Spray boy cats

New insights into the

infectious peritonitis of the cat

Feline Infectious Peritonitis (FIP) is a disease caused by coronaviruses (feline coronavirus - FCoV). These viruses usually cause harmless intestinal infections in cats. However, FIP can result from this in around 5% of infected cats.

Disease emergence
More than 50% of all cats excrete coronaviruses (mainly with their feces) or have antibodies against them. Many animals are completely healthy in the process, but become a source of infection for other cats. In the outside world, the virus can survive for up to 6 weeks. The infection occurs through the mucous membranes of the nose and mouth when sniffing and licking other cats or when pawing in the litter box. Transmission through contaminated clothing, toys, and food bowls is possible. This then usually leads to an intestinal infection. FIP only arises when the genetic information (mutation) changes in the intestine with the increased multiplication of the "harmless coronavirus" and the virus changes its properties. This is how it gets from the intestines into the blood and is distributed throughout the body. The main damage is not caused by the virus itself, but by the defensive reaction in the cat's organism and by substances that are released at the same time that cause inflammation. The result is accumulations of fluid (effusions) in the abdomen and / or chest due to changes in the vessels (= moist FIP) and, less often, inflammatory, nodular organ changes (= dry, granulomatous FIP).
So far, not all details about the development of the disease have been clarified. Ultimately, an increased virus replication in the intestine causes an increased risk of mutations. It is believed that the cat's immune status plays a crucial role. There are animals in which the disease does not break out despite virus mutation, because a strong cell-mediated immune reaction obviously prevents it. However, these cats continue to excrete viruses as latent virus carriers. Complete virus elimination is also suspected in some of the animals. However, this makes them susceptible to new infections again. Furthermore, young cats, genetic predispositions, the properties of the virus itself, the amount of viruses and the reinfection rate in multi-cat households are all risks for the outbreak of FIP.
It is assumed that the main cause of the disease is stress, which occurs, for example, when strange cats meet in the household or in the animal shelter. Other diseases can also promote FIP.

disease symptoms
As the virus spreads throughout the body, a variety of symptoms can be observed that can also occur with other diseases. FIP is suspected if a cat is apathetic for a long period of time, eats poorly, loses weight, has attacks of fever, or fluid builds up in the abdomen and / or chest cavity. Difficulty breathing, yellowing of the mucous membranes, impaired consciousness, diarrhea, runny nose and changes in the eyes may occur. An abdominal discharge is noticeable due to the increasing abdominal girth of a mostly lean cat.

Difficulties in making a diagnosis
Contrary to widespread opinion, there is still no way of distinguishing "FIP" viruses from "harmless coronaviruses" in routine diagnostics. The usual FIP test (antibody detection - FCoV-AK), which is positive in more than 50% of all cats, only allows a statement to be made about whether a cat has had contact with the coronavirus, but not about whether it is still infected and shedding the virus or whether she has or is developing FIP.

If there is an effusion, FIP can be diagnosed with great certainty by examining the fluid.
If there is no effusion, diagnosis is difficult, as all modern methods do not allow clear statements. A reliable diagnosis can be made by examining tissue samples or by detecting a virus.
By combining various diagnostic options (FIP screening), the suspicion of the presence of a FIP disease can be expressed. In FIP screening, the following parameters in the blood indicate FIP: mild anemia, neutrophilia, lymphopenia, increased globulins, lower albumin / globulin quotient, increased liver enzymes, increased bilirubin, sometimes increased urea. Other viral diseases should also be investigated, such as leukosis (FeLV) and cat eenids (FIV). Furthermore, an examination of the effusion (Rivalta sample, puncture examination) can further substantiate the suspicion.
Evidence is provided by the detection of the mutated coronavirus (FIPVirus RealPCR test) in the abdominal and / or thoracic fluid as well as in modified organ samples in combination with the typical symptoms of the disease.

Once a FIP has broken out, it was previously considered incurable. Since 2019 there has been an antiviral treatment with GS 441524, which can lead to a rapid improvement in symptoms and a cure. However, there is still no experience of how high the cure rate is. The active ingredient is not approved in Germany and may therefore not be obtained and used by veterinarians. If you violate this, you risk losing your license to practice medicine. However, it is not illegal for pet owners to use the drug privately. Therefore, pet owners get the active ingredient themselves and inject it into their cat. Cats receive 1 injection daily for up to 3 months. The active ingredient is now also available in tablet form (www.mutianstore.com). This therapy is relatively expensive. To protect the animal, however, it is advisable to carry out the therapy under veterinary supervision by the veterinarian. In addition to ultrasound and X-ray controls, blood tests are usually used to identify possible side effects at an early stage. At the moment we are working on an approval for veterinarians. You can find out about the purchase of the active ingredient via FIP-Warriors or a Facebook group on the net.
Symptomatic treatment can be attempted, which leads to the death of the animal in differently short periods of time.

There is no absolutely reliable protection against FIP. A cat that has contact with other cats will sooner or later come into contact with the coronavirus. Whether a cat has been infected with the coronavirus (not whether it has FIP!) Can be proven by means of an antibody test.
Overall, it is important, firstly, to avoid FCoV infections (reducing the risk of transmission) and, secondly, to minimize or control the development of FIP by primarily reducing stress.

Second cat: If you want to add another indoor cat that is negative in the FCoV-AK test, it is advisable to test the new cat before it comes into the household in order to avoid the introduction of the virus.
Group keeping of cats: Prevention of spread and reinfection is achieved through special hygiene (cleaning the toilets several times a day, disinfecting regularly, feeding bowls in another room, max. 4 cats per group, one toilet per animal). If a cat has FIP or is suspected of having FIP, separation should take place if that cat has only been with the other cats for a short time. Otherwise she has already excreted viruses and the other cats have already had contact with the virus. The risk of another cat developing FIP is no higher than with a coronavirus infection (5%; slightly higher in immunocompromised young cats), as the FIP virus is most likely not transmitted. However, stress (operations, pregnancy, change of ownership) should be avoided. Many cats manage to eliminate coronavirus infection over the course of months or years. Maximum hygiene is important and a new animal should not be admitted.
Individual keeping: If a single cat has died of FIP, after thorough cleaning and disinfection, a 3-month waiting period should be observed to be on the safe side before a new cat comes into the household. If you want to take in a young kitten from an uncontrolled environment (farm, animal shelter), you should make sure that it comes to the new home before the end of the 6th week of life, as contact with the virus is unlikely at this age .

The vaccination is the only protection against FIP ​​for cats that have not had any contact with coronaviruses. Since this cannot be determined with certainty, the vaccination is controversial among experts.
The vaccine is instilled into the cat's nose and aims to create a protective barrier at the entry point and thus prevent the virus from entering the body. Efficacy is not certain in cats that have already had contact with the coronavirus. The vaccination doesn't do any harm. In contrast, in cats without antibodies (FCoV-AK negative) the occurrence of FIP can be reduced by the vaccination. It should be noted that vaccinated cats become "antibody positive" and it is then no longer possible to say whether natural contact with the virus has taken place.

Content and texts Copyright Tierarztpraxis Dr. Rottmayer Leipzig. Internet: www.tierarzt-leipzig.de