Transcript Feline infectious peritonitis - Dr. Brahmbhatt`s Class Handouts

FELINE
INFECTIOUS
PERITONITIS
Navies 2011
Feline Infectious Peritonitis (FIP) is a progressive, almost always fatal, viral
disease of domestic cats. It affects some exotic cats, with the cheetah being
particularly susceptible. It does not affect non-feline species, such as dogs.
Etiology or Cause
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Field strains of feline coronavirus vary in their ability to induce FIP.
Some isolates cause FIP (feline infectious peritonitis virus [FIPV]others
cause more localized GI disease)
Mutations from feline enteric coronavirus to FIPV occur.
FIP is thought to result from a mutation of the virus within the body,
combined with the response of the immune system, leading to
inflammation in various organ systems.
FIPV and canine coronavirus are very closely related antigenically
and may have crossed between hosts.
Feline coronaviruses are fairly stable in the environment and, once
dry, can survive for 4-6 wk. They are enveloped viruses and are
destroyed by most household disinfectants, particularly household
bleach at a 1:32 dilution.
History
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FIP was first described as
early as 1963 and even today
it is not fully understood how
this disease develops and
spreads.
History of disease
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This is the pathogenesis of the Feline Infectious
Peritonitis. The video shows how the infection of
monocytes by the feline Coronavirus leads to the
development of the clinical signs of feline infectious
peritonitis. This is still not well undestood
Because it was derived from the Coronavirus, history
on the disease was vague, as well as any dates on
when FIP originated.
Signalment
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FIP primarily affects cats under 1 years of age
Low prevalence ~ 5-10% of cats
Cats housed in dense populations
Cats under stress
A genetic predisposition may also exist. (Purebred
cats such as Birmans, Abyssinians and Himalayans,
among others, may also be at increased risk. Kittens
with littermates or mothers definitively diagnosed
with FIP are also at higher risk.)
Transmission
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Primarily FECAL –ORAL ROUTE: Ingestion of the virus;
aerosol is also possible.
Close contact with an infected cat or infected saliva or
feces
Because Cats shed viral particles in their feces, sharing
litter boxes and mutual grooming are important sources
of transmission
Cats living in multiple cat households are at greater
risks of contracting feline coronavirus and developing
FIP because of sharing multiple strains of the virus and
stress-associated immunosuppression.
Contaminated food or water dishes, bedding, and
personal clothing may also serve as sources of infection.
Clinical signs
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Wet (more common:
75%) :
Ascites
“Fluid wave”
Pleural
effusion
Anorexia
Depression
Weight loss
dehydration
+/- fever
Dry form
 Fever of unknown origin
 Anorexia
 Depression
 Weight loss
 Ocular lesion
 Neurologic signs
 Enlarged kidneys
(uncommon)
Diagnostic Tests & Expected Results
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There is no simple diagnostic test. The
ELISA, IFA, and virus-neutralization tests
detect the presence of coronavirus
antibodies in a cat, but these tests cannot
differentiate between the various strains of
feline coronavirus.
The only way to definitively diagnose FIP is
by biopsy, or examination of tissues at
autopsy.
Evaluation of the cat's history, presenting
symptoms, examination of fluid if it is
present, and the results of supporting
laboratory tests including a positive
coronavirus antibody titer.
Diagnostic Tests
The fluid has been described as :straw-colored
/ clear – yellow and is usually viscous It usually
has a relatively low cellular content : that is
pyogranulomatous (macrophages and neutrophils;
usually no toxic changes in the latter):
< 20,000 nucleated cells/microliter
 Protein rich > 3.5 microliter
 Albumin: Globulin < 0.81
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Recommended Treatment
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There is no known treatment that can cure FIP once clinical signs arise. Treatment
with anti-inflammatory and immunosuppressive drugs, along with supportive care,
can make the cat more comfortable.
In some cats, therapy may extend survival time by several months. Treatment is best
advised in cats that are in good physical condition, are still eating, have no
neurologic signs, and that do not have concurrent FeLV-induced malignancy or bone
marrow suppression.
Treatment is directed toward controlling the immune-mediated vasculitis and
reducing viral load. The most effective treatments are combinations of prednisolone
and cyclophosphamide. Supportive therapy for FIP is important and includes broadspectrum antibiotics, adequate nutrition and fluid intake, and high doses of ascorbic
acid. The use of low doses of aspirin because they can be useful as an antiinflammatory.
The Rivalta test is used in order to differentiate a transudate from an exudate[1]. A
test tube is filled with distilled water and acetic acid is added. To this mixture one
drop of the effusion to be tested is added. If the drop dissipates, the test is
negative, indicating a transudate. If the drop precipitate, the test is positive,
indicating an exudate
Recommended Treatment
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There is no cure for FIP. As with all
terminal illnesses, the basic course
of action is to provide supportive
care. A combination of
corticosteroids, immunosuppressive
drugs, antibiotics, good dietary
maintenance and proper fluid
intake. It may relieve discomfort.
Prognosis
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The likelihood of survival is very poor for cats who
are clinically diagnosed with FIP (~ 1 – 11/2 year)
With a 95% mortality rate, euthanasia is normally
the most appropriate course of action.
Pathologic Lesions of Disease
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In classic FIP, there is diffuse peritonitis or pleuritis (or
both) characterized grossly by variable amounts of
viscous abdominal or thoracic fluid, deposition of graywhite exudate, and disseminated necrotic plaques on
the visceral and parietal peritoneum or pleura.
Fibrinous adhesions (scar tissue), particularly between
the liver and diaphragm and between loops of bowel,
can develop in protracted cases.
Lesions in the CNS affect the brain and spinal cord and
can cause several types of masses.
Pathological Lesions
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The lesions are primarily
extraserosal.
Characterized by
granulomatous
inflammation in a variety
of organs but principally
affect the kidneys,
visceral lymph nodes,
lungs,liver, eyes, and
leptomeninges.
Prevention & Client Education
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An intranasal MLV vaccine to prevent FIP is
available (but has shown very little effectiveness)
Reducing exposure to the disease such as :
 Disposing
of Feces Properly
 Early Weaning
 Isolation of Cats that Test Positive for Coronavirus
Antibodies
 Isolation and Testing of Cats after Shows
 Proper Sanitation/Cleaning with Disinfectants
 Immunization Against Other Feline Viruses.
Prevention and client education
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Please see text book pg 231
REFERENCES
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"Client Education - Feline Infectious Peritonitis." Sheepshead Bay Veterinary Group. Web. 10 Mar. 2011.
<http://www.sbvet.net/ClientEducation_FIP.html>.
"Feline Infectious Peritonitis (FIP) in Cats & Kittens." Pet Health Care | Dog and Cat Behavior Information by
Veterinarians. Web. 10 Mar. 2011. <http://www.peteducation.com/article.cfm?c=1 2134&aid=212>.
Team, The Petside. "Peritonitis, Infectious (Feline) | Diagnose Dog & Cat Health Problems, Pet Health
Information." Petside.com | Pet Health Information, Dog & Cat Breeds, Pet News. Web. 10 Mar. 2011.
<http://www.petside.com/health/petvet/peritonitis-infectious-feline.php>.
Brown MA, Troyer JL, Pecon-Slattery J, Roelke ME, O'Brien SJ. Genetics and pathogenesis of feline infectious
peritonitis virus. Emerg Infect Dis. 2009 Sep. <http://www.cdc.gov/EID/content/15/9/1445.htm>.
"Genetics and Pathogenesis of Feline Infectious Peritonitis Virus | CDC EID." Centers for Disease Control and
Prevention. Web. 11 Mar. 2011. <http://www.cdc.gov/EID/content/15/9/1445.htm>.
"Merck Veterinary Manual." The Merck Veterinary Manual. Web. 11 Mar. 2011.
<http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/56900.htm&word=FIP>.
"YouTube - Pathogenesis of Feline Infectious Peritonitis (FIP) - the Infection of the Monocyte." YouTube Broadcast Yourself. Web. 11 Mar. 2011. <http://www.youtube.com/watch?v=6RyI2LI9R9Q>.