A top researcher starts an article with the quote that more cats have been put down due to a positive coronavirus titre than FIP. That’s scary! How many unnecessary deaths does that equate to? When FIP Advisory and Care Group celebrated its third month on facebook a very interesting fact arose from the cases we’d dealt with. Would any of you know what that one thing was? We found that of all the cases posted on our page we had identified 40% that were actually misdiagnoses. This again just highlights what those of us active in FIP advise / research / organisations constantly reiterate. FIP is firstly a rare disease and secondly its symptoms are very similar to the symptoms of so many other diseases. Always look for a vet who is knowledgeable in terms of cats and FIP; or if they are not then a vet who is not against being cross questioned and willing to know more about this disease; or a vet who will leave no stone unturned in confirming or dispelling each option he/ she thinks of
FIP is a disease diagnosed when all other possibilities have been ruled out. It must also follow the criteria of
a) history – breed, age, home environment, exposure to other cats, health
b) clinical assessment – physical check; temperature, anemic, jaundiced, in-house blood evaluation, lymph nodes
c) blood chemistry and complete blood count
d) further, more sensitised testing – FCOV RT-PCR, biopsy with immunohistochemisty, serum protein electrophoresis
FIP has long been the go-to diagnosis when there is an element of doubt as to what is wrong with a cat. And that makes it even more crucial to debunk these unknowns that do exist. Weight loss and lethargy with a temperature does not dry FIP make! Seizures do not dry FIP make. Oh and while we’re at it neither does uveitis. Remember there are so many other diseases that present similar symptoms! So our page has seen a 40% misdiagnosis within 3 months; Dr Diane Addie of catvirus.com estimates that figure can actually rise to 80% for dry FIP! It’s crucial to debunk these misconceptions and push for all other possible options to be considered first
Remember the statement that the word indicative by definition means to be a sign of or pointing towards. FIP, whether wet or dry, is a diagnosis that is difficult to make. A definitive diagnosis of dry FIP can only be made either post mortem through an autopsy OR by biopsy of the affected organ / lymph gland and sending it for immunohistochemistry and cytology. Bloodwork is only indicative. It is not a 100% guarantor of FIP. Some levels will be out but these may be exceeding the norms due to any inflammation or infection, not only FIP. Dry FIP is difficult to diagnose because the symptoms and indications are so similar to a number of other diseases. And this is why FIP should always be a disease diagnosed via the elimination of all other possible differentials.
Rule of thumb when faced with a possible diagnosis of dry FIP is
Step 1 – download and go through Dr Diane Addie ‘s FIP Diagnostic Flowchart. This is the gold standard
Step 2 – evaluate the cat in terms of history and clinical signs
Step 3 – request bloodwork and this means BOTH a Blood Chemistry and Complete Blood Count (CBC)
Step 4 – if A/G ratio is pointing toward FIP then a further test known as a Serum Protein Electrophoresis can be requested
Step 5 – if possible request a FNA (fine needle aspiration) to be done to obtain a tissue sample to be sent for the relevant testing
Cats with dry FIP exhibit symptoms as lethargy, inappetance, poor condition, anemia, jaundice with low-grade fever that do not respond to any medication. Treatments are mostly palliative and meant to make end stage more comfortable. However, some success has been seen with the dry form of the disease using Polyprenyl Immunostimulent or PI / PPI (www.vetimmune.com) and for both forms the use of feline omega interferon or FOI (see www.catvirus.com Time though is not your friend when faced with FIP. Time is always of the essence. Some cats have survived long term with the administering of PI. If you can afford it and it has been identified early then this may be an option.
South Africa has for a long time not had access to either PI or FOI. Through Project Fight FIP and a very proactive vet this changed. Next week’s FIP Awareness will deal with viable treatment options – they do exist!
As an admin and founder of FIP Advisory and Care Group I have singularly been involved with all things FIP for many years. I have come to known the tip of the iceberg that is this disease and what it means when it strikes a family. I have had our own personal experiences – I have lost FIP Angels. I want to bring hope, dispose the myths and bring advice. Remember euthanasia is final. No going back. Always ensure you have eliminated every possible other differential when it comes to a diagnosis. These are your babies, fight for them!
Written by Aurora Lambrecht