Feline infectious peritonitis (FIP) - Symptoms and treatment

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Feline infectious peritonitis is one of the infectious diseases more serious that affect felines, due, among other causes, to the serious prognosis it has and as a consequence of the absence, to date, of a truly effective treatment.

It is more common in young cats less than two years of age and in cats from 12 years of age, the incidence being much higher in cats that live in communities. The disease develops when the feline enteric coronavirus mutates, and it is from this moment that, depending on the feline's cellular immune status, the more severe dry or wet form of the disease will develop. In this AnimalWised article we will discuss in depth everything you need to know about the feline infectious peritonitis (FIP), a disease so worrisome to cat sitters and so devastating to felines.

You may also be interested in: Feline Coronavirus - Symptoms and Treatment Index
  1. What is feline infectious peritonitis?
  2. What virus causes FIP in cats?
  3. How is feline infectious peritonitis spread?
  4. Feline infectious peritonitis symptoms
  5. Diagnosis of feline infectious peritonitis
  6. Treatment for feline infectious peritonitis
  7. Life expectancy of a cat with PIF
  8. How to prevent PIF in cats?

What is feline infectious peritonitis?

Feline infectious peritonitis (FIP) is a severe, debilitating, progressive infectious disease and in most cases fatal, affecting wild and domestic cats. It is a process of viral origin and worldwide distribution that has a large immune component.

The incidence of this disease is higher in kittens less than 2 years old of age and in over 12 years old, especially those of purebred from hatcheries or those that live in communities, due to a greater possibility of contagion of the virus that causes it.

This virus, whether or not it produces peritonitis disease at some point, affects the digestive system in cats.

What virus causes FIP in cats?

The feline coronavirus (CoVF) is the agent that can lead to the development of the PIF. It is an enveloped RNA virus of the Coronaviridae family and genus Alphacoronavirus. It is estimated that up to 90% of cats that live in communities and up to 50% of those that live alone are seropositive for CoVF. This virus enters orally and goes to the intestinal cells (enterocytes), where it multiplies causing mild diarrhea from which they heal. The elimination of the virus begins two or three days after infection and can last for a long time, even the entire life of the cat.

However, in less than 20% of those HIV positive cats the virus mutates, granting it the ability to infect defensive cells called macrophages and thus distribute themselves throughout the feline's body, giving rise to the PIF disease. In the development of this disease, the state of the cat's cellular immune system is essential, so that:

  • If the cellular immune system is strong, the disease does not occur.
  • If the cellular immune system is partially suppressed, it develops Dry PIF.
  • If the cellular immune system is severely suppressed, it develops Wet PIF.

How is feline infectious peritonitis spread?

By affecting the digestive system, PIF is transmitted mostly indirectly through stool or any object contaminated by them, especially sandboxes where it can remain viable for up to seven weeks.

On the other hand, the virus can be transmitted directly by saliva and a case of transplacental infection has even been described. As we say, it is a very contagious disease, so it is essential to isolate the contagious cat from the rest if several cats live together in a household.

¿Feline infectious peritonitis spreads to humans?

Do not, PIF cannot be spread to humans. It is a virus that only spreads between cats, so people cannot get it.

Feline infectious peritonitis symptoms

Symptoms common to the dry and wet forms of PIF are nonspecific symptoms: fever, depression, fluctuating anorexia, pale mucous membranes or jaundice, progressive thinning and delayed growth of kittens.

Symptoms of dry FIP

In the dry form of FIP, a type IV hypersensitivity occurs characterized by the formation of pyogranulomatous infiltrates, often around the blood vessels. These pyogranulomas will produce variable clinical signs depending on the organ they affect:

  • In the kidney, they will produce clinical signs of kidney disease.
  • In liver, from liver failure.
  • In lung or pleura, dyspnea and respiratory signs.
  • In intestine, colon, cecum and ileocolic lymph nodes, it will cause digestive signs such as vomiting or diarrhea.
  • In the brain, neurological signs such as seizures, altered mental status, behavioral changes, cranial nerve deficits, vestibular signs, hyperesthesia, ataxia, tetraparesis, and abnormal postural reactions.

Cutaneous signs may also appear such as non-itchy erythematous papules on the trunk and neck, subcutaneous edema, skin fragility syndrome, and nodules on the neck and forelimbs. Generalized synovitis can be seen in the joints, and the eye can also be affected with anterior uveitis, chorioretinitis, hyphema, hypopyon, keratin precipitates, and retinal detachment..

Other clinical signs that can be seen in cats with dry FIP are abortions and metritis..

Symptoms of wet FIP

In wet FIP, infected macrophages infiltrate the tissue surrounding the blood vessels and subsequently deposition of immune complexes in the vessels together with complement activation resulting in vasculitis, vascular endothelial damage, and leakage of serum and protein albumin from capillaries. It is the most serious way and with a worse prognosis of the disease.

It is characterized by the formation of effusions painless composed of a straw yellowish liquid with protein albumins located in:

  • Accumulation of fluid in the abdominal cavity (ascites) in the vast majority of cats.
  • Pleura (pleuritis) in up to 40% of cats.

Chin, scrotal edema, and pericardial effusion may also appear, leading to heart failure..

Jaundice is more common than in the dry form due to liver failure or immune-mediated hemolytic anemia and interference from elevated levels of tumor necrosis factor alpha that interfere with bilirubin transporters in and out of the body. liver cells. The neurological and ocular signs of the dry form may also appear.

Diagnosis of feline infectious peritonitis

The least to do with a cat with signs of PIF is a blood test, where you can see leukocytosis with lymphopenia and neutropenia (increased white blood cells but reduced number of lymphocytes and neutrophils), together with a non-regenerative anemia typical of a chronic inflammatory process. However, this is very nonspecific and can square with numerous diseases that cats can suffer from..

Serological testing for feline coronavirus is useless as many cats are positive and do not have the disease. The probability that a cat will present PIF increases with:

  • An albumin / globulin ratio less than 0.4.
  • A Rivalta test positive, however septic exudates and lymphomas can also be positive. However, it is a good test to rule out the disease, with a 97% reliability.

If there are neurological signs, a sample of cerebrospinal fluid should be taken where an increase in proteins (50-350 mg / dl) and cells (100-100,000 nucleated cells / ml) will be seen.

For the diagnosis of the feline infectious peritonitis type, the following is done:

  • Diagnosis of wet FIP: A sample of the fluid from the ascites or pleuritis should be taken, which should be viscous, yellowish-reddish, without bacteria, with many proteins (greater than 35 mg / ml) and few cells (less than 5,000 / ml). The best test for the diagnosis of the wet form is the performance of an immunofluorescence to look for the virus in the fluid of the effusions.
  • Diagnosis of dry FIP: in many cases the diagnosis is made when the cat has unfortunately already died, taking samples of its organs. In the live animal, invasive tests must be carried out to take biopsies. In both cases, the most reliable diagnosis is obtained by immunohistochemistry with coronavirus antigen staining from these samples..

Treatment for feline infectious peritonitis

¿Feline infectious peritonitis has a cure? Unfortunately, PIF today continues to be a disease with a very poor prognosis that it is not cured, although there have been cases of remission, especially of the dry form.

The therapy is based on a symptomatic treatment consisting of:

  • High protein diet.
  • Administration of proteolytic enzymes.
  • Vitamin complexes (A, B, C, E).
  • Drainage of pleural effusions if respiratory capacity is compromised.
  • Fluid therapy for fluid replacement.
  • Dexamethasone injection into the abdominal or thoracic cavity (1 mg / kg every 24 hours until the effusion no longer occurs, up to seven days; if there is effusion in both cavities, the dose per cavity should be divided).
  • Cover antibiotics.
  • Prednisolone and cyclophosphamide to decrease the severity of immune complexes and vasculitis by depressing the humoral immune system.
  • Recombinant feline omega interferon (FelFN-w) as an enhancer of cellular immune response.

In recent years, the hope of finding a cure for this disease has increased, since various studies have been carried out evaluating the efficacy and safety of numerous active ingredients, most of them in cells, but others are already being tested in cats. Among them, two drugs are showing good efficacy and safety in the treatment of PIF: the 3C protease inhibitor GC376 and the nucleoside analog GS-441524. However, more studies are still necessary before they are commercially available in this species..

Life expectancy of a cat with PIF

The PIF prognosis is very bad. Unfortunately, most cats die at weeks or months diagnosis. In addition, if they develop a wet form, a large number of them are usually slaughtered within 10 days in order not to prolong the suffering of the animal..

Feline infectious peritonitis is a disease that kills around 0.3-1.4% of cats in the world, being the main infectious cause of death in young cats, and is an additional source of threat to wild cats in Danger of extinction.

If the disease is diagnosed, the care of a cat with FIP is described in the previous section for symptomatic treatment, so it will be necessary to establish an adequate diet and follow the guidelines established by the veterinarian..

How to prevent PIF in cats?

As feline infectious peritonitis is a mutation of the feline coronavirus, it is essential to try to prevent the latter. Thus, there is no vaccine for feline infectious peritonitis, but there is a feline coronavirus vaccine. However, it is important to note that it is very difficult to control this disease through vaccination, since it is done when cats are already between 16 and 19 weeks old, an age at which many cats have already had contact with the virus..

Once again, we insist on the importance of isolating the cat infected with PIF from the rest of the cats if several live in the same household..

This article is merely informative, at AnimalWised.com we do not have the power to prescribe veterinary treatments or make any type of diagnosis. We invite you to take your pet to the vet in the event that it presents any type of condition or discomfort.

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