Difference between revisions of "Feline Infectious Peritonitis"
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− | {{ | + | {{unfinished}} |
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− | == | + | {| cellpadding="10" cellspacing="0" border="1" |
− | + | | Also known as: | |
+ | | '''FIP''' | ||
+ | |- | ||
+ | |} | ||
+ | |||
+ | ==Description== | ||
+ | ====Antigenicity==== | ||
+ | *FIP occurs in 5-10% of cats infected with Feline Enteric Coronavirus (FECoV), which is quite common | ||
+ | *It is therefore antigenically indistinguishable from FECoV | ||
==Signalment== | ==Signalment== | ||
− | Domestic and wild cats | + | *Domestic and wild cats |
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==Diagnosis== | ==Diagnosis== | ||
− | FIP should be | + | *Clinical signs |
− | Simple serology is impossible as most cats will have antibody to FECoV | + | **FIP should be suspect in all cases of chronic weight loss or recurrent fever unresponsive to antibiotics, particularly in multiple cat situations |
− | + | *Simple serology is impossible as most cats will have antibody to FECoV | |
− | + | *However, 4 indicators can be used to cross reference: | |
− | + | **High FECoV Ab titres | |
− | *High FECoV | + | **Low albumin:globulin ratio in plasma/ascites (globulin levels rise in FIP) |
− | *Low albumin:globulin ratio in plasma/ascites (globulin levels rise in FIP) | + | **High levels of glycoprotein alpha 1-acid glycoprotein (AGP) |
− | *High levels of glycoprotein alpha 1-acid glycoprotein (AGP) | + | **Low white cell counts |
− | *Low white cell counts | + | *FIP antigen detection by '''immunofluorescence''' in macrophages gives a definite positive diagnosis |
− | FIP antigen detection by immunofluorescence in macrophages gives a definite positive diagnosis | + | *PM: look for characteristic lesions in vascular immune complex disease and lymphoid infiltration |
==Pathogenesis== | ==Pathogenesis== | ||
− | Weeks, months or years may intervene between localized primary FECoV infection and FIP development | + | *FECoV may cause mild respiratory symptoms and diarrhoea but is often asymptomatic |
+ | *Weeks, months or years may intervene between localized primary FECoV infection and FIP development | ||
+ | *FECoV replicates in the gut, but FIP spreads systemically in the circulation | ||
+ | *FIP gains ability to replicate in [[Monocytes|monocytes]] and macrophages | ||
+ | *Almost invariably '''fatal''' | ||
+ | *Failure of the immune system to clear antibody-antigen complexes leads to '''immune-mediated disease''' | ||
+ | **Deposited complexes cause '''inflammation''' and '''exudation''' | ||
+ | **This leads to characteristic '''oedema''' as fibrin-rich serum escapes to intercellular spaces | ||
+ | ** '''Pyogranulomas''' can develop in major organs as a result of the immune response and the body's failure to clear away excess [[Neutrophils|neutrophils]] | ||
+ | *Cats previously exposed to coronavirus (and therefore with circulating antibody) may be at greater risk as they are more susceptible to taking up virus into mononuclear cells | ||
+ | *Cats making a biased Th-1 response are more likely to evade infection, whereas cats making a balanced response are at moderate risk and cats making a biased Th-2 response are at greater risk, as the virus is best tackled by cell mediation and not antibody | ||
+ | *Cats compromised by '''immunosuppression''' (either iatrogenic or disease-related) are at a greater risk of developing FIP | ||
− | |||
− | + | ==History and Clinical signs== | |
+ | *Chronic weight loss | ||
+ | *Anorexia | ||
+ | *Pyrexia | ||
+ | *Depression | ||
+ | *Fluid in the abdomen, thorax or pericardium symptomatic of '''wet, or exudative FIP''' | ||
+ | *Granulomatous change in the organs symptomatic of '''dry, or nonexudative FIP''' | ||
+ | Can be shown to cause: | ||
+ | *Uveitis | ||
+ | *Hydrocephalus | ||
+ | *Neurological symptoms, such as ataxia or seizures | ||
+ | *Chronic diarrhoea | ||
− | + | ====Epidemiology==== | |
+ | *FECoV is '''endemic worldwide''', with the majority of cats showing a subclinical seroconversion | ||
+ | *'''Orofecal, aerosol, and contact''' transmission | ||
+ | *Particular concern for '''catteries''' and homes with '''multiple cats''' | ||
+ | *FIP arises from a '''mutation of FECoV''' (in 5-10% of chronically infected cats) and not directly from cat to cat | ||
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− | == | + | ==Granulomatous Enteritis== |
− | + | *Caused by feline [[Coronaviridae|coronavirus]] | |
− | |||
− | + | ===Pathology=== | |
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− | + | ====Gross==== | |
− | Larger, grey granulomatous masses | + | * '''Wet form''' |
+ | ** Widespread miliary, white, pinhead granulomas and fibrin deposition. | ||
+ | *** Including the serosa of the intestine. | ||
+ | ** Also high-protein exudates in [[Peritoneal cavity - Anatomy & Physiology|peritoneal cavity]]. | ||
+ | * '''Dry form''' | ||
+ | ** Larger, grey granulomatous masses causing thickening of the wall of [[Small Intestine - Anatomy & Physiology|small]] and [[Large Intestine - Anatomy & Physiology|large intestine]]. | ||
====Histological==== | ====Histological==== | ||
− | |||
− | + | * Multifocal pyogranulomas on serosa and throughout gut wall. | |
− | + | ** Infiltration by mononuclear cells. | |
+ | *** Lymphocytes, plasma cells, macrophages. | ||
+ | ** Fewer [[Neutrophils|neutrophils]]. | ||
+ | * Necrosis. | ||
+ | * Vasculitis. | ||
− | + | ==Hepatitis== | |
− | + | *coronavirus | |
+ | *causes pyogranulomatous lesions on the surface of many organs including the [[Liver - Anatomy & Physiology|liver]] | ||
− | + | ==Treatment== | |
==Control== | ==Control== | ||
− | Conventional | + | *Conventional vaccination is counterproductive as antibody worsens infection |
+ | *A non-systemic vaccine (Primucell) is available outside the UK | ||
+ | **Temperature-sensitive mutant | ||
+ | **Replication confined to nasal mucosa, providing local immunity and cell-mediated immunity | ||
+ | **Cannot protect cats already infected with FECoV | ||
+ | **Kittens must be isolated until old enough to vaccinate at 16 weeks | ||
+ | *Antibody tests are available to certify "FECoV-free" cat houses | ||
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==Prognosis== | ==Prognosis== | ||
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==References== | ==References== | ||
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− | [[Category:Coronaviridae]][[Category:Cat | + | [[Category:Coronaviridae]][[Category:Cat]] |
[[Category:Enteritis, Granulomatous]] | [[Category:Enteritis, Granulomatous]] | ||
[[Category:Enteritis,_Viral]] | [[Category:Enteritis,_Viral]] | ||
[[Category:Hepatitis,_Viral]] | [[Category:Hepatitis,_Viral]] | ||
− | [[Category: | + | [[Category:To_Do_-_Viruses]][[ |
− | [[ | + | [[Category:To_Do_-_Caz]] |
− | [[Category: |
Revision as of 23:02, 25 July 2010
This article is still under construction. |
Also known as: | FIP |
Description
Antigenicity
- FIP occurs in 5-10% of cats infected with Feline Enteric Coronavirus (FECoV), which is quite common
- It is therefore antigenically indistinguishable from FECoV
Signalment
- Domestic and wild cats
Diagnosis
- Clinical signs
- FIP should be suspect in all cases of chronic weight loss or recurrent fever unresponsive to antibiotics, particularly in multiple cat situations
- Simple serology is impossible as most cats will have antibody to FECoV
- However, 4 indicators can be used to cross reference:
- High FECoV Ab titres
- Low albumin:globulin ratio in plasma/ascites (globulin levels rise in FIP)
- High levels of glycoprotein alpha 1-acid glycoprotein (AGP)
- Low white cell counts
- FIP antigen detection by immunofluorescence in macrophages gives a definite positive diagnosis
- PM: look for characteristic lesions in vascular immune complex disease and lymphoid infiltration
Pathogenesis
- FECoV may cause mild respiratory symptoms and diarrhoea but is often asymptomatic
- Weeks, months or years may intervene between localized primary FECoV infection and FIP development
- FECoV replicates in the gut, but FIP spreads systemically in the circulation
- FIP gains ability to replicate in monocytes and macrophages
- Almost invariably fatal
- Failure of the immune system to clear antibody-antigen complexes leads to immune-mediated disease
- Deposited complexes cause inflammation and exudation
- This leads to characteristic oedema as fibrin-rich serum escapes to intercellular spaces
- Pyogranulomas can develop in major organs as a result of the immune response and the body's failure to clear away excess neutrophils
- Cats previously exposed to coronavirus (and therefore with circulating antibody) may be at greater risk as they are more susceptible to taking up virus into mononuclear cells
- Cats making a biased Th-1 response are more likely to evade infection, whereas cats making a balanced response are at moderate risk and cats making a biased Th-2 response are at greater risk, as the virus is best tackled by cell mediation and not antibody
- Cats compromised by immunosuppression (either iatrogenic or disease-related) are at a greater risk of developing FIP
History and Clinical signs
- Chronic weight loss
- Anorexia
- Pyrexia
- Depression
- Fluid in the abdomen, thorax or pericardium symptomatic of wet, or exudative FIP
- Granulomatous change in the organs symptomatic of dry, or nonexudative FIP
Can be shown to cause:
- Uveitis
- Hydrocephalus
- Neurological symptoms, such as ataxia or seizures
- Chronic diarrhoea
Epidemiology
- FECoV is endemic worldwide, with the majority of cats showing a subclinical seroconversion
- Orofecal, aerosol, and contact transmission
- Particular concern for catteries and homes with multiple cats
- FIP arises from a mutation of FECoV (in 5-10% of chronically infected cats) and not directly from cat to cat
Granulomatous Enteritis
- Caused by feline coronavirus
Pathology
Gross
- Wet form
- Widespread miliary, white, pinhead granulomas and fibrin deposition.
- Including the serosa of the intestine.
- Also high-protein exudates in peritoneal cavity.
- Widespread miliary, white, pinhead granulomas and fibrin deposition.
- Dry form
- Larger, grey granulomatous masses causing thickening of the wall of small and large intestine.
Histological
- Multifocal pyogranulomas on serosa and throughout gut wall.
- Infiltration by mononuclear cells.
- Lymphocytes, plasma cells, macrophages.
- Fewer neutrophils.
- Infiltration by mononuclear cells.
- Necrosis.
- Vasculitis.
Hepatitis
- coronavirus
- causes pyogranulomatous lesions on the surface of many organs including the liver
Treatment
Control
- Conventional vaccination is counterproductive as antibody worsens infection
- A non-systemic vaccine (Primucell) is available outside the UK
- Temperature-sensitive mutant
- Replication confined to nasal mucosa, providing local immunity and cell-mediated immunity
- Cannot protect cats already infected with FECoV
- Kittens must be isolated until old enough to vaccinate at 16 weeks
- Antibody tests are available to certify "FECoV-free" cat houses
Prognosis
References
[[