Revisiting feline infectious peritonitis

imageOn July 18-20th, the annual ASPCA Cornell Maddie’s Shelter Medicine Conference took place in Ithaca, NY. There were many engaging speakers from different aspects of shelter care. One of the speakers was Dr. Elizabeth Berliner, who is the Janet L. Swanson Director of Shelter Medicine at the Maddie’s Shelter Medicine Program at Cornell University. Dr. Berliner gave the last lecture of the conference, and overview and advances in the identification and development of feline infectious peritonitis (FIP).

Corona virus is very common among our small animals. Corona can be transmitted fecal to oral, through the saliva, as well as across the placenta. The virus primarily affects the lining of the GI tract, causing self-limiting diarrhea. However, there is potential for the virus to mutate into a highly pathogenic variant. The mutation allows the virus to enter into macrophages, a type of white blood cell, which will have effects on the host based on the severity of the virus and the host’s immune system. Some cats potentially clear the virus, others experience inflammation of blood vessels which leads to fluid build up in the abdomen or chest.

Clinical signs of FIP can include lethargy, anorexia, icterus/jaundice, and a waxing and waning fever. Abdominal masses may be palpated as a result of granuloma formation. Remember to look at the eyes! Blood in the eyes, color changes, inflammation and retinal changes may be some of the earliest signs observed. Neurologic abnormalities may also be observed, but keep in mind major differentials such as lymphoma, heart failure, liver disease, and bacterial peritonitis/pleuritis.

FIP is a disease of younger cats, generally from 6 months to 2 years. Currently, we believe that there is good evidence that the disease has a genetic component, since multiple kittens from one litter can all develop the disease. The cats with a litter mate that has developed FIP are 2-10 times more likely to develop the disease themselves, likely through a combination of genetics and exposure. Non related kittens have no increased risk of FIP development than any other kitten. Unfortunately there is no treatment or effective vaccine for the disease. Anti-inflammatory suppression of the immune system may serve to make the cat more comfortable, but does not alter the disease progression.

Interestingly enough, ferrets develop a remarkably similar corona virus mutant with many of the same clinical signs and clinical pathology abnormalities observed.

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