DRY FIP

(Feline Infectious peritonitis)

 

WHAT IS DRY FIP?

Dry FIP is usually more complicated to diagnose and cats who have this type of FIP tend to go longer with symptoms and a no diagnosis. With dry FIP the standard blood work markers don’t typically appear. (Look at Aggie’s blood work posted in her about section — not a single FIP marker.)

There is a higher chance of neurological symptoms occurring with dry FIP, when brain involvment happens it is important to seek treatment as soon as possible.

DRY TO WET
Sometimes in the beginning of dry FIP some cats experience a brief bout of fluid presenting in the abdomen. Aggie experienced a small amount of fluid around her kidneys which was first mistaken as pyelonephritis.

IMPORTANT NOTE

In the terminal stage of Dry FIP the immune system can completely collasped. This is the stage Aggie was in when she started treatment, while in hospital the ICU the team had to wear isolation gowns in order to interact with her to protect her. This all being said, even with her being in what is considered the “terminal stage”, the treatment saved her life.

SYMPTOMS
(Often cats who have Dry FIP experience multiple of these symptoms at once.)

  • Lack of appetite/not eating resulting in weight loss

  • Jaundice

  • Anemia that is non-regenerative

  • A high coronavirus titer

  • Fever (persists more than 4 days and antibiotics/anti-inflammatory medication is not improving it)

  • Mild ascites sits around the organs in the abdomen

  • Ocular lesions such as uveitis (Aggie experienced this she went completely blind from severe uvetits, but regained her vision from FIP treatment.)

  • Neurological symptoms such as: tremors, back leg weakness (sometimes all limbs are affect), limbs becoming rigid, moving slowly (could also be from vision impairment or neurological), unable to stand, confusion, unable to control bladder or defection.
    More severe neurological symptoms: seizures/convulsions, paralysis in some or all legs, and disorientation.

TESTING TO DISCUSS WITH YOUR VETERINARIAN

  • CBC Blood Panel (most important)

  • Chemistry 17 Blood Panel (most important)

  • X-Rays: Can help rule out if there is any fluid present.

  • Ultrasound: The most ideal to get a full picture of fluid in the abdomen and a more in-depth look at the organs and possible changes due to FIP. Changes for example if a FIP kitty is experiencing liver markers on blood work it would be helpful to take a look at the liver, looking for lymph node changes, masses cause by FIP, changes in the gastrointestinal track to name a few.

  • RTPCR-positive: Completed using abdominal fluid (ascites), chest fluid (pleural effusion), CSF (Cerebrospinal fluid) - this is often to invasive due to the cats stability status, stool, and/or serum/plasma.
    (For more detailed information please visit the veterinarian support section.)

WHAT TO EXPECT ON BLOOD WORK
It is understood that Dry FIP moves differently then Wet FIP on blood work. It is important to take into consider all symptoms the cat is expericing and not just base on blood work if you are not seeing the typical blood work markers. For reference please visit Aggie Story section to review her blood work.

  • Anemia that is non-regenerative

  • Increased absolute neutrophils

  • Decreased absolute lymphocytes

  • High total protein

  • Decreased albumin

  • Increased globulins

  • A/G ratio less than 0.6

  • Increased total bilirubin

STAGES OF WET FIP

EARLY STAGE

Young cats (≤2 years old) with periodic fever, lethargy, loss of appetite, weight loss, stunted growth, dry hair, and ineffective antibiotic treatment, all start to needs the doubts the possibility of FIP.  Clinical symptoms of diarrhea or constipation may also occur in some FIP cases.

FIP usually leads to leukocytosis, increased neutrophils, decreased lymphocytes, elevated serum total protein, hyperglobulinemia and hypoalbuminemia, A: G≤0.6.

Dry FIP usually has a long subclinical period, which can gradually form granuloma in various organs. This may cause not only swelling of liver, kidney and testicles but enlargement of intestinal lymph nodes, and extensive purulent peritonitis. In addition, renal medullary ring signs are also common in dry FIP.

MID STAGE

As the disease progresses, the above symptom will aggravate gradually. Or cause chronic non-regenerative anemia (HCT≤24%), jaundice, urine is golden yellow to dark yellow.

Some dry FIP can cause eye lesions, mainly uveitis (the eyeball becomes cloudy due to the aqueous humor exudation of the fluid fibers and cellular components). Sometime the iris texture is no longer clear.
As the inflammatory process increases in the eyes you can see the following:
- Floating white turbidity can be seen in the vitreous choroid
- Yellow-white granulomatous nodular plaques may appear in the blood vessels

When the virus invades the optic nerve system, it will be more difficulty to treatment, but still possible. Aggie experienced serve uveitis causing her to go blind, but about 4-5 days after starting treatment her vision returned. At her most recent appointment an eye exam was performed and her eyes were completely back to normal.

MID-LATE STAGE

As the virus destroys and impairs the function of immune cells and the virus worsens, you can see the following changes:
- Severe anemia (HCT≤16% ), when HCT≤14%, timely blood transfusion is recommended
- Deteriorate in neurological signs and symptoms such as nystagmus, resting tremor, unable to jump to high places, rear limb weakness, bradykinesia and postural instability.
- FIP can also cause aseptic meningitis or meningitis epidemic when the virus has penetrated the blood-brain barrier into the central nervous system (CNS). The treatment will be much more difficult than expected, but still very possible to be cured.

LATE STAGE

Even FIP cats who are in late stage still have a chance to beat this virus but must move in a timely manner in seeking treatment.

Late stage dry FIP you can see the following symptoms:
- Rigidity in joints
- Confusion
- Urine or fecal incontinence
- Convulsions, seizures
- Tremors
- Paralysis
- Disorientation
- Shock may be seen in the late stages

When these symptoms emerge, cats are often already in an advanced disease stage where the central nervous system is affected and can indicate a poor outcome. Although some cats completely reversed the condition and returned to a healthy life through treatment at this stage, there was also a recurrence rate of about 30% after stopping the drug (also known as a relapse).

I want to say a huge personal thank you and appreciation to Niels C. Pedersen, Diane Addie, Yunjeong Kim, Hui-Wen Chang, Carol Johnson DVM, and Heather Lorimer et al who have spent so much time researching FIP which has given a deeper understanding of this once deadly virus. My own cat would not be here if it wasn’t for your endless dedication to saving FIP cats. Thank you from the bottom of my heart for your long-term research on FIP, which gave us a deeper understanding of this once deadly virus and hope to owners like myself.