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Feline Infectious Peritonitis
By Chick Newman, Ph.D, DVM

1.1.1

I. Causes

Feline Infectious Peritonitis (FIP) is caused by a coronavirus that can

infect any cat, though young cats and very old cats (14yr and up) appear most susceptible. The FIP virus (FIPV) is very similar to the coronavirus that causes a transient, usually mild, self-limiting diarrhea (Feline Enteric Corona Virus, FECV). In fact, there is some evidence that FECV can mutate to FIPV in some individuals. This means that even an indoor-only cat in a single-cat household may, in theory, develop this disease. Indeed, there is now
belief that mutation from FECV to FIP is the most probable means of acquiring FIP! There is some research information concerning the topic of

transmission, (as well as diagnosis, vaccination, etc.) presented at a

relatively recent conference . Though still debatable, it appears unlikely that the virus can be passed to unborn kittens or via the milk to newborns. Some apparently healthy cats may carry the virus which can be shed intermittently in bodily fluids or feces, with feces being the most common source of oral infection (which is considered an uncommon means of infection). Interestingly, and most likely due to the primarily mutational mechanism of acquired FIP actual mortality from environmental exposure to the virus (i.e from animals shedding virus) is sporadic, even in a population of cats where FIPVcarriers are known to be present.
II. Clinical Disease

The type and development of disease is quite complex and, in large part, dependent on the status of the animals immune system. In some instances, the immune systems response to infection may actually worsen the clinical signs. In the Effusive Form of the disease there is accumulation of substantial quantities of fluid in body cavities (abdomen and chest). Some of these animals appear profoundly "pot-bellied", while the Dry Form of the disease does not present this way. In both forms, clinical signs can be quite variable; virtually any organ or soft tissue system can become affected, thus mimicking many diseases. The most common clinical signs are non-specific and include fluctuating fever, inappetance, lethargy and weight loss. Sometimes, if the central nervous system is affected, neurological abnormalities are apparent.

III Diagnosis Routine Labwork:

May show a profile consistent with (but not specific for) FIP. The presence of a "typical" FIP profile coupled with "typical" clinical signs provides a strong index of suspicion for the presence of the disease.
Fluid Cytology:

In the Effusive Form of the disease, body cavity fluid analysis can provide useful information with high predictive value for the presumptive diagnosis of FIP infection. Similarly, when neurological abnormalities are present, analysis of cerebral spinal fluid can produce findings strongly supporting the presence of this disease.
Histopathological Examination:

Histological examination (microscopic evaluation of tissue samples) of affected organs is the most specific of all the available tests for the definitive diagnosis of FIP.
Serum Antibody Tests

(Elisa, IFA, AGI, PH):

This is an area of considerable controversy among veterinarians. In the past it was assumed that a high level of antibody to the FIPV along with signs of the disease (which may or may not be specific) was diagnostic for active FIPV infection. We now know that is NOT true: The antibody tests for FIPV also test for antibodies to FECV, i.e. any a) cat exposed to any feline corona virus may test "positive" or even "strongly positive". b) cats given FIPV vaccine may also test positive. The antibody tests for FIPV may be negative in FIP-positive cats, because a) The immune system components may actually be involved in the progression of the disease and be "consumed" in the disease process. b) Early in diseasethere is not enough time to develop antibodies. Some animals are immune-suppressed from concurrent diseases (e.g. feline AIDS). c) Antibody levels fluctuate up and down, seemingly in random fashion, in either FIPV or FECV infected cats. There is NO SPECIFIC PATTERN! d) More recent research concerning the disease, including the use/misuse of serum serology to diagnose FIP is presented here.
PCR Test ("Polymerase-Chain Reaction")

This tests for the presence of virusnot antibody. Suffice it to say that at the time of this publication, this test also does not distinguish FECV from FIPV.
IV. Treatment

At present, there is no specific treatment for FIP! As there appears to be an immune-mediated component to the progression and severity of the disease, some have tried immune-suppressive and/or immune-modulating drugs. Some antiviral drugs alone or in combination with immune modulators are being investigated. Promising results for remission in noneffusive FIP utilizing immunosuppresive drugs and human recombinant

interferon have been reported in the October issue of Compendium on Continuing Education 19: 1111, 1997. Massive doses of interferon may help some severely debilitated cats...though effusive FIP has been much more difficult to treat.
V. Control

A recent discussion of husbandry practices in multicat households and catteries to limit exposure and disease from feline corona viruses appears in the Compendium of Continuing Education: 19: 1111, 1997. A photocopy of the recommendations in the journal can be viewed now if you have an Adobe Acrobat Reader integrated with your browser. To see the image, click here! However, keep in mind...as environmental exposure to FIP from shedding animals appears to represent a minor or inconsequential source of acquired FIP, the measures outlined by that publication to eradicate or to minimize prevalence of the virus and FIP infection within the population may need to be revised.
Vaccine:

There is an FDA approved intranasal (drops) vaccine available for cats who are at least 16 weeks old. Initially, two doses are given separated by three weeks; thereafter an annual booster is required. The extent of protection provided by the vaccine, according to the manufacturer, is claimed to be 50% to 70%, but there are independent studies which question whether the vaccine is beneficial. One older (1992) study, from Cornell University, showed that vaccineinduced antibody resulted in enhancement of the the disease! Several anecdotal reports of cats dieing from FIP within weeks of vaccination are published (albeit not considered scientific proof of cause & effect). The vaccine will not help a cat that is currently infected or recently exposed to FIPV (or FECV). Therefore, there is NO POINT in vaccinating a cat that already has a corona virus antibody titer or has been exposed to other infected cats.
Risk:

The risk of acquired FIP is small even in cat populations with proven FIP infection. Risk of exposure is, nevertheless, greatest in enclosed multicat facilities and much less via casual contact with neighboring cats. The least risk is in the single, indoor-only cat.
Premises:

The virus may persist in the environment for several weeks, but is easily killed with common household disinfectants. However, consider that cats with clear symptoms of FIP infection are rarely shedding virus.

http://www.newmanveterinary.com/FIP-Unravelling%20the%20Secrets %20of%20Feline%20Infectious%20Peritonitis.pdf
Unravelling the Secrets of Feline Infectious PeritonitisSOTAL
WORLD SMALL ANIMAL VETERINARY ASSOCIATION WORLD CONGRESS PROCEEDINGS, 2001

Marian Horzinek
The Netherlands

Feline coronaviral polyserositis, as it should be properly termed, is the fatal tip of the iceberg of a common infection of cats with a group of ubiquitous viruses. Coronaviruses are common pathogens found in mammals and birds, notorious for containing the largest of all RNA genomes. One out of 10,000 nucleotides is changed in any round of RNA genome replication; since the coronaviral genome holds about 30,000 nucleotides, one would differ from the next at least at one site. Thus no two coronavirus particles are genomically identicala notion that has led to the so-called quasispecies concept. Although generally associated with acute, self-limiting enteric and respiratory infections, coronaviruses can persist in infected animals. We have shown this to be true for feline coronavirus (FcoVs), which normally cause only mild enteric infections, and which occur in almost any cattery in Western Europe and America. The low-virulence enteric FCoVs and the disease-causing FIPVs are closely related genetically; we think that the latter are virulent variants of the former, which arise in individual FCoV-infected hosts. This means that no

two cases of FIP are caused by the same virus, and that horizontal transmission, i.e., cat-to-cat transfer is rather the exception than the rule.
On the basis of in vitro neutralization tests FCoVs can be allocated to serotypes: type I is prevalent in Europe and found in most fatal cases of FIP, type II may be more common in other parts of the world (e.g., Japan). The latter viruses are a showcase of viral evolutionthey arise de novo through RNA recombination, during which genetic information from the canine coronavirus is incorporated into FcoV type I genomes. To study viral evolution during chronic infection, the FCoVs sampled from individual cats were characterized. Phylogenetic comparisons indicated that they form clades (closely related clusters) and are likely to have originated from single founder infections. Each cat harbours a distinct FCoV quasispecies with immune selection (antigenic drift) occurring during chronic infection. Blood samples from healthy cats of different breeds from different catteriessome of which were FCoV antibody-negativewere shown to contain FCoV, as demonstrated by PCR. The important finding of this biologically meaningful analysis was that the isolated viruses were of the non-cultivable subtype I. All available data support a model in which chronic carriers maintain endemic infections in cat societies. Virtually every kitten born in a breeding facility becomes infected, probably from its queen, as soon as its maternal protection wanes. Once infected, the cats appear to resist superinfection by closely related FCoVs, every cat carrying its private, harmless clan of variants. The key pathogenic event in FIP pathogenesis is the infection of monocytes and macrophages. The difference between avirulent and virulent FCoVs is probably a quantitative one. In vitro, the virulence of FCoV strains was indeed correlated with their ability to infect cultured peritoneal macrophages. When strains were compared, however, the avirulent ones infected fewer macrophages and produced lower virus titres than virulent strains. Moreover, the avirulent strains were less able to sustain viral replication and to spread to other macrophages. This is no black-and-white phenomenon, rather a gradual transition, as the course of FIP is not uniform. There is ample evidence for an involvement of the immune system in the pathogenesis of FIP. Humoral immunity is obviously not protective. FCoVseropositive cats that are experimentally infected with FIPV often develop an accelerated, fulminating course of the disease, leading to the early death phenomenon mentioned above. Clinical signs and lesions develop earlier, and the

mean survival time is dramatically reduced as compared to seronegative cats. Direct evidence for the involvement of antibodies was obtained by transfusion of purified IgG from cat FCoV-antisera into cats, which indeed developed accelerated FIP upon experimental challenge. We also know, which antibodies are the killers: when vaccinia virus recombinants expressing singe gene products were used to immunize cats, early death occurred only in the group that had seen the spike (S) protein before. Most authors consider the vascular and perivascular lesions in FIP to be immunemediated, but there is uncertainty about the actual pathogenetic mechanism. At least some vascular injury may be attributed to immune-mediated lysis of infected cells: FIPVinfected white blood cells were detected in the lumen, intima and wall of veins and in perivascular locations. Furthermore, cytokines, leukotrienes and prostaglandins could play a role in the development of the perivascular pyogranulomas. These products could induce vascular permeability and provide chemotactic stimuli for neutrophils and monocytes. In response to the inflammation, the attracted cells may release additional mediators and cytotoxic substances; the monocytes would also serve as new targets for FIPV. The end result would be enhanced local virus production and increased tissue damage. Other observations point towards an immune complex (ICX) pathogenesis. Deposition of ICX and subsequent complement activation is thought to cause an intense inflammatory response that may extend across blood vessel walls. The resulting vascular damage would permit leakage of fluid into the intercellular space and eventually lead to the accumulation of thoracic and abdominal exudate. The morphologic features of the vascular lesions (necrosis, polymorphonuclear cell infiltration associated with small veins and venules) strongly indicate an Arthus type reaction. The lesions contain focal deposits of virus, IgG and C3. Although FIP viruses do not infect T-cells, depletion and programmed cell death (apoptosis) was observed in lymphoid organs of infected cats. Apoptosis was mediated by the ICX present in the serum and ascitic fluid of diseased cats and affected only activated T-cells, including lymph node cells, but not unstimulated T-cells. This hitherto unrecognised mechanism of T-cell suppression may operate not only in FIPV infection but also in other ICX diseases. The fatal scenario thus may be as follows: a kitten is born, suckled by its seropositive queen and protected by colostral antibody from infection during the first few weeks. As the maternal antibodies wane, mucosal protection ebbs away, and during an episode of maternal FCoV shedding, the kitten is infected. A bout of diarrhoea and occasional sneezing may be the only signs this has happened. It now develops an active immunity, but not a sterilizing one in most cases: virus and antibodies continue to co-exist in the kitten's organism and an efficient cell-mediated immunity keeps infected macrophages and monocytes in check. In a small, socially stable cat community, this animal can live happily ever after. Problems emerge when the kitten is under stress, to be equated with immune suppression. Infection with the feline leukaemia or immunodeficiency viruses would be the most unmistakable immunosuppressive event, but population density (numbers of cats per surface unit), geographic change (displacement into a new environment), and other territorial factors (e.g., change in group hierarchy, dominance) are becoming more and more important in view of the declining prevalence of retrovirus infections. The failing immune surveillance allows the coronaviral quasispecies cloud of mutants to expand, and more macrophage-tropic mutants would emerge in this stochastic process. Amongst them are some that reach high titres and outcrowd the moderate ones. This is the point when immune pathogenesis starts. In the absence of clinical signs, serology is of no use for the prognosis in individual cats. A statistical correlation exists between antibody titres and post-mortem confirmation of FIP three months after testing. However, about 40% of the animals with titres of < 300 do develop FIP, and of those with titres exceeding 1000 only about one half succumb; in other words, about half of the tested

animals that remained healthy showed the same high titer values as the cats at risk. Tossing a coin would have given a similar result. On the other hand, about 12% of the cats with titres <100 still developed FIP in the observation period. Based on these data, one in eight owners would have been sent home with the erroneous information that nothing will happen to his/her cat. Serology simply cannot distinguish between harmless and FIP-inducing FCoV mutants, it only shows pastand in many cases still ongoinginfection. Any seropositive cat may succumb to FIP, irrespective of the titer. Expansion of the coronavirus quasispecies cloud obviously not only provides much genomic material with the increased probability for FIP-inducing mutants to occur, it also provides the large antigenic mass to induce high levels of antibody. However, FIP-inducing mutants can always occur, also at low replication levels (with low antibody production), though with a lesser likelihood. On the other hand, an uninfected catwhich is not synonymous with a seronegative cat will not develop into a case of FIP. This may sound as a truism, but in one cattery study, 86% of infected animals were detected using PCR, while serology gave only 71% positive results. However, not a single seropositive animal tested PCR-negative. The question must be asked whether there is a place for diagnostic and prognostic laboratory testing for FIP at all. There are presently no diagnostic assays availableneither tests in use nor assays performed in the research laboratorythat would distinguish between virulent and avirulent FCoV variants. In addition, the novel PCR formats touted by some firms do not keep this promise, irrespective of the claims. There are reasons to believe that discriminatory assays based on the molecular properties of the variants will not be feasible, perhaps not even possible. However, there is a future for tests based on evidencing immunologic changes in an animal developing FIP. Both serology and PCR are able to detect infected cats (with different sensitivity) and are invaluable for the management of catteries. They can be used for monitoring the success of the quarantine and early weaning programs and the coronavirus-free status of catteries. Especially, PCR could be useful for monitoring individual animals to be introduced into FCoV-free catteries. A control approach based on isolation of litters after early weaning has been studied, but its effects could not be verified by other workers. Another possibility is the removal of strong shedders from a multi-cat society. These can now be recognized by using a real-time PCR (the TaqMan technique); for a reliable characterization of the shedding pattern, it is sufficient to test four feces samples taken at weekly intervals (Hans Lutz, Zrich, personal communication). Strong shedders can be identified under field conditions and separated from the group, thereby decreasing infection pressure for the remaining cats. It remains to be shown whether this approach will work. However, common sense suggests that in conjunction with other measures (keeping cats in small groups, without contact between groups, frequent cleaning of litter boxes, introduction of new cats only after quarantine and PCR testing etc.) the elimination of strong shedders might be useful. The seronegative catteries established through any control programme must of course be protected against re-introduction, and the live temperature-sensitive vaccine could prove useful for this purposeif it indeed did not induce antibodies, thereby compromising a serology-based test-and-isolation programme. Also, persistence and recrudescence of the vaccine virus might then be studied. Still much must be learned about this most enigmatic infectious condition in veterinary medicine, feline infectious peritonitis.

http://www.dr-addie.com/
Feline Infectious Peritonitis (FIP) is an unusual, but often fatal, consequence of Feline Coronavirus (FCoV) infection of the cat.

My name is Diane Addie, Im a senior lecturer in Veterinary Virology at the University of Glasgow, Scotland, U.K. and I have spent the last 18 years researching feline infectious peritonitis (FIP) and feline coronavirus infection (FCoV). My dream is to eradicate FIP, at least from pedigree/purebred cats, within the next 10 years.

What is FIP?

Feline infectious peritonitis (FIP) is the leading infectious cause of cat death. FIP occurs when the cat reacts inappropriately to feline coronavirus (FCoV) infection. Most cats simply become infected, shed FCoV for a month or two, mount an immune response, eliminate the virus and live happily ever after (see How to eliminate FCoV infection from a cattery or household of cats). However, for reasons that we don't yet fully understand, instead of clearing FCoV infection, an unfortunate few cats develop FIP. The name FIP is slightly misleading: FIP isn't inflammation of the peritoneum (the lining of the abdomen) it is a vasculitis (inflammation of the blood vessels). The clinical signs which the cat develops depend on which blood vessels are damaged, and on which organ(s) the damaged blood vessels supplied.

Wet or effusive FIP

This is the acute form of the disease, where many blood vessels are damaged severely and fluid leaks out of them into the abdomen or the thoracic (chest) cavity. When the blood vessels in the abdomen are affected, the cat's tummy swells up with fluid called ascites. When the blood vessels in the thorax are damaged fluid leaks into the chest, impairing the ability of the lungs to expand and the cat shows difficulty breathing.

Dry or non-effusive FIP

Dry FIP is the more chronic form of the disease. In dry FIP, the cat often has vague clinical signs, such as going off his or her food, losing weight, the coat looking dull. Many cats with dry FIP become jaundiced (icteric), when you look inside the eyelid, it looks yellow. If the cat has a pale nose, you may notice that that looks yellow. Many cats with dry FIP get signs in their eyes: usually the iris (the coloured part of the eye around the pupil) changes colour, parts of it may appear brown (see photos).

(Many thanks to Mrs M. for this photograph.) The cat may bleed into the eye, or white precipitates appear on the cornea (the clear membrane on the front of the eye).

For vets: check the eyes using an ophthalmoscope for vitreous flare and retinal vessel cuffing (see photo below).

(Many thanks to John Mould for this photograph.) Around 12% of cats with non-effusive FIP develop neurological signs: often they become ataxic (wobbly and falling over when walking), they may have head tremors, fits, their eyes may dart from side to side instead of being focussed. However, all of these clinical signs can be caused by other, sometimes treatable, conditions, which is why accurate diagnosis is essential.

Diagnosis

of FIP this section is intended for veterinary surgeons FIP is a notoriously difficult condition to diagnose, many other conditions present with very similar clinical signs. Definitive diagnosis is only possible at post mortem, or occasionally by biopsy (though for accurate biopsy results one has to actually biopsy a visible pyogranulomatous lesion, which may necessitate laparotomy). Only 18% of samples sent to our laboratory for FIP diagnosis turn out to be FIP. Since cats with FIP are usually euthanased, it is absolutely vital that FIP is accurately differentiated from other, treatable, conditions.
In our laboratory at the University of Glasgow, we offer an FIP profile which confirms or rules out a diagnosis of FIP in over 90% of cases. The FIP profile consists of four parts: a feline coronavirus (FCoV) antibody titre, albumin:globulin (A:G) ratio on the effusion or plasma, alpha 1-acid glycoprotein (AGP) level and cytology or haematology.

Effusive (wet) FIP profile Non-effusive (dry) FIP profile To submit a sample to the University of Glasgow for a FIP profile Feline coronavirus antibody tests Virus detection by RT-PCR

Effusive (wet) FIP profile

FCoV antibody titre The presence of antibodies indicates that the cat has been infected with FCoV, the cause of FIP. Any FCoV antibody titre can occur in cases of wet or effusive FIP, but most cats with FIP have extremely high antibody titres (1280 or greater). Antibody titres of 0 are unusual in FIP cases and are usually considered as indicating that the cat does not have FIP. (However, if other parameters suggest a diagnosis of FIP, despite having an antibody titre of 0, then this is the one situation where FCoV RNA detection (RT-PCR), performed on a sample of the effusion, is diagnostic of FIP. In these cats there is so much virus in the effusion that all the antibody is bound to it, and none is available to bind to virus in the test.)

Note: many healthy cats and cats with diseases other than FIP have FCoV antibodies. The presence of FCoV antibodies alone is NOT diagnostic of FIP, if the other parameters of the profile do not indicate a diagnosis of FIP. Total protein in the effusion and albumin:globulin ratio (A:G) The total protein concentration in the effusion of a cat with FIP is usually greater than 35 g/l and this usually consists of more globulin than albumin, pushing down the A:G ratio. An A:G of < 0.4 indicates FIP is quite likely; an A:G of >0.8 rules out FIP; A:G of between 0.4-0.8 - consider other parameters. The A:G of an effusion is one of the most useful tests to perform in practice for a quick indicator of whether or not a cat may have FIP and can be performed on a VetTest machine (divide the albumin by the globulin values). AGP level Alpha one acid glycoprotein (AGP) is an acute phase protein which has been shown to be very useful in distinguishing FIP from other clinically similar conditions. In FIP, AGP levels are usually greater than 1500 mg/ml. In normal cats, its up to 500 mg/ml. In cats with bacterial peritonitis or pleurisy the AGP is also raised, which is why cytology is also necessary to differentiate these conditions. In cardiomyopathy, non-infectious liver disease and tumours, which are the most common conditions mistaken for FIP, the AGP is normal. In the USA, AGP testing kits can be obtained from Cardiotech Services. Enquiries to Jeff Sarno or call (502)473-7066. Cytology In effusive FIP, there are generally less than 3 x 10 9 nucleated cells per litre in the effusion and the cells are predominantly neutrophils and macrophages. In bacterial peritonitis and pleurisy, the white blood cell count in the effusion is much higher and the cytologist will usually see bacteria (if they are intracellular, this indicates that they were not simply contamination of the sample). Cytology of pleural effusions is useful for differentiation of thymic lymphosarcomas, since the predominant cell is the lymphocyte and they often appear malignant. Summary Thus, a cat with wet FIP should be FCoV seropositive, the total protein of the effusion must be over 35g/l and the albumin:globulin less than 0.4 (or at least less than 0.8), the AGP should be high (over 1500 micrograms/ml) and the cytology should reveal few nucleated cells which are mainly neutrophils and macrophages.

Non-effusive (dry) FIP profile

FCoV antibody titre FCoV antibody titres in dry FIP are usually equal to or greater than 1280. An antibody titre of zero rules out non-effusive FIP. Note: many healthy cats and cats with diseases other than FIP have FCoV antibodies. The presence of FCoV antibodies alone is NOT diagnostic of FIP, if the other parameters of the profile do not indicate a diagnosis of FIP. A healthy cat with a high FCoV antibody titre is NOT a cat with dry FIP. Albumin:Globulin ratio (A:G) In FIP the globulin concentration in serum or plasma is raised to over 40g/l. Consequently the A:G is usually lowered. An A:G of < 0.4 indicates FIP is quite likely, provided that globulins are raised, remember than a low albumin (e.g. in liver disease) can also artificially lower the A:G. An A:G of >0.8 rules out FIP; A:G of between 0.4-0.8 consider other parameters.

AGP level AGP is an acute phase protein which is useful in distinguishing FIP from other clinically similar conditions. In FIP, AGP levels are usually greater than 1500 ug/ml. In normal cats, its up to 500 ug/ml. Bear in mind, however, that AGP is not specific, and will also be raised if there is viral (non-FIP), bacterial (e.g. ascending cholangiohepatitis or pyelonephritis) or fungal infections or recent trauma. AGP measurement is useful in distinguishing FIP from neoplasia or non-infectious liver disease, when AGP levels will be normal. In the USA, AGP testing kits can be obtained from Cardiotech Services. Enquiries to Jeff Sarno Onras43@aol.com or call (502)473-7066. Haematology In non-effusive FIP there is lymphopenia, a non-regenerative anaemia with a haematocrit of 30% or less and often a neutrophilia with a shift to the left. Bear in mind that cats with other chronic infections can have similar haematological changes. Haematology is useful in differentiating FIP from Haemobartonella felis infection where the anaemia is regenerative and there may be organisms visible on the erythrocytes. Summary A cat with dry FIP should have a high FCoV antibody titre, be hyperglobulinaemic and have a reduced albumin:globulin ratio. He or she should have a high AGP, lymphopenia, a haematocrit of less than 30% which is non-regenerative and possibly a neutrophilia. Clinically, the cat should have lost weight and will usually have ocular signs such as iritis, retinal vessel cuffing, keratic precipitates, aqueous or vitreous flare. Remember: a healthy cat with a FCoV antibody titre is NOT a cat with dry FIP.

To submit a sample to the University of Glasgow for a FIP profile

Note that the FIP profile is NOT for use in healthy cats. To screen a healthy cat for exposure to FCoV, simply send a heparin blood sample for a FCoV antibody titre. Effusive or wet FIP: send 1ml heparin blood and 1-2ml effusion in plain and EDTA tubes. (Note: sending the effusion will greatly increase the chances of an accurate diagnosis.) Non-effusive or dry FIP: send 2 x 1ml heparin blood and 1 ml EDTA blood and two airdried blood smears. Send samples with a test request form (can be downloaded from Companion Animal Diagnostics or obtained by calling UK 0141 330 5777) or with a note of your address to: Companion Animal Diagnostics University of Glasgow Veterinary School Bearsden Glasgow G61 1QH UK

Feline coronavirus antibody tests

Use a reliable FCoV antibody test Use of FCoV antibody tests It is essential that your veterinary surgeon use a RELIABLE FCoVantibody test such as the immunofluorescent antibody test we use at the University of Glasgow. Not all tests are comparable with ours. In our laboratory, we found that the FCoV Immunocomb, by Biogal Galed Laboratories, compared very favourably with our antibody test. This finding was presented at the

Second International Feline Coronavirus/Feline Infectious Peritonitis workshop and the abstract is available on that website if anybody wishes further information. The full paper is published in the April 2004 edition of the Journal of Feline Medicine and Surgery. The Immunocomb is an antibody test which can be used in the veterinary surgery. (Please note that although Biogal Galed have a link from this website, I am in no way an employee of theirs, nor a shareholder. They did fund the study in which their test was evaluated, but in the full understanding that I would publish my findings whether or not the results were favourable. I remain impartial - I make no personal gain from Biogal, nor do they donate to my research. Their link is there because I personally approve of their FCoV Immunocomb product. They are charged the same as other advertisers, but their fee goes to the Celia Hammond Animal Trust, a charity which rescues cats.) Note to FCoV antibody test manufacturers: I am happy to discuss evaluation of your antibody tests at any time.

Use of FCoV antibody tests

1. 2. 3. 4. 5. Diagnosis of FIP Testing cat(s) who have been in contact with a cat suspected of excreting FCoV Testing before mating with a known positive or negative cat Screening a household for the presence of FCoV Screening a cat for introduction into a FCoV-free household

1. Diagnosis of FIP (see FIP diagnosis above) Good antibody tests are incredibly useful in the diagnosis of FIP, most cases of FIP have very high titres and a negative test can often rule out a diagnosis of FIP. Occasionally, an effusive FIP will seem to be antibody negative because there is so much virus in the cat that all the antibody is bound to that and not available to bind to the virus in the test. A frequently asked question is: can antibody tests differentiate feline enteric coronavirus from FIP virus? It's not a good question, because wherever FCoV is, FIP can develop. No consistent genetic or serological difference has ever been found in viruses from cats with FIP compared with viruses from healthy cats. 2. Testing cat(s) who have been in contact with a cat suspected of excreting FCoV These cats are very likely to have antibody to FCoV, since it is an extremely infectious virus. However, testing can be useful to obtain an antibody titre which can be used for comparison, when in 2-3 months a repeat test is taken to determine whether the antibody titre is declining. Obviously if the cat's antibody titre is less than 10 (i.e. negative) it is good news - the cat won't develop FIP and isn't shedding FCoV, so it is safe to get a new feline friend to keep him or her company! Knowing that a cat is FCoV antibody positive can enable you to reduce stress on the cat in an attempt to prevent FIP. 3. Testing before mating with a known positive or negative cat It is important that cat breeders avoid infecting their own or another person's cats by only mating antibody positive cats to antibody positive cats, and antibody negative cats to antibody negative cats. 4. Screening a household for the presence of FCoV Since FCoV is highly infectious, it is not always necessary to test all the cats in a household to establish whether or not FCoV is present: if the cats are in groups, then only a sample from each group need be tested. Usually, when FCoV is endemic, over 90% of the cats have antibodies. In control programmes, the cats are tested every 2-3 months and as cats' antibody titres decline to zero, they are put in with the negative group to prevent re-infection.

5. Screening a cat for introduction into a FCoV-free household Once a household is FCoV-free, it is vital to stay that way, so all new cats and kittens need to be tested antibody negative before being introduced. It may even be sensible to quarantine and test cats coming back from stud or shows.

Virus detection by RT-PCR

See also What is RT-PCR. RT-PCR detects the FCoV genome, so indicates presence of the virus. However, interpretation of such tests is difficult: healthy cats as well as cats with FIP can be positive for the virus. Also, cats with illnesses other than FIP can coincidentally have the virus. In my research survey, I found that it was less useful to use RT-PCR than our antibody test: to show that a cat has eliminated FCoV required only one antibody titre of less than 10 in our laboratory, but required 5 monthly negative RT-PCR tests on faeces. However, RT-PCR remains the only way to detect a carrier cat - a cat who sheds FCoV continually for 9 months or more is likely to be a lifelong carrier. At time of writing, there is no RT-PCR which can differentiate FIP-causing coronaviruses from coronaviruses which do not cause FIP. The difference between the former and the latter is that in FIP, the FCoV can replicate in macrophages, whereas in FCoV infected cats without FIP, FCoV is not replicating in macrophages. (Replicate means multiply, macrophages are a type of white blood cell.) However, at the Second International Feline Coronavirus/Feline Infectious Peritonitis workshop, a young Dutch scientist, Fermin Simons, presented an RT-PCR he is working on which detects replicating FCoV in macrophages, his abstract is on the SIFFS website. This RT-PCR is not presently commercially available, but is a very promising test for the diagnosis of FIP.

In America, the FCoV RT-qPCR test which I would recommend you use is available from Dr Christian Leutenneger's laboratory. You can download a sample submission form from his website.

Treatment of FIP this section is intended for veterinary surgeons

What clinical signs (symptoms) should I look out for in my cat?

Any of the following clinical signs should alert you to the possibility of your cat developing FIP: weight loss recurring fevers (usually detected when your veterinary surgeon takes the cat's temperature) going off food the cat becomes even lazier than usual sudden swelling of the abdomen look closely at your cat's eyes regularly, watch for any change in colour of the iris (the coloured area of the cat's eye around the pupil) or any cloudiness, or bleeding (look closely at the cats' eyes in the Dry or non-effusive FIP section to get an idea of what you are looking for) difficulty breathing (the cat breathing through his or her mouth) if the cat has a fit or seizure if the cat seems to lose balance, become clumsy if the cat's personality changes

If you are a cat breeder, the following signs in your kittens should alert you to the possibility of FCoV being present in your cats: kittens of uneven size in a litter diarrhoea in kittens around 5-7 weeks of age transient sneezing or discharge from the eyes in young kittens Remember that all of the clinical signs described above can occur due to other, curable, conditions, so take your cats to your veterinary surgeon to be checked if any of these signs occur and hope for the best. Remember that 8 out of 10 cats whose samples were sent to our laboratory for FIP diagnosis turned out not to have FIP at all!

Treatment

Feline infectious peritonitis is generally believed to be an incurable condition. Most reported "recoveries" were probably curable conditions wrongly diagnosed as FIP. However, treatment can occasionally effect a remission, sometimes for months. Note: this section is intended for veterinary surgeons. Because FIP is an immune mediated disease, therapy includes suppressing the immune response, usually with corticosteroids. Anti-viral treatments alone don't usually prolong the cat's life by much and many are quite toxic to cats. It is also important to maintain the cat's general nutrition status, by adding vitamins and antioxidants. Before embarking on any of the following therapies, it is essential to ensure that the diagnosis is correct, immunosuppressive drugs could markedly worsen other conditions (such as bacterial peritonitis or pleurisy). See Diagnosis of FIP I should very much like to conduct a clinical trial on the effectiveness of various treatments for FIP, but unfortunately don't have the funding to do so. I'd like to thank Mr Wayne Carr, whose generous donation made some preliminary investigations possible. Immunosuppressants Interferon Vitamins and antioxidants Other supportive drugs Thromboxane synthetase inhibitors Monitoring treatment / Prognosis Further reading

Immunosuppressants
Cats receiving immunosuppressants should also receive antibiotic cover to protect them against other infections. Prednisolone Thalidomide Prednisolone Prednisolone is the main immunosuppressant used in feline infectious peritonitis, it is safe, tends to make the cat feel better and stimulates his or her appetite. I treated one cat with dry FIP with prednisolone alone and he survived for 10 months. Prednisolone suppresses both the humoral and cell-mediated immune response. Prednisolone has the advantage of also being the treatment for lymphocytic cholangitis, which can be mistaken for FIP, so where the diagnosis is in doubt, prednisolone can be given anyway: the cat with lymphocytic cholangitis has a good chance of recovery, the cat with FIP unfortunately will die. Prednisolone should never be used in cats with septic peritonitis or pleurisy, which is why cytology is a very important part of FIP diagnosis, as there will be many more white

blood cells in the effusion of a cat with sepsis, and a good cytologist will detect the bacteria or fungi. Dose: 2-4mg/kg/day given by mouth, sliding dose every 10-14 days, until optimal dose for that cat is found. Thalidomide The rationale of using thalidomide in the treatment of feline infectious peritonitis is to reduce inflammation and the humoral immune response to feline coronavirus while leaving the cell mediated (anti-viral) immune response intact. Only 4 cats with FIP have been treated with thalidomide so far and unfortunately all died. However, one with a thoracic effusion did eliminate his effusion and had a remission of 3 months. I think that, to be effective, thalidomide would need to be used very early in the disease, before too many blood vessels became damaged. Be sure to obtain the owner's consent for using a drug not licenced for cats. Dose: 50-100mg at night. CANNOT BE USED IN PREGNANT CATS as it is teratogenic.

Interferon
Feline interferon omega Human interferon alpha Feline interferon omega
Virbagen Omega (made by Virbac) is recombinant feline interferon omega (IFN omega) is available in many countries now. This product was first used in treatment of FIP by Japanese vet and scientist Takuo Ishida. He presented his data at SIFFS and his abstract can be read on the SIFFS website. This is his protocol: IFN omega was initially given subcutaneously at 1 MU/kg every other day, and then once every week for variable period if remission was seen. Glucocorticoid: (dexamethasone 1 mg/kg intrathoracic or intraperitoneal injection once only) or prednisolone. Oral prednisolone was initially given at 2 mg/kg once daily, and the dosage was gradually tapered to 0.5 mg/kg every other day after remission. In Dr Ishida's study, 4 cats of 12 completely recovered and two survived 4 and 5 months. Those cats which recovered completely all had the effusive form of FIP and were relatively older cats. Interferon Omega does seem to effect a cure in around a third of cats with FIP. I am working alongside vets in practice in the UK to monitor a number of cats being treated with this product. It seems to be very important to begin treatment as soon as possible after the onset of clinical signs. We are seeing success in younger cats too, and even cats with non-effusive FIP. Some cats are being treated orally using 50,000 Units a day. Once diluted (in water or saline) IFN Omega maintains its potency in the fridge for up to 3 weeks, so keep most IFN Omega in the freezer until needed.

Diluting feline interferon

Virbagen Omega comes in vials of 5 or 10 million units. It is reconstituted with 1ml of diluent. To get 50,000 Units/ml, put one 5MU vial into 99mls saline or sterile water, or a 10MU vial into 198 mls saline or water. Aliquot into 20ml syringes or tubes and freeze. Remember that reconstituted, diluted Virbagen Omega lasts only up to 3 weeks in the fridge. Updates on treatment will appear in the English version of the website before the translated pages. Contact for Virbagen Omega in UK: Callum Blair Suppliers: Virbagen Omega can be obtained from Abbeyvet

Reference: Ishida et al, 2004. Journal of Feline Medicine and Surgery. Vol 6 Issue 2 pp 107-110

Human interferon alpha

Dose: Non-effusive feline infectious peritonitis (FIP): 30 i.u./daily or for 7 days at alternate weeks given by mouth. In effusive FIP 30 i.u./daily can be used, or larger doses of interferon can be given by intramuscular injection daily (104 - 106 i.u. per day). By 6-7 weeks, if the cat is still alive, interferon will no longer work at this dose because the cat will make antibodies against it. To obtain human interferon-alpha (Roferon or Intron A), write a prescription for your local pharmacist. Obviously, in areas where feline interferon is available it is preferable as it is likely to have more effect than the human interferon.

Diluting human interferon

To get 30 i.u./ml: Intron A can be obtained as 1 million i.u. for about 10.00. Dilute whole vial in one litre of saline, giving 3000 i.u./ml. Put one ml of 3000 i.u./ml into 99ml of saline, to get 30 i.u. per millilitre. Aliquot into 1ml volumes* and freeze for up to a year. Defrost as required, keep refrigerated for up to a week. *In the UK: 2ml tubes are available from Sarstedt, supplier's ref: 72.694.006. Fax: 0116 236 66099 Tel: 0116 235 9023. To get 104 i.u./ml put 1 x 1 million i.u. vial of Intron A or Roferon into 99ml sterile saline and divide into 1ml doses and freeze. For 105 i.u./ml use 9mls saline and proceed as above. For 106 i.u./ml use the whole vial.

Vitamins and antioxidants

Vitamin A Vitamin A is an antioxidant. The dose of Vitamin A is 200 i.u./day given by mouth or in the food. Cats cannot metabolise the beta-carotene form so must be given vitamin A as fish oil, e.g. halibut liver oil. Too much vitamin A can cause excessive laying down of bone at the joints, so don't use this supplement for more than 4-6 weeks. Vitamin B1 (thiamine) Vitamin B1 (thiamine): 100 ug/day given orally (i.e. by mouth or in food). Vitamin B complex Multivitamins B are a good appetite stimulant and can be obtained from health food shops or chemists (I particularly like the one from Boots). Dose: paediatric dose. Vitamin C Ascorbic acid 125 mg twice daily given by mouth or in food. Vitamin C is an antioxidant. Remember that given over a long period of time, vitamin C can predispose to oxalate crystals in the urine. Vitamin E Dose of vitamin E: 25-75 i.u./cat twice dailty given by mouth or in food. Vitamin E is an antioxidant.

Other supportive drugs

Aspirin For anti-inflammatory activity and pain relief. Dose: 10mg/kg every 48-72 hrs per os. Ampicillin Antibiotic cover is essential when immunosuppressing a cat.

Dose: 50 mg bid per os. Anabolic steroids For appetite encouragement and anti-catabolism, especially if the kidneys are affected. Choose from the following (in the UK): Laurabolin injection: 2-5mg/kg every 21 days. Nandrolin injection: 2-5mg/kg as a weekly injection. Nandoral tablets - one a day either whole or crushed into food. Retarbolin injection: 1mg/kg every 21 days. Orandrone tablets: 0.5mg/kg daily (the tablets are 5mg). Remember to warn the owner that the cat's urine could become more strong smelling with this treatment. The injectables usually require to be kept in the dark.

Thromboxane Synthetase Inhibitors

Two cats with abdominal effusions were treated with ozagrel hydrochloride with success (Watari et al, 1998). Dose: 5-10mg/kg twice daily and prednisolone at 2mg/kg/day.

Monitoring treatment / Prognosis

Whatever treatment you opt for, it is important to monitor the cat's progress. Initially, I measure the haematocrit (Hct), globulins, albumin to globulin ratio (A:G), alpha1-acid glycoprotein (AGP) and the cat's weight every 7-14 days to see how the cat is progressing. Later, examinations might only be monthly if the cat is doing well. It is not worth measuring the FCoV antibody titre more often than every 2-3 months, there will be no discernible difference within a shorter period. The AGP should be the first to fall if treatment is having a positive effect because AGP is a measure of inflammation. Positive signs are globulin levels decreasing, and the albumin: globulin ratio(A:G) increasing, Hct increasing and reticulocytes appearing in blood smears and weight increasing. Negative signs are AGP remaining high, globulins staying high or increasing, A:G decreasing, weight loss. When Hct gets to below 20% and is non-regenerative (no reticulocytes seen on blood smear examination) then the cat should probably be humanely euthanased if your clinical opinion is that he or she is no longer getting any happiness out of life. Clearly, if the cat is distressed at any point in the treatment, then euthanasia will be required. Sadly, cats with effusive feline infectious peritonitis usually only survive a few days, possibly weeks at best. Cats with non-effusive FIP can last many weeks or months, though after neurological signs begin euthanasia usually ensues fairly rapidly. For AGP testing see Companion Animal Diagnostics.

Further reading
Feline Infectious Peritonitis Virus: Advances in Therapy and Control by Richard C. Weiss. 1994 Consultations in Feline Internal Medicine 2. Edited by John R. August. Published by W.B. Saunders Company. Harcourt Brace Jovanovich, Inc., The Curtis Center, Independence Square West, Philadelphia, PA 19106. pages 3-12 ISBN 0-7216-4674-3 Ishida T, Shibanai A, Tanaka S, Uchida K, Mochizuki M. 2004 Use of recombinant feline interferon and glucocorticoid in the treatment of feline infectious peritonitis. JFMS 6 http://www.felinecoronavirus.com/abstracts.htm#ishida Watari T, Kaneshima T, Tsujimoto H, Ono K, Hasegawa A. 1998 Effect of thromboxane synthetase inhibitor on feline infectious peritonitis in cats. J Vet Med Sci. 60(5):657-9.

How to prevent FcoV transmission

How do cats and kittens catch FCoV? FCoV is a very contagious virus, infecting nearly all cats who encounter it. The major source of infection is the faeces of infected cats, and uninfected cats become infected by sharing litter trays with infected cats. The second major route of infection is the unintentional exposure of uninfected cats to tiny particles of infected faeces on peoples shoes or clothing, hands, poop scoops, etc. The infected cat likely swallows the virus when grooming, or when particles of faeces contaminate their food. FCoV is occasionally shed in the saliva, early in infection, so sharing food bowls or inhaling sneezed droplets could possibly allow infection to occur. Close contact with infected cats, for example in mutual grooming, might, rarely, result in infection. Feline coronavirus almost never crosses the placenta to the unborn kitten. Most kittens which become infected do so after protective antibody they receive in their mothers milk has waned, usually when they are 5-7 weeks old.

Which of a cat's body secretions contain FCoV?

FCoV is mainly shed in the faeces, and is only shed in the saliva very rarely. At present, there is no evidence that FCoV is present in the tears or urine.

Litter tray hygiene - the most important thing you can do to save your cat from
FCoV If your cat uses a litter tray, then make sure it is declumped as often as possible and use dedicated poop scoops for each cat pen or tray. Better still, if possible, let the cat out to go to the toilet naturally outside (I am aware that this is not always possible or desirable where there is a lot of traffic). If you have several cats, make sure that you have enough litter trays, preferably one for each cat, and get covered or even self-cleaning litter trays. Site the litter tray away from food areas so that microscopic faecal particles cannot be blown onto the cat's food. Use a non-tracking cat litter, to minimise spread of microscopic particles around the house. Once or twice a week, clean your litter tray with domestic bleach (sodium hypochlorite). Do stick to bleach disinfectants, as pine based ones are toxic to cats. Vacuum as often as possible to reduce the number of contaminated cat litter particles.

How long does coronavirus survive in the environment?

In natural circumstances, cats go outside to defaecate and bury their faeces, in which case the virus lasts hours to days (it survives slightly longer in freezing conditions). However, in domesticating the cat we have introduced litter trays: FCoV may survive for several days and possibly up to 7 weeks in dried up faeces in cat litter. If you have lost a cat to FIP, wait around a month before obtaining another cat. However, if you have other cats already, remember they may be shedding FCoV, so wait until their antibody titres have reduced to zero before obtaining a new cat. Of course, dont forget to test the new cat for FCoV antibodies too.

How to eliminate FCoV infection from a cattery or household of cats

FCoV infection can be eliminated from a cattery, but it is a long and sometimes expensive process. Households of less than 10 cats will often spontaneously and naturally become FCoV free, but in households of more than 10 cats, it can keep passing from one cat to another (see fig 1.) and maintaining the infection in this way. At present, identifying carrier cats is a lengthy process (see What's new in FCoV/FIP research). We still need to find some test which will identify lifelong carriers sooner so that we can keep them apart from other cats, or to find a way to stop them shedding FCoV..... but these are the subjects of my future research.

How to prevent FCoV entering a cattery or household of cats once you are FCoV-free
Once your cats are FCoV free, take care not to re-introduce the virus. Test all new cats or kittens for FCoV antibodies using a reliable antibody test, such as the immunofluorescent antibody test from the University of Glasgow (see link to Companion Animal Diagnostics). There appear to be many antibody tests available which have no correlation with the Glasgow University gold standard test and using them will not only give you worthless results, but may endanger your cats lives. Only cats with an antibody titre of zero should be allowed to come into a FCoV-free cattery. Make sure that you only take your queen to stud cats with antibody titre zero and that only antibody titre zero queens visit your stud cat (see the Coronavirus tested stud and queen register). When you go on holiday, for preference, get somebody to come to your home and feed your cats rather than putting them in a cattery. Quarantining your cat after risky sex, a visit to the cattery or cat show, or stay at the vets. If you decide to mate your negative cat to a cat with FCoV antibodies, or your cat has been at a show, cattery or had to stay in your vets kennels, then place your cat in quarantine at home for 2 weeks and test him or her for FCoV antibodies, making sure (s)he is negative again before re-introducing him or her to your other cats.

Can I visit my friend, whose cats have FCoV?

It is extremely unlikely that you could bring the virus home to your cats on your person, unless you actually had infected cat faeces on you.

Ive heard about canine coronavirus can my dog infect my cats?

The short answer to this question is probably no. Type II feline coronavirus is actually a mixture of the type I, or wholly feline, coronavirus, and canine coronavirus (CCV). Therefore it is likely that CCVs can infect cats, since it must have been present in a cat with FCoV for the type II strains to arise. However, CCV doesnt harm cats and in my research we tested any dogs within survey households and only once found a dog with antibodies to coronavirus.

Prevention of FCoV transmission at cat shows

In the UK, 84% of cats are shows have antibodies to FCoV. Since, on average, one in three cats with antibodies to FCoV sheds virus, it would be likely that 28% of cats at shows is shedding FCoV at any one time. FCoV is mainly shed in the faeces, so cats at shows should not share a litter tray or poop scoop with cats from other households. Judges and veterinary surgeons should disinfect their hands and the table between handling of each cat: remember that some cats in early infection shed FCoV briefly in their saliva.

Prevention of FCoV transmission at stud

Obviously it is wisest to mate only cats with an antibody titre of zero to other FCoV free cats and cats with antibodies to other cats with antibodies, hence the FCoV tested stud register to help breeders to find each other. However, sometimes cat breeders have reasons for wanting to do a risky mating (of their cats!!!). In this circumstance, it is best to do a controlled mating, that is where the queen and tom do not get to live together for a day or two (so, importantly for FCoV transmission, do NOT share a litter tray) but are only put together for the duration of the actual mating. Clearly, the cat who was previously negative should be tested for antibodies 14 days after the mating to find out whether he or she became infected in spite of the precautions.

Prevention of FIP

How can I prevent my FCoV antibody positive healthy cat developing FIP?
Around 1 cat in 10 who is infected with FCoV develops FIP. Very often after one cat has died of FIP there is a second cat in the household which is known to be infected, but is perfectly healthy. There are currently no drugs which can prevent a FCoV infected cat developing FIP, but there are a number of other ways we can help our cats to deal with the infection:

Minimise the cat's stress Maximise nutrition and give anti-oxidants Minimise your cat's exposure to FCoV by good litter tray hygiene

Minimise the cat's stress

It has been shown that most cats who have developed FIP experienced stress before they developed FIP. Cats with wet (effusive) FIP are frequently stressed 2-4 weeks

before they develop FIP, cats with dry (non-effusive) FIP experience the stress up to a year before they get sick. It is therefore wise not to stress cats which have FCoV antibodies if at all possible - for example, don't rehome them; delay having them neutered or any other operation which is not life-saving; if you have to leave them, get somebody to look after them in their home rather than putting them into a cattery.

Examples of situations which cats find stressful: being rehomed moving house new additions to house: baby, dog, cat, kitten too many cats in one house (over 6) going into cattery surgery (being neutered, getting a dental) trauma (e.g. road accident) intercurrent illness pregnancy, parturition, lactation

Maximise nutrition and give anti-oxidants

Although it is fashionable to feed cats just one type of food, usually a dried preparation, in my opinion cats should have plenty of variety of food to optimise their chances of getting all the vitamins, minerals and proteins they need and to minimise their chances of suffering should a food accidentally contain some contaminant. Although the latter is rare, it does occasionally happen. Commercial preparations are better balanced nutritionally than home-made foods, but why put all your eggs in one basket? I offer Sooty (who lives with me) 3 or 4 different dried foods and up to 8 or 9 different wet foods in the course of a week. Anti-oxidants such as vitamins A, C and E and zinc possibly have anti-viral and/or immune stimulant activities. One has to be careful of using vitamin A in the cat for 2 reasons: first the cat can't absorb or convert well the beta-carotene forms (i.e. those found in plant foods), so s(he) must be given in the form of liver or fish oil (halibut or cod), secondly, vitamin A shouldn't be used for more than 6 weeks or there is a risk of hypervitaminosis A and excessive bone deposition. Vitamins C and E can be given for longer term, but vitamin C will make the urine more acidic and could predispose the cat to certain lower urinary tract problems (i.e. cystitis) (note for vets: vitamin C given long term can predispose to development of calcium oxalate crystals). Doses: vitamin A: 200-400 i.u./kg/day for less than 6 weeks vitamin C: 125mg/cat bid vitamin E: 25-75 i.u./cat/bid zinc: 7-10mg/cat/sid Remember that cats exposed to FCoV are most likely to develop FIP in the first year, so if your cat has had FCoV antibodies for more than a year, it is unlikely that (s)he will now develop FIP. There is no need to go on using anti-oxidants for more than a few months after FCoV exposure, indeed, it could be risky to do so.

Minimise your cat's exposure to FCoV by good litter tray hygiene:

see Prepare kitten room and Practise barrier nursing in the Prevention of FCoV infection of kittens page.

What is Primucell?
Primucell, made by Pfizer, is the only commercially available FIP vaccine in the world. Primucell is a temperature-sensitive mutant feline coronavirus which is instilled intra-

nasally and gives rise to local IgA immunity and cell-mediated immunity. Primucell prevents FIP in 50-75% of cats who would have otherwise developed it, but is ineffective in cats previously exposed to FCoV. Thus, in households where FCoV is endemic (most cat breeder's households) Primucell has to be used in kittens which have already undergone the special management procedure known as early weaning and isolation, so that they are FCoV free when vaccinated.

FAQ

I have lost a cat with FIP - how soon can I get another cat? How long will my house remain contaminated with coronavirus? Answer: FCoV is shed in the faeces, so the main area of contamination will be the litter tray, so clean and disinfect it thoroughly with a household bleach, such as Domestos, or Milton. Remember that microscopic particles of infected, dried up, litter could have been blown around the house or taken into other rooms on feet - so do a thorough vacuuming. FCoV can possibly survive up to 7 weeks in dried up faeces. FCoV is only shed in the saliva for a very few days at the beginning of infection, so it is unlikely your cat's food bowls will be contaminated, and I expect you would give them a good wash anyway. Thankfully, FCoV is a relatively fragile virus and if you follow this advice, it is unlikely that your house will be infected for more than a few days. However, my advice would be to wait perhaps a month before introducing a new cat. All the above assumes you only had one cat - the one who died of FIP. If you have other cats, it is likely that they, too, will be infected and you might choose to test them for FCoV antibodies every 3-6 months, keep them in small groups according to their antibody titres, and only get a new cat when your remaining cats' antibody titres return to zero. Remember to test the new cat for FCoV antibodies too - you don't want to re-introduce the problem!

My cat has antibodies to feline coronavirus - can I still take him to cat shows? Answer: Since 83% of cats at U.K. cat shows were found to have antibodies to FCoV, I don't see that one antibody positive cat more or less will make any difference!

I've just antibody tested one of my girls she's come up again as >1280 which is what she was last time we tested her ........ Answer: this means she's 75% likely to be shedding virus - so you'll need to use a stud with antibodies. It also means she'll give her kittens great maternally derived antibody, so although they will need to be isolated and early weaned, antibody from mum may well protect through to 6 weeks of age. ..... and she is now 15 months old and calling - do I mate her? Do I spay her? I really don't know what to do for the best. If she'd never been tested, I'd have blithely gone ahead and mated her, but one of her siblings died in suspicious circumstances (no PM unfortunately) so we did a titre count. Answer: this is a very difficult choice, because stress can push a cat over into FIP, and guess what - spaying, pregnancy and even calling are all stressful! In addition, call suppressants,

like Ovarid, are immunosuppressive, and could precipitate FIP. Probably pregnancy is least stressful of the options, but would you have to take her far to mate? Travelling is stressful to cats. Have you got a stud of your own? If you opt for spaying, could your vet set aside a time apart from the rest of the routine surgery so that she's in and out (home) within a few hours? Although we have no actual evidence of its efficacy in FCoV infection,* it might be useful to use a Feliway (feline pheromone) diffuser to reduce her stress whatever you choose. *The efficacy of Feliway has been shown to reduce the frequency of inappropriate urination around the house, which presumably indicates reduction in stress (Hunthausen, Veterinary Medicine, 95, 2, 151-155).

http://www.animalhealthchannel.com/fip/diagnosis.shtml Feline infectious peritonitis

Overview Feline infectious peritonitis (FIP) is a serious, nearly always fatal systemic viral disease of wild and domestic cats caused by a coronavirus, a type of virus that afflicts pigs, dogs, and in some forms, humans. However, the specific virus that causes FIP the FIP virus does not infect humans. The clinical name for the virus that causes FIP is feline coronavirus. (FcoV). A common, relatively benign form of feline coronavirus is the feline enteric coronavirus (FECV). When FECV mutates into a disease-causing form, it is called FIPV (feline infectious peritonitis virus). If a cats immune system responds poorly, the mutant FECV may cause the systemic infection called FIP. The onset of the disease may be sudden, especially in kittens. It often develops so gradually that the infection is well established before overt symptoms appear. When symptoms become apparent, they often include small tissue abscesses (pyogranulomatous lesions) in the liver, kidneys, and the membrane that lines the abdomen (peritoneum); and fluid accumulation within body cavities. Types FIP manifests in two forms: effusive, or wet, and noneffusive, or dry. The wet form comprises 60% to 70% of all cases and has a more rapid progression than dry FIP. In wet FIP, fluid accumulates in body cavities typically in the abdominal cavity, where it causes progressive, but generally painless, swelling; or in the thoracic (chest) cavity, where it causes respiratory distress due to compression of the lungs and fluid backing up into the airways. In dry FIP, fluid buildup is minimal and symptoms depend on which organs are affected by lesions. About half of all dry cases produce eye inflammation or neurological problems: paralysis, unsteady gait, and seizures. Other lesions may cause kidney or liver failure. Weight loss, pancreatic disease, depression, anemia, and fever are usually present. Despite these differences, wet and dry FIP are not two different diseases. The strength of a cat's immune system response appears to determine which form of the disease it develops. If the immune system reacts poorly, the cat probably will develop the wet form. A stronger response might result in the dry form. When the cats immune system responds optimally, the animal develops neither form but may become a virus carrier for several years. A carrier cat whose immune system weakens over time eventually may develop the full-blown disease. Incidence and Prevalence

There are two strains of FIPV. The Type I strain, or FCoV-1, is believed to cause about 85% of all identified FIP cases. The less common Type II strain, or FCoV-2, accounts for the rest. FIPV probably affects less than 1% of the cats brought to veterinarians for treatment. Coronavirus infections are common in cats, especially those in catteries and shelters where large numbers of kittens and adult cats share living space. It has been estimated that 80% to 90% of all the animals in multi-cat households where FECV is present become infected. The prevalence of FIPV, on the other hand, remains low in the wild and domestic cat populations, probably less than 2%. In multi-cat households or catteries where the disease is present, it can be as high as 10%. In some shelters and catteries, the disease rate can be as high as 20% over a period of several months. Risk Factors Experts agree that FIP appears to affect young (3 months to 5 years) and old (10 to 14 years) cats. Kittens may be most vulnerable, particularly those under 16 weeks, as they have incompletely developed immune systems. Males and females are affected equally. Purebred cats in general are regarded as being at higher risk, and certain breeds, notably Persians and Burmese, seem to be most susceptible to FIP. One study of pedigree and health data from 10 generations of cats in purebred catteries suggests the existence of a genetic predisposition to the development of FIP. Researchers found the inheritability of susceptibility to FIP could be as high as 50%. Outdoor cats and cats that live in catteries and multi-cat households are at greater risk than solitary, indoor animals. Exchanging animals, especially kittens and young cats, increases the risk. Cats in actively breeding households are also considered to be at risk. Cats in poor physical condition and those under stress are more susceptible to FIP. The presence of feline leukemia virus (FeLV) or feline immunodeficiency virus (FIV) may predispose a cat to developing FIP. Poor nutrition and husbandry practices that produce highly inbred cats increase the likelihood of infection. The stress associated with neutering, vaccination, or moving to a new home may be risk factors as well. Causes About 95% of cats with FECV remain healthy. In some cats, the infection begins a cascade of genetic mutations within the feline enteric coronavirus (FECV), and the cats immune system response climaxes in FIP. Most of these mutations are harmless, but some have the effect of causing disease. These mutant FECV strains are called FIPV. Another theory holds that FIP may be caused by FECV and other viruses combined. Research suggests that some cats have a preexisting antibody to FIPV, which sensitizes the animal to the mutant virus. Instead of killing the virus, the FIPV antibodies seem to accelerate and actually promote the disease process. This phenomenon is called antibody-dependent enhancement (ADE), in which the sensitized cat experiences a more serious disease than a cat that lacks the preexisting antibody. This vulnerability may be exacerbated by an undeveloped immune system in a kitten or young cat or by weakening the immune system in an older cat. This strongly suggests that most cats do not catch FIP, but develop it from their own mutant FECV. Transmission Transmission occurs when a healthy cat comes in direct physical contact with an infected animal or its feces. Infected cats shed coronavirus in their saliva and feces. Primary transmission occurs by ingestion of the virus by the fecal-oral route and, to a lesser extent, through saliva or respiratory droplets, followed by contact with an acutely infected animal that is shedding the virus. FIP viruses can survive for 2 to 3 weeks at room temperature on dry surfaces, including feeding bowls, toys, litter boxes, bedding, and clothing; and small particles of fecal material

can adhere to the dust in cat litter. The virus conceivably could be spread via litter dust picked up on shoes, clothing, or another animals fur. If a mother cat is an FECV carrier, she can shed the virus to her kittens. Preventive measures, such as early weaning and isolation from the mother, are advised. Symptoms Primary infection Most cats initially are asymptomatic, but the virus is at work. After ingestion, the virus immediately begins to replicate in the cats pharynx and small intestine. From there it moves into the throat, lungs, stomach, and intestines. About 1 to 10 days later, it can be spread to other cats. During this time, cats may display the symptoms of a mild upper respiratory infection: sneezing, watery eyes, and nasal discharge. Others give the appearance of having an intestinal problem: diarrhea, weight loss, and lethargy. Many cats have nonspecific symptoms: intermittent loss of appetite, depression, rough hair coat, weight loss, and fever. Most cats that undergo the primary infection recover fully, although some may become virus carriers. A small percentage of exposed cats develop lethal FIP weeks, months, and even years after primary infection. In some cats, especially kittens, the onset of symptoms may be sudden. In others, symptoms may appear and increase in severity over a period of weeks. When the classic symptoms of full-blown FIP appear, the disease typically is diagnosed as wet (effusive) or dry (noneffusive), and many cats present symptoms of both. When the infection reaches the lymph nodes, it spreads throughout the animals body. The disease is no longer contagious at this stage.

Effusive (wet) FIP

The hallmark of lethal effusive FIP is the accumulation of fluid inside the abdomen and/or chest cavity. Some animals take on a pot-bellied appearance. Excessive fluid buildup compresses the lungs and backs up into the airways, making it difficult to breathe. The lining of the affected cavity, along with the liver and spleen, becomes coated with white, fibrinous matter. Some lymph nodes may be enlarged. Other signs include: Gastrointestinal and eye ulcers Jaundice Mild anemia Neurological abnormalities Severe conjunctivitis

Noneffusive (dry) FIP

Noneffusive FIP usually develops slowly, with little fluid accumulation. Weight loss, depression, anemia, and fever are common. In young cats, growth may be stunted. Other symptoms depend on the organs affected: Increased water consumption and urination (kidneys) Jaundice (liver) Vomiting and/or diarrhea (pancreas) Ocular inflammation, conjunctivitis, and blindness (eyes) Brain inflammation, paralysis in the hind legs, weakness, shaking, vertigo, seizures, and personality changes (central nervous system) The affected organs often develop a characteristic pyogranulomatous inflammation, in which the diseased tissue becomes thickened with an accumulation of white blood cells. The only definitive way to diagnose this form of FIP is by postmortem biopsy of the lesions. Diagnosis A diagnosis of FIP usually is based on the animals clinical signs and symptoms, x-rays, routine laboratory tests, and an evaluation of the fluid in the abdominal or chest cavity. Some cases, however, are difficult to diagnose because the symptoms vary greatly and are similar to

those of other diseases. In all cases, microscopic examination of a tissue sample (biopsy) is the only way to confirm a diagnosis of FIP. Tests FIP is notoriously difficult to diagnose through standard laboratory blood tests, and many veterinarians simply do not bother with them. Those who do, generally use blood tests to look for an elevated level of gamma globulin proteins or a low level of albumin in the blood. Tests that detect the presence of coronavirus antibodies in a cat cannot distinguish between antibodies for FIP, FECV, or any other feline coronavirus (FCoV). A positive result only indicates that there has been exposure to some type of coronavirus, and a negative result does not rule out FIP. It is possible for a cat that has been vaccinated to have enough antibodies to produce a positive test. False positive readings may occur in up to 30% of tests. Results from one laboratory will not necessarily correspond with those from another, and labs do not use the same terms to describe results. There are no clinical standards for laboratories, no regulatory body to oversee them, and no requirements for validation of test results. For these reasons, pet owners are advised against placing too much emphasis on test results. Treatment There is no cure for FIP. As with all terminal illnesses, the basic course of action is to provide supportive care. A combination of corticosteroids, cytotoxic drugs, antibiotics, good dietary maintenance, and proper fluid intake may relieve discomfort. Some veterinarians may recommend homeopathy, herbs, and dietary changes as well. An FIP vaccine was introduced in 1991. Its use remains controversial because the vaccine cannot help a cat that is already infected or that previously has been exposed to FIPV or FECV. Therefore, vaccinating a cat that already has coronavirus antibodies or that has been exposed to other infected cats is not recommended. In fact, if the theory of antibodydependent enhancement is valid, vaccinating a previously exposed cat could actually increase its risk for developing FIP. The decision to vaccinate rests with the individual cat owner and the veterinarian. Prognosis In most cases, by the time a veterinarian makes the diagnosis, the disease has progressed substantially. After clinical signs appear, cats with effusive FIP may live a few days to a few weeks; some adults may linger for 6 to 8 months. Cats with noneffusive FIP usually die within a few weeks; some survive for a year or more. As long as a cat is not in obvious pain or discomfort, there is no reason to euthanize it, but as the disease progresses, euthanasia becomes the only option. Prevention Common household soaps, detergents, and disinfectants readily neutralize the FIP virus. An inexpensive preparation is a solution of 4 ounces of household bleach mixed with 1 gallon of water (a 1:32 solution). This will disinfect any surface an infected cat contacts, including clothing. Litter boxes should be scooped daily, and the litter discarded and the box thoroughly disinfected weekly. No more than two cats should use one box, and they should use that box only. Food and water should be changed daily, and the feeding bowls disinfected weekly. The same set of bowls should be kept with the same cats. Limit the number of new cats brought into the household. Isolate each new cat for at least a month, and watch it carefully for any sign of illness. An infected, pregnant cat should be completely isolated from all other cats in a household. The room should be disinfected and kept empty for a week prior to occupancy. The cat should be quarantined for 10 to 14 days with her own disinfected food bowls and litter box before delivery. Persons entering and leaving the isolation room should disinfect their hands

thoroughly. If possible, the owner or cattery operator should wear separate clothing, such as a smock and slippers, every time they enter the room to decrease the risk of spreading the infection. Early weaning and isolation of kittens from an infected mother is advised. Kittens should be raised in complete isolation from the mother and all other cats/kittens in the household. If the kitten is to remain in the cattery, it should be isolated for 16 weeks.

http://www.vetinfo.com/cfip.html
Feline Infectious Peritonitis (FIP)
FIP is a difficult disease to diagnose and to treat. Testing for this disease is not very accurate and the clinical signs are easily confused with a number of other diseases. The disease does not appear to affect all cats exposed to it in the same way. The only certain diagnoses are made at the time of a necropsy exam (autopsy). This makes FIP one of the most frustrating diseases for veterinarians and their clients. FIP is caused by a coronavirus. There are other coronaviruses that affect cats but that do not produce feline infectious peritonitis.The most common of these are the feline enteric coronaviruses. The antibodies produced against these other diseases are too similar to FIP virus for current tests to be able to distinquish between them. This is the difficulty in making a definite diagnosis of FIP. To make matters worse, a negative titer (no discernible antibodies) to FIP does not rule out the disease. There are several possible explanations for this but it is not uncommon for cats to have negative FIP titers when the disease is present. Feline infectious peritonitis is probably the most common cause of unexplained fevers in cats. It can cause a number of other signs, as well. Lethargy, weight loss, eye disease, swelling of the abdomen or fluid in the chest can all occur with FIP. Many secondary problems, such as liver or kidney disease can occur with FIP. Any cat with fevers that do not respond to antibiotics should be considered as a candidate for this disease. In any chronic illness in cats for which no other cause can be found, FIP should be considered. There are two commonly recognized syndromes associated with feline infectious peritonitis. In the "classic" FIP case, fluid accumulates in the abdomen and it can become quite distended. This is known as the effusive form of FIP. The abdominal distension does not appear to be painful. The other recognized syndrome is the "dry" form of FIP, in which the symptoms of fever, weight loss and other clinical signs develop but there is no fluid accumulation. This is the more common form of the disease. Not all cats that are exposed to the FIP coronavirus will develop the disease. In colonies of cats in which this disease is known to be present, estimates are that 8 to 20% of cats exposed to the virus will develop clinical signs of FIP. The rest of the cats may become immune to the disease or may simply not react to it. The reason that only a relatively small number of cats exposed to the virus develop the disease is unclear. It is known that the cell mediated immune response is the primary protection for the cat's body in the case of FIP. Cats that do not have a good cell mediated response may be more susceptible to the disease. The humoral (antibody) defense system actually enhances the damage caused by FIP virus and seems to be partly the culprit in the death of affected cats. The "war" with the FIP virus is won or lost at the places it seeks to gain access to the body. The cellular immune system consists of the white blood cells that find and destroy pathogens.

If a cat has a competent cellular immune system, it has a good chance of becoming immune or of becoming a carrier of FIP with no apparent symptoms. If the white blood cells fail to find and kill the virus where it seeks to enter the body through the nasal passages and oral tissue, then the humoral (antibody) immune system takes over. Unfortunately, it appears that the complexes of antibody and virus (antigen) that develop are very harmful to the body. The immune response appears to be the cause of death in FIP cats since cats that can not mount an effective antibody response are not affected by this virus. FIP virus itself lasts in the environment for up to 6 weeks. It is easily killed with disinfectants, so careful cleansing of a household may help prevent the spread of the disease if a cat with FIP is identified in a household with more than one cat. Due to the delay in the appearance of clinical symptoms once infection occurs, it is likely that most cats in a household have been exposed to the virus by the time it becomes evident that one of the cats is sick. Reducing stress levels by resisting overcrowding of cats in a household, providing adequate litterpans and vaccinating for other diseases may be helpful in reducing the spread of FIP as well. Once the FIP virus gains access to the cat's body it takes about 2 weeks for the virus to become widespread. After that, the length of time to clinical symptoms is variable but probably rarely exceeds 2 months. Most cats with FIP will die within 2 to 11 months from the damage caused by the virus, the immune system and secondary problems such as kidney or liver failure. An exception to this might be cats that are able to fight off the disease at the cellular level but never completely clear it from their bodies. It is possible that these cats are carriers of the disease and that they may be affected later in life if some immunosuppressive disease or event inhibits their ability to keep the FIP virus in check. It is possible to measure antibodies against coronaviruses in cats. This is the "FIP test" that is commonly available. Unfortunately, the cross reaction with other coronavirus antibodies makes it very likely that there will be antibodies found, sometimes in high levels, whether an FIP infection is present or not. To further complicate matters, it is not unusual for cats with FIP to have negative antibody titers because of antigen/antibody interactions, exhaustion of the ability to produce antibody, or other factors. When cats have the "effusive" form of FIP in which abdominal fluid accumulation occurs, the thick, straw colored fluid has characteristics that strongly suggest FIP. It is possible to run a more specialized lab test, a polymerase chain reaction test for FIP, on this fluid. This type of testing is more accurate than FIP antibody testing but still is not definitive. Blood tests to compare the various protein levels in the blood can be very suggestive of FIP infection, as well. High immunglobulin levels are very suggestive of FIP in the presence of clinical signs. Despite all of this, there is no clear-cut way to make a sure diagnosis of FIP prior to death. There are many instances in which the clinical signs and supportive labwork make it very likely that this disease is present and it is possible to be reasonably certain that FIP is the problem in many cats. It can be very very difficult to rule out FIP, though. Cats exhibit widely varying clinical signs of this illness and lab results can be completely inconclusive. It may be impossible for your veterinarian to tell you that FIP is definitely not the problem and it is easy for a veterinarian to overlook this disease when the clinical symptoms strongly resemble another problem. There is no treatment that has been proven to work on a consistent basis for feline infectious peritonitis. Aggressive treatment of the secondary problems and suppression of the humoral immune system with corticosteroids or other medications may be beneficial in prolonging the lifespan of cats infected with this disease. There have been reports of recovery from FIP infection in a limited number of cats. Newer anti-viral treatments have not yet proven to be successful in cats in clinical situations but work continues and there is some hope that effective treatment will one day be possible.

There are two ways to prevent FIP infection. Strict sanitation and isolation of infected cats and all susceptible kittens from each other is one approach. Vaccination is the other. Sanitation appears to be a major factor in preventing the spread of this virus. In catteries with known FIP exposure, it is possible to severely limit the spread of the disease by keeping kittens isolated from adult cats after the age of 6 weeks and following good sanitary practices. As noted previously, this virus is susceptible to most disinfectants. If kittens are not exposed to other cats in the household after six weeks of age, there is a very good chance that they can avoid infection. Once they go to a home where they are the only cat, there is little chance that they will be exposed to the virus. Vaccination for FIP is a controversial subject. Studies done at Cornell University with the new vaccine seemed to show that it was not very effective and that it may even sensitize some cats to the disease. The manufacturer of the vaccine, Pfizer, believes that the study was flawed by the severity of the viral challenge used. The increased sensitivity to FIP does not appear to occur in clinical situations, at present. The decision on whether or not to vaccinate is a difficult one. The best approach is to assess the risk of infection with FIP for an individual patient and make the decision accordingly. It is unlikely that an individual housecat will be exposed to the disease and vaccination probably does not make sense for these cats. It is much more likely that cats in a large cattery will be exposed and vaccination makes more sense in this situation. Even in this case, strict isolation of kittens from infected cats would be necessary until the entire course of the vaccine is administered, to allow the vaccine time to work effectively prior to exposure to FIP virus. Feline infectious peritonitis must always be considered in cats with persistent fevers or vague histories of "not doing right". In multiple cat households, it is worthwhile to confirm the presence of this problem through post-mortem examination (autopsy, necropsy) of cats that have died. Knowing for sure that it is a problem will help a great deal when mapping out a plan to eliminate it from a cattery or household. If other problems are the cause of death, knowing that will help as well. FIP is among the most complex of diseases to understand. There will continue to be controversy surrounding the prevention, treatment and diagnosis of this disease. (c) Michael Richards, DVM
.....

Cats who develop feline infectious peritonitis have a mutant form of the feline cornona virus which has developed the ability to penetrate the body's defenses and enter the tissues outside the intestine. This happens because the FeCo virus mutates within a cat and develops the ability to cause FIP. It is though that this mutation process produces almost all the cases of FIP, although there are a few exceptions that seem to have been proven to occur, in which already developed FIP virus has been passed from one cat to another. It is very easy to test for exposure to feline corona virus. The standard serology testing will pick up antibodies against feline coronavirus, measured as a titer. A positive titer indicates exposure to fein coronaviurs and high titers may occur in infected cats. All of the currently available tests for FIP are actually FeCoV tests -- they can not discern an FIP infection from a feline enteric coronavirus infection. So if you were to test all your cats and all were negative for coronavirus titers and you kept them all separate from other cats forever, in theory it would be really unlikely that they would ever develop a positive titer. On the

other hand, if one or more of them has a positive titer all that it means is that cat has been exposed to feline coronavirus. Based on the history and the fact that many cats have had exposure to feline coronavirus, it seems to me that testing your cats is very likely to show that at least some of them have antibodies to feline corona virus. Since you can't tell from that if any of them will ever actually develop FIP it doesn't seem to be worth doing the testing, to me. Even though it is likely that one or more of your cats were exposed to coronavirus from Huckleberry, it is highly likely that none of them will develop FIP. The virus they picked up would be feline coronavirus and the virus would still have to mutant again in the next cat for FIP to develop. While this actually happens (two or more cats in one household get FIP), it isn't a common problem. I also think that this makes it unlikely that a new cat exposed to your present cats would be at a higher than average risk of developing FIP, either. My best advice would be to maintain a high degree of suspicion for FIP among your cats but not to try to test for it on a routine basis. There just isn't any test procedure that is specific enough for this virus to make it worthwhile, at this time. Feline corona virus can be transmitted from oral or nasal secretions as well as passed through the feces. The virus lives longer in the environment when it is passed in the stool, though. It was an oversight not to include the oral to oral and nasal to oral transmission possibilities, as they are probably about equal to fecal to oral spread of the feline corona virus. If I have just confused clarifications again. Mike Richards, DVM 2/18/2001
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Most cats that develop FIP are less than two years of age or over thirteen years of age. This is probably due to the fact that cats who live to be two years of age probably have immune systems that function well and are therefore able to control the mutant virus. The return of susceptibility after cats age is probably due to the development of immunosupressive disorders, such as diabetes, kidney failure, liver disease and cancers as cats mature, which weakens immune systems that were formerly functioning well. This brings out the first point that it is necessary to make regarding control of FIP. Cats can be exposed to this virus and have sufficient immune competence to either eliminate it from their body or keep it suppressed to the point that they can live with it. Cats that merely suppress the FeCoV viruses may be long term carriers. It is known that cats can carry the virus for long periods, at least a year and probably longer. ......

http://www.2ndchance.info/fip.htm

Feline infectious peritonitis ( FIP ) of cats occurs sporadically in cats throughout the world. Feline infectious Peritonitis is caused by a cat coronavirus. Many cats have been exposed to feline infectious peritonitis ( FIP ) without developing disease. When feline infectious peritonitis develops in cats the surfaces of membranes and organs throughout the body become inflamed. Feline infectious peritonitis ( FIP ) of cats develops as a dry and a wet form. Sometimes feline infectious peritonitis ( FIP ) of cats attacks the nervous system. Once a cat develops feline infectious peritonitis ( FIP ) it will invariably die from the disease. Feline infectious peritonitis ( FIP ) in cats can be diagnosed by typical tissue pathology. The antibody test for feline infectious peritonitis (FIP) in cats often gives false positives.

http://www.faqs.org/faqs/cats-faq/FIP/
Summary To begin and unfortunately in sum: There is NO effective treatment, there is NO diagnostic test, there is NO way to positively identify asymptomatic carriers (cats which shed the virus, but do not themselves show outward signs of illness), the incubation time is UNKNOWN, NO one is 100% sure of how it is spread between cats, and there is NO proven effective way to control its spread in a multi-cat household or cattery. So what is known? Read on. Is my cat at high risk? If it comes in regular contact with other cats (i.e.: an indoor/outdoor cat), the answer is YES! The lowest risk groups are indoor only, single-cat households. The higher the number of cats, the more risk of FIP. The higher the number of cats, the higher the titer test results (more on titers below). Single-cat households are generally free of all coronaviruses. FIP occurs in greatest incidence in cats between six months and two years old, although infections are high up to five years old. Of course the most susceptible group to catching FIPV are kittens because under the age of 16 weeks their immune system is very bad in general. Studies also show that poor nutrition, high stress levels or poor husbandry increase the likelihood of getting FIP. Outside exposure, exchanging of animals, especially kittens and young cats, highly inbred cats, and cats in actively breeding households increase the risk. Males and females are equally affected. How is it transmitted? Wouldn't we all like to know! Seriously, there seems to be two schools of thought. One group (from Cornell-based publications and seminars) states that the spread is not known with certainty, but is believed to be by ingestion or inhalation of the virus. The other school of thought (from Dr. Pedersen and the UC, Davis based publications) believes that transmission is most prevalent when cats have close contact with other infected cats or their feces/urine. Both schools seem to feel that feces may play a large role in the method of transmission. Some studies suggest that viruses that can cause FIP can survive on dry surfaces (food/water bowls, litter boxes, human clothing, etc.) and can survive at room temperature probably up to 2 or 3 weeks. If this is the case, then the two schools of thought on methods of transmission may not be so far apart, especially given that litter can contain dust to which small particles of feces can adhere. Thus the virus can possibly be spread via litter dust on shoes or clothing or etc. making it behave as if it were an airborne virus!

(1995)

Feline Infectious Peritonitis

(FIP)

for information click here FIP email list CFA Health Committee VETINFO - Mike Richards, DVM Cornell Feline Health Center THE CAT NETWORK Feline Infectious Peritonitis FAQ The Winn Feline Foundation Feline Advisory Bureau Longbeach Animal Hospital

http://www.furr-angels.com/fip.htm
Feline Infectious Peritonitis is a severe disease of domestic cats and some exotic cats. It is caused by a "coronavirus" and the incubation period is controversial. As seen in household situations, it appears that the virus may be dormant in some cats for several months, or even years, before the disease occurs. Other claims indicate the virus appears within weeks of infection. FIP results in poor appetite, fever, and weight loss over several weeks. Because various organs may be affected (i.e. liver, kidneys, brain, eyes, etc.) a variety of clinical signs may be associated with this disease. For example, blindness or seizures may occur in one cat, while another will have signs of liver disease.

Diagnosis of FIP may be difficult and frustrating. Although there are approximately 8 tests, there is no specific test which is reliable in all cases. Although organ biopsy is the most reliable, this requires major surgery. For obvious reasons, surgery may not be advisable in a sick cat. Your vet will advise you as to which is most appropriate for your cat and his/her symptoms. There are three stages of FIP infection, and significant risk to other cats occurs in only the first two stages. The first stage is initial infection. During the two to four week period following viral infection to the cat, a large amount of virus is shed; others cats in direct contact with the virus will be exposed. The second stage is one of dormancy. The virus is inactive within the cat, so it causes no disease. If the cat is stressed during this stage, some virus shedding may occur. Otherwise, the cat is not contagious. However, some cats shed enough virus during the stressed period to be a threat to surrounding cats. This stage may last a few weeks to several years. The third stage is clinical illness. It usually lasts a few weeks. As a rule, the cat is not contagious during this final stage. Many treatments have been tried for cats with FIP, but none have been consistently successful. The conronavirus may live for up to three weeks in the environment. If viral shedding into the environment seems likely, a 1:30 mixture of household bleach and water should be used to disinfect food and water bowls, litter pans, cages, bedding material, and items that will not be adversely affected by household bleach. There is a vaccine but neither veterinarians nor the manufacturer recommend that the vaccine be given routinely to all cats. The vaccine is generally recommended for cats in contact with free-roaming cats or for those living in households that have had a cat with FIP. Initially, two doses are given at a 2 - 4 week interval. An annual booster is needed to maintain immunity.

Informational links:
21Cats.org article on FIP. Direct linking not available -go to "Health and Disease" and then look for the link to "FIP" About.com - approximately 35 links/articles re: FIP Cat Fanciers' Association: information on FIP Health Committee -

Center for Companion Animal Health - Frequently Asked Questions on FIP revised Jan. 2000 Cornell University - Feline Health: FIV, FeLV & FIP as well as many other feline related health articles! Dr. Addie This vet is a prominent FIP researcher

Feline Advisory Board - FIV, FIP and FeLV info Foothill Felines Begals - questions & answer re: FIP Long Beach Animal Hospital - FIV, FIP and FeLV Tomball Veterinary Clinic - addressing "What is FIP" Vet Info - FIV, FeLV, FIP and just about any thing 'feline medical' related that you'd want to know!

http://winnfelinehealth.org/reports/FIP-update-pt2.html
1.2 A Winn Feline Foundation Report On ...

Feline Infectious Peritonitis - Virus Shedding and Infection - The British Experience Progress Report Feline Infectious Peritonitis - Virus Shedding and Infection - The British Experience Second in a Series of Feline Infectious Peritonitis Updates Virus Excretion of Feline Coronavirus Diane D. Addie, BVMS, PhD and Oswald Jarrett, BVMS, PhD University of Glasgow, Scotland 1.2.1 Aim of the project

The aim of the project is to determine precisely how FCoV (feline coronavirus) spreads
among domestic cats so that control measures can be established to prevent infection and development of FIP (feline infecious peritonitis). 1.2.2 Animals recruited

One hundred and six cats from a total of 25 households have been enrolled in the survey.
Six cats are from single cat households and a seventh is from a home which became a two-cat household this year. The other cats are from multicat households of up to 13 cats. Some are outdoor cats, but most are kept indoors. There is a variety of purebred and domestic cats. Although we have reached our target number of cats, we would like to enroll more for three reasons: first, some of the most interesting findings so far have occurred in only a tiny number of cats; second, almost 20% of the cats have stopped shedding FCoV; third, nine cats have died or left the survey. Greater numbers of cats will be essential in order to make statistically viable comparisons.

1.2.3

The fate of survey cats

Nine cats have been lost to the survey: two have moved to new homes; two developed FIP;
one was euthanized because of chronic diarrhea; two developed alimentary lymphosarcomas; one was euthanized because of acute urethral blockage; one developed a cholangiocarcinoma.

Both cats which died of FIP had chronic, intractable diarrhea before developing FIP. One
cat had been seronegative for 20 months before seroconverting, and she died of FIP within three months of seroconverting. She had been in a household where seropositive and seronegative cats had been kept apart. The second cat was in isolation (he was a stud cat) within a multicat household, and died within four months of his FCoV infection being discovered. Conclusions: The deaths to FIP, though few, occurred within six months of infection, as previously reported (Addie et al, 1995). Cats are at greatest risk of developing FIP following their first infection. It follows that keeping FCoV-naive seronegative cats away from FCoV excreters is absolutely essential in the prevention of FIP. Three cats have had chronic, intractable diarrhea and two developed FIP. The roll of FCoV in diarrhea in the adult cat warrants further investigation (Kipar et al, 1997) and may be an early indictor of a cat being in danger of developing FIP. 1.2.4 Nineteen cats stopped shedding FCoV and became seronegative

All of the cats in five households have eliminated FCoV infection: three were in single-cat
households, three more cats formed one household. Seven seronegative cats are part of a 14cat group which has been divided between two premises: the seronegative cats were removed to a new house with the owner, the seropositive cats remained at the mother's house. As cats become seronegative, they are removed to the owner's house.

The remaining six cats which have become seronegative are from multicat households of up
to seven cats. Three cats are from one household where segregation of shedding cats from non-shedding cats is being attempted. Of the remaining three cats: one cat was kept in total isolation until she became seronegative and the other two cats have become seronegative despite being in contact with others which are still shedding virus. It remains to be seen whether these latter two seroconvert again. Conclusions: So far, FCoV infection has been temporary in 20% of the survey households. Segregating seropositive cats from seronegative cats is effective in the elimination of FCoV infection from a household. Seronegative cats need to be monitored every six to 12 months to confirm that spontaneous recrudescence of infection does not occur in the seronegative animal. More cats need to be enrolled in the survey to take their places.

1.2.5

Some cats' antibody titers fall despite being in contact with FCoVshedding cats

Four cats' antibody titers are in decline despite being in households of FCoV-shedding cats,
and a further two cats remain seronegative despite being in contact with FCoV-shedding cats. If we can identify sufficient cats which are eliminating FCoV infection despite being in an environment where the virus is endemic, we might be able to define which immune response is protective: Is it a particular class or type of antibody; is it a response to a particular epitope of the virus; or does the cat's management determine its ability to fight off infection? One of the seronegative cats is from a household of seven cats who are free-ranging. Since their feces, which constitute the greatest source of virus to other cats, is buried outside, are freeranging cats therefore more likely to eliminate this infection?

In our previous survey we followed 50 cats whose antibody titers declined and then increased
again (Addie et al, 1995). In the present survey there are cats following the same pattern, but this time we have the advantage of being able to monitor their virus excretion. Our findings so far seem to confirm those of Foley et al (1997) that in most cats the pattern of FCoV infection is exposure, virus shedding, seroconversion, temporary immunity, and then re-exposure which starts the cycle all over again. Conclusions: The key to elimination of FCoV from an infected cattery is to interrupt the cycle of reinfection. Our previous assumption that cats' antibody titers can remain elevated due to exposure to the virus from in-contact cats (as well as to the virus in their own bodies) appears to be erroneous: cats in contact with virus-shedders often still become seronegative. One cannot conclude, therefore, that if some cats have reducing antibody titers, then incontacts with stable antibody titers must not be shedding virus. Some cats appear not to seroconvert or, at least, not to make immunofluorescent antibodies, despite being exposed to FCoV. We are building up a valuable bank of sera (from blood samples of study cats) which will be used for further investigation into the immune response to FCoV. 1.2.6 Does declining antibody titer mean that a cat has eliminated FCoV infection?

Two cats continued to shed virus while their antibody titers were reducing, even when their
immunofluorescent antibody titres (IFAT) were as low as 40. Conclusions: Only cats with IFATs of under 40 are definitely not shedding virus. 1.2.7 Chronic FCoV shedding in feces

In another survey (Foley et al, 1997), 10 cats of 121 which were serially tested shed virus at
more than 75% of tests. In this survey, five cats have been identified as chronic virus shedders. Two cats from single cat households were, in fact, part of a previous survey and have been known to be seropositive to FCoV for nine years. This year another cat was introduced into one of these households and seroconverted, confirming the infectivity of the resident cat. The other cat is kept indoors and in isolation. One of the other chronic shedders

belongs to a household of seven cats where separation of shedding and non-shedding cats is being attempted. The remaining two cats are kept in isolation as part of a large multicat breeding household. It is crucial that we establish the role of the chronic FCoV excretor in maintaining infection in a multicat household. Clearly, most cat owners will not be able to RT-PCR test their cats monthly for two years to establish which cats are chronic shedders; it is hoped that we will be able to find another marker for detecting these cats.

We are now able to answer some of the questions posed in our 1996 report: chronic carriers
do not appear to be at greater risk of developing FIP; they seem not to stop shedding virus; their antibody titers are indistinguishable from those of cats which shed virus only transiently. Conclusions: In most cats, FCoV infection is temporary. Chronic FCoV excretors exist, however, and such cats may be the mechanism by which FCoV persists in a household. A technique for identifying chronic FCoV shedders needs to be found, as at present there is no way to differentiate them from cats undergoing a transient infection other than by repeated testing over many months. 1.2.8 When can you say that a seropositive cat is not a FCoV shedder?

In multicat households, when a cat which had stopped shedding FCoV begins to shed virus
again, it is impossible to know whether this is because it has been reinfected by one of the other cats, or because of reactivation of virus latent in its gut or elsewhere. In four cats in single cat households there have been occasions when virus was not detected at one sampling, but was detected at the next sampling. The possible explanations for this finding are: the cat is truly shedding virus intermittently; RNA-ases (contaminant enzymes which destroy RNA) were inadvertently introduced, causing a false-negative test; or the positive test after the negative one was a false positive, due to contamination. At present, we do not consider a cat to have ceased shedding FCoV until it has been negative on three consecutive monthly samples (this figure is arbitrary). Further work is required to clarify this question. Conclusions: Some seropositive cats appear to shed virus intermittently. More cats from single cat households need to be followed to establish criteria for knowing when a cat has truly ceased to be infectious. 1.2.9 Salivary FCoV shedding

The vast majority of saliva tests on survey cats were negative. Twelve cats have had RTPCR positive saliva swabs on a solitary occasion. There were two curious positive results on two cats which did not seroconvert. These may have been false positive results, since contamination is a risk in PCR. Alternatively, they may indicate that in some cats infection may be contained at the level of the oropharynx. Conclusions: RT-PCR of saliva swabs is not useful in detecting which cats are potentially infectious. Since most cats do not shed FCoV in their saliva, mutual grooming and food bowls are presumably not a major source of transmissible virus. It is possible that the immune response in the oropharynx is important in determining the outcome of infection.

More cats need to be saliva tested to establish whether this hypothesis is true. If so, the immune response that contains the infection needs to be determined. 1.2.10 Conclusion

Two-thirds of the way into the survey we have answered many of the questions that we
asked at the outset pertinent to the practicing veterinarian, cat breeder and ordinary cat owner. It remains to build up statistically significant numbers in the last year, so that the conclusions outlined above may either be proven or disproven with certainty and the results published to benefit cats everywhere. 1.2.11 References 1. Addie D.D., Toth S., Murray G.D., Jarrett O. (1995), "The risk of feline infectious peritonitis in cats naturally infected with feline coronavirus," Am. J. Vet. Res. 56 4, 429-434 2. Foley J.E., Poland A., Carlson J., Pedersen N.C. (1997), "Patterns of feline coronavirus infection and fecal shedding from cats in multiple-cat environments," JAVMA 210 9 1307-1312 3. Kipar A., Kremendahl J., Addie D.D., Leukert W., Grant C.K., Reinacher M. (1998), "Fatal enteritis with coronavirus infection in cats," J. Comp. Path. 119:1-14. 1.2.12 Related Links:

1994 International Feline Infectious Peritonitis (FIP) and Feline Enteric Coronavirus (FECV) Workshop Updates on Feline Infectious Peritonitis New Tests Being Commercially Marketed for FIP Detection Feline Infectious Peritonitis - Virus Shedding and Infection - The American Experience (FECV in the Cattery) Feline Infectious Peritonitis - An Update for Breeders

http://www.fabcats.org/fip.html

Feline infectious peritonitis (FIP)

Feline infectious peritonitis (FIP) is fatal disease of cats, caused by a feline coronavirus. Infection with coronavirus is actually very common in cats but most of the time it does not cause any problems, other than maybe mild self-limiting diarrhoea. Uncommonly, the virus mutates (changes) within an infected cat, and it is this mutated form that causes the disease of FIP.

How do cats get coronavirus?

Coronavirus is ubiquitous among cats and infection with the virus is particularly common where large numbers of cats are kept together. It is estimated that 25 to 40 per cent of household pet cats are infected. This infection rate increases to 80 to 100 per cent of cats kept in multi-cat households, rescue and breeding colonies. The virus is spread by the faecal-oral route, that is, the virus is shed in faeces into the environment and cats become infected following ingestion when grooming or eating. Most infected cats shed the virus in faeces for a variable period of time and then stop. The cat can then become re-infected from another cat and start shedding virus again. In contrast, some cats shed virus continuously. Although coronavirus is the cause of FIP, infection with coronavirus does not mean that the cat will go on to develop FIP. In comparison to the number of cats infected with the virus, the number that develop FIP is very small. It is only when the virus mutates that FIP may develop.

What causes the virus to mutate?

While the precise cause of the viral mutation is unknown, several factors are likely to play a role. The majority of cases of FIP develop in younger cats. A poorer immune response together with other stress factors such as rehoming, neutering, vaccination or other concurrent disease may make younger cats more vulnerable to FIP. FIP can, however, develop in any age of cat and predisposing factors or risk factors are not always evident. Genetics may also play a role in some cases as purebred cats appear to be at a greater risk. Sometimes particular lines of a breed have a high rate of developing FIP.

What are the clinical signs of FIP?

FIP has very diverse clinical manifestations, but there are no clinical signs associated that are unique for the disease. The classic form of the disease, often termed 'wet' FIP is characterised by a build up of yellow fluid within the abdomen (resulting in abdominal distension) and/or chest (resulting in breathing difficulties). However, the presence of this fluid is not diagnostic for FIP, and in addition a large number of FIP cases will not have any visible fluid build up. Initial clinical signs are often very vague, consisting of lethargy and loss of appetite. In some forms of the disease inflammatory lesions in the eye and nervous system can occur, resulting in visual disturbances and abnormal behaviour, a wobbly gait or tremors. The disease is usually rapidly progressive and ultimately fatal.

How can FIP be diagnosed?

There is no specific diagnostic test for FIP. Tissue biopsies can confirm a diagnosis, but often the cat is too sick for these procedures to be undertaken and so in many cases a definitive test is only made on post mortem examination. If FIP is suspected, the veterinary surgeon will perform a thorough clinical examination, including examination of the eyes and neurological assessment. The more findings that are present that are consistent with FIP, the more likely the cat does have FIP. If any fluid is present within either the chest, abdomen or both, analysis of this fluid is one of the most useful tests that can be performed. X-rays of the chest and abdomen, and ultrasound examination of the abdomen are very useful to detect very small amounts of fluid when obvious signs of fluid build up are lacking. This fluid can then be sampled via ultrasound guidance. The fluid is most often (but not always) thick and straw-coloured in appearance, and on analysis has a very high protein content and low cell count. The presence of fluid in the abdomen does not confirm a diagnosis of FIP as some other diseases can also lead to the build up of similar fluid. If the fluid is present within both the chest and abdominal cavity, then FIP is even more likely. Routine blood tests (haematology and biochemistry) are very helpful firstly in trying to exclude other causes for the clinical signs, and secondly to look for changes which may support a suspicion of FIP. Frequently the numbers of one type of white blood cell (lymphocytes) are low, there may be a mild anaemia, blood protein levels are usually very high, and sometimes blood bilirubin (pigment from old red blood cells) levels are high. All these changes are very non-specific and do not make a diagnosis of FIP, but help to increase suspicion of the disease. Many of these abnormalities may not be present in the early stages of the disease, but may become evident as the disease progresses. Thus some tests that give normal results may have to be repeated later. Cats can be tested to see if they have been exposed to coronavirus by checking for the presence of specific antibodies. However, such a coronavirus serology test is of very limited use in diagnosing FIP. This test does not distinguish between the coronavirus encountered commonly with few associated problems, and the mutated form that causes FIP. So, as many cats are infected with coronavirus, many cats will be positive with this test. It does not give any information as to whether that cat has or may develop FIP. Furthermore, some cats with confirmed FIP are actually negative for antibodies, so it also can not be used to exclude FIP. In cats with neurological signs without any other abnormalities, MRI scan of the brain and analysis of CSF fluid can also be useful.

Can FIP be treated?

Once clinical signs of FIP develop, it is generally an incurable and fatal disease. Treatment is given to relieve symptoms and may include anti-inflammatories and appetite stimulants. While there are a handful of anecdotal reports suggesting some success with newer antiviral drugs, studies have yet to show a proven benefit of any such treatments. In most cases euthanasia is the most humane course of action to avoid suffering.

Is there a vaccine for FIP?

There is a commercial vaccine that has been developed and is used in the USA . It is not available in the UK . The efficacy of the vaccine is really unknown with different studies producing very different results. It does not appear to be particularly effective, and is only licensed for use in kittens over 16 weeks of age, by which time most kittens are already infected with the virus anyway.

How can FIP be prevented and controlled?

Household pets FIP is least common in household pets. The risk can be minimised by obtaining cats from a source with relatively few cats and by keeping cats in small stable groups (less than five cats in a household). Minimising stress factors', such as rehoming, worming, vaccination and neutering happening all at once, or while the cat is suffering from another illness, may also help minimise the risk of the disease.

2.

Breeding catteries with endemic FIP

Total eradication of coronavirus infection from catteries is extremely difficult as the virus is so ubiquitous, and it is unsuitable in most cattery situations to attempt this. A more practical approach is to consider elimination of coronavirus infection in newly born kittens, providing the opportunity of re-homing kittens free of coronavirus. If pregnant queens are isolated one to two weeks before they are due to kitten, and then the queen is kept isolated with her kittens (whilst employing good hygiene procedures to prevent environmental spread of infection to the kittens), a substantial number of these kittens with remain negative for coronavirus. Following weaning, the queen can be removed and the kittens still kept isolated and tested at 12 to 16 weeks of age for coronavirus antibodies. If they are negative, the isolation procedure has been successful. This procedure sometimes fails if the queen is shedding the virus and passes it on to her kittens. It is thought that this is less likely in queens over two years of age, and can be helped by early weaning of the kittens (at five to six weeks of age when maternally derived antibodies are still protective) and removing the queen from the environment. Good hygiene is also an important part of the control of spread of the virus to kittens in these situations. Although these procedures are successful, they require considerable commitment from breeders, and there are some concerns about the behavioural development of kittens when they are reared is isolation up to the age of four months. Often it is more appropriate to accept that there is endemic coronavirus infection and institute measures to try and minimise its impact. Considering that the virus is spread by the faecal-oral route, practical control measures that can be used include: Having at least one litter box for every two cats, located in easy to clean/ disinfect areas Litterboxes should be kept away from food and water bowls to prevent cross contamination Faeces should be removed from litterboxes at least once daily, and litter should be completely changed as often as possible accompanied by disinfection of the trays Cats should be kept in small stable groups of four or less minimising cross-contamination within a household Breeding programmes with more than eight to 10 cats (including kittens) should not be undertaken in a normal household. Larger numbers require some purpose built facilities to enable proper hygiene and care to be maintained. Regular brushing of the coat, particularly of long-hair cats is desirable to reduce contamination with faeces and litter Isolation of queens and their kittens can be recommended as a means to controlling spread of coronavirus to the kittens. Rescue catteries Adequate hygiene and avoiding overcrowding are essential strategies for minimising the risk of FIP in such situations. Cats should be housed individually, or if this is not possible, they should be batched on arrival, and kept in small stable groups.
Updated November 2005

http://www.marvistavet.com/html/body_fip.html

FELINE INFECTIOUS PERITONITIS (FIP) (A SUMMARY)

Imagine a disease that is infectious yet not contagious, has 100% mortality, virtually no diagnostic test to confirm it, and no effective treatment. When FIP becomes a possibility for a pet cat, questions abound yet not nearly enough answers. In the past, we have simply linked to other sites to review this complicated infection but after numerous requests to get our own version of a summary, we have decided to cover some basics here in an FAQ format. WHAT IS FIP? Feline Infectious Peritonitis is a syndrome that results from wide-spread infiltration of the bodys organs with inflammatory tissues called pyogranulomas. The resulting global inflammation leads to the failure of the infiltrated organs, fevers unresponsive to antibiotics, and often the accumulation of thick yellow fluid in the belly or chest. The wet form of FIP, includes the effusion of thick, yellow fluid as noted. The dry form is more insidious, leading to death over a much longer period (often years). Both forms are felt to have 100% mortality. IS FIP CONTAGIOUS? Very simply, the answer is no. SO HOW CAN AN INFECTIOUS DISEASE NOT BE CONTAGIOUS? Feline Infectious Peritonitis is a reaction to infection with the feline coronavirus. Most cats who become infected with the feline enteric coronavirus (often simply called feline coronavirus) essentially get the flu and never develop anything that can in any way be described as serious. Some cats, however, react with this devastating syndrome. WHAT DO WE KNOW ABOUT THE FELINE ENTERIC CORONAVIRUS? Here are some basics about this virus: It is common wherever cats are housed in groups and it is readily transmitted between cats. Transmission is typically by contact with infected feces. This means that the litter box is the usual place where infection takes place. This infection is unusual in cats that free-roam outdoors (no litter box) or who live in homes where there is only one cat. The virus enters the new hosts body via the nose and mouth. An active infection lasts several weeks to a few months. Virus is shed in the infected cats stool during this period. If the cat is reinfected, virus sheds again for weeks to months. During this time, the cat may or may not seems at all ill. Some infected cats do not shed virus. Households with fewer than 5 cats eventually spontaneously clear of coronavirus. Households with more than 5 cats virtually never clear of coronavirus. Most household disinfectants readily kill coronavirus immediately. Room temperature kills coronavirus within 48 hours. Carpeting is protective to the virus and the virus is able to survive in carpeting for at least 7 weeks. Once a cat has been infected with the virus and recovered, the cat can be easily re-infected by continued exposure to infected feces. In this way, many catteries where there are always cats sharing litter boxes never rid themselves of this infection. The enteric coronavirus attacks intestinal cells and creates GI upset. As the long as the infection is confined to the GI tract, there will be no FIP. The process of immunological defeat of the virus involves a cell called a macrophage. The macrophage consumes infected material, packaging it in special structures which it floods with acids and digestive enzymes. Any virus is killed by this process and its components are then used by the immune system to help mount a specific immunological reaction (i.e. make the proper antibodies, send specific killer cells etc.) In some cats, a mutation occurs in the coronavirus. This mutation occurs during

infection and allows the virus to survive the treatment by the macrophage. Instead of being killed by the macrophage, the virus essentially uses the macrophage to hitch a ride into the bodys core. The macrophage response mounts in an attempt to kill the virus but ends up producing heaps of ineffective macrophages and immunologic proteins which make up a special immunologic tissue called a pyogranuloma. FIP is basically the infiltration of normal organs with pyogranulomas. The mutation to a form of virus that can cause FIP is more likely to occur in a cat with an immunecompromise. Most cats with FIP are under age 1 year (their immaturity being their immunecompromise). Crowding is also an important source of immune-compromise.

WHY ISNT THE MUTATED VIRUS CONTAGIOUS? We do not know for sure why. We can inject fluids from a cat with FIP into a normal cat and cause FIP but short of this kind of experimental transmission, the mutated virus doesnt seem to infiltrate into the natural external secretions of an infected cat. This effectively confines the mutated virus inside the sick cats body, though the sick cat will still shed non-mutated virus.
HOW IS IT POSSIBLE THERE IS NO TEST FOR THIS CLASSICAL DISEASE? We used to think that the difference between getting the flu and getting FIP was all about the strain of the virus with which a cat gets infected. Lots of time and effort was spent trying to determine what made the FIP virus special. We no longer think there is a special strain of virus that causes FIP. FIP results, as described above, from a mutation that occurs in the virus after infection has occurred. Whether or not this mutation occurs seems to relate more to the immune status of the cat than any factor in the virus. The more virus there is replicating, the greater the chance of mutation occurring. Having an immature or suppressed immune system means more virus replicating. WHY CANT WE JUST TEST FOR MUTATED VIRUS? The mutation isnt the same every time. There are two viral genes and the mutation pretty much always involves at least one of them but the mutation can occur in any number of places within either of these two genes. There are currently too many possible mutations to develop a meaningful test. WHAT KIND OF TESTING IS AVAILABLE? At this time the diagnosis of FIP is clinical. This means that there is no positive or negative test; the doctor must look at the sum of several findings. These are some of the findings that are coupled with the physical examination and history findings to come up with a diagnosis of FIP Elevations in Total Protein and Gamma Globulins Total serum protein is a simple value that can be checked in virtually every animal hospital in a matter of minutes. Cats with FIP commonly have very high serum protein levels. Now, there are many types of proteins in the blood. The type that elevates in FIP is basically antibody levels of assorted types. If a blood panel is checked on a cat with FIP, serum protein is often divided into albumin and globulin amounts (adding these together provides the total protein level.) When protein levels are broken down into these two groups, it will be the globulin level that is elevated. If the globulin level is further broken down, using a special test called electrophoresis, it will be found that it is the gamma globulin levels that are elevated. The gamma globulins include antibodies and the FIP infection classically creates so much immune reaction that all antibody levels are elevated. The Albumin to Globulin Ratio FIP tends not only to elevate globulin levels but it also tends to decrease albumin levels. Albumin is an important carrier protein in the blood and ones body tends to conserve it at all costs. Albumin can be lost through glomerular disease, protein-losing enteropathy, or it can be under produced by a failing liver. All these conditions can occur with FIP. If the albumin to globulin level is less than 0.8, there is a 92% statistical chance that the cat has FIP. If the ratio is greater than 0.8 there is a 61% chance the cat does not have FIP. The FIP Titer This test is often included on a feline blood panel and reflects a cats circulating antibody level against

coronavirus. The problem is that exposure to coronavirus is common in cats and is not particularly meaningful in diagnosing FIP. Further, cats with fulminant FIP may not be producing FIP antibodies and have negative titers. The only time such a titer might be useful is if one is screening a healthy cat for coronavirus; in this event a negative titer would indicate that the cat will not be shedding virus and can be introduced into a coronavirus free living situation. Many breeders strive for coronavirus-free catteries and such screening is important. The test is not helpful in diagnosing FIP in a sick cat, however. Testing the Belly/Chest Fluids FIP classically produces a clear but viscous yellow effusion, usually in the belly but possibly in the chest or in both locations. The fluid typically has a total protein level greater than 3.5 mg/dl. Several efforts to find a diagnostic test that could be performed on this fluid have been made. So far we know that typically FIP fluid is high in lactate dehydrogenase, alpha-amylase, and adenosine demaminase. It is controversial whether or not an FIP antibody titer in the effusion fluid is of significance. Studies have been conflicting. Rivaltas Test This is a test with which few veterinarians are familiar but it can be very helpful in the diagnosis of FIP. A test tube is filled with distilled water and one drop of 98% acetic acid is added. To this mixture one drop of effusion is added. If the drop dissipates, the test is negative. If the drop retains its shape, the test is positive. A negative Rivaltas test is 97% accurate in ruling out FIP. A positive test is 86% accurate in ruling in FIP. PCR Testing PCR testing is an extremely sensitive method for detecting DNA, in this case coronavirus DNA. The advantage it has over traditional antibody titers is that it distinguishes active virus infection from past exposure. At least at this time, PCR testing cannot distinguish mutated FIP-causing virus from regular coronavirus. Immunofluorescent Coronavirus Staining of the Effusion In this test the effusive fluid is tested immunologically for presence of coronavirus using antibodies tagged with fluorescent dyes. In a study using a large number of cats, there were no false positives meaning that if this test is positive there is a 100% confirmation that the cat has FIP. Unfortunately, if the test is negative that does not mean the cat does not have FIP (only 57% of negatives did not have FIP). Tissue Biopsy Most FIP cats are too sick for surgery, though sometimes flushing away the belly effusion surgically provides a rally of improvement temporarily. A tissue sample is the best method for confirming FIP as there are few conditions that create pyogranulomas throughout the body but if regular biopsy is equivocal, tissues can be stained for the presence of coronavirus and only in FIP will there be enough coronavirus within macrophages for positive staining. A positive tissue stain is 100% accurate in confirming FIP

IS THERE REALLY NO EFFECTIVE TREATMENT? There is really no effective treatment for FIP and virtually 100% mortality. The goal of confirming FIP (as best as can be done) is to rule out other diseases which might be treatable. Currently the best we can offer with treatment is the possibility of temporary palliation of signs. It is important to realize that this is a progressive disease one should become familiar with criteria for euthanasia and emotionally prepare for this decision. ISNT THERE AT LEAST EXPERIMENTAL TREATMENT? There is virtually always experimental treatment. Here are some treatments that are being explored or which have been explored: Immune suppression FIP is a disease created by the cats own immune system. Immunosuppressive drugs such as prednisone and cyclophosphamide have been used to slow the progression of FIP.

Removing the effusion Suctioning of the effusion will ease the difficulty breathing of a cat with fluid in its chest but even removing the effusion from the belly helps remove a large source of inflammation. Some cats experience a temporary improvement with the fluid removed. Antiviral Drugs Ribavarin was tested and not found to be helpful. Interferon alpha was tested and not found to be helpful when given as an injection and actually made infection worse when given orally. Feline Interferon gamma is being investigated.

WHEN A CAT DIES OF FIP WHAT IS THE INFECTION RISK TO THE REMAINING CAT? You can bet that the roommate has already been infected with the coronavirus. If there are only one or two surviving cats, the chances are that in time the virus will completely clear and they will stop getting reinfected. Surviving cats are felt not to have any higher risk over the general population for developing FIP from their coronavirus, though a littermate of the FIP cat might have a slightly higher incidence due to predisposing genetic factors. WHEN IS IT SAFE TO GET ANOTHER CAT AFTER ONE DIES OF FIP? Since this is not a contagious disease, one can argue that one does not need to wait before getting another cat. If one wants to see that there is no remaining coronavirus around the house leftover from the deceased cat, a 3 month period has been advocated. If there are surviving cats, one can periodically check FIP titers and wait for them to go negative before adding another cat if one wishes to avoid further passing around of coronavirus. The new cat can also be screened for an FIP titer. When one considers that only 5% of cats in multi-cat homes get FIP despite the incidence of exposure to coronavirus being as high as 80% in some studies, this may not be necessary. ISNT THERE A VACCINATION? Developing a vaccination has historically been fraught with difficulty simply because it is the immune response against the virus that causes the disease. How does one make a vaccine without creating the same immune response against the virus? Pfizer has developed the only FIP vaccine on the market by using a temperature sensitive mutant coronavirus. This virus is innoculated into the cats nose. The virus is incapable of spreading beyond the nose and throat because it cannot survive at body temperature. In the nose and throat, however, it generates a localized immune response that prevents a coronavirus from effectively entering the body. The effectiveness of this vaccine has been questionable and remains in controversy. The vaccine is given to cats over age 4 months of age and is thus not helpful in the chief situation where a vaccine could do the most good: the breeding cattery. Because most cats are not at risk for FIP infection and those that are, are at risk at an age too young for the vaccine, most veterinary teaching hospitals do not stock this vaccine. The ideal candidate for vaccination would be an uninfected cat going to a cattery where litter box sharing is likely. This would seem to be an unusual situation but it might come up in these circumstances: A feral cat is moved into an indoor or shelter colony. (It is not unusual for FIV+ cats from feral colonies to be removed from the colony and put in a sanctuary for FIV+ cats). A cat from a single cat home is released to a rescue group goes to a foster home where there are a number of other cats already present. A cat moves from a single cat home to live in a multi-cat home.

The information in this summary was largely drawn from the following article: K. Hartmann. Feline Infectious Peritonitis. Veterinary Clinics of North America Jan 2005; 39-79.

http://www.ovma.org/pets/fip.html
Feline Infectious Peritonitis (FIP) Feline Infectious Peritonitis Virus (FIPV) is a coronavirus. There are many strains of feline coronaviruses. Strains that cause a mild intestinal disease (diarrhea) are called Feline Enteric

Coronavirus (FECV). Strains that cause FIP are thought to be a form of the enteric virus (FECV) that mutates into the lethal FIPV due to environmental and genetic factors in the affected cat. FECV and FIPV are connected because all cats that have FIPV also have FECV. The opposite is not true. FECV is widespread in the cat population. Feral or free roaming cats have an FECV incidence of about 30%. Catteries where there is a dense population of genetically related cats can have an incidence of FECV of about 100%. The same is true for households with more than 6 unrelated cats. Households with 3-4 cats have a 75% incidence of FECV. The FECV can spread from cat to cat through contact with infected feces, water bowls, articles of clothing, litter and litter pans, etc. The incidence of FIPV on the other hand, does not follow the same infectious pattern. In fact, FIP is not considered an infectious disease. If one cat in a house dies of FIPV, this does not increase the likelihood that another cat in the same house will die of the disease. There may be houses where several or all cats are positive for FECV, but none or only one cat gets FIPV. This pattern of disease fits more with the concept that FECV may mutate or change to a lethal FIPV within an individual cat. Whether this mutation occurs depends on a cat's genetic make-up, immune function, state of health, age and the stresses the cat experiences. There is an age-related resistance to FIP. The most susceptible to FIP are very young cats (under 1 year) and the very old. Testing for feline coronaviruses is frustrating. There are no tests that distinguish FECV from FIPV. Tests that look at the number of antibodies produced (this is called a titre) by a cat against the coronavirus only indicate that the cat has been exposed to a coronavirus. It does not give any indication as to the likelihood that the cat will develop FIP. Several things can cause a high coronavirus antibody count (or titre) in a cat. These include: 1) vaccination for FIP, 2) vaccination against other unrelated diseases. To further complicate things, some cats can shed coronavirus but never mount an immune response so they will have low coronavirus titre. Recently, a DNA-based test has been developed. This type of test identifies the actual presence of the coronavirus itself, as opposed to identifying the cat's response (antibody titre) to the virus. The DNA based tests do not yet distinguish FECV from FIPV. Also, false negatives can occur. That is to say that some cats that succumb to FIPV have tested negative for coronavirus with the DNA based test. At present, there is no perfect test for the feline coronavirus. A cat with FIPV does have characteristic changes in infected tissues (kidney, spleen, liver). By taking a sample of these tissues (surgically or after the cat is dead) a definative diagnosis of FIPV can be made by examining the tissue at the microscopic level. Cats recently infected with the FECV virus often have mild or no clinical signs. They may experience upper respiratory signs (sneezing, watery eyes) or intestinal signs (diarrhea). Usually cats make a complete recovery from this primary infection; although some will go on to become reinfected and some will become carriers of the virus. Unfortunately, a few cats will experience the lethal disease of FIP. This may occur weeks to years after the initial infection. The lethal form of FIP may have a sudden or insidious onset. The two main forms of FIP are the dry and wet (or effusive) forms, although a cat may develop a combination of these two forms. Cats that get these forms of FIP have very active immune responses, but they are ineffective at neutralizing the virus. It is their active, but futile, immune response that contributes to many aspects of the clinical disease. The result of the ineffective immune response is vasculitis (inflammation in and around the blood vessels). This inflammatory process makes the vessels leaky and fluid escapes. In the wet form, fluid accumulates in the abdomen or chest, often making breathing difficult. The wet form is 4 times more common than the dry form. The dry form usually has a slower onset. The body compensates for the damaged vessels and the 'leakiness' is controlled, although the inflammation still proceeds. The cat usually experiences loss of appetite and weight, dull hair coat, depression, anemia and fever. This progresses to organ failure of the kidneys, liver, pancreas and neurological system. The signs an infected cat exhibits at this stage mimic numerous other disease processes and can make the diagnosis of FIP difficult. To assess whether a cat's signs are compatible with FIP, a veterinarian will consider several things including the cat's lymphocyte (a type of White Blood Cell) numbers, globulin levels, physical findings and possibly the results of antibody titres and the coronavirus DNA based test. There is no effective cure or treatment of FIP. Supportive care is aimed at making the cat as comfortable as possible and treating the signs that arise. This may involve immunosuppressive medication and removal of excess fluid accumulation. These measures only treat the cat's signs, they do not stem the progression of the disease.

Development of FIPV in a cat depends on that cat's individual gentic make-up and to some extent, environment. To prevent the disease, breeders should aim at breeding cats with a natural ability to avoid the disease and elect not to breed cats that produce FIP susceptible offspring. This involves keeping detailed records on the disease status of their own animals and of the kittens they sell. People who live in multicat households should take care when introducing a new (especially young or old) cat into their household. If this new cat comes from an environment where it has likely been exposed to FECV, it is likely safe. If it has never been exposed to the virus, this new cat may have problems, especially if it is younger than a year, or very old. Prevention also involves attention to hygiene and cleanliness, reducing the "stress" in the cat's environment, and minimizing exposure to other diseases, especially Feline Leukemia Virus and Feline Immunodeficiency Virus. There is an intranasal vaccination available for FIP for cats over 16 weeks of age. It appears to be safe, but different studies show various levels of efficacy of the vaccine. Also, kittens are usually infected with FECV by 10 weeks of age. Once exposed to FECV, there is no need to vaccinate the cat. So many kittens will aready be exposed before they are able to be vaccinated. Vaccinated cats will have a positive coronavirus titer. If a breeder or multicat owner uses titers as the basis for accepting or rejecting a cat into the household, vaccination may confuse this method of screening. For more information on FIP, visit the Cornell Feline Health Center Web Site, and talk to your veterinarian.

http://www.catchow.com/catcarecenter_physical3.aspx?combinedID=21409
Our 2 year old cat, Kit, had to be put down last week for FIP. Our 6 month old kitten, Reese, has a 1/100 titer, which, I was told, means he is has been exposed, but doesn't mean he will definitely get it. I read in one of your answers (I think) that he has a 20% chance of contracting the disease full blown. We have to get him tested in 3 weeks, and then again in 6 months. If his titer doesn't increase, then he will be fine I was told - he won't contract the disease. I was told by one vet that if he is fine, we can get another cat for him after 6 months, and they will be in no danger of getting it, even though he's been exposed. Then I was told by another vet, if he is fine, we can NEVER get another cat (as long as he lives) because they could still contract the disease from him, just because he has the titer. Could you please break the tie and tell me what your thoughts are? Feline Infectious Peritonitis (FIP) has become a complicated and confusing topic for veterinarians and clients. FIP is a viral disease caused by a type of virus called a coronavirus. The most common type of coronavirus that infects cats is a coronavirus that isnt very virulent and only reproduces itself in mature intestinal cells. This coronavirus is called the feline enteric coronavirus (enteric meaning intestinal). This enteric coronavirus just causes mild diarrhea that goes away on its own, in young cats. Every now and then, one of the harmless intestinal coronaviruses can mutate into a highly virulent, nasty virus that can escape the intestine and spread throughout the body. This mutant, more dangerous virus can cause the disease FIP, and we call this virus the FIP virus. In 1995, a very important study was published in the American Journal of Veterinary Research to see what happens to pet cats that test positive after exposure to intestinal coronaviruses. Their study showed that cats who tested positive for coronavirus and are living in a house where FIP was recently diagnosed (for example, YOUR cat) is not any more likely to develop FIP than cats who test positive but live in a household where FIP has never been diagnosed. Basically, ANY cat that carries ANY coronavirus is potentially at risk for developing FIP. Approximately 30% of pet housecats have been exposed to coronaviruses, compared to 80-90% of cats in catteries. It is more likely that an individual cat will develop FIP as a result of infection and reinfection with coronaviruses, some of which may spontaneously mutate into the deadly FIP virus, as opposed to the spread of the FIP virus between cats. The risk of an individual cat developing FIP decreases with time. As time goes on, seropositive cats like yours are more likely to become more immune to the disease, as opposed to being more susceptible. There is no point in continuously testing your cat. It makes no difference, really, if the titer increases or decreases. In fact, that study that I cited followed 56 cats whose antibody levels decreased, then suddenly increased, indicating that they had been reinfected with a coronavirus, yet only 3 of these 56 cats ended up developing FIP. To summarize things: FIP is a sporadic disease, and whether it will develop in a coronavirus-infected environment is simply a matter of luck. It is estimated that the FIP mortality rate is households with only one or two cats is about 1 in 5000 cats. These are very small odds. You can add another cat to your household whenever you want. The odds of that cat getting FIP is very small. And the longer your present cat goes without developing FIP, the less and less likely he will develop it in the future. I hope this clears this up for you.

http://www.angelfire.com/fl/furryboots/fip.html

YEAR 2001 KNOWLEDGE ON FIP ... full name FELINE INFECTIOUS PERITONITIS by Irene de Villiers
There is new information about FIP and how it behaves, and which tells us more than we knew before. Corona virus indeed can spread from one cat to another - so is contagious as *corona* but not as FIP. The mutated FIP can NOT spread from one cat to another, and it has to mutate from corona to FIP within each cat that is infected. the FIP disease is in any case not a virus attack - it is the cat's own antibodies attacking itand of course that too can not be handed from one cat to another. In group situations where it might look like there is an epidemic of FIP - the reason for the FIP looking contagious is not that it spreads from cat to cat, but that the common factors that predispose the corona mutating to FIP, are there for all the cats in that environment. So we really need to look at what predisposes corona to mutate to FIP. There is thought to be a genetic predisposition though this is currently not *proved* one way or the other. It may just be a case of predisposition due to genetic lack of heterozygocity (ie inbreeding depression) and thus lower resistance in general. The details of any possible genetic predisposition are as yet unexplained I believe. But there is known predisposition where there is stress. Stress is the biggest known predisposition factor for FIP. In the past it was thought that corona virus titer would indicate likelihood of mutation of that corona to FIP. That too is disproved. You can get high FIP incidence with low corona titer. You can also get low FIP incidence with high corona titer. It is the presence of stress that is the direct correspondence item for chances of FIP - not the presence of Corona virus. All cats have some corona virus, so theoretically, all cats can have their corona mutate to FIP. The problem with corona virus is that it DOES cause symptoms in many cats, and that is of course stress inducing, in that corona can cause intestinal problems like diarrhea. From that perspective, the stress from this can predispose mutation to FIP. Some multi-cat homes therefore try to rid themselves of high corona titer, or re-home high corona titer cats. I don't go along with this - and prefer to take the approach that the true predisposer is stress AS PERCEIVED BY THE CAT. FIP will attack by mutating in a stressed cat even if the kindest environment is present - but where the cat feels stressed. Some cats have a personality to stress more easily and about different things, than other cats.

In general, cats feel stressed if there is overpopulation. rule of thumb is one room per cat as territory - and this correlates closely with the finding statistically, that FIP is far more prevalent where there are 7 cats or more, than where there are less cats. As for tests to determine presence of FIP, there are two tests n the market, which give 95% predictive values for FIP. The one is a PCR test that looks for mutated FIP virus (not corona virus) and which is recommended for use to confirm FIP virus presence at autopsy rather than as a screening test. It was developed in 1994. It will find the virus itself, and is not dependent on antibody from an intact immune system. The other is an ELISA test developed in 1998, using the principle of looking for antibody to mutated FIP virus. This does depend on the immune system being viable enough to make antibody, and is recommended as one of the things to use to determine whether a cat has FIP, as a screening test. It is "95% predictive" which means that it will predict a case of FIP being present, with 95% success if the test is positive. I have personally seen this test in use and it was accurate in prediction for 40 out of 40 cases where I worked. It tends to find cats negative who the vet thinks are positive - and definitely saved the life of a couple of cats that way where I worked. I especially remember one 16 year old rather overweight lady who looked like a wet FIP case, and who was so lethargic as to be totally immobile. The vet was really pushing the owner to euthanize and stop what he called the "heroic IV measures", but the owner wanted a positive test and twice it came back negative. Sure enough, Cleo two days later, hopped off the IV table when her hydrating session was about to start, and next thing was other side the clinic building, feeling fine thank you very much. It's my opinion that this test is a great asset, and that it should be used when FIP is suspected. I would still treat the cat for FIP symptoms homeopathically, and use it only for diagnosis - I would never use any test as a way to make a decision on euthanasia. That decision is for the cat to make - they tell you when they are not enjoying life. No test does that - but tests DO help you devise symptoms the cat may have but which they might be unable to communicate. Blood tests for example, will often tell you a cat is nauseous or whatever,so you can use that rubric when repertorizing for the matching homeopathic remedy. A positive FIP test would also trigger my wanting to make a nosode from the fluid that is specific to the cat and I would use the FIP nosode treatment - the general nosode for FIP/FIV/FeLV in the meantime. Later one can go on to specific homeopathic remedies to match symptoms, as the case progresses. But with alternative health, and conventional tests, there is hope for FIP cases to live with more quality days/weeks/years than conventional medicine can offer. Cats have survived correct positive FIP diagnosis. The cat's first line of defense against FIP is a cellular immune response. This can in fact overcome FIP. The danger with FIP, happens when the invading virus gets PAST the cellular response, to the general immune antibody system. Once the cat's antibody system "sees" the FIp virus, it makes antibodies to the FIP virus, and these antibodies kill the cat. That is why traditional FIP treatment is things like cortisone that knock out the antibody immune system. It's because the cat's antibodies to FIP are the killer action, not the virus growing in the cat as with "normal" viruses. But if the cat can fend off the FIP at the cellular response level (local level of cell immunity), not the general level of antibody manufacture through the overall immune system, then it can get rid of FIP altogether. It's only the antibody "defense" that kills the cat who has mutated its corona to FIP.

I hope that helps explain this horrid FIP phenomenon. You can see why a conventional vaccine for FIP would be contraindicated, as it would teach the body to make antibodies and that would actually *predispose* death from FIP if FIP got into the cat after that. The so-called FIP vaccine that is currently available is not used by any vet who understands this mode of death of FIP. The theory behind the vaccine, is that it is a nonvirulent temperature-sensitive form of FIP, which they HOPE will only get to the cellular response system, and not through to the antibody system - they hope this from the perspective that the virus gets into the nose where it is cool, and that the temperaturesensitive virus will die before it gets further into the body where it can trigger antibody manufacture (and thus death.) Most vets consider that playing with fire. I think the homeopathic nosode's approach of strengthening cellular immunity and prevention of infection this way, without any fear of a virus getting in there to be able to trigger an antibody response (since there is no virus in the nosode), is the way to go. That said, in a well developed case of FIP, where the symptoms may NOT be the initial FIP symptoms, but something different in an advanced case, I would see a real homeopath for the best way to treat those symptoms in the specific cat. These thoughts are mine about FIP - after my information research on FIP, my experience at the clinic with it, and my my experience with homeopathy principles and practice. I hope it is useful info somewhere along the line. Finally, here is one example of a FIP case handled with homeopathy and nutrition. It also explains the principles I apply when suggesting a homeopathic approach to FIP. FIP Case, March 2003, using homeopathy and nutrition.

http://experts.about.com/q/700/4186394.htm
Expert: Jennifer Fry Date: 12/2/2005 Subject: FIP, Pregnancy, Other Cats, and Risks Question I recently took in a stray female cat, her name is Ash and she is about 6 months old. I took her to the vet at the beginning of November. She had a FeLuk/FIV test done which had a negative result, and was vaccinated with FVRCP+FeLuk, and dewormed. She is supposed to go back at the beginning of December to get a second shot...... On Monday 11/28, I took her, and two of my other cats (also 6-7 months old), to another veterinarian to be spayed and neutered...... Monday evening when I went to pick up the male they also gave me Ash and told me that they couldn't do the procedure because she had a temperature of 104.2 (which they didn't take until after they had already put her under anesthesia and had already shaved her belly before they realized she felt warm). They proceded to tell me that she probably had FIP-wet form, because of the temperature, she seems under-developed/underweight for her age, and she had a "pot belly", and that she probably only has about 6 months to live...... The next day after the anestesia wore off she was back to her usual affectionate self and didn't have a fever, temp was 102.2.... She is eating fine, has normal stools and urine, and not vomiting. She does not have any discharge from her eyes, nose or ears, and is active and playful. She seems like a happy healthy cat to me.

My questions are these: 1. I recently found out that I am pregnant; is there any risk to me or my baby from a cat that has FIP? If so what is the risk?.... 2. I have 3 other cats. One is 7 1/2 years old, and the other 2 are 6-7 months old. The two 6-7 month olds interact frequently with each other, but not much with Ash. The 7 1/2 year old doesn't interact with any of the other 3 cats. Are they at risk for being infected with FIP? I'd read that the incidence of Environmental exposure to FIP is really low if the cats don't really interact with each other; Is this true?.... 3. Is there any way that it could be something other than FIP, and if so what are the other possiblilites?.... 4. Can an adverse reaction to anestesia cause a cats temperture to rise for a time?.... Thank you for any information you can give me on this, I really appreciate you taking the time to answer my questions. Answer 1. I recently found out that I am pregnant; is there any risk to me or my baby from a cat that has FIP? If so what is the risk?.... NO, this is a cat to cat issue from a corona virus. However, being pregnant you should not be scooping litter boxes due to Toxoplasmosis exposure from any cat. 2. I have 3 other cats. One is 7 1/2 years old, and the other 2 are 6-7 months old. The two 6-7 month olds interact frequently with each other, but not much with Ash. The 7 1/2 year old doesn't interact with any of the other 3 cats. Are they at risk for being infected with FIP? I'd read that the incidence of Environmental exposure to FIP is really low if the cats don't really interact with each other; Is this true?.... Corona virus is EVERYWHERE in the environment and many cats are exposed to it. They are not sure exactly what happens with the case of FIP but it is believed to be the body mutating the virus which leads to formation of the fluid and immune complexes. I would separate the other cat to be on the safe side. 3. Is there any way that it could be something other than FIP, and if so what are the other possiblilites?.... If the fluid in her belly is yellow and sticky, then it is FIP and she is terminal. If the fluid is clear, then it could just be an overwhelming amount of intestinal parasites. I would take a stool sample to the vet to be checked as intestinal parasites can be transmitted to your other cats as well as people. Even if the stool sample is negative, I would recommend giving her a course of deworming as well to be on the safe side. Or she could be pregnant. 4. Can an adverse reaction to anestesia cause a cats temperture to rise for a time?.... Yes this could be a possibility and they should have taken her temperature BEFORE anesthesia. Often with FIP cats will spike fevers that are not responsive to antibiotics. Expert: Jennifer Fry Date: 11/3/2005 Subject: FIP Question I have a 1yr old cat who I recently noticed was breathing rapidly. My cat had no other symptoms (fever, weight loss, lethargy, etc), but to be on the safe side, I took him to our local vet. After a phsyical exam and an x-ray, the vet informed me that my cat had was suffering from fluid build up in his lung cavity that made it so that his lungs couldn't expand and take in a full breath. Out of concern for my cat, my local vet sent me to an emergency clinic in another town where they tapped my cat's lungs and did some blood work. At the clinic I was informed that the fluid in his lungs was yellow and

contained protien (but no bacteria). Based on this they diagnosed him with the effusive form of FIP with a 95% of certainty. It was made clear to me that this is a VERY serious disease and that if my cat does in fact have it he will die in a very short amt. of time. I am writing to you in the hopes that you will be able to provide me with any possible alterative diagnosis that I could expore with my local vet. It is a very hard pill to swallow that my cat is deathly ill and yet shows no symptoms other than shortness of breath. I would really appreciate ANY insight you could offer. Thank you. Answer I would recommend having the fluid sent out for PCR analysis along with the FIP Elisa Specific test. Typically the fluid from an FIP cat is yellow and sticky/stringy. If there is heart disease or a tumor in the chest, then the fluid is usually clear and not sticky....either way, fluid in the chest does not lead to a good long-term prognosis. However, if it is indeed wet FIP, then it is a very poor prognosis. Sometimes steroids will help reduce the immune complexes that form with FIP, and diuretics such as Lasix may help reduce some fluid build up. Usually they will spike fevers unresponsive to antibiotics with FIP. You could consider a chest/heart ultrasound with the specialist to see if they can determine heart disease or tumor. Otherwise feed a high quality all-natural diet and try to build up his immune sytem with supplements such as Transfer Factor. One of my cats is FIP + on the ELISA specific test but I have had him for 2 years and there is no fluid accumulation but he has severe inflammatory bowel disease, so the possibilities are that he has indeed has dry FIP or has just been exposed to corona virus. FIP is not understood that well and there are a lot of unanswered questions about it. Expert: nicole damphouse Date: 7/26/2004 Subject: FIP Question Hello. My cat has been acting very peculiarly lately. She has the corona anti-body. She has been hiding under the bed for about a week. today she came out and could barely walk. she hasn't been eating much. she is walking with much difficulty and doesn't seem to be very coordinated. What should i do? i am afraid to take her to the vet because they never seem to know what is really bothering her and in the mean time she is traumatized with the visits. thank you. Answer Hi Lourdes! There is new information about FIP and how it behaves, and which tells us more than we knew before. Corona virus indeed can spread from one cat to another - so is contagious as *corona* but not as FIP. The mutated FIP can NOT spread from one cat to another, and it has to mutate from corona to FIP within each cat that is infected. the FIP disease is in any case not a virus attack - it is the cat's own antibodies attacking it and of course that too can not be handed from one cat to another. In group situations where it might look like there is an epidemic of FIP - the reason for the FIP looking contagious is not that it spreads from cat to cat, but that the common factors that predispose the corona mutating to FIP, are there for all the cats in that environment. So we really need to look at what predisposes corona to mutate to FIP. There is thought to be a genetic predisposition though this is currently not *proved* one way or the other. It may just be a case of predisposition due to genetic lack of heterozygocity (ie. inbreeding depression) and thus lower resistance in general. The details of any possible genetic predisposition are as yet unexplained I believe. But there is known predisposition where there is stress. Stress is the biggest known predisposition factor for FIP. In the past it was thought that corona virus titer would indicate likelihood of mutation of that corona to FIP. That too is disproved. You can get high FIP incidence with low corona titer. You can also get low FIP incidence with high corona titer. It is the presence of stress that is the direct correspondence item for chances of FIP - not the presence of Corona virus. All cats have some corona virus, so theoretically, all cats can have their corona mutate to FIP.

The problem with corona virus is that it DOES cause symptoms in many cats, and that is of course stress inducing, in that corona can cause intestinal problems like diarrhea. From that perspective, the stress from this can predispose mutation to FIP. Some multi-cat homes therefore try to rid themselves of high corona titer, or re-home high corona titer cats. I don't go along with this - and prefer to take the approach that the true predisposer is stress AS PERCEIVED BY THE CAT. FIP will attack by mutating in a stressed cat even if the kindest environment is present - but where the cat feels stressed. Some cats have a personality to stress more easily and about different things, than other cats. In general, cats feel stressed if there is overpopulation. rule of thumb is one room per cat as territory and this correlates closely with the finding statistically, that FIP is far more prevalent where there are 7 cats or more, than where there are less cats. As for tests to determine presence of FIP, there are two tests n the market, which give 95% predictive values for FIP. The one is a PCR test that looks for mutated FIP virus (not corona virus) and which is recommended for use to confirm FIP virus presence at autopsy rather than as a screening test. It was developed in 1994. It will find the virus itself, and is not dependent on antibody from an intact immune system. The other is an ELISA test developed in 1998, using the principle of looking for antibody to mutated FIP virus. This does depend on the immune system being viable enough to make antibody, and is recommended as one of the things to use to determine whether a cat has FIP, as a screening test. It is "95% predictive" which means that it will predict a case of FIP being present, with 95% success if the test is positive. I have personally seen this test in use and it was accurate in prediction for 40 out of 40 cases where I worked. It tends to find cats negative who the vet thinks are positive - and definitely saved the life of a couple of cats that way where I worked. I especially remember one 16 year old rather overweight lady who looked like a wet FIP case, and who was so lethargic as to be totally immobile. The vet was really pushing the owner to euthanize and stop what he called the "heroic IV measures", but the owner wanted a positive test and twice it came back negative. Sure enough, Cleo two days later, hopped off the IV table when her hydrating session was about to start, and next thing was other side the clinic building, feeling fine thank you very much. It's my opinion that this test is a great asset, and that it should be used when FIP is suspected. I would still treat the cat for FIP symptoms homeopathically, and use it only for diagnosis - I would never use any test as a way to make a decision on euthanasia. That decision is for the cat to make - they tell you when they are not enjoying life. No test does that - but tests DO help you devise symptoms the cat may have but which they might be unable to communicate. Blood tests for example, will often tell you a cat is nauseous or whatever, so you can use that rubric when repertorizing for the matching homeopathic remedy. A positive FIP test would also trigger my wanting to make a nosode from the fluid that is specific to the cat - and I would use the FIP nosode treatment - the general nosode for FIP/FIV/FeLV in the meantime. Later one can go on to specific homeopathic remedies to match symptoms, as the case progresses. But with alternative health, and conventional tests, there is hope for FIP cases to live with more quality days/weeks/years than conventional medicine can offer. Cats have survived correct positive FIP diagnosis. The cat's first line of defense against FIP is a cellular immune response. This can in fact overcome FIP. The danger with FIP happens when the invading virus gets PAST the cellular response, to the general immune antibody system. Once the cat's antibody system "sees" the FIP virus, it makes antibodies to the FIP virus, and these antibodies kill the cat. That is why traditional FIP treatment is things like cortisone that knock out the antibody immune system. It's because the cat's antibodies to FIP are the killer action, not the virus growing in the cat as with "normal" viruses. But if the cat can fend off the FIP at the cellular response level (local level of cell immunity), not the general level of antibody manufacture through the overall immune system, then it can get rid of FIP altogether. It's only the antibody "defense" that kills the cat who has mutated its corona to FIP.

I hope that helps explain this horrid FIP phenomenon. You can see why a conventional vaccine for FIP would be contraindicated, as it would teach the body to make antibodies - and that would actually *predispose* death from FIP if FIP got into the cat after that. The so-called FIP vaccine that is currently available is not used by any vet who understands this mode of death of FIP. The theory behind the vaccine, is tat it is a non-virulent temperature-sensitive form of FIP, which they HOPE will only get to the cellular response system, and not through to the antibody system - they hope this from the perspective that the virus gets into the nose where it is cool, and that the temperature-sensitive virus will die before it gets further into the body where it can trigger antibody manufacture (and thus death.) Most vets consider that playing with fire. I think the homeopathic nosode's approach of strengthening cellular immunity and prevention of infection this way, without any fear of a virus getting in there to be able to trigger an antibody response (since there is no virus in the nosode), is the way to go. That said, in a well developed case of FIP, where the symptoms may NOT be the initial FIP symptoms, but something different in an advanced case, I would see a real homeopath for the best way to treat those symptoms in the specific cat. These thoughts are mine about FIP - after my information research on FIP, my experience at the clinic with it, and my my experience with homeopathy principles and practice. I hope it is useful info somewhere along the line. Finally, here is one example of a FIP case handled with homeopathy and nutrition. It also explains the principles I apply when suggesting a homeopathic approach to FIP. And this one which has more up-to-date info on corona virus and FIP: http://www.cfainc.org/health/FIP.html "Recent research has shown that mutant FECVs arise within an individual cat. Thus, we now know that the vast majority of cats do not "catch" FIP, but they develop it themselves from their own mutant FECV. Transmission of FIP from cat to cat is considered to be rare. This fact has caused leading FIP researchers to state that cats who are ill with FIP are unlikely to be a risk to other cats and thus do not need to be isolated."

http://www.rfwclub.org/vfip.htm
One of the most confusing and frightening health issues facing pet cats today baffles pet owners, cat breeders, and researchers alike. Feline Infectious Peritonitis (FIP) kills cats of all species, from house pets to lions. It affects very young or very old cats. Although a vaccine is available, experts disagree on its effectiveness and benefits. Routine use remains very controversial. Sadly, perfectly healthy cats are euthanized when so-called FIP tests are misinterpreted. There is no test available to prove your cat has FIP. The only definitive test for FIP must be performed on tissue samples taken after the cat has died. The confusion arises because common tests measure the titer (levels of immune components) in the cats bloodstream. Cats are susceptible to Feline Enteric Coronavirus

(FECV), Canine Coronavirus (CCV), and a virus that normally affects swine called Transmissible Gastroenteritis Virus (TGEV). Different labs offer variable interpretations of what constitutes a negative or positive Corona titer level. Your kitty may test positive from one lab, and negative from another using the same sample. A positive titer simply means exposure took place and one of these viruses left a fingerprint (antibody) behind. It does not mean Kitty has FIP, nor does it predict a cat will get sick. In fact, experts estimate that up to 90 percent of pet cats are exposed to a Corona virus during their lives. Immunity doesnt last very long, though, and cats continuously infect and re-infect each other particularly in multiple cat environments. For that reason, cats from shelters, catteries, feral colonies and the like are at highest risk. Another test, RT-PCR (Reverse Transcriptase-Polymerase Chain Reaction) offered by some commercial laboratories measures the amount of virus shed in the feces. Cats do transmit Corona virus to each other through infected feces or saliva, but shedding cats arent necessarily sick with FIP. Correlation between fecal shedding and FIP hasnt been proven. Only one out of ten Corona infections results in FIP. On top of that, the RT-PCR tests often are wrong because a single molecule can corrupt the test and cause false positives and false negatives. The next part of the puzzle sounds like science fiction. FIP develops when the harmless form of Corona virus infects a cat, and later mutates into a monsterand then the cats over-enthusiastic immune response ultimately kills. In a very real sense, each FIP virus is unique to that individual cat. Direct cat-to-cat transmission of FIP is rare. Once FIP virus passes through the intestinal wall into the bloodstream, infected white blood cells turn into virus factories and carry their lethal cargo everywhere. A variety of symptoms develop, depending on which organ(s) become infected. Finally, the cats immune response speeds up destruction of the tissue. The effusive form causes leakage of fluid into the abdomen, which swells with a straw-colored liquid. However, symptoms can be vague to severe, and mimic many other diseases. Without specific tests, veterinarians must be pet detectives and rule out other causes before suggesting a diagnosis of FIP. There is no cure for FIP. Treatment focuses on making the cat comfortable for as long as possible. Often the disease has been called the purring disease because cats purr up to the moment of deathin an effort to comfort themselves and ease the pain. If you lose a cat to FIP that does not mean other cats in your care will become ill. The FIP virus arises as the result of a mutation, and cant be predicted or prevented. Even the most fastidious and caring cat owners, shelters, and breeders lose cherished cats to this disease. An FIP Guarantee from a reputable cat breeder simply means the kitten/cat will be replaced should he become illnot that he wont get the disease.

http://www.thepetprofessor.com/articles/article.aspx?id=369

cat owner can hear from their veterinarian, is your cat has FIP. FIP stands for feline infectious peritonitis, a mutation of the common corona virus, which is present in almost all catteries and multi-cat households. Many cats carry elevated levels of the virus in their blood without being infected, or asymptomatic carriers. 2.1 Why then, is it so deadly? When people ask me about the chances of their cat getting or having FIP, I try to use a comparison to a human disease, as they may be more familiar with that, and have some understanding of how it progresses. The example I use is commonly known in people as flesh-eating disease, or necrotizing fascia-itis. This often fatal disease in humans is a mutation of the common strep throat virus. As yet, science has no explanation for why it mutates in some people, and not in others. It has been beaten with prompt and aggressive intervention. Unfortunately, that is not the case for FIP, which is now acknowledged as the RNA virus with the most variations discovered, all of them deadly. The corona virus can be considered something like a cold virus. It exists in a household, but not everyone is going to get it, let alone is someone going to die from a severe form of it. You can perform a blood test to determine the level of corona virus, but this is not an indication that your cat has active FIP. Only that it has a high level of the virus in its blood. This can mean it is a carrier, it has been in close contact with cats who have active FIP, or it can mean nothing more than the cat is stressed. FECV, or feline enteric corona virus is the common form present in many cat households. Its spread by the fecal to mouth route, making thorough disinfecting of litter boxes and their surroundings, imperative as a preventative measure. Many cats acquire FECV and recover. Others do not recover, in the sense that they become shedders of the virus, but are perfectly healthy themselves. These are the cats that may pose a problem for other cats susceptible to the virulent mutation. The solution of course, is to separate the shedder from the other cats. It does not mean you have to euthanize or give them away. Indeed, if your other cats are in good health, it may not be a concern at all in a pet household of two or three animals, which are not in contact with other cats. Identifying shedders is nearly impossible, unless you peform PCR (polymerase chain reaction) fecal analysis for 5-9 months. There is also no known way to identify cats who will contract the mutation which becomes FIP. It is not known to be genetic, or hereditary in origin, but recent research indicates that cats with a tendency to a compromised immune system, e.g. those who do poorly, dont thrive, and contract various minor ailments, may be at the highest risk. If your cat is seriously ill with symptoms such as high fever, lethargy, vomiting (which are not exclusive to FIP), it can be many things. At this point in time there is no exact diagnosis, except on post mortem, where a pathologist will either find thick, viscous strings of mucoid type material in the abdomen (know as wet FIP), or lesions somewhere in the body, which can be very difficult to locate. (known as dry FIP) There is a vaccine, but its efficacy and possible side effects are hotly debated, and it is used by very few breeders, who consider the risks outweigh the chances of contracting the virus. The bottom line is: if your vet diagnosis your cat with FIP, ask them how they made the diagnosis. Blood titres are unreliable. So is guessing on the basis of a certain set of symptoms. If you have the opportunity, your best bet is taking the cat to a teaching facility, where they would be more familiar with the condition. An exploratory can be done for the wet form, which often will show itself in a swollen abdomen with ascites, in advanced cases. But

lesions are harder to locate. There are further tests, including ultra sounds and analysis of the spinal fluid. The decision is yours, as the pet owner. Ask for all the information available. You have the right to a second opinion, and to insist on treatment if it is at all possible your cat has another condition.

http://www.shelterpetsink.com/FIP.htm
For anyone whos dealt with it, the thought of FIP brings stark fear. FIP is a disease that breaks all the rules. Rescuers have to deal with it frequently and they know that its hard to diagnose and that the diagnosis is a usually a death sentence. Recently, I was fortunate enough to be able to attend the FIP Symposium at the Western Veterinarian Conference in Las Vegas. The speakers were Dr. Melissa Kennedy, who specializes in researching viruses at the University Dr. Susan Little, a renowned lecturer, Dr. Danielle Gunn-Moore from the U.K. and Dr. Niels Pedersen from UC Davis who is one of the leading researchers in the field. The information in this article comes from that symposium. Feline Infectious Peritonitis (FIP) comes in two forms: Wet (effusive) and dry (non-effusive). The experts all agree, and emphasized that there is no diagnostic test for FIP. There may be some abnormal lab values that make a veterinarian suspicious of FIP, but the diagnosis is rarely firm until the cat or kitten dies. Often the cat or kitten presents to the veterinarian as just not being right. The symptoms, particularly for the dry form can be very vague. There are some symptoms, though, that should cause suspicion that a cat may have FIP. These include:
age of the cat (usually less than 3 years or older than 13 years) fever that comes and goes and is not responsive to antibiotics loss of appetite weight loss low energy neurological signs such as seizures or difficulty with balance urinary incontinence, which is rare in cats and is almost always a sign of FIP a very large abdomen filled with fluid (in the wet form only)

Symptoms may occur suddenly or may happen so gradually that by the time they are noticeable, they are very severe. Cats with FIP usually have had a recent stressor such as illness, surgery, moving to a new place, or a recent addition to the family such as a baby or a new cat or dog. It has been noted that many cats with FIP are declawed, so although theres no research on this, it is thought that declawing is a bigger stress to cats than many other surgeries. So how do cats get FIP? Recent advances tell us that there's a genetic component as well as an environmental one. FIP is a mutation of a virus called Feline Enteric Corona Virus (FECV) that is shed by some cats in their feces. It can also be shed through saliva, though this is rare. FECV and FIP are not communicable to humans. Many cats have FECV but never show signs of illness. If a cat's immune system and genetics are such that they can be exposed to FECV without converting it to FIP, they don't ever get the disease. It's important to note that once a kitten has FIP it doesn't have to be isolated as it is no longer contagious in this form. In fact, the experts believe that it may be more stressful to the kitten to isolate it. Older cats who get FIP are cats who have been carrying the FECV virus all along, but whose immune systems are now no longer able to handle it. Many of the experts believe that kittens should be kept away

from adult cats until they are 6 months old so that they have no chance of being exposed too FECV while their immune systems are still developing. It used to be that most cases of FIP were the wet form and in this form, kittens usually only live a few days to a few weeks. Now, however, veterinarians are seeing more of the dry form, which, according to Dr. Pedersen, means that cats are developing more immunity. In the dry form, some cats survive several weeks to over a year. Although there is no cure for FIP, the diagnosis itself is not a reason to euthanize a cat or kitten. If euthanasia is necessary, it is because the cat no longer has a good quality of life. To try to prevent FIP, it is important to keep the environment very clean. Litter should be scooped twice daily and then thrown out after a week. The box and litter scooper should be cleaned with a disinfectant before new litter is put in. Food and water should be changed daily and the bowls should also be disinfected weekly. For rescue groups with kennel facilities, the same bowls should be kept with the same group of cats or kittens. New cats or kittens should be isolated for a minimum of 21 days. Kittens should then be kept separate from adult cats (as mentioned earlier) until theyre at least 6 months of age. One of the many tragedies of FIP is that often the people affected are those whove lost a beloved older cat and then adopt a kitten. After the adoption, the kitten becomes sick and FIP may be suspected. This is frustrating to both rescuers and adopters as the rescuers see the kitten as healthy and ready for adoption. This is because rehoming can be a great stress for some cats and kittens. When the kitten dies, the adopter who so recently dealt with the death of a beloved pet must now deal with death again. When the panel was asked about this, they said that potential adopters might want to adopt a cat 1-2 years of age so as to try to avoid this. Cats of any age bond equally well with new families. While there's still no news of a cure, more information is now known about this disease so that hopefully it can become less prevalent. Kari Winters is a Registered Nurse, member of Cat Writers' Association, and volunteers with Siamese rescue. She can be reached through her website www.shelterpetsink.com. This article was first published in The Pet Press in Los Angeles, CA.

http://www.homevet.com/petcare/flnvrs.html
Is FIP Contagious?
As with other viruses, spread of infection to other cats is a concern. However, there are three stages of FIP infection, and significant risk to other cats occurs in only the first two stages. 1. The first stage is initial infection. During the two- to four-week period following viral infection of the cat, a large amount of virus is shed; other cats in direct contact with virus will be exposed. 2. The second stage is one of dormancy. The virus is inactive within the cat, so it causes no disease. If the cat is stressed during this stage, some virus shedding may occur. Otherwise, the cat is not contagious. This stage may last a few weeks to several years. 3. The third stage is clinical illness. It usually lasts a few weeks and terminates in death of the cat. As a rule, the cat is not contagious during this stage.

http://www.fip-support.org/faq.htm
See the kitten in the upper left hand corner. See what is behind him? It is part of the suns corona. The corona virus looks something like this, seen under a microscope - hence the name. What is FIP? FIP is short for Feline Infectious Peronitis. FIP caused by infection by the corona virus (FeCV). It is one of the most feared diseases in catteries. It is also one of the most misunderstood diseases, wrapped in a veil of myths and quite often gossip. Lets change that! FIP is lethal! It kills cats and quite often brings out the worst in people. Knowlegde should change things, so lets take a closer look at this dreaded disease! What is the corona virus? It is an RNA virus that very willingly mutates. It is a viral infection that is limited to infecting intestinal villi. This is one of the most common viruses - it also has equivalents in man, pigs, dogs etc - but remains species specific. In it self the parent virus is fairly harmless - often the cat may only get a minor diarrhoea and/or a slight fever, maybe not even that. In most catteries up to 80-90% of the population is corona positive. This situation is fairly harmless the problem arises when the virus mutates within a single cat. My cat has tested Corona positive - is it going to die? Not likely! The corona virus is very widespread and highly contageous. However only about 5% of all cats who have contracted the virus, will actually develop FIP. That gives you an average survival rate of 95%! What are the symptoms? There are two forms of FIP: wet (effusive) and dry (non-effusive). FIP is a disease with many faces and may not always be easy to determine. What happens is this: In a cat who has been infected with the corona virus (FeCV), sometimes the parent virus mutates - by then we call it FIP-virus. This is very different than the parent virus. Where the parent FeCV virus will not cause many symptoms and generally is harmless, the mutated form of the virus will cause the cats blood vessels to start leaking. In the wet form, the chest cavity and/or abdomen will fill with yellowish fluid, containing high amounts of proteins, but no sign of bacterial infection. The cat will be pot-bellied, a clear sign that the abdomen is filling up. This may happen in a matter of only a few days - wet FIP can develop very dramatically and quickly! Dry FIP is more tricky! The cat will start out with very subtle symptoms. The added sum of symptoms will help pinpoint the diagnosis. You may be looking at a cat, who for weeks is losing appetite, losing weight, being lethargic - jaundice and anemia may develop as well. At some point you will find your self at the vet, and a full blood panel is a good thing to do. Dry

FIP will cause tiny "knots" placed different places in the cats body. They may be found in the heart, liver, kidneys, behind the eyes - when examined under a microscope you will find crystallized virus parts and white blood cells. In some cats the central nervous system (CNS) may be affected, and the cat will start to lose its balance on its hind legs. Any changes in the eyes should be carefully examined. What to look for in a blood panel: a very high titer, high globulin count and low lymphocyte. Then you might have a cat with FIP - but there really is no exact way to tell other than by biopsy of affected organs, and often we are talking about necropsy rather than biopsy. A cat with FIP is a very sick cat...! My vet says my cat has developed FIP - is it going to die? Sadly, if the diagnosis is correct, the answer is yes.... There is no cure for FIP. But DO remember a corona positive cat with no clinical symptoms is NOT the same as a cat with FIP!!! Only a cat with clinical symptoms of disease can be a cat with FIP! Should I titer test my cats? That depends on why you want to do titers - what do you want to learn? Realize that a titer will only show you what you might already know, namely that your cat is forming antibodies against the corona virus. But the test cannot tell you which strain of corona the cat is infected with! Nor can it tell you whether the cat will ever succumb to FIP in the future! Remember this: Only about 5% of corona positive cats will develop FIP! The titer is mainly a bunch of meaningless numbers - it will cost you lots of money, but if you are looking for guarantees of life, this is not the road to take. Titer testing cats with no clinical symptoms is fruitless! How is the corona virus spread? The primary route of infection is faecal -> oral. In other words, the virus is spread via the litterbox. Kittens and teenage cats will shed up to 100 times as much virus in their faeces compared to adults! It is therefore important to keep litterboxes clean - and maybe not have too many kittens running around at the same time, sharing litterboxes if you want to keep the viral load down. The virus is only very sparsely spread in saliva - only in newly infected cats; only for a few days and in very low degree. It is not really considered a route of infection. Read this next paragraph very carefully: Only the PARENT corona virus is spread via faeces! A cat with FIP in outbreak is not contageous! The parent virus may still be shed in its faeces, but will be harmless - it is the mutated form of the virus that will kill the cat. HOWEVER - the mutated form of the virus connects to the macrophages. This is a special type of white blood cells - these are not shed from the body! Therefor a cat with clinical FIP is NOT contageous. Remember this - it may take away the edge of panic attacks, when you first encounter FIP! Its overwhelming - what can I do? Good husbandry is a good start. Keep litter boxes clean. Try to keep a harmonic cat group stress has great influence on the immune system. Some may try to raise corona negative kittens by doing early weaning. This means removing the kittens from their mother at age 5 weeks and letting them grow up in isolation. However this method is certainly not for everybody! Give it careful consideration before you go down this road!

The corona virus is highly contageous - and the risk of cross contamination is quite obvious. You may do your very best, but it IS very difficult to keep up quarantaine in a regular home. You must also consider if you can properly stimulate the kittens in isolation - if they turn into frightened pets because of lack of human contact, how much will you have gained? And be prepared that IF you chose this solution, their mother will be severely affected by losing her kittens at such young age. Yes, she WILL get over it - but she is likely to search frantically for her kittens for several days. It can be quite heartbreaking to watch. Therefore early weaning is not for everybody... Personally I find that if kittens can only be raised safely by removing them from their mother much earlier than nature would have it, maybe it has come too far and a new and different strategy must be found. This may include changing bloodlines! Because you may also need to look at pedigrees! Part of the key to why some cats develop FIP while others dont, is genetics. Some lines / breeds may be clearly more prone to develop FIP than others. Take a stern look at the lines you are working with - it may be that some cats need to be removed from your breeding program. And learn to live with the fact that FIP is nobodys fault! It just happens - sometimes people s children get cancer, but you dont see anybody shouting "bad parents" at them... Same thing with cat breeders - FIP is not a disease that anyone "gives" to their cat! The key is in each cat s own immune system response. Cell- mediated immunity, unfortunately, does not protect a cat against the corona virus (FECV). Antibody-mediated immunity is needed to clear FECV infection. Cell-mediated immunity is only effective in controlling FIP mutants of that benign coronavirus. Setting up cell- mediated immunity with an intranasal vaccine is useless in preventing a cat's infection with FECV. Where there is FECV, there is the POTENTIAL for FIP. But almost all cats that have FECV infection do not develop FIP. Why do some cats activate a cell-mediated immune response and others a antibody-mediated immune response? We dont know yet..... So is there a vaccine - or not...? Most likely not...! If a cat cannot wage an adequate immune response to the native virus, it cannot form an effective immune response to the vaccine strain either. There IS a product out there, being marketed as an FIP vaccine. But many scholars believe it to be at best useless. Here is a report on the value of the FIP vaccine: University of Giessen. It is in German language, about 150 pages and somewhat discourging to read. The conclusion of the report is that in the test made here, more cats in the group of cats who received the vaccine, ended up dying of FIP, than in the control group who did not receive the vaccine! You may draw your own conclusions as to its safety...

http://www.lbah.com/feline/fip.html
One of the ways we check for fluid during an exam is to look for a fluid wave. Double click on the picture below and you can see the wave.