Feline Infectious Peritonitis In Cats....
Most first time cat parents visiting Companion Veterinary Clinic in Dubai, come prepared to know and learn everything with reference to the best pet care, well-being of their pets, diet , vaccinations, neutering, dental care, grooming and lately even the abnormal signs to look out for in their pet.
Sadly, the truth is there can be precious little in each of their meows about what is going on inside. Hence awareness about a few diseases adds to the basic guideline for being a pet cat parent. And while ranting about the common diseases like panleukopenia and calici, a significant addition has been the feline infectious peritonitis, commonly known under the nick name FIP.
Now what is FIP?
FIP, which is encountered quite frequently by all pet clinics in Dubai, is a contagious and infectious viral disease caused by mutations occurring in feline corona virus (FCoV). FCoV, a seemingly non-lethal RNA virus is ubiquitous among cats showcasing no symptoms to an occasional mild diarrhea only. But rarely,as quoted by the best vets, this simple strand is capable of undergoing mutations within the pet’s system to cause the much dreaded and mostly fatal FIP infection.
The How and Where
Crowded environments and multi-cat household, common in shelters and rescue centres tend to increase the susceptibility of kittens to the infection. Even activities like grooming among cats can lead to the spread of this infection, although mostly the spread is via feco-oral ingestion.
The proper pathogenesis, although unclear, includes theories that play into the pet’s reduced immunity along with the pathogens’ increased virulance at the time of infection.
Once inside the body, the main site for viral replication is the intestine from which the virulent forms spread to all other internal organs including spleen and liver.
Previously, two forms of the disease, the wet and dry form were recorded. Do note that these forms are usually not exclusive. The wet form involves fluid buildup causing effusions into the abdomen, thorax and sometimes even to the pericardium thus resulting in outward symptoms like breathing difficulty or ascites. In the dry form, inflammatory changes occur within body thus leading to organ damage. In this form, involvement occurs with the CNS hence resulting in the neurological form of FIP which can show symptoms like behavioural changes, ataxia and even seizures.
What to look out for?
Cat vets says, signs as simple as reduced food intake, lethargy and fatigue can all indicate to an FIP. Other symptoms can include diarrhea, fluid buildup, and respiratory distress to even neurological signs.
Initially when infected by the virus the pet will show no symptoms post which they might show slight lethargy, reduced food intake, depression and inactivity. Chronic cases of lethargy showing no improvement to treatment should always be suspected for FIP
Vets will have to be aggressive with their diagnostics to ascertain the chances of FIP. The Companion Veterinary Clinic has diagnosed many cases of FIP with combined techniques like physical examination, laboratory tests along with imaging techniques like X ray and Ultrasound Scans. History of the pet will give some good leads to the diagnosis.
Blood tests can reveal lymphopenia, neutrophilia, anaemia or even thrombocytopenia. Biochemistry can reveal elevated liver enzymes along with hyperproteinemia.
Evident yellow fluid diagnosed on an abdominal ultrasound scan is usually very promising for FIP. Such samples collected could be sent for RT PCR.
The confirmation to the diagnosis can only be obtained by biopsy of affected tissues or post-mortem examination.
- Vaccination: RNA viruses such as Corona can undergo mutations hence challenging the efficacy of vaccines. Though a vaccine Felocell FIP has been marketed since 1991, due to constraints associated with the mutation, the efficiency is questionable.
- Regular cleaning of catteries, providing clean litter trays, regular vet visits could help with the reduction in the spread of the virus.
- Screening cats for antibody testing is performed in some places
The first step into the treatment option should come with the acceptance that the disease is fatal – spanning from days to maybe months. Though researches has been made and innovative drugs are improving the prognosis, the reduced awareness, the difficulty to procure the medications and the increased cost of the treatment along with chances of re-occurrence can all hinder the survivability of an affected pet.
- Symptomatic treatment :
In pets having minimal symptoms, symptomatic treatment to ensure the comfortable living of the pet can be ensured.
Addition of immune-suppressants like Prednisolone or cyclosporine coupled with a high protein diet and supplements can be recommended.
In pets with effusions, removal of fluid buildup is controversial unless it is in the chest cavity wherein immediate thoracocentesis is needed.
- Anti-viral drugs
Remdisivir, available for the treatment of COVID-19, has been successfully used in FIP cases for treatment extending a time period of 84 days.
Some proteases and nucleoside analogues like GS are also found to be effective in FIP cases but sadly they are not approved by the FDA.
Despite the milestones conquered in finding a cure for this disease, the complexity now lies in the difficulty to procure the very same medications. Further research is warranted to ascertain their safety so as to obtain approval from the FDA so that we can guarantee a future for FIP affected pets.
Although the journey with FIP is a long way from the finishing line, the effort going on is cumulative of the fact that we will reach the goal in the near future.