Difference between revisions of "Feline Infectious Peritonitis"

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Feline Infectious Peritonitis is commonly abbreviated to FIP
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{| cellpadding="10" cellspacing="0" border="1"
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| Also known as:
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| '''FIP'''
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==Description==
 
====Antigenicity====
 
====Antigenicity====
 
*FIP occurs in 5-10% of cats infected with Feline Enteric Coronavirus (FECoV), which is quite common
 
*FIP occurs in 5-10% of cats infected with Feline Enteric Coronavirus (FECoV), which is quite common
 
*It is therefore antigenically indistinguishable from FECoV
 
*It is therefore antigenically indistinguishable from FECoV
  
====Hosts====
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==Signalment==
 
*Domestic and wild cats
 
*Domestic and wild cats
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==Diagnosis==
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*Clinical signs
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**FIP should be suspect in all cases of chronic weight loss  or recurrent fever unresponsive to antibiotics, particularly in multiple cat situations
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*Simple serology is impossible as most cats will have antibody to FECoV
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*However, 4 indicators can be used to cross reference:
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**High FECoV Ab titres
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**Low albumin:globulin ratio in plasma/ascites (globulin levels rise in FIP)
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**High levels of glycoprotein alpha 1-acid glycoprotein (AGP)
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**Low white cell counts
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*FIP antigen detection by '''immunofluorescence''' in macrophages gives a definite positive diagnosis
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*PM: look for characteristic lesions in vascular immune complex disease and lymphoid infiltration
  
====Pathogenesis====
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==Pathogenesis==
 
*FECoV may cause mild respiratory symptoms and diarrhoea but is often asymptomatic
 
*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
 
*Weeks, months or years may intervene between localized primary FECoV infection and FIP development
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*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 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
 
*Cats compromised by '''immunosuppression''' (either iatrogenic or disease-related) are at a greater risk of developing FIP
Clinical signs:
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==History and Clinical signs==
 
*Chronic weight loss
 
*Chronic weight loss
 
*Anorexia
 
*Anorexia
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*FIP arises from a '''mutation of FECoV''' (in 5-10% of chronically infected cats) and not directly from cat to cat  
 
*FIP arises from a '''mutation of FECoV''' (in 5-10% of chronically infected cats) and not directly from cat to cat  
  
====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
 
 
====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
 
  
 
==Granulomatous Enteritis==
 
==Granulomatous Enteritis==
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*causes pyogranulomatous lesions on the surface of many organs including the [[Liver - Anatomy & Physiology|liver]]  
 
*causes pyogranulomatous lesions on the surface of many organs including the [[Liver - Anatomy & Physiology|liver]]  
  
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==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==
  
 
[[Category:Coronaviridae]][[Category:Cat]]
 
[[Category:Coronaviridae]][[Category:Cat]]

Revision as of 23:02, 25 July 2010



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

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.
  • Dry form

Histological

  • Multifocal pyogranulomas on serosa and throughout gut wall.
    • Infiltration by mononuclear cells.
      • Lymphocytes, plasma cells, macrophages.
    • Fewer neutrophils.
  • 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

[[