Feline Infectious Peritonitis, Slides of Veterinary

Download Feline Infectious Peritonitis and more Slides Veterinary in PDF only on Docsity! FELINE INFECTIOUS PERITONITIS = — Feline Infectious Peritonitis (FIP) History ➢ First discovered in Boston in 1963 as a syndrome in cats characterized as an immune-mediated Vasculitis & Pyogranulomatous inflammatory reactions ** ➢ 1978 a virus identified as etiologic agent ➢ 1979 classified as a Coronavirus labeled as Feline Infectious Peritonitis Virus, Immune mediated disease triggered by infection with Feline Corona Virus (FCoV) Meaning an imbalance response of the immune system; immune system may overreact by attacking the body ex. Autoimmune diseases Feline Infectious Peritonitis (FIP) Geographic Distribution ➢ FCoV and FIP are known worldwide in both domestic & wild populations; Of those infected with FCoV only a few < 5% develop FIP. ➢ Among FCoV strains isolated in the field in the USA and Europe, 70%–95% are serotype I ➢ In Japan serotype II is most prevalent ** ➢ Most cats with FIP are infected with FCoV serotype I. However, both serotypes can cause FIP and both can cause clinically inapparent FCoV infections ➢ FCoV is pathogenic and is susceptible to nondomestic animals as well; In South Africa, a study was done that included wild & captive animals. Cheetahs were more prone to developing FIP due to their lack of genetic diversity along with a deficiency in their cellular immunity which predisposes them to FIP ➢ Similar findings were also noted in USA and Europe for nondomestic cats in captivity ➢ Domestic cats in catteries, multi cat households, and shelters are at higher risk for FIP ➢ FIP is closely tied to genetics and the least understood of all cat diseases ** Feline Infectious Peritonitis (FIP) FCoV Symptoms Usually none but if present, they are the following: ➢ Diarrhea ➢ Vomiting ➢ Stunted Growth ➢ Upper respiratory sign ➢ Weight loss ***This stage may last several days or months if severe FIP **Signs of FIP Vary depending on which organs are involved ➢ Liver, Kidneys, Pancreas, CNS, Eyes, Immune system dependent ➢ Length of time between infection, mutation of the virus & development of signs varies between cats. Some cats eat with a normal or increased appetite; others refuse to eat Symptoms ➢ Progressive distention in the abdomen; ascites ➢ Lung involvement & difficulty breathing ➢ Fever lasting 2-5 Weeks ➢ Loss of appetite ➢ Weight loss, lethargy ➢ Jaundice/ Icterus (later) ➢ depression ➢ Enlarged lymph nodes ➢ Ocular & CNS signs simultaneously or independently ➢ Vague/Similar to many other diseases ** Ascites Anterior Uveitis seen with noneffusive cases Aqueous Flare Fibrin Formation Blood ocular barrier breakdown (mild uveitis) Severe Iritis Chronic Granulomatous disease Uveitis inflammation of the uveal coat of the eye Cat kidneys (A) Multifocal to coalescing granulomatous inflammation (white, rough appearance) following the superficial blood vessels. (B) Cut section also shows the vascular-oriented distribution Spleen with Yellowish- white Raised nodule Jejunum with multiple granuloma serosa Feline Infectious Peritonitis (FIP) Diagnosis ➢ FIP is difficult to diagnose!! FCoV is highly contagious ➢ The viral DNA of feline enteric coronavirus can be detected in feces by RT-PCR ➢ Histopathology exam of affected tissue; Biopsy (Gold Standard) Immunohistochemistry ➢ Blood Chemistry abnormalities can be found in routine blood work but none specific to FIP * ➢ Serum Chemistry: shows increase in total serum protein concentration increase globulins decreased albumin/globulin ratio show <0.8 High chance (92% PPV) of FIP If >0.8 Likely no FIP (61% NPV) * ➢ Effusion Analysis * ➢ Rivalta’s Test PPV86% NPV 97% Analysis of cerebrospinal fluid (a drop of effusion fluid delicately on the surface of distilled water & acetic acid mixed in reagent tube) If the drop disappears or solution remains clear then its neg, if it retains its shape, sinks, or stays attached at the surface it’s positive * ➢ X-rays, ultrasounds (visualize effusion) ➢ PCR Detects a very small amount of the FCoV; downside false +/ false – * ➢ FIP can be a challenge to Diagnose because clinical signs are similar to many diseases. It can be a diagnosis of exclusion ruling out other diseases first. * Feline Infectious Peritonitis (FIP) A)Peritoneal effusion from a cat with classic wet (or effusive) form of FIP. Collected by abdominocentesis. B)Close view of a plastic bag containing 350 ml of abdominal effusion and large clumps of fibrin. Pleural Effusion Peritonitis Pericardial Effusion Feline Feline Infectious Peritonitis (FIP) Transmission Remember FIP is a mutation from FCoV ➢ Fecal Oral (most common) shed in their feces, most for only a few months. In a small percentage some cats will shed FCoV for the remainder of their life * ➢ Can be inhaled (rare) * ➢ The Virus is fragile in normal environments usually lasts 24-36hrs, however litter boxes can be contaminated for up to 7 weeks; Cold temperatures can preserve the virus. ➢ If a cat has FCoV it can mutate early or much later in life lying dormant for years before disease is present * ➢ Infection is generally via the oronasal route. Virus can begin to shed in 1 week ➢ Virus may be found in Saliva, respiratory secretion and urine early on ➢ Majority of cats that become infected will develop antibodies <5% mutate into FIP ➢ Some cats are asymptomatic and shed FCoV which leads to reinfection ➢ Anti body negative cats are unlikely to shed the virus, Antibody positive cats only about 1/3 will shed the virus * ➢ Once FIP has developed the FCoV load decreases in feces. FIP FCoV Feline Infectious Peritonitis (FIP) Risk Factors for developing FIP ➢ Younger cats 3months to 2yrs of age; any can still develop it ➢ Sexually intact males ➢ Cats are at greatest risk of developing FIP in the first 6–18 months after infection with FCoV; the risk decreases to ~4% at 36 months after infection. ➢ Purebreds such as Abyssinian, Bengal, Birman, Himalayan, Ragdoll & Rex are at higher risk due to the genetic background; FIP is a mutation and because there isn't a lot of genetic diversity then there is susceptibility with mutations. Tom cats are also a concern because they’re used over and over ➢ Shelters, Catteries and multi cat homes are at higher risk of infection due to crowed conditions * ➢ Shared and contaminated litter boxes * Feline Infectious Peritonitis (FIP) Treatment ➢ FIP is almost always fatal Euthanasia is the most humane treatment ➢ FCoV while highly contagious * the rate of mutation is <5% * ➢ Many cats are asymptomatic ➢ Most cases do not require therapy FCoV ➢ Supportive care may be needed in both FIP & FCoV fluid therapy, oral electrolyte solutions, antiemetics, nutritional support ➢ Control and prevention of FECV are usually a concern only in breeding catteries and rescue shelters ➢ Supportive treatment for FIP is aimed at suppressing the immune overreaction * *Corticosteroids, Immunosuppressives Prednisolone, cytotoxic drugs cyclophosphamide ➢ Cats with large effusions benefit from removal of the fluid; injection of dexamethasone into the abdominal or thoracic cavity may follow (1 mg/kg/day until no effusion is present) ➢ If a cat has been euthanized or has died due to FIP, the owner should wait 2 months before obtaining another cat. FCoV can remain infectious for at least 7 wks. in the environment, particularly where litter boxes are in use ➢ Housing and husbandry practices that reduce exposure to feces and contaminated environments have a tremendous influence on the number of cats exposed to FCoV **