Given that obtaining tissue for histopathology may not be possible in a cat suffering FIP, demonstration of FCoV antigen by immunostaining in effusions, CSF, or cytology of aspirates from abnormal organs, in association with typical cytological features of FIP, is very supportive of a diagnosis. The definitive diagnosis is only confirmed with positive immunostaining for coronavirus antigen in macrophages in formalin-fixed tissue samples. FCoV RNA RT-PCR (not specific for FIP associated FCoV) performed in blood (not helpful due to low sensitivity), CSF, aqueous humour, effusions, or cytology of organs (the latter two are particularly helpful if high viral load and cytological features of FIP e.g pyogranulomatous).Also, around 10% of cats with FIP are seronegative. Although FIP cats tend to have higher FCoV antibody titres than non-FIP cats, there is much overlap. FCoV serology: A positive results indicates the exposure to FCoV.CSF may show elevated protein concentration and increased cell counts. It is typically pyogranulomatous (macrophages, non-degenerate neutrophils) with low cell counts of 35 g/L and A:G ratio and AGP like in serum. Analysis of effusions: usually clear, viscous/sticky, straw yellow.MRI changes (e.g obstructive hydrocephalus, meningeal enhancement). Diagnostic imaging: effusion in body cavities, granulomas in organs, large intra-abdominal and mesenteric lymph nodes or thickening of the ileocecocolic region.Acute phase proteins (α-1 acid glycoprotein: AGP): often markedly elevated (>1.5mg/ml).Clinical pathology: lymphopenia (common), neutrophilia with a left shift, mild to moderate non regenerative anaemia, microcytosis (IMHA is uncommon), hyperglobulinaemia (common), with low-normal albumin and a low albumin: globulin (A: G) ratio 0.8 makes FIP unlikely) and hyperbilirubinaemia.How is the diagnosis made?Ī presumptive diagnosis is made by a combination of the clinical suspicion based on the signalment and clinical signs, alongside clinical pathology, imaging, and molecular diagnostic tests. Frequent non-specific clinical signs include lethargy, anorexia, weight loss as well as fluctuating pyrexia and mild jaundice. However, there is overlap between the two forms, with cats that present with the non-effusive disease going on to develop effusions, and vice versa. It is typically associated with neurological and/or ocular signs (e.g uveitis). Wet FIP is present in up to 80% of FIP cases due to a vasculopathy (the effusion can be abdominal, pleural and/or pericardial).ĭry FIP is caused by the presence of granuloma formation. Living in a multi-cat household increases the risk of FCoV seropositivity and pedigrees may be predisposed. Male cats are over-represented, and a recent history of stress may contribute. There is a small subset that present older than 10 years old. What is the signalment and clinical signs?įIP is most common in young cats (particularly those under 2 years). The host immune response and the level of stress/overcrowding are also thought to contribute to the development of FIP. Regarding viral factors, mutations in the Spike protein gene (although these can also be present in non-FIP cats), the tropism of the FCoV for macrophages and its sustained replication in monocytes leading to a disseminated infection, are thought to be correlated with FIP after FCoV infection. The factors that contribute to the development of FIP are viral, host and environmental. In a small percentage of cats (around 10%), FCoV infection results in FIP. FCoV is a large, enveloped RNA virus, which is very common in cats (around 40% of the domestic cat population are seropositive, increasing to 90% in multi-cat households), and generally causes only mild intestinal signs. Feline infectious peritonitis (FIP) is a condition caused by feline coronavirus (FCoV).
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