How Does The Vet Diagnose Fip
Theres no denying it, reaching a definitive diagnosis of FIP is a headache. The problem is there is no one, single test that puts a big red Yes in the box next to the question: Is this FIP?
Straight away you can see part of the problem testing positive for coronavirus doesnt mean the cat has FIP, it just means the cat has been exposed to a bug that causes diarrhoea.
Diagnosing FIP is like having a 1,000 piece jigsaw puzzle with now ideal of what the finished picture looks like. You have to piece together as many pieces as you can, to build the most likely picture.
The tests a vet uses to piece things together are:
- Clinical signs: a belly full of fluid in a young feverish cat is a pretty heavy hint
- Coronavirus titre: A negative result rules out FIP
- Protein levels: FIP changes the balance of proteins in the blood stream, and high globulins with normal albumin levels are a signpost
- Analysis of abdominal fluid: very high protein levels are suspicious
- High AGP levels: Acid glycoprotein can help rule out fluid in the belly due to other causes such as cancer or liver disease
- Inflammatory changes such as iritis
- Antigen tests to look for FIP virus: False negatives are common.
Typically, the vet pulls together as much evidence as possible and gives the most appropriate treatment, and hopes against hope the cat gets better. If they dont, then FIP becomes even more likely.
Image: Mikael Tigerström via Flickr
Symptoms Of Wet Or Effusive Fip
In this form of the disease fluid builds up in the abdomen making a swollen tummy one of the most obvious signs. This might also happen in the chest cavity causing breathing problems. But other diseases can cause this fluid accumulation as well, so its important to wait for more clear diagnostics from your vet in order to make a presumptive diagnosis.
What Is The Cause Of Fip
FIP is associated with a viral infection called feline coronavirus. There are many different strains of feline coronavirus, which differ in their ability to cause disease. Previously there had been an attempt to classify these strains as either feline infectious peritonitis virus strains or feline enteric coronavirus strains . It is now recognized that feline enteric coronavirus strains can mutate to the more harmful type of virus and cause FIP disease.
“FIP remains one of the least understood of all cat diseases.”
Diagnosing FIP is very challenging for many reasons. Unfortunately there are no laboratory tests available that can distinguish between the enteric coronavirus and the FIP-causing strains. Even when infected with known FIP-causing strains, many cats do not develop FIP disease. The factors determining why one cat becomes diseased while others remain unaffected are unclear. FIP remains one of the least understood of all cat diseases.
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What Is Fip In Cats
FIP is a relatively rare but often fatal viral disease which is common in young cats and kittens and is caused by an infection with the virus named feline coronavirus. Its important to note that this is different from the coronavirus that infects people and leads to COVID-19. This is a feline coronavirus that is very common and only causes mild symptoms, but in a few cases, it mutates into the feline infectious peritonitis virus, triggering FIP, a serious disease that is deadly for most cats.
A mutated feline coronavirus can trigger feline infectious peritonitis, so before we get to the specifics of the FIP disease in cats, lets look at what the feline coronavirus is and how your pet might get it.
Feline Infectious Peritonitis Virus And Feline Infectious Peritonitis
The virus becomes feline infectious peritonitis virus when random errors occur in the virus infecting an , causing the virus to mutate from FECV to FIPV. FIPV causes a lethal, incurable disease: .
In their pre-domestication natural state, cats are solitary animals and do not share space . Domestic cats living in a group therefore have a much higher risk of mutation. After this mutation, the FCoV acquires a for while losing intestinal tropism.
In a large group of cats, n, the epidemiological risk of mutation is higher and expressed theoretically as: E = n2 ân. A house hosting 2 cats therefore has risk of mutation E = 2. When 4 kittens are born into this house, the risk increases from 2 to 30 . Overcrowding increases the risk of mutation and conversion from FECV to FIPV, which constitutes a major risk factor for the development of feline infectious peritonitis cases. FIP has been shown to develop in cats whose immunity is low such as younger kittens, old cats, immunosuppression due to viralâFIV and/or FeLV and stress, including the stress of separation and adoption.
Infection of by FIPV is responsible for development of a fatal granulomatous , or FIP . Development of FIP depends on two factors: virus mutation and low immunity where virus mutation depends on the rate of mutation of FECV to FIPV and the immune status depends on the age, the genetic pool and the stress level. High immune status will be more effective at slowing down the virus.
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Treatment Prevention And Control
There is no specific treatment for feline infectious peritonitis. Although recovery from signs has been reported, it is uncommon. Up to 95% of cats with feline infectious peritonitis will die from the disease. In one study, half of the affected cats died within 9 days. However, some cats may live for several months.
Treatment with drugs that reduce inflammation and suppress immune reactions, along with supportive care, can make the cat more comfortable. In some cats , treatment may extend survival time by several months. Treatment offers the most hope for cats that are still in good physical condition, still eating, have not yet developed nervous system problems, and that do not have additional disease . If a cat shows no improvement after 3 days of treatment, it is unlikely to improve. If the cat’s quality of life is poor and treatment has not helped, euthanasia is often considered.
When a cat in a household develops feline infectious peritonitis, all in-contact cats will have already been exposed to the same virus. Fortunately, in most cases, in-contact cats will not develop the disease. However, cats with feline infectious peritonitis should not have contact with any new cats, especially kittens, that have not been exposed to the virus. In addition, if your cat died because of the disease, you should wait 2 months before obtaining another cat to be sure that the virus is no longer present in the environment.
Diagnosis Of Fip In Cats
FIP is difficult to diagnose. Many of its symptoms could also be symptoms of other issues, and there is no single blood test available to confirm FIP. Your veterinarian is more likely to assume FIP is present if your cat:
â Has a low number of white blood cells
â Has an unusually high number of white blood cells
â Has elevated concentrations of protein in the blood
â Shows yellowing of the gums or eyes
â Is in a higher risk group
If there is a build-up of fluid in your catâs abdomen or chest, your veterinarian may collect a sample of the fluid for testing. Fluid with a high protein percentage is an indicator of FIP and will frequently be yellow-tinged. If FIP is suspected, your veterinarian may take an X-ray or ultrasound of your cat.
There are a few other tests that may help support a FIP diagnosis. The immunoperoxidase test can detect white blood cells infected with the virus. Polymerase chain reaction technology can be used to test for the virus in the tissue or body fluid. Sometimes, a biopsy of the infected tissue inside the abdominal cavity may be performed.
Although these tests can help support a veterinarianâs diagnosis, none of them is 100% accurate.
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How To Diagnose Fip In Cats
Diagnosing FIP is challenging, given that FIP’s symptoms resemble those of other diseases.
After conducting a thorough physical exam, a veterinarian will perform several diagnostics tests, such as bloodwork to measure white blood cell count and protein levels. Vets can also administer chest and belly X-rays and analyze chest and belly fluid . However, none of these tests alone definitively indicate FIP.
The definitive way to diagnose FIP is to identify the feline coronavirus in a tissue sample taken via biopsy. If a cat is too sick for this surgical procedure, the tissue sample would be taken after the cat dies to make a postmortem diagnosis.
Symptoms Of Effusive Fip
Effusive FIP is characterized by a build up of fluid in the cats abdomen , lungs or heart .
Cats who have ascites will often appear pot-bellied and their belly may feel like a water balloon. If the effusion is in the heart or lungs, the cat may not have any outward changes in appearance. If the fluid build up is severe, breathing may sound congested or be visibly labored.
Other typical symptoms of wet FIP include high fever, inappetence, lethargy, and third eyelid protrusion.
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Are Other Cats In The Household At Risk
If your cat has FIP, other cats in your household may be at a greater risk for becoming infected with feline coronavirus. Fortunately, infection will lead to this fatal disease in a minority of cats. As a precaution, many veterinarians recommend that you wait about a month after an infected cat dies before introducing a new cat into the house, to minimize the chance of exposure to the virus. In a multi-cat household in which an infected cat has died, it is recommended to wait at least three months to see if any other cats develop clinical disease. However, these previously exposed cats could be carriers of the disease and could potentially infect any new cats.
“Infection will lead to this fatal disease in only a few cats.”
Cleaning with dilute bleach is adequate to kill the virus. Keeping adequate numbers of litter boxes can also help minimize exposure to other cats feces.
|Contributors: Tammy Hunter, DVM Ernest Ward, DVM
Feline Coronavirus And Fip
A group of viruses collectively called coronaviruses are responsible for FIP. These little pathogens are actually really common. Many cats carry or have carried them, but most never develop FIP or display any symptoms of sickness at all. Only about 5 to 10 percent of cats with coronavirus develop FIP, according to Cornell University College of Veterinary Medicine. Coronavirus turns into FIP only when it can hijack your kitty’s white blood cells, which tends to occur in kittens and adult cats with a weak immune system.
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What Clinical Signs Does A Cat Infected With Fip Develop
In cats that develop FIP disease, the first signs of illness may be very vague. Listlessness, lethargy, decreased or absent appetite, weight loss, and a fluctuating fever are commonly reported clinical signs. After a period of several days to a few weeks other symptoms typically begin to occur.
At this stage, most cats will develop the ‘wet’ or effusive form of FIP, which refers to the accumulation of fluid in body cavities fluid may accumulate in the abdomen, leading to a swollen abdomen, or in the chest cavity, resulting in difficulty with breathing.
Some cats develop ‘dry’ or non-effusive FIP where little to no fluid accumulates. The dry form often involves severe inflammation in one or more organs including the eyes, brain, liver, intestine, or other organs of the body, leading to a variety of clinical signs. Many cats with non-effusive FIP will have ocular symptoms as their only clinical sign.
Once disease develops, most individuals deteriorate rapidly, although some cats remain normal for several weeks. Unfortunately, the disease will eventually result in death in almost every case.
Most cats exposed to feline coronavirus, even to the potentially FIP-inducing strains, are able to develop an immune response that protects them, therefore only a small proportion of infected cats actually develop clinical disease. However, as stated above, those that do develop the disease almost invariably die.
How Veterinarians Diagnose Fip In Cats
Diagnosis of FIP can be very challenging. The wet form that presents with abdominal swelling is relatively straightforward to diagnose by drawing a sample of fluid from the abdomen for analysis. For other cats, additional testing may be required to piece together the puzzle and suggest FIP.
There is no completely reliable FIP test available to run on living cats. A conclusive diagnosis sometimes comes with a necropsy after the cat passes away. In most cases, many tests need to be run to rule out other diseases, leaving FIP as the most likely possibility.
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Clinical Signs Of Feline Infectious Peritonitis
The symptoms of feline infectious peritonitis depend on the type of immune response. In the wet form, the symptoms depend on where fluid has gathered. In the dry form of FIP, the symptoms are even more varied.
The clinical signs of Feline Infectious Peritonitis are variable, depending on which type of disease is present, and which part of the body is affected.
Typically, infected cats have vague signs at first, such as lethargy, loss of appetite and weight loss. There may be episodes of pyrexia .
In the wet form, the signs depend on where the fluid gathers.
- The abdomen is most commonly affected, resulting in ascites, with the abdomen visibly swollen and full of fluid. Sometimes, hard objects can be felt in the fluid when the abdomen is palpated, representing enlarged lymph nodes or the diseased internal organs such as spleen, liver or kidneys.
- If the fluid gathers in the chest cavity , there is difficulty breathing , caused by the fluid preventing normal expansion and functioning of the lungs.
- If the fluid gathers in the sac surrounding the heart , signs of heart disease may be seen, caused by the inability of the heart to contract normally due to the pressure of the fluid.
Signs And Symptoms Of Feline Infectious Peritonitis
An owner brings a young cat into my clinic. The cats been off her food for a few days, has a dull unkempt coat, and is running a fever. Something clicks and the thought FIP pops into my head. I take a history, hoping for a simple explanation, such as the cat got into a fightbut, no, shes strictly indoors and an only petand the suspicion of FIP ratchets up a notch.
As a vet, feline infectious peritonitis is a condition which leaves me feeling rather helpless because there is no effective treatment But before I get carried away, lets start at the beginning with some facts about FIP.
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How Can Fip Be Diagnosed
Many of the clinical signs of FIP are vague and occur with other diseases found in cats, making FIP particularly difficult to diagnose. There may be abnormalities in a routine blood analysis, but none is specific for FIP. X-rays may be helpful to determine the presence of fluid in the abdomen or chest. If fluid is present, some of it can be removed by tapping the chest or the abdomen. Analysis of this fluid at a veterinary laboratory can be particularly valuable, as few other diseases produce the same type of fluid that FIP creates. Nevertheless, fluid analysis does not always provide a definitive diagnosis of the disease. Sometimes FIP is a diagnosis of exclusion, meaning that a variety of similar conditions have been ruled out. The diagnosis may be further complicated because FIP may exist at the same time as some other conditions such as feline leukemia virus diseases. See the handout Feline Infectious Peritonitis Testing for further information on diagnosing FIP.
“Your veterinarian may advise that a biopsy be taken from your cat, so that FIP can be distinguished from a treatable disease.”
Currently the only way to make a positive diagnosis of FIP is by histological examination of affected tissue by a pathologist at a laboratory. If there is any doubt about the diagnosis, your veterinarian may advise that a biopsy be taken from your cat, so that FIP can be distinguished from a treatable disease.
Fip Causes And Symptoms
FIP is caused by a mutation of the FeCv virus. This genetic change can occur at any time after your cat is exposed to FeCv, even years later. Strains of feline coronaviruses will usually live dormant in your cats stomach, but for reasons that are still not understood, sometimes it will morph into FIP.
If your cat is exposed to FeCv, they might have diarrhea and/or mild respiratory symptoms, but most times your cats immune system will build antibodies that will make it immune against the virus within 7-10 days after exposure. In certain cases, however, your cats immune system wont fight it off correctly and the virus will mutate into FIP at some point in your cats life.
The struggle between the virus strain and your cats immune system is what causes FIP, not the virus itself. If FeCv mutates, youll notice symptoms for either the effusive or non-effusive form. As the disease progresses, your cat may have symptoms of both. Regardless of which form they eventually develop, most cats with FIP share common non-specific symptoms such as fever, weight loss, depression, and loss of appetite.
Effusive specific symptoms
- Inflammation of various parts of the eye
- Neurological symptoms
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What Cats Are Most Often Affected With Fip
Although FIP can occur in cats of any age, it is most often seen in young cats. Around 80% of cases diagnosed are in cats less than 2 years old, and many cases are seen in kittens around 4-12 months old. FIP is also more common in cats kept in groups or colonies as this is an environment where FCoV infections are spread easily. A crowded environment may also contribute to stress, which can be a factor in disease development as it compromises the cats immune response. There is evidence that genetics can also play a role in susceptibility to disease, although this is complex. Many cats that develop FIP are now in single cat homes, despite coming from multi-cat environments.