Feline Infectious Peritonitis (FIP): Understanding a Complex and Deadly Disease in Cats
Feline Infectious Peritonitis (FIP) is a complex and previously fatal viral disease that affects cats, primarily young kittens and immunocompromised adults. FIP is caused by a mutation of the feline coronavirus (FCoV). Being a virus that is a mutation of another, it presents a serious challenge for veterinarians and cat owners alike. Although it was once considered untreatable and 100% fatal, recent advancements in research and medication have brought new hope for affected cats. This page offers information to explore the causes, symptoms, diagnosis, treatment options, and prevention strategies related to FIP.
1. What is Feline Infectious Peritonitis?
FIP is caused by a mutation of the feline coronavirus, a virus commonly found in cats. While most cats infected with FCoV remain asymptomatic or experience mild gastrointestinal symptoms (such as diarrhea), in some cases, the virus mutates and leads to FIP. This mutation causes the virus to invade the cat’s immune system, leading to an inflammatory response that affects various organs, including the liver, kidneys, and central nervous system.
FIP is not directly contagious between cats; however, the underlying coronavirus is spread through feces. More than 80% of cats have been exposed to FCoV but less than 2% of cats will experience the mutation. When the mutation occurs in an individual cat, the disease progresses rapidly and is fatal without treatment.
2. Types of FIP
There are two primary forms of FIP:
1. Effusive (Wet) FIP: This form is characterized by the accumulation of fluid in the abdomen and/or chest. Affected cats may exhibit symptoms such as bloating, difficulty breathing, and weight loss. The fluid buildup occurs due to inflammation of the vessels, which causes them to leak fluid into body cavities.
2. Non-effusive (Dry) FIP: The dry form of FIP is less common but often more insidious. Instead of fluid accumulation, this form leads to the formation of granulomas (small clusters of immune cells) in various organs, such as the eyes, brain, liver, and kidneys. Symptoms can vary greatly, depending on the organs involved, and may include neurological signs, eye problems, and fever.
3. Symptoms of FIP
The symptoms of FIP can vary widely depending on the form of the disease and the organs affected. Some common signs include:
● Fever: Often the first symptom, which does not respond to antibiotics.
● Weight loss: Cats may lose significant weight despite a normal or increased appetite.
● Abdominal or chest fluid accumulation (in wet FIP).
● Difficulty breathing (in wet FIP).
● Jaundice: A yellowing of the skin or eyes.
● Neurological signs: Including seizures, uncoordinated movements, and behavioral changes (more common in dry FIP).
● Eye issues: Inflammation, blindness, or changes in eye appearance (common in dry FIP).
Due to the wide range of symptoms and the similarity of many signs to other conditions, diagnosing FIP can be difficult.
4. diagnosis of fip
Diagnosing FIP is a challenging and often lengthy process, as there is no single test that can definitively confirm the disease. A veterinarian will typically consider several factors, including clinical symptoms, medical history, and laboratory tests. Some common diagnostic methods include:
● Blood tests: Elevated levels of certain proteins, such as globulins, may indicate an immune response associated with FIP. Anemia is also commonly seen in this condition.
● Fluid analysis: In wet FIP, a sample of the fluid accumulated in the abdomen or chest can be analyzed. The fluid typically has a high protein content and few white blood cells, which is indicative of FIP. A PCR can also be performed on the fluid, this is the most reliable test to achieve a diagnosis of FIP.
● Fine needle aspirate and cytology: During an ultrasound, lymph nodes or abdominal organs such as the liver or spleen may be sampled with a fine needle aspirate. These samples are submitted for cytology to ascertain what type of cells are present. There is also special staining that can be performed to determine if the virus is present.
● Biopsy or imaging: In some cases, a biopsy of affected tissue may be necessary to confirm the diagnosis.
Given the complexity of diagnosing FIP, a definitive diagnosis may require multiple tests and clinical evaluation by a veterinary specialist. There are some cases where a definitive diagnosis is not achieved.
5. Treatment Options for FIP
For many years, FIP was considered an untreatable disease with a grave prognosis. However, recent advancements in antiviral therapies have revolutionized the management of FIP. The most promising treatment is the use of antiviral drugs, particularly those targeting the virus itself.
1. GS-441524: This antiviral drug, a close relative of Remdesivir (an antiviral used to treat COVID-19), has shown significant efficacy in treating FIP. Clinical studies have demonstrated that GS-441524 can reduce the viral load and inflammation in affected cats, leading to remission in many cases. Treatment typically requires oral medications for 6-12 weeks, and the drug has proven to be a game-changer in FIP management.
2. Other treatments: In addition to antiviral therapy, supportive care is crucial. This may include fluids, pain management, and nutrition support to help the cat recover from the effects of the disease. Steroids may also be used in some cases to reduce inflammation.
It’s important to note that treatment for FIP can be costly and require long-term commitment from cat owners. However, the prognosis for cats receiving antiviral treatment is much improved compared to previous years, with many cats going into remission and leading healthy lives after therapy.
Dr. Love has helped over 50 cats with FIP achieve remission since 2021.
6. Prevention of FIP
Currently, there is no vaccine that provides 100% protection against FIP. However, preventing the spread of feline coronavirus can help reduce the risk of FIP. Some prevention strategies include:
● Quarantining new cats: Introducing new cats into a household should be done cautiously, especially in multi-cat households where the spread of FCoV is more likely.
● Proper hygiene: Regular cleaning of litter boxes and food dishes can reduce the spread of the virus.
● Stress reduction: Stress can weaken a cat's immune system, so minimizing stress in the home can help maintain a cat’s overall health.
While there is no foolproof method to prevent FIP, reducing the spread of the coronavirus and promoting overall cat health can help lower the likelihood of the disease.
Conclusion
Feline Infectious Peritonitis is a devastating disease that has historically been difficult to diagnose and near impossible to treat. However, recent advancements in antiviral therapies have given cat owners and veterinarians renewed hope in managing this once-fatal condition. Early diagnosis and prompt treatment with antiviral drugs like GS-441524 offer the best chance for affected cats to survive and thrive.
As research into FIP progresses, there is growing optimism that even more effective treatments and preventative strategies will be developed. In the meantime, it is crucial for cat owners to remain vigilant, seeking veterinary attention as soon as symptoms arise and staying updated on the latest advancements in FIP research and treatment. Dr. Love is deeply committed to combating this devastating disease, having personally experienced the heartbreaking reality of euthanizing affected cats during the first 11 years of her career due to a lack of effective treatment options. Now that a viable treatment exists, she is dedicated to helping as many cats as possible who are suffering from this condition.
