L7: FIP: Dx And Control (Levy) Flashcards by Sara Prent

FIP can present like:

liver dz
lymphoma
FIV
CNS dz
abd. Neoplasia
toxoplasmosis
bacterial peritonitis

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Transmission of FCoV

fecal-oronasal
highly infectious
shed in feces (also saliva, resp. Excretions, urine)

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Prevalence of FCoV Ab in pet cats

25-75%

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Prevalence of FCoV Ab in feral cats

12%

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What percent of carriers of FCoV develop FIP

Less than 10%

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What proportion of FCoV seropositive cats shed the virus? Seronegative?

Seropositive: One third
Seronegative: none

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CS of FCoV

asymptomatic or brief mild upper resp. Tract signs

- self-limiting diarrhea, vomiting

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Etiology of FIP

clinical IMMUNE-MEDIATED syndrome
induced by infection with FCoV (may involve viral mutation)
can be systemic or affect single organ
pathogenicity enhanced by FeLV > FIV

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Epi of FIP

prevalence about 1%
most common in young cats w/ hx of multi-cat env
purebreds, males have higher risk

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Dx of FIP

PE/Hx

- CBC/Chem, serology, effusion analysis, CSF analysis, RT-PCR, virus culture, tissue biopsy

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CS of FIP

fever unresponsive to abx
rapid wt. loss
icterus and/or yellow plasma
anorexia, depression
body cavity effusions
abd. Mass
neuro signs

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4 main types of FIP

Effusive
Noneffusive
Intestinal
Neurological

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Effusive FIP char. By:

vasculitis, serum exudation
peritoneal, pleural, pericardial effusion
abd masses (omental and visceral adhesions, granulomas, mesenteric lymphadenopathy)

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Noneffusive FIP char. By:

vague signs
ocular inflammation (uveitis)
neuro signs
irregular kidneys
mesenteric lymphadenopathy
intestinal obstruction

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Intestinal FIP char. By

-focal granulomatous lesion of colon or ileocecocolic junction
-death by 9 mo. Usually
-may mimic intestinal adenocarcinoma
+/- GI obstruction

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Most common cause of inflammatory CNS dz in cats

Neurological FIP

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CS of neurological FIP

multifocal CNS signs
hyperasthesia
flaccid, mentally dull

What do you expect to find on CBC in cat with FIP?

lymphopenia
neutrophilia +/- mild L shift
hyperproteinemia
nonregen. Anemia

*may be normal!

What do you expect to find on Chemistry in cat with FIP?

hyperglobulinemia w/ low A:G ratio
hyperbilirubinemia
inc. LIV enzymes

*may be normal!

Rivalta Test

easy test for FIP
H2O + acetic acid + effusion
if congealed, positive for FIP

Ab titer levels in healthy cats do/do not correlate w/ FIP risk

Do NOT

No FIP serologic test; must test for FCoV

FCoV serologic testing indications

support dx of clinical FIP
contact with FCoV shedder
screening catteries
screening before adding new cats to FCoV-free catery
controlling FCoV in catteries
not indicated for screening healthy pet cats or in shelters

Effusion analysis in FIP

-color clear to YELLOW
-viscous, frothy, may clot in cold
-protein >3.5 g/dL w/ low A:G ratio
-

CSF Analysis in FIP

- extremely high protein (>200) - extremely high nucleated cells (>100), esp. NEUTS, lymphs, macs - risk of herniation during CSF collection

RT-PCR testing for FCoV

- sensitive - excellent for detecting FCoV shedding in feces - does NOT distinguish cats at risk for FIP - can be done on effusion or biopsy

Pathologic findings of FIP

- serosal surfaces covered in white plaques (fibrin) - nodules on intestines, etc. - omentum looks like scrambled eggs - adhesions of omentum, mesentery - lymphadenopathy - focal lesions

Histologic findings of FIP

-pyogranulomatous, vasculitis

What is gold standard for diagnosing FIP

IHC for viral antigen + biopsy

A:G ratio usually low/high in cats with FIP

Low (high globulins)

TP usually low/high in FIP

High (globulins)

Most reliable confirmatory test for FIP

IHC

FIP vaccination

- efficacy is controversial - IgG seroconversion DOES occur - not a core vaccine - only replicates in lower body temps of the nose

Heritability of FIP susceptibility

>50% | -may have polygenetic inheritance

Seropositive cats in households from which other cats died of FIP had the same/different risk of developing FIP as cats from household without history of FIP

Same (Siblings may be at higher risk) HOWEVER, FCoV seroNEGATIVE kittens placed in catteries with endemic FIP suffered 90% mortality

Risk of testing positive for FCoV in animal shelters

-massive increase in amount of coronavirus shed within first week of being in shelter (stress to blame for increase in shedding and transmission)

Epizootic of FIP in catteries

- uncommon - may last 6-12 months - causes high losses in kittens and juveniles - may return to enzootic form - due to new virus strain introduction

Enzootic of FIP in catteries

- most common pattern (low grade, chronic) - sporadic, infrequent, unpredictable losses - overall 1-5% mortality

Tx of FIP

- no tx for healthy seropositive cats - supportive tx for coronaviral enteritis (self-limiting) - palliative tx of FIP (predinosolone, anti-inflammatories, supportive care)

Antiviral and immunomodulating drugs for FIP

- none available right now | - UC davis has clinical trial w/ protease inhibitor drug used against SARS and MERS in people

Why is it hard to misdiagnose FIP?

- nonspecific CS - widespread seropositivity of FCoV Ab - no discriminating tests for FIP

Diagnostic Algorithm for FIP

See slide 38 (or pic)