We went out on a house call to see a cat, a new patient, that had been coughing for a couple of days. It was a young adult, and the household was made up of the humans that lived there, this cat, her brother and one other cat that was unrelated. The patient had been healthy since adoption several years ago from a reputable local rescue group and had just started to do poorly over the previous weekend. The other cats were showing no signs of illness. This cat was obviously sick. In fact, it was obvious immediately that it was having difficulty breathing, just with a casual look as we entered the room. I couldn't hear the heart well and the breath sounds were muffled. We transported the cat back to the hospital for radiographs and blood work. My worst fears were confirmed, the chest was filled with fluid and there were some subtle changes in the blood work.
(The orange outline is the only lung that is aerated. The blue arrows are the fluid line)
After contacting the owner, we withdrew over 150 cc of fluid from the chest and started the cat on some medications in an attempt to help her to breath better. An ultrasound of the chest was performed to rule out tumors and cardiac disease. Fluid was submitted for pathology review and bacterial culture.
The test results came back negative for bacterial infection but positive for feline corona virus and our diagnosis is FIP. FIP, Feline Infectious Peritonitis, is a strange and unfortunately deadly disease of cats. It is caused by the interaction of a mutated virus and the individual cat's immune system. There are two forms of FIP. In the dry form, granulomas (inflammatory lesions) form on the organs and in the lungs. It is usually a chronic wasting type disease with waxing and waning fevers, eventually leading to organ failure and death. In the wet form, like we saw here, fluid accumulates in the abdominal cavity or the chest. It too is progressive and eventually fatal.
The nature of the disease is i that it is infectious (a virus is involved) but not contagious. While feline enteric corona virus, the type that causes diarrhea is contagious, the FIPV biotype that causes FIP is not contagious. Increased numbers of cats in the household increase the risk of other pets in the home contracting the disease, mostly due to increased corona virus burdens in the environment with the increased risk of those viruses mutating.
Diagnosis of FIP can be a challenge. Often tissue samples must be submitted for pathology, especially in the dry form. In this case the clinical pathology data that we accumulated along with the signs and symptoms of the patient make us as certain as we can be that this is a case of wet FIP.
There is no good screening test to detect carriers or cats that might be infected with FIPV and are preclinical. There was a vaccine that was determined to be ineffective and in one study at Cornell, actually increased the risk of vaccinated cats contracting the disease when challenged with the FIPV virus post vaccine.
There is no cure for FIP. Palliative care involves suppressing the immune cells that are causing the problem. In the case of cats with fluid in the chest, periodically removing that fluid may make them more comfortable. In the end, cats with FIP will die from this disease. Once the quality of life starts to deteriorate, euthanasia is often the best option.
I posted this case history, with the permission of this cat's owner. Of course, the details have been left out to protect everyone's privacy. I just wanted owners that have had this disease enter their lives to be aware that they did not do anything wrong. There is nothing that you could have done to prevent this horrible disease, nothing that you could have noticed earlier that would let us intervene earlier and effect a cure, no food, no supplement, no magic bullet that would have kept your cat from getting sick.
Sometimes, there are just things that are so broken that we can't fix them. This is one of those times.
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