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Small Animal Medicine: Exam 1 (Spring 2016) > L7: FIP: Dx And Control (Levy) > Flashcards

L7: FIP: Dx And Control (Levy) Flashcards

1
Q

FIP can present like:

A
  • liver dz
  • lymphoma
  • FIV
  • CNS dz
  • abd. Neoplasia
  • toxoplasmosis
  • bacterial peritonitis
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2
Q

Transmission of FCoV

A
  • fecal-oronasal
  • highly infectious
  • shed in feces (also saliva, resp. Excretions, urine)
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3
Q

Prevalence of FCoV Ab in pet cats

A

25-75%

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4
Q

Prevalence of FCoV Ab in feral cats

A

12%

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5
Q

What percent of carriers of FCoV develop FIP

A

Less than 10%

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6
Q

What proportion of FCoV seropositive cats shed the virus? Seronegative?

A

Seropositive: One third
Seronegative: none

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7
Q

CS of FCoV

A
  • asymptomatic or brief mild upper resp. Tract signs

- self-limiting diarrhea, vomiting

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8
Q

Etiology of FIP

A
  • clinical IMMUNE-MEDIATED syndrome
  • induced by infection with FCoV (may involve viral mutation)
  • can be systemic or affect single organ
  • pathogenicity enhanced by FeLV > FIV
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9
Q

Epi of FIP

A
  • prevalence about 1%
  • most common in young cats w/ hx of multi-cat env
  • purebreds, males have higher risk
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10
Q

Dx of FIP

A
  • PE/Hx

- CBC/Chem, serology, effusion analysis, CSF analysis, RT-PCR, virus culture, tissue biopsy

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11
Q

CS of FIP

A
  • fever unresponsive to abx
  • rapid wt. loss
  • icterus and/or yellow plasma
  • anorexia, depression
  • body cavity effusions
  • abd. Mass
  • neuro signs
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12
Q

4 main types of FIP

A

Effusive
Noneffusive
Intestinal
Neurological

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13
Q

Effusive FIP char. By:

A
  • vasculitis, serum exudation
  • peritoneal, pleural, pericardial effusion
  • abd masses (omental and visceral adhesions, granulomas, mesenteric lymphadenopathy)
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14
Q

Noneffusive FIP char. By:

A
  • vague signs
  • ocular inflammation (uveitis)
  • neuro signs
  • irregular kidneys
  • mesenteric lymphadenopathy
  • intestinal obstruction
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15
Q

Intestinal FIP char. By

A

-focal granulomatous lesion of colon or ileocecocolic junction
-death by 9 mo. Usually
-may mimic intestinal adenocarcinoma
+/- GI obstruction

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16
Q

Most common cause of inflammatory CNS dz in cats

A

Neurological FIP

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17
Q

CS of neurological FIP

A
  • multifocal CNS signs
  • hyperasthesia
  • flaccid, mentally dull
18
Q

What do you expect to find on CBC in cat with FIP?

A
  • lymphopenia
  • neutrophilia +/- mild L shift
  • hyperproteinemia
  • nonregen. Anemia

*may be normal!

19
Q

What do you expect to find on Chemistry in cat with FIP?

A
  • hyperglobulinemia w/ low A:G ratio
  • hyperbilirubinemia
  • inc. LIV enzymes

*may be normal!

20
Q

Rivalta Test

A
  • easy test for FIP
  • H2O + acetic acid + effusion
  • if congealed, positive for FIP
21
Q

Ab titer levels in healthy cats do/do not correlate w/ FIP risk

A

Do NOT

22
Q

No FIP serologic test; must test for FCoV

A

:)

23
Q

FCoV serologic testing indications

A
  • support dx of clinical FIP
  • contact with FCoV shedder
  • screening catteries
  • screening before adding new cats to FCoV-free catery
  • controlling FCoV in catteries
  • not indicated for screening healthy pet cats or in shelters
24
Q

Effusion analysis in FIP

A

-color clear to YELLOW
-viscous, frothy, may clot in cold
-protein >3.5 g/dL w/ low A:G ratio
-

25
Q

CSF Analysis in FIP

A
  • extremely high protein (>200)
  • extremely high nucleated cells (>100), esp. NEUTS, lymphs, macs
  • risk of herniation during CSF collection
26
Q

RT-PCR testing for FCoV

A
  • sensitive
  • excellent for detecting FCoV shedding in feces
  • does NOT distinguish cats at risk for FIP
  • can be done on effusion or biopsy
27
Q

Pathologic findings of FIP

A
  • serosal surfaces covered in white plaques (fibrin)
  • nodules on intestines, etc.
  • omentum looks like scrambled eggs
  • adhesions of omentum, mesentery
  • lymphadenopathy
  • focal lesions
28
Q

Histologic findings of FIP

A

-pyogranulomatous, vasculitis

29
Q

What is gold standard for diagnosing FIP

A

IHC for viral antigen + biopsy

30
Q

A:G ratio usually low/high in cats with FIP

A

Low (high globulins)

31
Q

TP usually low/high in FIP

A

High (globulins)

32
Q

Most reliable confirmatory test for FIP

A

IHC

33
Q

FIP vaccination

A
  • efficacy is controversial
  • IgG seroconversion DOES occur
  • not a core vaccine
  • only replicates in lower body temps of the nose
34
Q

Heritability of FIP susceptibility

A

> 50%

-may have polygenetic inheritance

35
Q

Seropositive cats in households from which other cats died of FIP had the same/different risk of developing FIP as cats from household without history of FIP

A

Same
(Siblings may be at higher risk)

HOWEVER, FCoV seroNEGATIVE kittens placed in catteries with endemic FIP suffered 90% mortality

36
Q

Risk of testing positive for FCoV in animal shelters

A

-massive increase in amount of coronavirus shed within first week of being in shelter (stress to blame for increase in shedding and transmission)

37
Q

Epizootic of FIP in catteries

A
  • uncommon
  • may last 6-12 months
  • causes high losses in kittens and juveniles
  • may return to enzootic form
  • due to new virus strain introduction
38
Q

Enzootic of FIP in catteries

A
  • most common pattern (low grade, chronic)
  • sporadic, infrequent, unpredictable losses
  • overall 1-5% mortality
39
Q

Tx of FIP

A
  • no tx for healthy seropositive cats
  • supportive tx for coronaviral enteritis (self-limiting)
  • palliative tx of FIP (predinosolone, anti-inflammatories, supportive care)
40
Q

Antiviral and immunomodulating drugs for FIP

A
  • none available right now

- UC davis has clinical trial w/ protease inhibitor drug used against SARS and MERS in people

41
Q

Why is it hard to misdiagnose FIP?

A
  • nonspecific CS
  • widespread seropositivity of FCoV Ab
  • no discriminating tests for FIP
42
Q

Diagnostic Algorithm for FIP

A

See slide 38 (or pic)

Small Animal Medicine: Exam 1 (Spring 2016) (3 decks)

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